Endodontic Procedures Research Articles

Evaluation of the effect of three different base endodontic sealers on the periapical region's discomfort and healing after root canal therapy

Seventy-five single-rooted teeth diagnosed with asymptomatic necrosis and apical periodontitis were randomly assigned to 3 experimental groups (n=25), according to the root canal sealer: MTA Fillapex, CPM Sealer, and AH Plus. Calcium hydroxide was employed as intracanal dressing throughout used during endodontic procedure. Classify each patient's discomfort as none, slight, moderate, or severe. Pain was rated between 1 and 4 after 24 hours, 48 hours, and 7 days. Also, analgesic use was monitored. The chi-square test contrasted postoperative pain and painkiller use. The ordinal (linear) chi-square test measured pain following therapy. There were no differences between groups in postoperative pain frequency, severity, or analgesic intake (p>0.05). After 7 days, no pain. Postoperative discomfort and the requirement for analgesics were the same for AH Plus, CPM Sealer, and MTA Fillapex. Aim of study: This clinical study was created to evaluate the frequency and intensity of pain with analgesic intake following root canal therapy utilizing various root canal sealers (MTA Fillapex, CPM Sealer, AH Plus).

Evaluation of apical extrusion of debris during retreatment: R-Endo rotary instruments versus hand files

Aim: The aim of this ex vivo study was to compare the amount of debris extruded during retreatment using stainless steel hand files (Hedstroem files) and R-Endo Nickel Titanium rotary instruments. Methodology: Eighty single-rooted freshly extracted human mandibular premolars were divided into two groups consisting of 40 teeth each. Retreatment was performed with R-Endo (Micro-Mega, Besançon, France) and Hedstroem files (Dentsply, Maillefer, Ballaigeus, Switzerland). The experimental teeth were obturated with lateral condensation technique. Then, 1.5-mL Eppendorf tubes were used to collecting the material that was extruded during preparation by subtracting post-instrumentation weight from pre-instrumentation weight. Results: There were significant differences in the amount of debris extruded between the groups (p<0.001). The amount of apical extrusion in the R-Endo group was determined to be less than in the hand instrumentation group. Conclusion: Within the limitations of this study, it might be concluded that all tested instruments resulted in apical extrusion of debris. During endodontic retreatment procedures, the hand files extruded a significantly higher amount of debris than the R-Endo. How to cite this article: Yırgın Akgül N, Haznedaroğlu F, Vardar Ç. Evaluation of apical extrusion of debris during retreatment: R-Endo rotary instruments versus hand files. Int Dent Res 2022;12(2):82-7. https://doi.org/10.5577/intdentres.2022.vol12.no2.6 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Effect of Sodium Hypochlorite in Dental Unit Waterline on Aerosolized Bacteria Generated from Endodontic Procedures

IntroductionAerosol generation in a dental setting is a critical concern, and approaches that aim at decreasing bacterial load in aerosols are of high priority for dental professionals. The objectives of this study were to evaluate the relative effect of various endodontic procedures on the generation and dissemination of aerosols and the effect of 0.1% sodium hypochlorite (NaOCl) in dental unit waterlines (DUWLs) on the bacterial load in the generated aerosols in a clinical setting. MethodsThe study was completed in 2 phases. The classic passive sampling technique using brain-heart infusion agar plates was used. Agar plates were strategically placed throughout the operatory at predefined locations. In phase 1, to evaluate the effect of different endodontic procedures on the generation and dissemination of aerosols, we collected a total of 38 samples. After baseline collection, test samples were collected during vital pulp therapy (VPT) full pulpotomy (n = 10), nonsurgical root canal therapy (NSRCT, n = 10), surgical root canal therapy (SRCT, n = 10), and incision and drainage (n = 8) procedures. Bacterial growth was expressed as colony-forming units at 48 hours after sample collection. Data were analyzed using 1-way analysis of variance with the Tukey multiple comparison post hoc test. In phase 2, to evaluate the effect of 0.1% NaOCl in the DUWL on the bacterial load in the generated aerosols, a total of 30 samples were collected. All procedures including VPT (n = 10), NSRCT (n = 10), and SRCT (n = 10) were performed with 0.1% NaOCl in the DUWL. Bacterial growth was expressed as colony-forming units at 48 hours after sample collection. Data were analyzed using 2-way analysis of variance with the Tukey multiple comparison post hoc test. ResultsAll endodontic procedures generated aerosols at all tested locations, except incision and drainage. Aerosols were disseminated as far as 3 m from the patient's head with no significant difference between various locations (P > .05). VPT procedures generated the maximum number of aerosols compared with NSRCT and SRCT. Adding 0.1% NaOCl to DUWLs significantly reduced the bacterial load in the generated aerosols in all treatment groups compared with groups treated with untreated waterlines (P < .05). No significant difference was noted in the bacterial load between all groups with treated waterlines (P > .05). ConclusionsAll tested endodontic procedures led to the generation and dissemination of contaminated aerosols, and the addition of 0.1% NaOCl as a biocide to the DUWL led to a statistically significant reduction in the bacterial load.

Sodium Hypochlorite Accident during Canal Treatment: Report of Four Cases Documented According to New Standards

Hypochlorite accidents are relatively rare events. Therefore, there is a lack of precise and accurate reports in the scientific literature that could help clinicians better understand the phenomenon and associated risk factors. This study reported four hypochlorite accidents attributable to 5% NaOCl extrusion in patients who had undergone treatment of the maxillary elements canal treatments. In all cases, the accidents occurred during the irrigation phase and were characterised by intracanal bleeding, ecchymosis, and swelling on the hemiface corresponding to the treated tooth. Antibiotics, paracetamol, NSAID, corticosteroids, and cold or warm compresses for oedema were prescribed to treat the symptoms of the accidents. Significant improvement of symptoms was observed in all patients after 5–6 days. Anatomic risk factors such as apical fenestration, root perforation, and large foramina were identified as possible risk factors for the accidents. After the accidents, clinicians applied endodontic procedures for which there is no scientific evidence to continue endodontic treatments, such as changing the type of irrigant or the irrigation method. Our results suggest that using a standardised approach to document each hypochlorite accident will allow researchers to collect more accurate and detailed data that can subsequently be used to identify potential risk factors and better manage the symptomatology of hypochlorite accidents.

Knowledge, Attitude and Practice on Regenerative Endodontics among Endodontists of Nepal

INTRODUCTION: Regenerative Endodontics is one of the most fascinating development in modern dentistry. Since Endodontists are the first providers of this type of dental treatment, it is essential to learn their knowledge, attitude and practice of these procedures. Aim: This online questionnaire-based study was conducted amongst Endodontists practicing in Nepal with the aim to learn their knowledge, attitude and practice of regenerative endodontic procedures. MATERIALS AND METHODS: A cross-sectional study was conducted among Endodontists in Nepal. In total 65 Endodontists participated in this study. The questionnaire was distributed to the participants using the available electronic measures. Descriptive statistical analyses were performed on the responses given by Endodontists using SPSS Statistical Software package (version 21.0). RESULTS: A total of 20 questions were included in this study. Out of the responses analyzed, 100% (n=65) had come across the term regenerative endodontics. Respondents had good knowledge about the sources of dental stem cells (87.3%, n=55). A high percentage (98.4%, n=62) of respondents strongly recommended regenerative therapy to be incorporated into dentistry. Among the participants of this study, 87.1% (n=54) had a belief that regenerative endodontic treatment could serve as the alternative treatment option to dental implant. CONCLUSIONS: The Endodontists practicing in Nepal had sound knowledge about regenerative endodontic procedures. They were enthusiastic in practicing regenerative endodontics and interested in stem cell therapy. It’s a high time to uplift the regenerative endodontic procedure from simple revascularization via blood clotting to more advanced procedure.

Potentiality and Inflammatory Marker Expression Are Maintained in Dental Pulp Cell Cultures from Carious Teeth.

Objectives: This investigation aimed to isolate and culture human dental pulp cells from carious teeth (cHDPCs) and compare their growth characteristics, colony-forming efficiency, mineralization potential and gene expression of Toll-like receptors (TLR)-2, TLR-4, TLR-9, tumour necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, IL-8, IL-17A, 1L-17R, IL-23A, nuclear factor-kappa B (NF-κB), mitogen-activated protein kinase (MAPK1), dentin matrix protein (DMP)-1, dentin sialophospho protein (DSPP), sex determining region Y-box 2 (SOX2) and marker of proliferation Ki-67 (MKi67) with cells isolated from healthy or non-carious teeth (ncHDPCs). Methods: Pulp tissues were obtained from both healthy and carious teeth (n = 5, each) to generate primary cell lines using the explant culture technique. Cell cultures studies were undertaken by generating growth curves, a colony forming unit and a mineralization assay analysis. The expression of vimentin was assessed using immunocytochemistry (ICC), and the gene expression of above-mentioned genes was determined using quantitative real-time reverse-transcription polymerase chain reaction. Results: ncHDPCs and cHDPCs were successfully isolated and cultured from healthy and inflamed human dental pulp tissue. At passage 4, both HDPC types demonstrated a typical spindle morphology with positive vimentin expression. No statistical difference was observed between ncHDPCs and cHDPCs in their growth characteristics or ability to differentiate into a mineralizing phenotype. ncHDPCs showed a statistically significant higher colony forming efficiency than cHDPCs. The gene expression levels of TLR-2, TLR-4, TLR-9, TNF-α, IL-6, IL-8, IL-17R, IL-23A, NF-κB, MAPK1, DMP1, DSPP and SOX2 were significantly higher in cHDPCs compared with ncHDPC cultures. Conclusion: cHDPCs retain their differentiation potential and inflammatory phenotype in vitro. The inflamed tooth pulp contains viable stem/progenitor cell populations which have the potential for expansion, proliferation and differentiation into a mineralizing lineage, similar to cells obtained from healthy pulp tissue. These findings have positive implications for regenerative endodontic procedures.

Comparison of Local and Systemic Ibuprofen for Relief of Postoperative Pain in Symptomatic Teeth with Apical Periodontitis.

BackgroundOne of the aims of endodontic treatment is to control preoperative and postoperative pain. The present study evaluated the effects of local and systemic ibuprofen on postoperative pain. It aimed to determine the most effective method for relieving postoperative pain due to chemomechanical preparation.Material/MethodsNinety patients with symptomatic apical periodontitis were randomly assigned to local ibuprofen, systemic ibuprofen, and control groups (n=30 each). Chemomechanical preparations were performed using a ProTaper Universal Ni-Ti rotary file under 2.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid irrigation. After the root canals were dried with sterile paper points, while Odontocide paste was applied into the root canals of the patients in the local ibuprofen group, calcium hydroxide paste was applied into the root canals of the patients in the systemic ibuprofen and control groups. Following completion of the endodontic treatment procedure, 200 mg ibuprofen was prescribed to patients in the systemic ibuprofen group. Friedman and Wilcoxon tests were used for statistical analysis.ResultsPosttreatment pain scores were recorded at 6, 12, 24, and 48 h using a visual analogue scale. Although there were no significant differences between the local ibuprofen group (Odontocide) and the control group (Ultracal) (P>0.05), pain scores in the systemic group (Ultracal+200 mg ibuprofen) were significantly lower than those in the other 2 groups (P<0.05).ConclusionsThese results indicate that systemic administration of ibuprofen is effective for postoperative pain relief.

Effect of Duration of Root Canal Infection on the Ability of Dentin-Pulp Complex Regeneration of Immature Permanent Teeth: An Animal Study

IntroductionPersistent infection is always considered the most important reason for the failure of dentin-pulp complex regeneration. The present study aimed to evaluate the effect of the duration of root canal infection (from 1–12 weeks) on the ability of dentin-pulp complex regeneration. MethodsIn this animal study, 64 roots of immature premolar teeth of 4 dogs were randomly divided into the following groups: the positive control group, 8 root canals treated with the regenerative endodontic procedure (REP); the negative control group, 12 infected root canals; the intervention groups, 36 root canals infected with supragingival plaque (1, 3, 6, and 12 weeks) and treated with REP; and an additional positive control group, 8 normal roots. After 3 months, the teeth were investigated by radiographic images and immunohistochemical staining (CD31, CD34, and S100 markers). In addition, DSPP gene expression was assessed using a real-time polymerase chain reaction technique. ResultsBased on radiologic evaluation among the intervention groups, the highest root canal development (length and width) occurred in the intervention group of 1 week, and the lowest radiologic results were in the intervention groups of 6 and 12 weeks (1-way analysis of variance, P-value < .05). There was a significant difference between the groups in terms of CD31, CD34, S100, and DSPP expression percentage (1-way analysis of variance, P-value < .05); the highest and lowest expression percentages belonged to the 1- and 12-week groups, respectively, among the intervention groups. ConclusionsThis study demonstrated that long root canal infection decreased the ability of the body to regenerate the dentin-pulp complex.

The Impact of COVID-19 on Dental Treatment in Kuwait-A Retrospective Analysis from the Nation's Largest Hospital.

Background: The COVID-19 pandemic has changed the way dentistry has been practiced the world over. This study sought to assess the impact of the COVID-19 pandemic on the patterns of attendance for dental treatment in a large hospital in Kuwait through comparisons with data from the year prior to the pandemic. Methods: A total of 176,690 appointment records from 34,250 patients presenting to the AlJahra specialist hospital in Kuwait for dental treatment from April 2019 to March 2021 were analyzed. The types of procedures and the departments in which they presented were analyzed, and the patterns of attendance before and during the pandemic were compared. Results: While there was a significant reduction in the number of orthodontic, endodontic, and periodontal procedures, there were no impacts on oral surgery, restorative procedures, or pediatric dentistry. Conclusions: There has been a return in the number of patients obtaining dental treatment; however, there has been a definite shift in the use of certain dental procedures.

Evaluation of concentrated growth factor and blood clot as scaffolds in regenerative endodontic procedures: Aretrospective study.

The study aims to investigate and compare the success rate of concentrated growth factor (CGF) and blood clot (BC) as scaffolds in regenerative endodontic procedures (REPs). Immature permanent necrotic teeth treated by REPs with at least a 6-month follow-up were included. These teeth were divided into the CGF (53 teeth) and BC (68 teeth) groups. Treatment outcomes were assessed using a combined clinical and radiographic scoring system. The total success rate was 91.74% over a mean follow-up period of 23.15months. There was no significant difference between the CGF group (86.79%) and BC group (95.59%). The success rate of traumatic teeth (84.31%) was significantly lower than that of teeth with developmental dental anomalies (98.39%) (p <0.05). CGF may be a suitable alternative scaffold in REPs when adequate bleeding cannot be achieved. Moreover, compared to developmental dental anomalies, traumatic teeth treated by REPs may be more vulnerable to failure.

Carboxymethyl cellulose hydroxyapatite hybrid hydrogel used to evaluate the osteogenic and odontogenic differentiation potential of dental pulp and periodontal ligament stem cells

In order to maintain optimal function, the aim of pulp treatment is to maintain the tooth structure intact. Retaining the vitality of teeth damaged due to caries or trauma is also one of the purpose of pulp treatment. In particular, the preservation of pulp vitality is essential for continuous root development and apical closure in the case of immature permanent teeth. In recent years, regenerative endodontic treatment procedures have been suggested in order to replace the damaged pulp tissue with viable tissue. The idea of regeneration of the dentin-pulp complex was introduced into endodontics to restore the vitality of young permanent teeth that have been non-vitalized due to trauma/dental caries. The concept of success in regenerative endodontic procedures is relied on three basic elements that are; stem cells, growth factors, and scaffolds. Each of these play their own important role in the regeneration of pulp-dentin complex. This invitro comparative study had intended to deal with the new experimental custom prepared semi-synthetic hybrid scaffold (CMC-HA), its acceptance for the cells (DPSCs and PDLSCs) seeded on it and osteogenic and odontogenic differentiation of both the dental pulp and periodontal ligament stem cells.

Current trends and future perspectives on dental nanomaterials – An overview of nanotechnology strategies in dentistry

The field of nanotechnology or nanoscience encompasses research and development in the applied sciences at the atomic or molecular levels and has a huge impact on nearly every aspect of human health and well-being, including pharmacological studies, clinical diagnosis, and supplemental immune system treatments. The numerous dental uses of nanotechnology have led to the development of the field of nanodentistry. The efficacy of dental operations and the field’s possibilities have grown greatly over the years as a result of extensive research in the fields of biomaterials and nanotechnology. Materials with nanoscale dimensions can display features not found in their larger-scale equivalents. Endodontic procedures are time-consuming and usually require multiple visits to attain the best results. The eradication of primary bacterial infection from dental root canals is still a serious concern in dentistry. Nanoparticles have been shown to be more efficient than standard materials and to have superior capabilities in terms of surface chemistry and bonding. Their antimicrobial characteristics are also promising in all medical procedures, particularly in endodontics. Because of their versatility, nanomaterials are a useful tool in dental clinics for a variety of operations including pulp regeneration, drug administration, root restoration, cleaning, obturation, and canal filling. This review provides an overview of the synthesis and characteristics of nanomaterials and their potential applications in dentistry and describes future perspectives of nanotechnology in dentistry with an updated literature review.

Comparison of Post-Operative Pain Frequency After Single visit and Multiple visit Root Canal Treatment in Non-Vital Teeth

OBJECTIVES: Root canal treatment (RCT) is performed to get rid of pain resulting from the infection in the tooth. It is a safe procedure with high success rate. One of the main issues with root canal treatment is post-operative pain. There are many factors which can cause pain and distress to patients. If the clinician follows the guidelines properly and use the anxiety reduction protocol, then the procedure is not painful. RCT can be performed in multiple visits or it can be done in single visit. Present research was conducted to compare the single visit versus multiple visits endodontic treatment in teeth with pulpal necrosis in terms of post-operative pain frequency. METHODOLOGY: This study was a randomized controlled trial conducted at Department of Operative Dentistry, Fatima Memorial Hospital, Lahore, over a period of six months. Total number of participants was 302 and the teeth were lower and upper first and second molars with pulp necrosis and they were were equally assigned in two groups of 151with equal number of men and women. Single visit RCT was done in Group A patients, in which the endodontic procedure was performed in one day and multiple visit RCT was done in Group B, in which endodontic treatment was done in two or more visits. RESULTS: In necrosed teeth single visit endodontic treatment 20.5(%) resulted in less frequent post-operative pain than in multiple visit endodontic treatment (26.5%). CONCLUSION: Single visit endodontic treatment is a better technique in terms of pain control as compared to multiple visit in teeth with pulp necrosis. KEYWORDS: Endodontics, Non-vital teeth, Post-operative pain, single visit root canal treatment, multiple visit root canal treatment.

The Effect of the Amnion-Chorion or Collagen Membrane as a Matrix on the Microenvironment During a Regenerative Endodontic Procedure

IntroductionDuring regenerative endodontic procedures, the microenvironment of the canal is formed by the degree of disinfection and release of ions from the applied materials onto the top surface. This study aimed to characterize the effects of amnion-chorion membrane and collagen membrane on pulp-dentin regeneration compared to calcium silicate cements (CSCs), focusing on cell migration, mineralization potential, anti-inflammation, and angiogenesis. MethodsTwo CSCs and 2 membranes were used: ProRoot MTA (Dentsply, Tulsa, OK, USA), RetroMTA (BioMTA, Seoul, Korea), Collagen Membrane (Genoss, Suwon, Korea), and BioXclude (amnion-chorion membrane; Snoasis Medical, Colorado, USA). Transwell and scratch assays were used to evaluate cell migration and wound healing. Mineralization potential was evaluated using alkaline phosphatase activity, Alizarin red S staining, and quantitative real-time polymerase chain reaction for the expression of marker genes. Quantitative real-time polymerase chain reaction was used to measure the levels of angiogenic genes and inflammatory mediators. An endothelial tube formation assay was used to assess angiogenesis. ResultsThe membranes showed superior migration and wound healing compared with CSCs. Except for RetroMTA, ProRoot MTA and the 2 membranes showed high alkaline phosphatase activity and mineralization nodule formation and upregulated mRNA expression of markers for mineralization. Membranes upregulated the mRNA of angiogenesis genes and increased the capillary tube formation of endothelial cells compared to CSCs. Furthermore, the membrane matrix decreased the expression of inflammatory genes. ConclusionsCollagen membrane and Amnion-chorion membrane showed prominent cell migration, angiogenesis, and healing effects against inflammation, as well as comparable mineralization potential compared to CSCs, recommending the use of membrane as a matrix.

LncRNA SNHG1 regulates odontogenic differentiation of human dental pulp stem cells via miR-328-3p/Wnt/β-catenin pathway

BackgroundElucidating the mechanism of odontogenic differentiation of human dental pulp stem cells (hDPSCs) is the key to in-depth mastery and development of regenerative endodontic procedures (REPs). In odontogenic differentiation, lncRNAs have a regulatory role. The goal of this research is to determine the involvement of short nucleolar RNA host gene 1 (SNHG1) in hDPSCs’ odontogenic differentiation and the mechanism that underpins it.MethodshDPSCs were isolated from the dental pulp tissue of healthy immature permanent teeth. Follow-up experiments were performed when the third generation of primary cells were transfected. The proliferation ability was measured by CCK-8. The biological effects of SNHG1 and miR-328-3p were determined by real-time quantitative polymerase chain reaction (qRT-PCR), western blot (WB), alkaline phosphatase (ALP) staining and activity, alizarin red S staining (ARS) and quantification, and immunofluorescence staining. The binding of SNHG1 and miR-328-3p was confirmed using a dual-luciferase reporter assay. qRT-PCR and WB were used to determine whether the canonical Wnt/β-catenin pathway was activated.ResultsOn the 0th, 3rd, and 7th days of odontogenic differentiation of hDPSCs, SNHG1 showed a gradual up-regulation trend. SNHG1 overexpression enhanced the mRNA and protein expression of dentin sialophosphoprotein (DSPP), dentine matrix protein 1 (DMP-1) and ALP. We found that SNHG1 could bind to miR-328-3p. miR-328-3p inhibited the odontogenic differentiation of hDPSCs. Therefore, miR-328-3p mimics rescued the effect of SNHG1 overexpression on promoting odontogenic differentiation. In addition, SNHG1 inhibited Wnt/β-catenin pathway via miR-328-3p in odontogenic differentiation of hDPSCs.ConclusionlncRNA SNHG1 inhibits Wnt/β-catenin pathway through miR-328-3p and then promotes the odontogenic differentiation of hDPSCs.

Treatment of Necrotic Anterior and Posterior Teeth with Regenerative Endodontic Procedures Using PRF as a Scaffold: A Retrospective Study

We assessed the impact of regenerative endodontic procedures (REP) using a platelet-rich fibrin (PRF) scaffold on necrotic immature permanent anterior and posterior teeth based on the following parameters: periapical healing, changes in root development, and associations between increases in the radiographic root area (RRA), and degree of root to apical closure. The study included 50 teeth consisting of 57 roots (36 anterior and 21 posterior) treated between 2017 and 2019, with an average follow-up of two years. Complete periapical healing was achieved in 91.2% teeth, and uncertain healing was achieved in 8.8%. RRA increased in 95% of teeth and root lengthening was achieved in 86% teeth (without any mutual effect). Apical closure was significantly associated with tooth location (89% and 30% of the posterior and anterior roots, respectively). Trauma was the most common aetiology of necrotic anterior teeth, whereas caries was the only aetiology of necrotic posterior teeth. REP using PRF scaffold achieved a high success rate for periapical healing and root maturation in both anterior and posterior necrotic immature teeth. The favourable results obtained in posterior teeth may encourage the use of REP for treating necrotic immature permanent posterior teeth.

Antibacterial Efficacy of Herbal Solutions in Disinfecting Gutta Percha Cones Against Enterococcus Faecalis.

Objective:Even when endodontic procedures are performed with the utmost care, reinfection can occur. One possible explanation is that contaminated gutta-percha cones were used in the root canals. The study's goal is to assess the antimicrobial activity and efficacy of Neem, Turmeric, and Calotropis Procera in disinfecting gutta percha cones prior to obturation.Materials and Methods:80 Gutta percha (GP) cones were contaminated with 0.5ml Ferlands standard Enterococcus Faecalis for 10 minutes.20 cones each were treated up to 5 minutes in their prepared neem, turmeric, calotropis and sodium hypochlorite solutions. Then, they placed in BHI broth and vertex is done for 1 minute. One loopful of broth was stroked on 20 blood agar plates of 5 each neem, turmeric, calotropis and sodium hypochlorite. The plates were then incubated for 24 hours aerobically at 37°C and the colony forming units were counted with a digital colony counter.Results:Mean colony forming units were compared in all the groups and there was a statistically significant difference present among the groups (p<0.01). Sodium Hypochlorite (NaOCL)as control group showed average of 5 colony forming units(CFU). Turmeric had the least average of 55 CFU and was the most effective of the experimental groups. Neem and Calotropis had the higher average of 130 CFU and 200 CFU respectively, making it the least effective of the solutions tested.Conclusion :All of the herbal solutions tested positive for disinfection of GP points. When compared to Neem and Calotropis, Turmeric was the most effective and has superior antibacterial activity.

Introduction to endodontic diseases and their treatment in companion animals

Background: Endodontically diseased teeth are a common finding in clinical practice, with treatment depending on the duration of the injury, the stage of development of the tooth, and the type of tooth. Endodontic therapy eliminates oral pain and retains tooth functionality, and has decreased surgical complications compared to extraction. It is important that practitioners are aware of this therapy and can advise clients on why their pet's teeth should be treated and the treatment options available.Aim of the article: This article reviews the endodontic anatomy of a tooth, and discusses different types of endodontic procedures, as well as their indications in companion animal practice. This will enable a deeper understanding of this specific dental pathology and help you to communicate the significance of treating these conditions to the client.

Various applications of fibers in Endodontics

Fiber reinforced composites are bondable, biocompatible, aesthetic, translucent and easy-to-use in clinical practice. They have various applications in clinical dentistry due to their wide spectrum of intended properties. Composite is an better esthetic material which has an inherent problem of bulk fracture where cohesive failure occurs within the restorative material. When fibers are incorporated with composites they enhance the cohesive strength and thereby prevents bulk fracture.Some of the fibers which are commonly used in reconstruction procedures in operative dentistry and endodontics are polyethylene fibers, quartz glass fibers, carbon fibers and aramid fibers. This case report enumerates usage of Fiber reinforced composites as an endodontic post and cores material. It can be used as an alternative to conventional treatment in dentistry.

Accuracy of Dynamic Navigation for Non-Surgical Endodontic Treatment: A Systematic Review.

In recent years, the application of Guided Endodontics has gained interest for non-surgical endodontic treatment and retreatment. The newest research focuses on the accuracy of Dynamic Navigation (DN). This article systematically reviewed existing data on the accuracy of non-surgical endodontic treatment procedures that were completed using DN. Following the PRISMA criteria, an electronic database search was conducted in PubMed, Web of Science, Scopus, and Cochrane Library. Studies comparing the accuracy of non-surgical endodontic treatment using DN and the conventional freehand technique were eligible. The literature search resulted in 176 preliminary records. After the selection process six studies were included. The risk of bias was evaluated using the modified Cochrane Collaboration Risk of Bias 2.0 tool. Five studies examined the aid of DN for planning and executing endodontic access cavities, and one for fiber post removal. In two studies, endodontic access cavities were performed in teeth with pulp canal obliteration. The main outcomes that were measured in the included studies were preparation time, global coronal entry point and apical endpoint deviations, angular deviation, tooth substance loss, qualitative precision, number of unsuccessful attempts or procedural mishaps. The risk of bias was rated from low to raising some concerns. Overall, DN showed increased accuracy compared to the freehanded technique and could be especially helpful in treating highly difficult endodontic cases. Clinical studies are needed to confirm the published in vitro data.