Department Of Endodontics Research Articles

Perception and Behavior of PIDC Patients Towards Online Dental Health Information

Modern Research in Dentistry Perception and Behavior of PIDC Patients Towards Online Dental Health Information Jalison Jacob Cheruvathoor1, Philip Pradeep1*, Deevisha Raj2, Choo Qi En2 and Nicholette Tan Cheng Lynn2 1Lecturer, Department of Conservative Dentistry & Endodontics, Penang International Dental College, Penang, Malaysia 2Year 5 student, Penang International Dental College, Penang, Malaysia *Corresponding author: Philip Pradeep, Lecturer, Department of Conservative Dentistry & Endodontics, Penang International Dental College, Penang, Malaysia Submission: September 15, 2021;Published: October 21, 2021 DOI: 10.31031/MRD.2021.06.000649 ISSN:2637-7764Volume6 Issue5

CLINICAL DECISION MAKING ON DEEP CARIES MANAGEMENT IN THE ERA OF EVIDENCE BASED DENTISTRY IN INDIA- A SURVEY

1Professor and HOD, Department of Conservative Dentistry and Endodontics, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
 2Professor, Department of Conservative Dentistry and Endodontics, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
 3Professor, Department of Conservative Dentistry and Endodontics, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
 4Reader, Department of Conservative Dentistry and Endodontics, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India.
 5Post Graduate student, Department of Conservative Dentistry and Endodontics, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India.
 6Post Graduate student, Department of Conservative Dentistry and Endodontics, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India.

Extra canal in permanent maxillary first molar in patients undergoing root canal treatment at a tertiary care dental hospital, Nepal

Background: Permanent maxillary first molar normally has three root canals but it can have extra root canals for which several studies were done in many parts of the globe. However, this type of study to explore extra canal is lagging in the context of Nepal. Objectives: The objective was to determine the percentage of extra canal in permanent maxillary first molar in patients undergoing root canal treatment and to compare the same between male and female. Methods: The descriptive cross-sectional study was conducted in the department of conservative dentistry and endodontics of People’s Dental College and Hospital from 20th December 2019 to 20th December 2020 after receiving ethical approval from Nepal Health Research Council on 18th December 2019 (ERB protocol No 888/2019) . One hundred and eighty permanent maxillary first molar teeth without root canal calcification were enrolled. Convenient sampling was done. Access opening was done and all canal orifices were located and recorded. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 22.0 with frequency table. Chi-square test was used for inferential statistics. Results: Out of 180 teeth, extra canals were present in 44(24.4%) having more numbers in male than in females. Extra canal was present in the mesiobuccal root. Conclusion: Extra canal in the permanent maxillary first molar is present in Nepalese population with greater number in male than in female. Thus, exploration of the pulp chamber in search of an extra canal is necessary to prevent failure of root canal treatment.

Aesthetic Rehabilitation of Anterior Incisor: Post and core treatment –A Case Report

This case report describes the post and core treatment of a maxillary central incisor. An 18-year-old female patient reported to the Department of Conservative Dentistry and Endodontics with the chief complaint of pain in upper front tooth region. On clinical examination, there was Ellis class III fracture resulting in loss of significant tooth structure necessitating post and core treatment. Treatment was initiated with removal of carious region, canal was located, working length was established followed by chemo mechanical preparation and obturation. Post space preparation was done in the canal followed by post cementation and core build up.
 Keywords: Post, core, ceramic, crown lengthening.

The Relationship between Coronary Atherosclerosis and Dental Pulp Calcification

Modern Research in Dentistry The Relationship between Coronary Atherosclerosis and Dental Pulp Calcification Helen Rushdi Ayoubi* Assistant Professor, Department of Endodontics and Operative Dentistry, Faculty of Dentistry, Damascus University, Damascus, Syria *Corresponding author:Helen Rushdi Ayoubi, Department of Endodontics and Operative Dentistry, Faculty of Dentistry, Damascus University, Fayez Mansour Street, P.O. BOX: 30621, Mazzeh Highway, Damascus, Syria Submission: August 06, 2021;Published: September 02, 2021 DOI: 10.31031/MRD.2021.06.000646 ISSN:2637-7764Volume6 Issue5

Effect of low-level laser therapy on postoperative pain after single-visit root canal retreatment of mandibular molars: A randomized controlled clinical trial.

To compare the effect of low-level laser therapy (LLLT) on postoperative pain after single-visit root canal retreatment on mandibular molars. This randomized controlled clinical trial included 36 patients referred to the Department of Endodontics, Islamic Azad University, Tehran, Iran. Healthy patients who required root canal retreatment on symptomatic first or second mandibular molars, with a PAI index score of 2 or 3, preoperative tooth and percussion pain of <56mm on a 170-mm visual analogue scale (VAS) were included. After local anaesthesia using inferior alveolar nerve block followed by rubber dam isolation and access cavity preparation, the D RaCe retreatment system was used to remove the existing root filling material, and after canal negotiation and gaining patency, working length was determined with an apex locator. Further canal enlargement was carried out with size 35, 0.04 taper, and size 40, 0.04 taper RaCe rotary instruments and then canals were filled using laterally compacted gutta-percha points and AH Plus sealer. The patients were randomly assigned to treatment groups: In the LLLT group, a 980-nm diode laser set at 6.89W/cm2 energy density, 0.5W power, and a tip diameter of 10mm were activated from the buccal side on the mesial and distal root apices for 15s. In the sham group, the laser handpiece was placed inside the patient's mouth at the same location, but the laser was not activated. Then patients were instructed to record their postoperative pain levels at 4, 8, 12 and 24h and 2, 3 and 7days after treatment on separate VAS scales. For data analysis, the independent sample t and the Mann-Whitney U tests were used. Nominal variables were analysed by using the chi-square test. In the LLLT group, the most intense pain was reported 24 and 48h post-treatment [mean (SD)=0.22 (0.54) for both], whereas in the sham group, the most intense pain level was observed 4h post-treatment [mean (SD)=0.78 (0.80)]. At the 4-h interval, pain intensity was significantly lower in the LLLT group (p=.016). Low-level laser therapy reduced postoperative pain after single-visit root canal retreatment of mandibular molars only four hours following the procedure.

Challenges of Oral Radiography Prescriptions During the COVID-19 Outbreak in Shiraz, Iran

Background: Considering the severity of the COVID-19 outbreak and its rapid person-to-person transmission and the challenges it has brought about in dentistry, especially in intraoral radiography, following the established guidelines in prescribing radiographs is of great prominence. Objectives: We aimed to evaluate the necessity of prescribed intraoral radiographs and to estimate the number of unnecessary prescriptions during the COVID-19 pandemic. Methods: This cross-sectional study was conducted among 143 patients with a mean age of 29.36 ± 14.11 years who visited the Radiology Department of Shiraz Dental School during the peak of the COVID-19 outbreak. Information, including gender, age, systemic diseases, referring department, and type and urgency of radiography, was collected using a checklist. Chi-squared test and Fisher’s exact test were run to assess the relationships between variables. Results: Among all the patients referred to the Radiology Department, the endodontics and oral medicine departments accounted for the highest percentage of referrals. The relationship between the necessity of radiography prescriptions and dental departments was significant (P &lt; 0.05). The lowest rate of unnecessary referrals was reported in the Department of Endodontics (13.3%), whereas the highest rate of unnecessary referrals was attributed to the aesthetic and restorative dentistry departments (73.3%). There was a significant association between dental department and the type of prescribed radiographs (extraoral/intraoral). The Orthodontics Department was the only department with more extraoral radiograph prescriptions than intraoral radiographs. One-third of the prescribed intraoral radiographs and half of the extraoral radiographs were unnecessary, with a significant difference during the pandemic (P = 0.019). Conclusions: Although there has been some success in the development of COVID-19 vaccines, this pandemic will not be easily eradicated. Therefore, it is crucial to follow the established guidelines and postpone unnecessary dental procedures to improve the safety of our community and the world in general.

Variability in caries management decision-making in a dental school setting.

To assess variability in caries management decision-making by faculty and dental students. Understanding sources of variability during training can aid in implementing evidence-based clinical decision-making in caries management. A voluntary, anonymous survey including clinical scenarios was distributed online to dental students in their first (D1) and third-year (D3) of training, and to faculty in the Department of Cariology, Restorative Sciences and Endodontics. The response rate was100% (108/108) for D1 students, 56% (73/130) for D3 students, and 39% (34/88; 12 full-time and 22 part-time) for faculty. D1 students, who were completing a cariology course, were in general more conservative in restorative thresholds for less severe caries lesions than D3 students and sometimes clinical faculty (e.g., for lesions at the DEJ, a significantly [p<0.05] higher percentage of D3 students would restore these [53%] compared to D1 students and faculty [19% and 18%, respectively; p>0.05]). For all groups, the threshold for doing restorative intervention was shifted toward less severe caries lesions as the caries risk increased (e.g., very few respondents would restore an occlusal lesion confined to enamel, with significantly [p<0.05] less percentage of D1 students [lower risk scenario-LR=4%; higher risk scenario-HR=22%] compared to D3 students and faculty [LR=15% and 18%; HR=66% and 62%, respectively; p>0.05]). Class lectures/preclinical instructors were the most important factor influencing decision-making for D1 students, versus clinical experiences/instructors for D3 students. Although the majority of respondents used best-evidence deciding caries management, there was variability in how to manage less severe lesions, with caries risk influencing clinical thresholds, and clinical experiences influencing students' decision-making over time.

Aesthetic management of fluorosis

With increasing awareness and aesthetic concerns, the number of people seeking professional dental help for improvement in the appearance of their dentitions and for smile makeovers are on rise. Dental fluorosis, tetracycline staining, localised and chronological hypoplasia, and both amelogenesis and dentinogenesis imperfecta can all produce a cosmetically unsatisfactory dentition. The aetiology of intrinsic discolouration of enamel may sometimes be deduced from the patient's history, and one factor long associated with the problem has been a high level of fluoride intake. Optimal use of topical fluorides leads to a decrease in the caries prevalence but may show an increase in the prevalence of fluorosis staining because of metabolic alterations in the ameloblasts, causing a defective matrix formation and improper calcification. A 28 yr female patient was screened at the Department of Conservative Dentistry and Endodontics at desh bhagat dental college, mandi gobindgarh, Punjab. She wanted us to remove and/or minimise the noticeable brown/yellow staining of his teeth. She requested the least invasive and most cost-effective treatment to change his smile. Various treatment modalities are present for the treatment of fluorosis stains. This report discusses the microabrasion technique in the patient having dental fluorosis.

Follow-up of Endodontically Treated Teeth Without Crown Coverage in Vidarbha Region

Statement of Problem: Teeth are weakened after endodontic treatment and should, preferably, be crowned, especially posterior teeth. However, this is not always possible due to certain reasons. Information about the appropriate treatment modalities. This retrospective study was carried out to evaluate the survival of endodontically treated teeth (ETTs) without crown coverage on the basis of various parameters in the region of Vidarbha in Maharashtra, India. Purpose: The aims of this cohort study were to evaluate the survival rate for endodontically treated molars without crown coverage and to identify possible related factors. Materials and Methods: Relevant data from 300 subjects for 148 ETTs was recorded at the Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College, Wardha, Maharashtra. Follow-up data were derived from a clinical examination and review of the dental record and radiographs. Subjects were not included in the study if teeth had provisional crowns, definitive restorations with cuspal coverage, or with dowel and core and/or crown restorations. The outcome evaluated was defined as a failure if there were negative findings in the condition of a tooth that required a restoration, tooth repair, or extraction. Tooth loss due to endodontic and periodontal reasons was excluded. The independent variables assessed were patient age, gender, location (maxilla or mandible), the existence of an opposing dentition and adjacent teeth, remaining tooth structure, and types of restorative material. One hundred and forty-eight teeth restored using glass-ionomer cement (GIC), SF, and composites were considered successful during the observation time of 3 years because no intervention was needed in these teeth were labeled as “survived.” The teeth restored with composite were 90. The teeth restored with GIC were 14. The teeth restored with silver amalgam were 44. Out of 148 teeth were considered successful during the observation time of 3 years because no intervention was needed in these teeth were labeled as “survived.” Follow-up was done at regular intervals after 5, 7, and 10 years, respectively. At the end of 10 years, the number of teeth survived was 26. The teeth restored with composite were 14. The teeth restored with GIC were 4. The teeth restored with silver amalgam were 8. Results: At the end of the observation time period (10 years), 13 teeth had to be extracted at the end of 6 years and 19 restorations were repaired or replaced at 5, 7, and 9 years. Conclusion: Within the limitations of this study, the amount of remaining tooth structure and types of restorative material have a significant association with the longevity of endodontically treated molars without crown coverage. ETTs evaluated after 10 years showed positive survival and success in long time period. Various parameters were significantly seen to influence the outcome and thereby survival of teeth in the arch when no crowns were placed on ETTs.

Assessment of shade matching using visual and instrumental methods

Aims: This study aimed to compare the shade selection of natural teeth using visual method, digital photographic method, spectrophotometric method, and using an intraoral scanning device. Settings and Design: A study was conducted at the department of conservative dentistry and endodontics. Subjects and Methods: Right maxillary central incisors of ten subjects without caries, defects, or any restorations were selected for the study. Shade selection was done from the middle third of the labial surface of the tooth. In visual method the shade selection was carried out by an experienced clinician and in digital photographic method by a technician with gray cards as background and software analysis the other methods were spectrophotometric method and using an intraoral scanning device. Statistical Analysis Used: Statistical analysis was done using the nonparametric Kruskal–Wallis test. Post hoc was done using the Mann–Whitney U-test. Results: When the shades selected using the four methods were compared, with spectrophotometric methods, statistically significant differences were found for visual and digital photographic methods. Conclusions: Whenever possible, it is better to combine visual and instrumental methods so as to reduce the subjective errors that can happen while using the visual method alone. Among the instrumental methods, the less expensive digital photographic method can be opted for instead of the more sophisticated methods with chances of minimal errors.

C-Shaped Canal in Second Molar of Mandible among Cases of Cone Beam Computed Tomography in Tertiary Care Centres: A Descriptive Cross-sectional Study.

C-shaped canal configuration is mostly found in the mandibular second molar. The morphological characteristic of a C-shaped canal is the presence of a fin or web connecting the individual canal, making it difficult for cleaning, shaping, and obturation. The objective of this study was to find out the prevalence of C-shaped canal in mandibular second molar among cases of Cone Beam Computed Tomography in tertiary care centres. The descriptive cross-sectional study was conducted in the department of conservative dentistry and endodontics of tertiary care centres from 20th June 2020 to 20th December 2020 after receiving ethical approval from the Nepal Health Research Council on 19 June 2020. Cone-beam computed tomography images of 199 mandibular second molars with completely formed roots were used. Teeth with orthodontic braces, root resorption, root canal filling, and post were excluded from the study. The research was conducted taking a tooth as a unit. Convenience sampling was done. Statistical analysis was done by using Statistical Package for Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. The prevalence of C-shaped canal according to this study is 25 (12.6%) (7.99-17.21 at 95% Confidence Interval). The findings of the study conclude that C-shaped configuration is quite frequent in mandibular second molar among cases of Cone Beam Computed Tomography. A careful pre-operative radiographic evaluation may be helpful for diagnosing C-shaped configuration prior to root canal treatment.

Effect of Neem (Azadirachta indica) versus 2.5% sodium hypochlorite as root canal irrigants on the intensity of post-operative pain and the amount of endotoxins in mandibular molars with necrotic pulps: a randomized controlled trial.

To assess the effect of Neem versus 2.5% NaOCl as root canal irrigants on the intensity of post-operative pain and amount of endotoxins following root canal treatment of mandibular molars with necrotic pulps. This parallel, prospective, double-blinded, randomized controlled trial with allocation ratio 1:1 was conducted in the out-patient clinic of the Endodontic Department, Faculty of Dentistry, Cairo University, Egypt. Fifty healthy patients with mandibular molars with necrotic pulps were randomly assigned into two equal groups using computer software. In the intervention group, root canals were irrigated using Neem; whilst 2.5% NaOCl was used in the control group. A standard root canal treatment was performed in two visits using ProTaper Next rotary files, with no intracanal medication. Pain intensity was assessed using a numerical rating scale (NRS) 6, 12, 24 and 48h following instrumentation and canal filling. Endotoxin samples were collected using three paper points before and after canal instrumentation and a sandwich ELISA method was used to quantify the level of endotoxins. Demographic, baseline, and outcome data were collected and analysed using chi-square tests (for the comparisons of categorical variables), Mann-Whitney tests (for non-normally distributed variables) and Student's t tests (for normally distributed variables), A P-value<0.05 was considered to be statistically significant. The mean pain scores within the two groups decreased continually over time. The mean pain scores in the Neem group were lower than those in the 2.5% NaOCl group at 6, 12, 24 and 48h following instrumentation and canal filling with no significant difference between them except at 24h following instrumentation (P=0.012). Both irrigants significantly reduced endotoxin levels compared to the pre-instrumentation samples (P<0.001) by 8% for the NaOCL group and 18% for the Neem group. Neem and 2.5% NaOCl were not significantly different in terms of reducing the intensity of post-operative pain during all follow-up periods except at 24h following instrumentation where Neem was associated with lower pain intensity. Both irrigants significantly reduced endotoxin levels but were not effective in eliminating endotoxins completely from root canals of mandibular molars with necrotic pulps.

CAUSES OF ROOT CANAL TREATMENT FAILURE

The aim of this study was to determine different causes of endodontic treatment failure in patients who approached our Department of Conservative Dentistry and Endodontics for re- treatment.This study included one hundred fifty patients of both genders with different post endodontic treatment complaints.Clinical and radio- graphic examination was used to confirm treatment failure. The most common clinical symptoms were tenderness, tenderness and pain, or swelling (72%, 29.3% and 22.7% respectively). The common causes of endodontic treatment failure were poorly filled (40%), under filled (34.7%) and no root canal filling (17.3%).Root canal failure due to overfilling was 5.3%.Most of these failed cases were either treated by internees (House officers) in the teaching institutes (34.7%) or general dental practitioners (57.3%).

EFFECTS OF THREE ORAL ANALGESICS ON POSTOPERATIVE PAIN FOLLOWING ROOT CANAL PREPARATION: A CONTROLLED CLINICAL TRIAL

Objective: To compare the effect of single dose of three analgesics on postoperative endodontic pain following pulpectomy in teeth with irreversible pulpitis.&#x0D; Study Design: A quasi-experimental study.&#x0D; Place and Duration of Study: Endodontics Department, Fatima Jinnah Dental College Hospital Karachi, from Jan to Oct 2018.&#x0D; Methodology: In this Double Blind placebo controlled study, 120 subjects coming with the complaint of irreversible pulpitis in any one tooth were randomly allocated into 4 groups. Each group took either naproxen sodium (550mg), ibuprofen (400mg), tramadol (100mg) or placebo medication (multivitamin tablet) immediately after the pulpectomy appointment. A questionnaire was designed to assess the experienced pain based on VAS scale at 6, 12 and 24 hours postoperatively. KruskalWallis test was applied followed by post-hoc analysis to compare the VAS scores by taking p-value ≤0.05 as significant.&#x0D; Results: Pain levels were significantly lower in experimental groups as compared to placebo (p&lt;0.001) but there was no statistically significant difference between the effectiveness of naproxen, ibuprofen and tramadol at 6, 12 and 24 hours postoperatively.&#x0D; Conclusion: Naproxen, Ibuprofen and Tramadol were found to beequally effective in reducing pain after instrumentation in teeth with irreversible pulpitis.

Evaluating the frequency of patients' application to dentistry departments during the COVID-19 pandemic period and examining the reasons for application to the department of endodontics

Objective: The aim of the study is to assess the number of patients in terms of departments of dentistry, who applied to Dicle University Faculty of Dentistry during the period of COVID-19 pandemic, and to examine their causes of application to the endodontics clinic. Material and Methods: Between the dates of 11 March 2020, the day COVID-19 was identified for the first time in Turkey, and 31 July 2020, the first clinic that the patients applied following the Department of oral diagnosis and radiology was taken as a basis. Additionally, patients applying to the department of endodontics were assessed clinically and radiologically, and their causes of visit were examined. Result: Applied departments are determined respectively as follows: endodontics (37,62%), oral and maxillofacial surgery (25,32%), pediatric dentistry (12,52%), periodontology (8,11%), orthodontics (7,02%), prosthodontics (5,3%), and restorative dentistry (4,04%). The reasons for applying to Endodontics are found respectively as follows: irreversible pulpitis (44,02%), pulpal necrosis with symptomatic apical periodontitis (22,33%), acute apical abscess (18,01%), symptomatic apical periodontitis or acute apical abscess in endodontically treated teeth (7,83%), chronic apical periodontitis (4,12%), chronic apical abscess (2,92%), and traumatic dental injures (0,72%) Conclusion: Most of the patients, who applied to Faculty of Dentistry at Dicle University, were directed to department of endodontics. The cause of application to endodontics is identified mainly as irreversible pulpitis.

Outcome of Root Canal Treatment of Necrotic Teeth with Apical Periodontitis Filled with a Bioceramic-Based Sealer

Introduction Apical periodontitis is among the most common pathologies in endodontics. The treatment of apical periodontitis has always been an important occupation in the modern practice of endodontics, and the failure has been associated with nonhermetic root canal filling. With that in mind, bioceramic-based sealers have been incorporated into endodontic practice. The purpose of this study was to evaluate the outcome of nonsurgical root canal treatment (RCT), using a single-cone and Bioroot RCS filling of necrotic teeth with apical periodontitis. Materials and Methods This follow-up study included patients treated in the department of Restorative Dentistry and Endodontics in the Dental Clinic of Monastir, from January 2018 to December 2019. The study intended to include all adult patients presenting a symptomatic or asymptomatic apical periodontitis. Once the diagnosis was performed, the patients were divided into two groups: a one-session treatment group and a two-session treatment group. All cases were obtured with BioRoot using a single-cone technique with a minimum of a 6-month recall. At 6-month follow-ups, teeth were classified as healed, healing (success), or not healed (failure), based on clinical and radiographic findings. Results Twelve patients met the inclusion criteria, six patients per group. Seven patients returned for follow-ups. At 6-month follow-ups, the overall success rate was 100%, with 57.1% determined to be “healed” and 42.8% determined to be “healing.” All the PAI scores decreased compared to the baseline situation. Conclusion The results obtained showed the contribution of BioRoot RCS in the healing of periapical lesions. Accordingly, bioceramic-based sealers seem to optimize the prognosis of root canal treatments.

Effect of XP-endo Shaper versus conventional rotary files on postoperative pain and bacterial reduction in oval canals with necrotic pulps: a randomized clinical study.

To assess postoperative pain and bacterial reduction following the use of XP-endo Shaper versus conventional rotary files in preparation of oval canals with necrotic pulps. This superiority, parallel, randomized, double blinded clinical trial was conducted in the clinic of the Endodontic Department, Faculty of Dentistry, Cairo University, Egypt. Sixty single-canalled mandibular premolars with necrotic pulps were randomly assigned into two equal groups. Canals were instrumented using XP-endo Shaper files in the intervention group and iRaCe rotary files in the control group. Bacterial samples were taken before and after canal instrumentation. Incidence and severity of postoperative pain was assessed using a modified VAS after 6, 12, 24h and daily for 5days. A culture method was used to assess the number of bacterial colony forming units. Incidence of analgesic intake as well as flare-ups was recorded. Data were analysed using chi-square, Fisher Exact, Mann-Whitney, Independent t-test, and Spearman's correlation for pain and bacterial counts. The XP-endo Shaper compared with the iRaCe group was associated with a significantly lower incidence of postoperative pain at 6, 12, and 24h (P=0.039, 0.047, and 0.026, respectively), and severity of postoperative pain at 6h (mean difference: 1.33, 95% CI: 0.307-2.352, P=0.02), 12h (mean difference: 1.1, 95% CI: 0.26-1.936, P=0.007), 24h (mean difference: 0.94, 95% CI: 0.178-1.701, P=0.008) and 48h (mean difference: 0.97, 95% CI: 0.192-1.747, P=0.038). There was a significant decrease in bacterial count following canal instrumentation in both groups (P<0.001) with no significant difference between them (mean difference: 0.83×105 , 95% CI: 0.336×105 -1.996×105 , P=0.56). A weak correlation existed between postoperative pain severity and bacterial counts (P=0.54). There was no significant difference in analgesic intake between the two groups (P=0.085). Flare-ups occurred in 3.3% of teeth in the iRaCe group, while no flare-ups occurred in the XP-endo Shaper group. XP-endo Shaper was associated with a significantly lower frequency of postoperative pain for up to 24h, and lower severity of postoperative pain for up to 48h compared with iRaCe files. Both systems were equally effective in bacterial reduction from oval root canals with necrotic pulps.

Hidden reservoirs of pathogens in dental settings.

Nosocomial infections are a major concern to both clinicians and health care seekers. Investigations have suggested that laptops & mobile phones may contribute to cross-contamination and can serve as vehicles for infection transmission. Therefore, it is of interest to document the data on hidden reservoirs such as mobile phones and laptops of pathogens in dental settings at the Hazaribag College of dental sciences and Hospital, Jharkhand. The samples were collected from 25 laptops and 25 mobile phones from dentists working in a dental college in Hazaribag city. The samples were collected aseptically using sterile cotton swabs dipped in sterile saline by rotating the swabs on the keyboard surfaces of laptops and mobile phones, inoculated into Brain Heart Infusion broth, vortexed for 1 minute in Fischer Vortex Genie 2 on highest setting & streaked immediately on 5% sheep blood agar plates and were incubated at 37°C for 24 hours aerobically. The isolates were identified based on the colony morphology, colony characteristics and biochemical reactions. The bacterial species isolated were Staphylococcus aureus, Coagulase negative Staphylococcus, Bacillus species, Enterococci, Micrococci, and Pseudomonas etc. Predominant species isolated was Staphylococcus aureus and least was Micrococci. Higher percentage of organisms was found at the Department of Periodontics, Endodontics and least was found in Department of Public Health Dentistry. The percentage and type of organism isolated from keyboards of laptops and mobile phones were similar. Thus, laptops and mobile phones act as vehicles for transfer of potential pathogens associated with dental hospitals. Disinfecting the hands prior to examination of patients and disinfection of laptops and mobiles with alcohol wipes should be done to prevent nosocomial infections.

Comparison of Sealing Efficiency of Mineral Trioxide Aggregate and Biodentine used in Perforation Repair in Acidic and Neutral Environments- An In-vitro Study

Introduction: Furcation perforation is one of the complications that occur during endodontic treatment due to anatomical differences or iatrogenic causes. Repairing the perforation with a biocompatible material eliminates the connection with the gingival sulcus and positively affects the prognosis. The sealing ability of the repair materials is very important and is affected by the conditions of the environment in which they are applied. Aim: To compare the sealing efficiency of Mineral Trioxide Aggregate (MTA) (Angelus, Londrina, PR, Brazil) and Biodentine (Septodont, Saint Maur des Fosses, France) materials used in the repair of furcation perforations in acidic and neutral environments. Materials and Methods: This in-vitro experimental study was carried out in the Department of Endodontics at Dicle University Faculty of Dentistry, Diyarbakır, Türkiye and Dicle University Science and Technology Application and Research Center from 10th June 2020 to 22nd July 2020. A total of 96 mandibular molars were used in the study. The specimens were randomly divided into two equal groups (n=48). When the perforations were repaired with MTA and Biodentine materials, each group was divided into four subgroups (n=12). These subgroups were kept in Phosphate Buffered Saline (PBS) and Acetic Acid (AA) solutions for different periods of time from 4 or 34 days, and all groups were immersed in methylene blue solution. The dye penetration level of the divided sections was examined under a stereomicroscope (Leica, Wetzlar, Germany). Microleakage data of all groups were statistically analysed using Kolmogorov Smirnov, Shapiro Wilk’s and Mann-Whitney U Test. Statistical significance was set at 0.05, it was stated that there was a significant difference when p-value &lt;0.05. Results: The short-term (4 days) microleakage level of biodentine material in the AA environment was significantly lower than that of MTA material (p-value=0.005). There was no statistically significant difference between the materials in terms of long-term (34 days) microleakage levels in the AA environment (p-value &gt;0.05). The long-term microleakage level in PBS environment of biodentine material was significantly lower than that of the AA environment (p-value=0.008). Conclusion: Lower microleakage levels were observed in the neutral environment than the acid environment with both MTA and biodentine during both holding periods.