Operative Dentistry Department Research Articles

Evaluation of Post-operative Pain by using Calcium Hydroxide Based Root Canal Sealer: A Clinical Study

Objective: To assess the post-operative pain by using calcium hydroxide Ca(OH)2 based root canal sealer, a clinical study at tertiary care Hospital
 Materials and Methods: This cross-sectional study was performed at operative dentistry department of Liaquat University of Medical and health Sciences Jamshoro Pakistan. Study duration was 6 months from March 2020 August 2020. Total 60 patients, those having permanent anterior teeth with irreversible pulpitis, teeth restoration after root canal treatment and either of gender were included. Multiple visits of endodontic treatment were performed by obturating the canals using calcium hydroxide Ca(OH)2 (sealapex, Sybron endo). Patients were recalled next day, after 3rd day and after one week of obturation to assess the severity of post-operative pain (POP) via visual analogue scale (VAS). All the information was recorded via study proforma. Data analysis was done by using SPSS version 20.
 Results: Mean age of the study participants was 26.77+8.72 years. males were in majority 36(60.0%). On the next day as per severity of pain, mostly patients were presented with severe pain as mean visual analogue scale was 8.7+0.3. On third day pain was markedly decrease among almost all of the cases as average of visual analogue scale was found 2.6+0.2. However after one all the patients were seen without pain as average of visual analogue scale was 0.65+0.7. Pain was statistically insignificant according to gender.
 Conclusion: Calcium hydroxide based root canal sealer found to be feasible and effective for endodontic treatment in terms of lower postoperative pain.

Movement Matters; How Physical Activity Impacts Endodontic Therapy

Objective: To understand impact of physical activity on pain perception in patients presenting with acute pulpitis for endodontic therapy. Study Design: It was quantitative correlational by design. Place and duration of study: Department of Operative Dentistry, Dental Section, Islam Dental College, Sialkot. Materials & Methods: 500 patients from the Dental Section of Islam Dental College Sialkot were included in this study. The correlation of movement/walk and pain during endodontic treatment was determined. Numeric pain scale was used to document pain. Activity was measured by the number of minutes of walk of the patient. Results: There is a significant association between physical activity/exercise and pain. Statistical significance between pain and exercise was -.158. Conclusion: Pre-operative assessment of physical activity may be a predictor of pain perceived by patients. Therefore, it is important to educate and consider patient’s physical activity to manage pain during the dental treatment. Life style modification may seems insignificant but has proven positive impact in pain management. Keywords: Exercise, local anaesthesia (LA), endodontic therapy, pain.

EVALUATION OF SUCCESS OF RESIN INFILTRATION TECHNIQUE IN SUPERFICIAL PROXIMAL CARIOUS LESIONS OF POSTERIOR TEETH

Objective: To determine the effectiveness of resin infiltration technique in arresting superficial proximal carious lesions of posterior teeth.
 Study Design: Quasi experimental study.
 Place and Duration of Study: Operative dentistry department, de’ Montmorency College of Dentistry Lahore, from Oct 2018 to Mar 2019.
 Methodology: Meeting inclusion criteria were selected. Informed consent was obtained. After application of rubber dam; etchant gel was applied to superficial proximal carious lesions in these patients; water-rinsed and air-dried for 30 sec; resin was then infiltrated into each lesion. Patients were recalled after 6 months for follow up.
 Results: Total patients were 30 out of which 18 (60%) were males and 12 (40%) were females. Mean age of patients was 25.77 years ranging from 16-35 years. Success of resin infiltration technique in superficial proximal carious lesions in posterior teeth was 86.7% measured by bitewing radiograph taken on follow up after 6 months to see any progression of carious lesion.
 Conclusion: Resin infiltration was effective in 86.7% patients in arresting progress of superficial proximal carious lesions with no significant difference for age and gender. Hence it is suggested that resin infiltration being promising micro invasive approach should be considered in addition to non-operative and operative treatment approaches.

Comparison of Clinical Attachment Level Gain Using Scaling Root Planing Versus Adjunctive Azithromycin on Chronic Periodontitis

Objective: The objective of the study was to compare the mean clinical attachment gain in patients of chronic periodontitis after scaling and root alone versus Azithromycin as an adjunct to scaling and root. Study Design Comparative study Place and Duration: Conducted at Operative Dentistry Department, Azra Naheed Dental College, Lahore for a duration of 4 months from December 2019 to March 2020. Methodology: Total Sixty patients fulfilling the selection criteria were randomly allocated to SRP and SRP+Az groups. In both groups, conventional scaling and root planing was done. In the SRP group placebo capsules were prescribed, while in the SRP+Az group, Azithromycin (500mg) once daily was prescribed for 3 days. Clinical attachment level (CAL) was measured initially and after 5 weeks. Data was analyzed in SPSS version 19.0 using independent sample t-test. Results: Both groups showed gain in CAL compared to baseline. However, SRP+Az group showed significantly more gain in CAL in comparison to SRP group (P value < 0.05). Conclusion: Use of Azithromycin adjunctive to SRP is an effective treatment modality in chronic periodontitis patients. Keywords: Anti‐Bacterial Agents, Azithromycin, Chronic periodontitis, Clinical attachment level, Periodontal Debridement, Scaling and root planing,

Regenerative Endodontics Procedure in Treatment of Permanent Immature Teeth with Necrotic Pulp

Aim: To evaluate the radiographical success of Regenerative endodontics procedure in permanent immature teeth with necrotic pulp. Methods: This Descriptive case series was conducted at the Department of Operative Dentistry, de’Montmorency College of Dentistry/ Punjab Dental Hospital, Lahore from November 2015 to November 2016. A total of 30 cases were included using non-probability consecutive sampling. Patients of both genders with age range from 9 to 14 years were considered. Performance of procedure and evaluation of success was done in terms of root development on periapical radiographs. . Data was entered and analysed with IBM SPSS 20. Level of significance was kept at p-value ≤ 0.05 Results: Out of 30 patients, 13 were females and 17 were males. Mean age of patients included in this study was 11.5±1.737. Follow up at 12 months showed 90% success, with 27 cases showed root development on periapical radiograph. There was no significant relation of success with age and gender of patient with p- value greater than 0.05. Conclusion: It is concluded from current study that Regenerative Endodontics procedure in permanent immature teeth is encouraging and can be recommended for the treatment of permanent immature teeth with necrotic pulp. Further research studies are required for evaluation of root development in regenerative endodontics procedure. Key words: Regenerative Endodontics, Permanent Immature teeth, Root development

Role of Sleep and Pain Control in Endodontic Therapy

Aim: To discover and relate the role of sleep with pain perception in patients undergoing endodontic therapy. Study design: The study was quantitative correlational design in nature. Place and duration of study: Department of Operative Dentistry, Dental section Islam Dental College, Sialkot. Duration of study was two years 2019-2020 Methods: Five hundred patients were included in the study, which were scheduled for endodontic therapy. Results: Five hundred patients were included in the study. The correlation between sleep and pain during endodontic therapy was -.039 which was found non-significant. 250 cases have mild pain (50%), 158 cases (31.6%) have moderate pain, 92 cases (18.4%) have severe pain. Sleep deprived cases in the study were 264(52.8%), while cases who were practicing good sleeping habits were 236 (47.25%). Conclusion: There exists a statistically significant relationship between perception of pain during endodontic therapy and sleep. In order to improve the outcome of endodontic therapy dental professionals should educate their patients on the importance of good sleep hygiene along with dental hygiene. Keywords: Sleep, pain, endodontic therapy.

Dental Anxiety Measurement of Children in Abbottabad Using Audio Visual System

Aim: To measure the anxiety and fear in children while visiting dentist and to observe effectiveness of audiovisual assistance to overcome anxiety Study design: Qualitative study Place and duration of study the study is done in Rehmat Memorial Hospital Abbottabad department of operative dentistry, affiliated with Women Medical and Dental College Abbottabad, from December 2014 to February 2017. Methods: Total two hundred children were observed aged between 5-8 years at Rehmat Memorial Hospital Abbottabad under controlled conditions showing cartoons on TV screen by using wireless headphones. There were two main groups divided into the controlled group and uncontrolled group containing one hundred participants in each group. Each patient's pulse rate, heart rate was recorded and live pulse rate was in sight by using wristband with pulse rate detector. Venham's picture test was used to check the correct reaction of the patient for the assessment of degree of anxiety more realistically. Results Controlled group n=100 and uncontrolled group n=100 patient aged 5-8 years treated for various procedures in different appointments. With mean age 6-7 years, Male to female ration of participants in controlled group was 34% and 66% and in uncontrolled group male and female ration was 45% and 55%. Significant reduction in anxiety was noted in controlled group distracted by audio visual stories and rhymes. Conclusion: Both groups were statistically evaluated and the result showed that audiovisual distraction can decrease the anxiety level in the controlled group but couldn't eliminate completely. This issue needs more studies and experiments to resolve anxiety in children completely. Keywords: Dental anxiety, Venham’s picture test, child behaviour

Clinical Outcome of Class II direct composite restorations using total-Cetch versus selective etch adhesives

Background: The composite restoration of anterior is always a challenging job. Aim: To compare the clinical outcome of class 2 direct composite restorations using total-etch and selective etch adhesives, according to USPHS criteria. Methods: One hundred patients were included in this randomized controlled clinical trial study at Operative Dentistry department of LMDC, Lahore. They were divided in two groups. Group 1 for total etch technique, group 2 for selective etch technique enamel was etched with 37% phosphoric acid for 20 second and then washed thoroughly with water for 5-10 seconds and was dried with air for 5 seconds till frosty white and bond with self etch. Results: The majority of patients were in the age range of 25-31 years, 25 (50%) patients used total etch technique and 22 (44%) patients used selected etch technique. When compare the overall rating for restorations, 38 patients (76%) have acceptable restoration in total etch technique and 46 patients (92%) in selected etch technique. Statistically the difference was significant (P<0.05). Conclusion: Selected etch technique presented a successful clinical performance over total etch technique for Class II restorations. Keywords: Class II direct composition restoration, Total etch technique, Selected etch technique.

Evaluation of Success of Pulpotomy in Mature Permanent Teeth with Carious exposure using Mineral Trioxide

Aim: To evaluate the radiographical success of pulpotomy in cariously exposed mature permanent teeth using mineral trioxide aggregate. Methods:This Descriptive case series was conducted at the Department of Operative Dentistry, de’Montmorency College of Dentistry/ Punjab Dental Hospital, Lahore from December 2015 to December 2016.A total of 75 cases were included using non-probability consecutive sampling..Patients of both genders with age range from 15 to 26 years were considered. Performance of procedure and evaluation of success was done in terms of absence of periapical radiolucency on periapical radiographs.Data was entered and analyzed with IBM SPSS 20. Level of significance was kept at p-value ≤ 0.05 Results: Out of 75 patients, 41 were females and 34 were males.Mean age of patients included in this study was 20.5 ±3.60. Follow up at 6 months showed 92% success, with 69 cases showed absence of periapical radiolucency on periapical radiograph. There was no significant relation of success with age and gender of patient with p- value greater that 0.05. Conclusion: It is concluded from current study that the protocol of pulpotomy using Mineral trioxide Aggregate (MTA) in mature permanent teeth with carious exposure of pulp is encouraging and can be recommended for the treatment of mature permanent teeth with carious exposures. Keywords: Pulpotomy, Mineral trioxide aggregate, periapical radiolucency

Efficacy of Carbamide Peroxide and Sodium Perborate as Bleaching Agent in Non-Vital Discolored Teeth

To estimate the effectiveness of sodium perborate with carbamide-peroxide (urea peroxide) to remove the staining of non-vital discolored teeth. Comparative cross sectional study. Dental department of operative dentistry, LUMHS, Jamshoro Sindh, Pakistan, from December 15-12-2014 to June 15-6-2015. A total of 160 single rooted teeth with intact clinical crowns have been collected. Using human blood, the teeth were discolored. With the vita shade guide, shades of discolored teeth were taken. Each tooth was handled with the root canal. 2 mm of root-canal-filling material cleaned under the junction of cement-enamel. In addition, it was then coated with glass ionomer cement 1 mm thickness. Teeth were divided randomly into two groups based on bleaching content used in the pulp chamber; group-A (C.P): 16% Carbamide-peroxide. Group-B (S.P): tetra-hydrate sodium-perborate mixed with distilled water. After 21days, the results were checked for efficacy. The analysis included a total of 160 teeth extracted (80 teeth extracted in each group). In group A, 78 (51.7%) found effectiveness compared to 73 (48.3%) in group B. The experimental groups showed statistically similar bleaching results at the end of twenty one days and p value found to be not significantly different (p=0.078). With a significant result, intracoronal bleaching of non-vital colored teeth is less invasive, comparatively safe and effective to remove the staining of non-vital discolored teeth.

Comparison of Working Length Determination in Mandibular Single-Rooted Teeth

OBJECTIVES: The objective of this study was to compare working length calculated with conventional radiographs and an electronic apex locator (IPEX II) during the root canal treatment of mandibular anterior teeth. METHODOLOGY: A cross-sectional study was done in the Department of Operative Dentistry, Sardar Begum Dental Hospital, Peshawar during February and March 2018. A consecutive sampling technique was used for sampling. Only 30 patients fulfilled the inclusion criteria of our study. Detailed medical and dental history was taken. Only patient fulfilling inclusion criteria were enrolled in the study. Data were analyzed using SPSS version 20. RESULTS: The mean age for patients was 45.33±5.16. 33% out of 30 patients (10) were male and 20 were females. The mean working length calculated from radiographs was 22.25±1.29 (min 20.09-max 24.10). The mean working length calculated by the electronic apex locator (IPEX II) was 22.17±1.28 (min 20.00-max 24.07). The mean difference between working length calculated by radiograph and electronic apex locator was -0.084mm, which means the working length determined by radiographs and by electronic apex locator has no difference in mandibular anterior teeth with single canals. CONCLUSION: Both the methods can be used effectively in endodontics for single-rooted mandibular teeth, but if both are used in combinations can lead to an improvement in the working length accuracy, which may significantly reduce the number of radiographs exposure, and increase the success and comfort for endodontic patients. KEYWORDS: Working Length, Apex Locator, Conventional Radiograph

A COMPARATIVE STUDY OF FREQUENCY OF RETENTION OF FLOWABLE NANOCLUSTER COMPOSITE AND RESIN MODIFIED GLASS IONOMERS IN NON CARIOUS CERVICAL LESIONS IN MAXILLARY MOLARS

Objective: To investigate and compare the retention rates of Flowable-Nanocluster-Composite and Resinmodified-Glass-Ionomers in non-carious cervical lesions in maxillary molars.
 Study Design: Prospective cross-sectional comparative study.
 Place and Duration of Study: Department of Operative Dentistry, Armed Forces Institute of Dentistry,Rawalpindi, from Jan 2017 to Dec 2018.
 Methodology: Male patients ranging from 30-40 years with moderate non-carious cervical lesions of maxillarypremolars and molars of either quadrant presenting to out-patient department were selected through convenience sampling. These lesions were restored with Flowable-Nanocluster-Composite and Resin-Modified-GlassIonomer. Retention of these two materials over the period of 6 months, 1 year and 2 years was noted. Chi square statistics were used to compare groups.
 Results: The retention of Flowable-Nanocluster-Composite was 92% in 6 months, 85% in one year and 81% in two years. Whereas, for resin-modified-glass-ionomer restorations, the frequency of retention of the filling material was 97% at 6 months, 93% at one year and 89% at two years period. Out of the total 74 resin-modified-glassionomers restorations, 8 (11%) had dislodged by the end of the second year as compared to 14 (19%) dislodged restorations for Flowable-Nanocluster-Composite.
 Conclusion: In conclusion, the study reveals that resin modified glass-ionomer has a superior retention rate over the period of two years as compared to Flowable-Nanocluster Composite. A dentist should have an insight into compositions of restorative materials for the longevity of their retention in various lesions.

Accuracy of Working Length Measured by Apex Locator and Digital Radiography

OBJECTIVE: The objective of this study was to compare the measurements of electronic and radiographic method of working lengths calculation with actual working length of root canals. Precise working length determination is the most important part for successful root canal procedure. The most commonly used methods to determine the working length in root canal treatment are radiography and electronic apex locator. METHODOLOGY: A cross sectional study was done over a period of 06 months in the Department of Operative Dentistry, Fatima Memorial Hospital, Lahore. Sixty patients who were recommended extraction of their premolar teeth with sixty canals were selected by convenience sampling. The Root ZX* apex locator was used to determine electronic working length exactly identifying the apical constriction. Reference points were identified and radiographic working length were determined 1mm short of radiographic apex. The teeth were extracted along with file cemented before extraction inside root canal. The actual length of the root canal was then calculated using the same files and reference point with 3.5X magnification. Pearson chi square test was applied to compare the apex locator and digital radiographic measurement with actual working length. RESULTS: The Root ZX® apex locator was 95% accurate to identify the apical constriction as compared 70% accuracy given by radiographs within 0.5 mm of the apex. CONCLUSION: Electronic apex locator was more accurate as compared to digital radiography in working length determination. KEYWORDS: Working length (WL), Electronic apex locators (EAL), Radiographic working length(RWL), Apical constriction (AC) HOW TO CITE: Khan GI, Khan MT, Ehsan S, Fayyaz A, Malik HA, Hussain S. Accuracy of working length measured by apex locator and digital radiography. J Pak Dent Assoc 2021;30(1):24-28.

Comparison of gingival biotype in smokeless tobacco users (Gutka and Paan) and non-tobacco users.

To assess the gingival biotypes in smokeless tobacco (Gutka and Paan) users and compare it with non-tobacco users in Karachi sub-population using trans-gingival probing method (TRAN). This in-vivo, cross sectional study was conducted in the department of Operative Dentistry from 20th February 2019 to 25th June 2019 Dow University of Health Sciences, Karachi after obtaining ethical approval from the Institutional review board of DUHS (Ref: IRB-1207/DUHS/Approval/2019/21). A total of 70 participants, 35 subjects currently using smokeless tobacco (Gutka and Paan) and 35 non-tobacco users from both genders were included in the study after taking informed consent. Gingival biotype was recorded using probe transparency method. Probing of the gingival sulcus was performed at the mid-buccal aspect of both maxillary incisors. Depending on the visibility of the underlying probe gingiva was categorized as thin or thick. Statistically significant differences in gingival biotype was observed of both groups (p=0.005). Males were recorded with a higher percentage of thick gingiva in both groups (81% in smokeless tobacco and 65% in non-tobacco) while in females thick gingiva was more prevalent in smokeless tobacco group (85.7%) whereas thin gingiva was noted in non-tobacco group (66.7%); although the results between genders was statistically insignificant. The comparison between different age groups, genders and both groups was statistically insignificant. Significant difference was observed between gingival biotype of smokeless tobacco and non-tobacco user groups. No statistically significant results were observed between genders and age groups.

Effect of pre-cooling agent on intensity of pricking pain at intraoral injection site in adults: An experimental study.

To determine the effect of pre-cooling agent on the intensity of pricking pain at the intraoral injection site in adult patients. The in-vivo interventional study was conducted at the Department of Operative Dentistry, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, from September 2018 to August 2019, and comprised adult patients of either gender. The pricking pain perception during needle administration was assessed using split-mouth technique. Topical anaesthesia benzocaine gel was applied on the left side, which was treated as controls, for 1 min, while on the right side, which was treated as the experimental side, refrigerated cartridge was placed for 2 min. Infiltration anaesthesia was then administered on both sides. Pain perception ratings were measured through visual analogue scale. After profound anaesthesia was achieved, restorative treatment was performed under rubber dam isolation. Data was analysed using SPSS 24. Of the 152 subjects, 77(50.65%) were females and 75(49.34%) were males. The overall mean age was 35.97±8.669 years (range: 21-50 years). The effect of refrigerated cartridge was significant on the intensity of pricking pain at the intraoral injection site in patients aged 41-50 years, and in female patients aged 21-30 years (p<0.05), whereas its effect was non-significant in males aged 21-30 years and patients aged 31-40 years (p>0.05). Pre-cooling agent was found to be effective in decreasing pricking pain felt by patients.

Effect of Supraperiosteal Injection of Dexamethasone on Interappointment Pain in Teeth with Symptomatic Irreversible Pulpitis: A Comparative Study

&#x0D; &#x0D; &#x0D; Objective: To compare the effect of supraperiosteal injection of dexamethasone with 2% lidocaine on the frequency of interappointment endodontic pain at different time intervals. Study Design: Prospectivecomparativestudy. Place and Duration of Study: The study was carried out at operative department of Armed Forces Institute of Dentistry, Rawalpindi from 1st October 2019 to 31st March 2020. Materials and Methods: A total of 100 patients presenting to the Department of Operative Dentistry, Armed Forces Institute of Dentistry, Rawalpindi and giving consent for participation, aged 20-50 years from both genders, presenting with acutely inflamed pulp in their maxillary first molars were selected for this study using convenient sampling technique. The patients were randomly divided into two equal groups of 50 patients with the help of scientific random number table. Endodontic therapy was initiated, pulpectomy canals were prepared with ProTaper Next system, intra-canal dressings of calcium hydroxide were placed and the cavity was restored with Cavit till the next appointment. Group A patients were then injected with dexamethasone at the mucobuccal fold and group B patients were injected with lidocaine used as placebo. Pain was recorded at 48 and 72 hours using the visual analogue scale. Data was analyzed using SPSS 21. Results: The study included equal number of male and females. The mean age of group A was 35 ± 4.5 years while of group B was 33 ± 6.7 years. The results showed that dexamethasone does not reduce pain at 48 and 72 hours compared to the placebo. Conclusion: It is concluded that dexamethasone does not reduce interappointment endodontic pain when compared to a placebo.&#x0D; &#x0D; &#x0D;

Comparison of calcium hydroxide and chlorhexidine gel as intracanal medicament in relieving interappointment pain: Effect of gender and age.

Objectives: This study was done to compare calcium hydroxide (Ca(OH)2) and chlorhexidine (CHX) in relieving interappointment pain, in addition to observe influence of gender and age. Study Design: Randomized Control trial. Setting: Department of Operative Dentistry, Fatima Memorial Hospital, Lahore. Period: 3rd October 2016 to 20th May 2017. Material &amp; Methods: 100 subjects were divided into 2 groups of 50, group A (Ca(OH)2) and group B (CHX). Information was recorded regarding the gender, age, intracanal medicament used, VAS pain scores of preoperative pain, 24 hours, 48 hours and on the 4th day of placing medicament. Change in pain scores was assessed as the main outcome variable. Results: VAS score mean difference for both medicaments was significant for 24 hours, 48 hours and 4th day (p &lt; 0.0005. CHX medicament decreased pain more as compared to Ca(OH)2. Age had no significant effect on VAS score decrease but females had significant decrease in pain (p=0.04). Conclusion: CHX decreased the mean interappointment pain score more as compared to Ca(OH)2.

To compare post obturation endodontic flare-ups following single and multiple visit root canal treatment.

Objective: To compare post obturation endodontic flare-ups following single and multiple visit root canal treatment. Study Design: Quasi experimental study. Setting Operative dentistry department, DOW university hospital Karachi. Period: 2nd October 2017 to 2nd April 2018. Material &amp; Methods: A total of 100 patients of permanent exposed anterior teeth with positive pup response / vital, either gender were included. Patients divided into two groups according to single and multiple visit root canal treatment. At each post obturation recall visit the patients were interviewed and inspected to determine whether or not there are symptoms. Results: A total of 100 patients came for root canal treatment. At 1st post obturation day, out of 50 patients treated in one visit, four experienced a flare-up (8%). Out of 50 patients treated in two visits, eight experienced a flare-up (16%) (P-value=0.12). At 3rd post obturation day, out of 50 patients treated in one visit, three experienced a flare-up (6%). Out of 50 patients treated in two visits, five experienced a flare-up (10%) (P-value=0.37). Conclusion: We conclude that almost same results for single and multiple visit endodontics were achieved not statistically significant.

Comparison of temperature change of one-step self-etch adhesive and two-step self-etch adhesive during photo polymerization of composite restoration.

Objectives: To compare the mean temperature difference in one-step self-etch adhesive versus two-step-self etch adhesive during photo polymerization of composite. Study Design: Randomized control trial. Study Design: Was done at Department of Operative Dentistry Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Karachi. Period: From January 2017 to June 2017. Material &amp; Methods: A total of 92 human extracted maxillary and mandibulars third molar teeth were selected in this study. All discs were divided into two groups. 46 were treated with one-step self-etch adhesive and other 46 were treated with two-step self-etch adhesive. For both the study groups, the temperature was recorded at the start of procedure of photo polymerization and at the end of procedure. From the other side of the disc temperature was measured by non-contact infrared thermometer and recorded. Results: Male to female ratio 1.6:1. The age of the study population ranged from 20 years to 65 years, with mean age of the patients was 32.41±3.01 years. Pre and post mean and the standard deviation (SD) of temperature was 31.95±2.14 and 38.40±1.97 in One-step self-etch adhesive and 31.91±2.25 and 38.45±2.26 in two-step-self-etch adhesive group respectively. Mean change was 6.45 ± 0.78 in One-step self-etch adhesive and 6.45±0.74 in two-step-self-etch adhesive group. Mean difference was not statistically significant between groups (p=0.605). While within group comparison, mean temperature was significantly high in one-step self-etch adhesive and also in two-step-self-etch adhesive. Conclusion: It is concluded that dental practitioners should be aware of the risk of thermal insults to the pulp as a result of photo polymerization of resin-containing restorative materials, especially when caries-affected deep dentin is involved for longer periods.

Accuracy of working length measurement with endo motor having built-in apex locator and comparison with periapical radiographs.

To determine the accuracy of working length measurement with endomotor having builtin apex locator by comparing it with periapical radiographs. The cross-sectional study was conducted at the Department of Operative Dentistry, Dr Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, from January to June 2014, and comprised permanent maxillary anterior teeth with mature apices. A preoperative radiograph was taken by using standardised paralleling technique. The access cavity was prepared by a high speed water-cooled diamond bur. After doing initial filing and drying the canal, the working length was taken with an endomotor with built-in apex locator in dual mode using the Protaper Rotary File S1. The length was measured using a millimeter scale. After attaining tentative working length from the pre-operative radiograph, 1mm was subtracted from the radiographic apex. A stainless steel K-file was placed in the canal at this length and a radiograph was taken by paralleling technique using intraoral film holder. The electronic and radiographic findings were noted. Accuracy was considered positive if the endomotor reading was 0-2mm short of the radiographic working length. Data was analysed using SPSS 16. Of the 96 cases, working length with X-Smart Dual was acceptable in 85(88.5%) cases, and unacceptable in 11(11.5%) cases. Accuracy of working length measurement with endomotor having built-in apex locator was found to be a better measuring tool compared to the conventional periapical radiographs.