Comparative evaluation of remaining dentin thickness, canal centering ability and apical deformity between ProFit S3 and Protaper gold - A nano CT study

Purpose

For the root canal treatment to be successful, the root canal system must be cleaned and shaped, and must be gradually widened from the apical to the coronal region in order to preserve dentin thickness. ProFit S3 (Profit Dental, India) patented rotary file with variable taper design preserves dentin. The study employs ultra-high-resolution nano-computed tomography to assess the volumetric changes of two new rotary files in permanent mandibular premolars.

Materials and methods

Based on inclusion and exclusion criteria, this in-vitro investigation used extracted premolars. Before the pre-operative scan, samples were made and the working length was determined using a high-precision nano-CT (SkyScan 2214, Bruker, Kontich, Belgium). A single skilled pediatric dentist used ProFit S3 (Profit Dental, India) and Protaper Gold (PTG; Dentsply, Tulsa Dental Specialties, Tulsa, OK, USA) to prepare the canals. Post-op scans were similar to pre-ops. For 3D root canal visualization and analysis, NRecon software was used to rebuild images.

Results

Profit S3 has a mean value of 0.65500 and Protaper gold 1.38800, indicating a significant range. Protaper gold followed Profit S3 in canal volume differential. The two rotating file systems differed significantly (p 0.05). ProFit S3 maintained mesiodistal and buccolingual dentin thickness at 4 mm, 8 mm, and 12 mm, followed by Protaper Gold.

Conclusions

ProFit S3 exhibited the lowest mean canal volume difference compared to Protaper gold. Unlike Protaper Gold, ProFit S3 offers a variable taper design that preserves root canal anatomy, peri cervical dentin, and dentin thickness.

Comparative evaluation of volumetric changes following rotary and hand files' canal preparation of primary maxillary canine: an in vitro nano-CT analysis

PURPOSE

To evaluate the volumetric changes of two recently introduced paediatric rotary file systems in comparison with conventional hand file systems in primary maxillary canines using an ultra-high-resolution nano-computed tomography.

METHODS

This in vitro study was performed in extracted primary maxillary canines based on certain inclusion and exclusion criteria. Samples were prepared, and working length was determined after the pre-operative scan using a high-resolution nano-CT device (SkyScan 2214, Bruker, Kontich, Belgium). A single well-experienced paediatric dentist prepared the canals using three file systems: Kedo-S plus, Kedo-SG blue and hand K-files. All samples were subjected to post-operative scans performed similar to pre-operative scans. Image reconstruction was performed with NRecon software for 3D volumetric visualisation and analysis of the root canals.

RESULTS

Kedo-SG blue file systems had the highest mean difference in the canal volume (4.05%). Hand K-files had the least difference at (3.71%) of canal volume. Kedo-S plus file system had a moderate mean canal volume difference (3.82%) which is closer to hand K-files. Intergroup comparison between the three groups showed that the mean difference in canal volume was statistically significant between all three file systems (p = 0.000).

CONCLUSION

Within the limitations of the current study, rotary file systems produced a significant enlargement of canals as compared to hand files. Kedo-SG blue created a uniform preparation of the canal cervico-apically. Kedo-S plus files were prepared more coronally with minimal preparation apically as close to the preparation of hand files.

TRIAL REGISTRATION

Trial registration number: IHEC/SDC/PEDO-2103/22/651, Date of registration: 2022.

Comparative evaluation of volumetric changes between two pediatric rotary files (Kedo-S plus, Kedo-SG blue) and manual files (hand K-files) during canal preparation of primary mandibular molars: an in-vitro nano-CT analysis

Pediatric endodontics has become popular due to advancements in cleaning, shaping and irrigation systems, resulting in faster and effective removal of infected pulp, saving time, and creating a pathogen-free environment. The patented rotary file system, Kedo-S, designed for primary teeth, introduced a single file generation for efficient pulp therapy. However, there are currently no studies assessing canal preparation in primary mandibular molars using nano-CT (computed Tomography). To evaluate the volumetric changes of two recently introduced pediatric rotary file systems in comparison with conventional hand file systems in primary mandibular molar using an ultra-high resolution nano-CT. This in-vitro study was performed in extracted primary mandibular molar based on certain inclusion and exclusion criteria. Samples were prepared and working length was determined before the pre-operative scan using a high resolution nano-CT device (SkyScan 2214, Bruker, Kontich, Belgium). A single well-experienced pediatric dentist prepared the canals using three file systems: Kedo-S plus, Kedo-SG blue and Hand K-files. A post-operative scan was performed similar to pre-operative scan. Image reconstruction was performed with NRecon software for 3D volumetric visualization and analysis of the root canals. Kedo-SG blue file systems had the highest mean difference in the canal volume (8.85%). Hand K-files had the least difference at (1.24%) of canal volume. Kedo-S plus file system had a mean canal volume difference (6.14%) which is closer to hand K-files. Rotary file systems resulted in a significant enlargement of canals compared to hand files.

Comparative Evaluation of Push-Out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, a Modified Mineral Trioxide Aggregate, and Two Novel Antibacterial-Enhanced Mineral Trioxide Aggregates

Background The challenges associated with incorporating antimicrobial agents, such as the potential diminishment of the cement's physical properties, highlight the need for comprehensive evaluations. Balancing antimicrobial efficacy with the maintenance of structural integrity is a crucial aspect of material development. The acknowledgment of cytotoxic properties associated with tricalcium aluminate, a major constituent in conventional mineral trioxide aggregate (MTA), is critical in terms of long-term evaluation of treatment procedures. The primary focus of the push-out test is to evaluate the resistance of the tested material to dislodgement. Greater push-out strength implies stronger adhesion between the tested material and the tooth surface. Aim This study aims to evaluate the push-out bond strength of two antibacterial-enhanced MTAs with conventional MTA and Biodentine. Material and methods A total of five materials were tested: a) modified MTA, b) doxycycline-enhanced MTA, c) metronidazole-enhanced MTA, d) conventional MTA, and e) Biodentine. All the materials were mixed based on a predetermined powder:liquid ratio and then carried using a plastic instrument to the desired experimental design. Single-rooted permanent teeth, preferably incisors, were used in the present study. Teeth were embedded vertically in a rubber mold, and sectioning of the tooth was performed. A single operator instrumented the canal space in each slice using Gates-Glidden burs, and the mixed cements were placed in the respective groups and stored for 72 hours. A push-out test was carried out using a universal testing machine. Following the bond failure, the slices were examined under a stereomicroscope to determine the nature of the bond failure. The collected data was subjected to a one-way analysis of variance test, post hoc test, and chi-square test for statistical analysis. Results The mean push-out bond strength was found to be the highest for Biodentine (43.25 ± 0.62 megapascals (MPa)), followed by doxycycline- and metronidazole-enhanced MTAs (39.54 ± 0.65 MPa and 39.29 ± 0.16 MPa, respectively), modified MTA formulation (37.75 ± 0.73 MPa), and the lowest for conventional MTA (25.93 ± 0.7 MPa). Conventional MTA samples had an adhesive failure (89.4%), while Biodentine samples had a cohesive failure (80.3%). Mixed failures were noticed with the samples containing modified MTA formulation (71.3%), doxycycline-enhanced MTA (76.6%), and metronidazole-enhanced MTA (78.0%). Conclusion Despite not surpassing Biodentine in bond strength, antibacterial-enhanced MTAs are considered potential alternatives to conventional MTA in day-to-day clinical practice.

Comparative Evaluation of Push-out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, and Two Novel Antibacterial-enhanced Mineral Trioxide Aggregates

AIM

To evaluate the push-out bond strength of two newly modified mineral trioxide aggregates (MTAs) with conventional MTA and biodentine.

MATERIALS AND METHODS

Material preparation: Two commercially available bioactive bioceramics: Group I: Mineral trioxide aggregate; Group II: Biodentine; and two newly formulated modified MTAs: Group III: Doxycycline incorporated MTA formulation; Group IV: Metronidazole incorporated MTA formulation was used in the present study. All the test materials were then carried using a plastic instrument to the desired experimental design. Teeth sample preparation: A total of 120 teeth samples were collected and divided into four groups of test materials with 30 teeth samples per group. Single-rooted permanent teeth, that is, incisors were collected and stored in saline until the study was performed. Sectioning of the teeth into 2.0 ± 0.05-mm thick slices was performed perpendicular to the long axis of the tooth. The canal space was instrumented using Gates Glidden burs to achieve a diameter of 1.5 mm. All four prepared materials were mixed and placed in the lumen of the slices and placed in an incubator at 37°C for 72 hours. Push-out test and bond failure pattern evaluation: The push-out test was performed using a universal testing machine. The slices were examined under a scanning electron microscope (SEM) at 40× magnification to determine the nature of bond failure. All the collected data were recorded and statistically analyzed.

RESULTS

The mean push-out bond strength was found to be the highest for group II (37.38 ± 1.94 MPa) followed by group III (28.04 ± 2.22 MPa) and group IV (27.83 ± 1.34 MPa). The lowest mean push-out bond strength was noticed with group I (22.89 ± 2.49 MPa). This difference was found to be statistically significant (p = 0.000). Group I samples had the predominantly adhesive type of failure (86.4%), while group II samples showed the cohesive type of failure (94.2%). Both the modified MTAs (groups III and IV) primarily showed mixed types of failures.

CONCLUSION

Both the antibacterial-enhanced MTAs had better pushout bond strength compared to conventional MTA but did not outperform biodentine. Hence, it could serve as a substitute for conventional MTA due to its augmented physical properties.

CLINICAL SIGNIFICANCE

Carious pulp exposure and nonvital open apices pose a critical challenge to pediatric dental practitioners. In such circumstances, maintaining the vitality of pulp and faster healing would help in a better prognosis. Novel MTAs without any cytotoxic components, and enhanced antibacterial contents with augmented physical properties can help in treating such clinical conditions. How to cite this article: Merlin ARS, Ravindran V, Jeevanandan G, et al. Comparative Evaluation of Push-out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, and Two Novel Antibacterial-enhanced Mineral Trioxide Aggregates. J Contemp Dent Pract 2024;25(2):168-173.

Comparative analysis of novel heat-treated retreatment file system on the removal of obturating material using nano-computed tomography

Introduction

The aim of nonsurgical retreatment is to remove the previous filling material followed by chemo-mechanical preparation of the canal to achieve proper disinfection of the root canal system. This is then followed by re-obturation. This study evaluates the time taken to retrieve the gutta-percha and the quantity of remaining filling material after retreatment with two different file systems. The quantity of remaining filling material was assessed using nano-computed tomography (CT) due to its increased accuracy.

Materials and Methods

Forty extracted single-rooted teeth were split into two groups at random and decoronated and obturated at a standard root length of 16 mm. Solite RS3 (SRS-3) Retreatment and ProTaper Universal Retreatment (PTUR) systems were used to retrieve the gutta-percha after a preoperative nano-CT scan. Postoperative nano-CT scan was taken and both the scans were superimposed to quantify the remaining filling material. The time taken to remove gutta-percha was measured using a stopwatch. The statistical analysis comparing the two groups was conducted using the independent t-test.

Results

The quantitative analysis of remaining filling material using nano-CT showed no statistical difference between both the file systems used (P > 0.05). However, SRS-3 took significantly less time in the removal of gutta-percha (P < 0.05).

Conclusion

Hence, we can conclude that there is no significant difference in the amount of remaining filling material between both the file systems. However, time taken to remove the gutta-percha was lesser in SRS-3 compared to PTUR file system.

Evaluation of Risk Factors associated with Caries Development after Full-mouth Rehabilitation for Early Childhood Caries Under General Anesthesia

AIM

To evaluate the risk factors associated with caries development after full-mouth rehabilitation for early childhood caries (ECC) under general anesthesia.

MATERIALS AND METHODS

A total of 100 children diagnosed with ECC requiring full-mouth rehabilitation under general anesthesia were recruited for the study. At baseline, caries status, plaque index, Streptococcus mutans count, and Lactobacillus count were evaluated. The risk assessment for caries was evaluated using a cariogram. Children were recalled after 12 months for evaluation. All children returned for the recall and data was recorded at the recall visit. Children were grouped into caries-free or caries recurrent based on the absence or presence of caries. Chi-square tests and student's t-test were used for statistical analysis using the statistical package for the social sciences (SPSS), version 23.

RESULTS

All 100 children returned for follow-up. 76% of the children developed new carious lesions in a period of 1 year. A statistically significant association between caries recurrence and S. mutans count and caries risk assessment (CRA) score was found (p < 0.001). No significant associations were seen between parental education levels and the oral health practices of the child.

CONCLUSION

Children treated under full-mouth rehabilitation for ECC under general anesthesia are at risk for developing new carious lesions after treatment. New carious lesions are strongly correlated with the presence of S. mutans, and high cariographic risk scores serve as an indication of future caries. Early childhood caries may be avoided if children are more diligent in practicing good dental hygiene.

CLINICAL SIGNIFICANCE

Relapse of caries after full-mouth rehabilitation under general anesthesia can affect the quality of life of children. Preventive measures should be initiated and reinforced to prevent the occurrence of new carious lesions after full-mouth rehabilitation. How to cite this article: Mathew MG, Jeevanandan G, Maganur PC, et al. Evaluation of Risk Factors associated with Caries Development after Full-mouth Rehabilitation for Early Childhood Caries Under General Anesthesia. J Contemp Dent Pract 2024;25(1):85-91.

Evaluation of Changes in Oral Microflora in Children with Early Childhood Caries after Full Mouth Rehabilitation

Aim

To evaluate the change in microflora in children suffering from severe early childhood caries (ECC) after full mouth rehabilitation.

Materials and methods

A total of 60 children, aged 3-5 years suffering from severe ECC who fulfilled the inclusion and exclusion criteria were included in the study. Pooled plaque samples were taken and subjected to quantitative reverse transcriptase polymerase chain reaction (PCR) to obtain baseline mean values of Streptococcus mutans (S. mutans), Streptococcus sobrinus (S. sobrinus), Candida albicans (C. albicans), and Candida dubliniensis (C. dubliniensis) before full mouth rehabilitation was done under general anesthesia. Posttreatment samples were collected at 6, 12, and 18 months. Wilcoxon signed-rank test was used to compare the mean values of S. mutans, S. sobrinus, C. albicans, and C. dubliniensis before and after full mouth rehabilitation.

Results

A total of 60 patients recruited for the study were present at the follow-up at 6 and 12 months. At 18 months, 55 patients returned, and five were lost due to follow-up. A statistically significant reduction was seen in all microorganisms at 6, 12, and 18 months compared to baseline values. At 18 months a slight increase in S. mutans, S. sobrinus, and C. albicans was seen. C. dubliniensis was not detected in any cases after full mouth rehabilitation. Caries recurrence was seen in four patients at 18 months.

Conclusion

Significant reduction of S. mutans, S. sobrinus, C. albicans, and C. dubliniensis was seen at 6, 12, and 18 months. A complete reduction of only C. dubliniensis was seen. A significant but not permanent reduction of S. mutans, S. sobrinus, and C. albicans. Caries recurrence was seen in 7.27% of patients at 18 months.

How to cite this article

Mathew MG, Jeevanandan G, Rathod NN. Evaluation of Changes in Oral Microflora in Children with Early Childhood Caries after Full Mouth Rehabilitation. Int J Clin Pediatr Dent 2024;17(1):21-25.

Interrelationship Between Intelligence Quotient and Space Maintainers Among Children: A Cross-Sectional Comparative Study

Introduction Intelligence quotient (IQ) is an indicator to measure a child's cognitive ability to learn or understand and to deal with new situations with their logical and analytical skills. Children with better IQ exhibit increased cooperation when undergoing dental treatments, leading to a positive attitude toward dental care. The primary aim of the study was to assess the interrelationship between the IQ of children, space maintainer therapy, and the behavior of children aged 6-10 years. Materials and methods A total of 104 children were divided into two groups: group 1 included children undergoing space maintainer therapy and group 2 included children who did not undergo space maintainer therapy. Their IQ scores were assessed using Raven's Coloured Progressive Matrices and behavior and the Frankl behavior rating scale. The data were analyzed by SPSS Version 23 (IBM Corp., Armonk, NY). Independent t-tests were used to evaluate the differences between IQ and children with space maintainers, and Mann-Whitney U tests were used to assess the differences between behavior and space maintainers. Results The mean age of the participants was approximately 8.28 years. The mean IQ score of the group of children undergoing the space maintainer therapy was 90.69 ± 7.65 and that of the control group was 105.59±10.71. Based on the Frankl behavior rating scale, the mean score in the space maintainer group was 35.44 and that of the control group was 69.56. There was a significant association between IQ, behavior, and the presence of space maintainers. Conclusion The group of children undergoing space maintainer therapy demonstrated comparatively lesser IQ, and the majority of children exhibited negative behavior. Also, children wearing space maintainers had undergone one or multiple extractions, which is traumatic for children and may lead to them likely exhibiting a negative behavior than children in the control group. Hence, it may be concluded that intelligence, behavior, and space maintainers are all significantly associated with each other.

Evaluation of Clinical Success, Caries Recurrence, and Oral Health-Related Quality of Life of Children Undergoing Full Mouth Rehabilitation for Early Childhood Caries: A Prospective Cohort Study

AIM

This prospective cohort study aimed to assess the clinical success, caries recurrence, and oral health-related quality of life of children undergoing full mouth rehabilitation for early childhood caries under general anesthesia. The study sought to understand the long-term impact of these interventions on early childhood caries (ECC) management.

METHODOLOGY

The study included 300 children aged three to six years diagnosed with ECC requiring full mouth rehabilitation under general anesthesia. The assessment included clinical success of various dental treatments, caries recurrence rates, and oral health-related quality of life using the Early Child Oral Health Impact Scale at baseline, 12 months, and 24 months post-treatment. Specialized caries preventive protocols were implemented, including education on oral hygiene, reminders, and nutritional guidance.

RESULTS

272 children attended the 12-month follow-up, out of which 11 children had new carious lesions. Two hundred fifty-two children were reported for the 24-month follow-up, in which 19 children reported new carious lesions. The clinical success rate of treatment was found to be high. The oral health-related quality of life showed a significant and sustained improvement from baseline to 12 months and further improvement at 24 months post-treatment.

CONCLUSION

Full mouth rehabilitation under general anesthesia is an effective approach for managing ECC in young children, with high clinical success rates and significant improvements in the oral health-related quality of life over two years. Preventive oral health strategies are necessary to maintain these positive outcomes and improve the overall well-being of affected children.

The Cytotoxic Assessment of Antibacterial-Enhanced Mineral Trioxide Aggregate Compared to Commercially Available Bioceramic Cements by Using Methyl-Thiazoldiphenyl-Tetrazolium (MTT) Assay on Human Dental Pulp Stem Cells: An In Vitro Study

Background and objective Preserving the vitality of the tooth is of prime significance during therapies such as direct pulp capping and pulpotomy that promote tertiary dentine formation and healing of pulp stumps. Procedures like apexogenesis and apexification also stimulate dentin and bone formation for root growth and closure. Conventional mineral trioxide aggregate (MTA) has good biocompatible and physical properties like longer setting time, presence of a cytotoxic component, i.e., tricalcium aluminate (TCA), moderate compressive strength, and moderate antimicrobial activity. Eliminating TCA and the addition of antibacterial components would improve the properties of the cement. In this study, we aimed to assess the cytotoxicity of MTA Angelus, Biodentine, and two antibacterial-enhanced MTAs by using methyl-thiazoldiphenyl-tetrazolium (MTT) assay. Materials and methods Human dental pulp was extirpated from extracted third molars, and human dental pulp stem cells (HDPSCs) were isolated and characterized by flow cytometry. HDPSCs were treated with MTA, Biodentine, or two antibacterial-enhanced MTAs depending on the study group. The control group constituted the untreated HDPSCs. The cell viability of HDPSCs was assessed using an MTT assay on days one, three, and seven. Results Varied levels of cytotoxicity were noticed at different time periods assessed using the tested materials, which was statistically significant (p=0.01). At all time periods assessed, the highest cell viability was noticed with Biodentine (88.7% on the first day, 80.4% on the third day, and 91.8% on the seventh day). Antibacterial-enhanced MTAs, either added with metronidazole or doxycycline, had more mean viable cells compared to conventional MTA on the third and seventh day (p=0.043 and 0.018 respectively). Conclusion Antibacterial-enhanced MTAs showed reduced cytotoxic properties when compared to conventional MTA. Biodentine was associated with the highest cell viability at all time periods.

Perceived Outcomes, Parental Satisfaction, and Oral Health-Related Quality of Life After Full Mouth Rehabilitation Under General Anesthesia for Early Childhood Caries

AIM

The aim of this article is to evaluate the perceived outcomes, parental satisfaction, and oral health-related quality of life after full mouth rehabilitation under general anesthesia for children with early childhood caries.

MATERIALS AND METHODS

A total of 200 children requiring full-mouth rehabilitation under general anesthesia for the management of early childhood caries were recruited for the study. Perceived outcomes, oral health-related quality of life, and parental satisfaction were evaluated at the follow-up visit after six months.

RESULTS

All participants reported back for the follow-up visit after six months. Oral health-related quality of life after full-mouth rehabilitation showed statistically significant improvement at follow-up (P <0.001); 97.5% of the parents were satisfied with the treatment. Perceived outcomes were found to be satisfactory, and a significant improvement (P <0.001) was seen after treatment.

CONCLUSION

The perceived outcomes of participating parents were met. Significant improvement in oral health was seen after full-mouth rehabilitation under general anesthesia. Parental satisfaction was found to be high at the follow-up visit after six months. Parents found the improvement in the oral and general health of their child to be significant.

Evaluation of Factors Affecting Clinical Outcomes of Full Mouth Rehabilitation Under General Anaesthesia for Children With Early Childhood Caries: A Prospective Cohort Study

AIM

This study was designed to evaluate the factors affecting the clinical outcomes of full mouth rehabilitation under general anaesthesia for children with early childhood caries (ECCs).

MATERIALS AND METHODS

A prospective cohort of 200 children with early childhood caries and requiring dental rehabilitation under general anaesthesia was evaluated and treated. Children were recalled at six-month intervals for a period of two years and evaluated for the recurrence of caries and the need for repeat treatment of failed cases.

RESULTS

86.5% of the patients adhered to the six-month recall visits for 24 months. An overall caries recurrence rate of 14.5% was seen. Children who did not adhere to the follow-up plan and visited ad hoc had the highest caries recurrence rate (88%).

CONCLUSION

Good compliance with postoperative instructions after full mouth rehabilitation resulted in good oral hygiene and a limited recurrence of caries. Patients with poor compliance with recall visits and postoperative instructions had high rates of caries recurrence. Rehabilitation under general anaesthesia can be considered a viable treatment option for children diagnosed with early childhood caries.

The Evaluation of Postoperative Complications and Oral Health-Related Quality of Life Following Dental General Anesthesia for Early Childhood Caries

Aim The study aims to evaluate the postoperative complications and oral health-related quality of life (OHRQoL) following dental general anesthesia for early childhood caries (ECC). Materials and methods Two hundred children aged between three and six requiring full-mouth rehabilitation for general anesthesia were recruited for the study. Demographic data and oral health-related quality of life using the Early Childhood Oral Health Impact Scale (ECOHIS) were collected before the surgery. Postoperative complications and oral health-related quality of life were evaluated after 24 hours and at a one-week follow-up appointment. Results All 200 children returned for the follow-up appointment after one week. Pain was found to be the most common postoperative complication after 24 hours (52%) and one week (6%). The oral health-related quality of life showed a significant improvement after one week (P < 0.001) Conclusion Children may experience a postoperative complication after full-mouth rehabilitation, which resolves within a week. Dental pain was the most common operative complication in the present study. Oral health-related quality of life showed significant improvement after full-mouth rehabilitation.

In Vitro Evaluation of Viscosity, Depth of Penetration, Microleakage, and Shear Bond Strength of Conventional and Hydrophilic Sealants

Background

Sealants are effective in preventing and arresting pit and fissure caries. Newer brands of sealants continue to be developed despite the lack of scientifically based information addressing the caries-preventive properties of these materials. Hence, laboratory in vitro tests play a vital role in providing the necessary information regarding the efficacy of new products in a short period of time.

Objectives

To compare and evaluate the viscosity, resin tag length, microleakage, and shear bond strength between conventional and hydrophilic sealants.

Materials and methods

A total of 40 extracted third molars were selected. Only 20 were evaluated for microleakage and resin tag length and another 20 for shear bond strength evaluation between group I-ClinPro and group II-UltraSeal XT hydro. After sealant placement, specimens were immersed in 0.1% rhodamine dye, followed by thermocycling. Microleakage testing was done using a confocal laser scanning microscope and resin tag length evaluation using a scanning electron microscope (SEM) and shear bond strength using an Universal Instron machine. Viscosity was assessed using an Anton Paar viscometer. Results were subjected to statistical analysis using Statistical Package for the Social Sciences (SPSS) software version 20.

Results

Viscosity and mean microleakage scores for group I (0.92 MPa and 1.50) were found to be higher than for group II (0.72 MPa and 0.60). Mean resin tag length and mean shear bond strength for group I (7.46 ± 0.95 μm and 13.71 ± 0.94 MPa) were found to be less compared to group II (10.03 ± 1.00 μm and 20.39 ± 0.98 MPa). The results were found to be statistically significant (p < 0.05).

Conclusion

Group II was found to be less viscous, which resulted in the formation of resin tags of sufficient length and showed less microleakage and higher shear bond strength than group I.

How to cite this article

Prabakar J, Jeevanandan G, Kengadaran S. In Vitro Evaluation of Viscosity, Depth of Penetration, Microleakage, and Shear Bond Strength of Conventional and Hydrophilic Sealants. Int J Clin Pediatr Dent 2023;16(5):745-750.

Comparative Evaluation of the Physical and Antimicrobial Properties of Mineral Trioxide Aggregate, Biodentine, and a Modified Fast-Setting Mineral Trioxide Aggregate Without Tricalcium Aluminate: An In Vitro Study

Background Tricalcium aluminate, one of the major constituents of mineral trioxide aggregate (MTA), has been shown to have cytotoxic properties. Mineral trioxide aggregate has moderate to low antimicrobial activity against the most common endodontic pathogen, Enterococcus faecalis. Aim To assess the physical and antimicrobial properties of a newly modified formulation of mineral trioxide aggregate. Materials & methods The final setting time, compressive strength, and antimicrobial properties were tested for three groups of materials. The material used for Group 1 was mineral trioxide aggregate (white MTA, Angelus, Londrina, Brazil); the material for Group 2 was Biodentine (Septodont, Saint Maur des Fossés, France); and for Group 3, a modified MTA formulation was used. Results Group 1 had the longest setting time, and Group 2 had the shortest setting time. Group 3's material was set at 83.65 ± 0.28 minutes. This difference among the groups was statistically significant (p < 0.05). The highest mean compressive strength during all the time periods was seen in Group 2, followed by Group 3, and the least in Group 1. This difference in compressive strength was statistically significant (p=0.001). The largest zone of inhibition against Enterococcus faecalis, Candida albicans, and Streptococcus mutans was seen in Group 3, followed by Group 2 and Group 1. Conclusion Under the limitations of the present study, the newly modified MTA could serve as an alternative to the conventional MTA in terms of faster setting, higher strength, and better antimicrobial properties.

Comparative Evaluation of Extrusion of Apical Debris in Primary Maxillary Anterior Teeth Using Two Different Rotary Systems and Hand Files: An In Vitro Study

Successful outcome of pulp therapy depends on good chemomechanical preparation of the canals. This is completed with the help of various upcoming rotary and hand files. However, during this preparation, there might be an apical extrusion of the debris which may result in postoperative complications. The aim of this study was to evaluate and compare the number of debris apically extruded during canal preparation using two different pediatric rotary file systems and conventional hand file systems in primary teeth. 60 primary maxillary central incisors that were extracted due to trauma or untreated dental caries with no signs of resorption were taken. Canal preparation was executed using three different file systems: Group A: Group A hand K file system, Group B Kedo S Plus, Group C Kedo SG Blue. For each of these files using the Myers and Montgomery model, the pre- and post-weight of the eppendorf tube was assessed to quantify the number of apical debris. The maximum extrusion of apical debris was noticed with the Hand K-file system. The least debris was noticed in the Kedo S Plus file system. Statistical analysis revealed that there were highly significant differences in apical extrusion and debris when comparing hand files and rotary files and also between the two rotary files used. Apical debris collection is an unavoidable outcome of canal instrumentation. Among the file systems compared, rotary files had lesser extrusion when compared to hand files. Among the rotary files, Kedo S plus showed normal extrusion compared to SG Blue.

Comparison of Total Salivary Antioxidant Capacity of Children with and without Severe Early Childhood Caries before and after Complete Dental Rehabilitation

Introduction

Early childhood caries (ECC) is the most chronic disease affecting children all over the world. Children often complain of pain and need complete rehabilitation, which is often done under general anesthesia due to extensive treatment and behavioral problems that are often encountered. The present study was undertaken to evaluate the total salivary antioxidant capacity of children with severe ECC (S-ECC) before and after complete dental rehabilitation and compare it with caries-free children.

Materials and methods

Salivary samples were obtained from 30 children aged 3-5 years and diagnosed with S-ECC, along with 30 age and sex-matched controls. Complete dental rehabilitation under general anesthesia was performed on the children with S-ECC, and follow-up salivary samples were obtained after 3 and 6 months postoperatively. Total salivary antioxidant capacity was measured using a commercially available Oxygen Radical Absorbance Antioxidant Assay measurement kit. At baseline, children with S-ECC had higher total antioxidant capacity (TAC) compared to the controls.

Results

A significant difference in total salivary antioxidant capacity between both groups was seen at baseline. At 3 months following, the total salivary antioxidant capacity of children treated for S-ECC was slightly higher than controls but had significantly reduced compared to baseline. At 6 months, there was no significant difference between both groups.

Conclusion

Within the limitations of our study, it can be concluded that the total salivary antioxidant capacity associated with children suffering from S-ECC is reduced after complete rehabilitation.

How to cite this article

Mathew MG, Jeevanandan G. Comparison of Total Salivary Antioxidant Capacity of Children with and without Severe Early Childhood Caries before and after Complete Dental Rehabilitation. Int J Clin Pediatr Dent 2023;16(3):474-477.

Evaluation of Change in Quality of Life, Dental Fear and Dental Anxiety in Young Children Following Full-mouth Dental Rehabilitation under General Anesthesia for Early Childhood Caries

AIM

To evaluate the change in quality of life, dental fear, and dental anxiety in young children following full-mouth dental rehabilitation under general anesthesia for early childhood caries.

MATERIALS AND METHODS

About 200 children who were diagnosed with early childhood caries requiring full-mouth rehabilitation under general anesthesia were recruited after obtaining parental consent. Oral health-related quality of life (OHRQoL) was measured using the Early Childhood Oral Health Impact Scale (ECOHIS). Dental fear was evaluated using Children's Fear Survey Schedule-Dental Subscale and dental anxiety was evaluated using the Facial Image Scale. Scores were taken on the day of intervention, and after 14 days when the child reported for posttreatment follow-up.

RESULTS

All 200 participants returned for a follow-up visit after 2 weeks. The child impact section was reduced from 15.7 ± 4.1 to 7.7 ± 1.9 after treatment. The family impact section was reduced from 9.6 ± 2.7 to 3.5 ± 2.6 after treatment. A statistically significant difference was seen in both sections when pre-and posttreatment values were compared (p < 0.001). The total ECOHIS showed statistically significant improvement as the pretreatment score of 21.6 ± 9.5 reduced to 11.2 ± 4.2 showing 51.9% improvement in OHRQoL after full-mouth rehabilitation under general anesthesia was done (p < 0.001). Dental fear and anxiety among the participants showed a statistically significant reduction after treatment was done and most participants were found to be less fearful of doctors, dentists, and injections after treatment.

CONCLUSION

Full-mouth rehabilitation was found to be a reliable treatment modality to improve the OHRQoL of children suffering from early childhood caries.

CLINICAL SIGNIFICANCE

Significant improvement was seen in the OHRQoL within 2 weeks after treatment and most participants were found to be less anxious and fearful toward dentists and dental treatment. Comprehensive dental rehabilitation under general anesthesia has been proven to be an effective treatment modality for early childhood caries and a productive treatment technique to reduce dental fear and anxiety.

A New Criteria to Assess Quality of Obturation in Primary Teeth: KEDOO Classification

Aim

The success of the pulpectomy depends on adequate access, cleaning, shaping, and good-quality obturation. Evaluating the quality of obturation is the major tool that determines the success of the procedure. The present study aimed to assess the quality of obturation in all the canals of primary teeth and suggest a new classification.

Materials and methods

A total of 1,000 radiographs of the pulpectomy procedure performed in primary molars were evaluated. The quality of obturation was assessed for each canal using the criteria given by Coll and Sandrian. The prevalence of each obturation criterion in every canal was represented in the form of a percentage.

Results

It was observed that among the mandibular primary molars, most of the mesial canals were underfilled, and in the distal canal, most of the canals were overfilled. Among the maxillary primary molars, most of the mesial canals were overfilled, more distal canals were underfilled, and with respect to palatal canals, optimal obturation was seen.

Conclusion

The pitfalls of the previous classification were revised, and a new classification for assessing the quality of obturation was proposed, which is arch, segment, and canal specific.

Clinical significance

The new classification will give a more precise assessment for the evaluation of various techniques and materials used for pulpectomy in primary teeth.

How to cite this article

Jeevanandan G, Govindaraju L, Kotian N, et al. A New Criteria to Assess Quality of Obturation in Primary Teeth: KEDOO Classification. Int J Clin Pediatr Dent 2023;16(2):376-379.

Evaluation of the antimicrobial efficacy of different concentrations of a novel root canal filling material for primary teeth - An in vitro study

Background

The demand for an ideal root canal filling material in primary teeth with maximum antibacterial properties keeps escalating to improve the success rate of root canal treatment in primary teeth. Hence, the present study was conducted to determine the antimicrobial efficacy of the different concentrations of a novel root canal filling material.

Materials and Methods

An in vitro study was designed to compare the antimicrobial efficacy of different concentrations of the novel obturating material for primary teeth. Different concentrations of the novel obturating material were prepared using calcium hydroxide, zinc oxide cement, and metronidazole and were tested for its antimicrobial efficacy against Streptococcus mutans and Enterococcus faecalis using Mueller-Hinton Agar for 24 h at 37°C. The zone of inhibition was measured in millimeters after 24 h. The values were entered into a Microsoft Excel spreadsheet and subjected to statistical analysis. Descriptive statistics were used for data summarization and presentation. Friedman test and Kruskal-Wallis test were used to compare the different concentrations of the novel obturating materials against S. mutans and E. faecalis. P < 0.05 was considered to be significant.

Results

Against S. mutans at 1% concentration, the zone of inhibition was statistically greater at 50 μl and at 2% and 3%, the zone of inhibition was greater at 100 μl. Similarly, against E. faecalis, the zone of inhibition was statistically greater at 100 μl at 2% and no significant difference was noted at 1% and 3%. Comparison between the groups at 25, 50, and 100 μl shows no significant difference against S. mutans between 1%, 2%, and 3% of 60-40 concentration. However, 3% 60-40 concentration at 50 μl shows significantly increased zone of inhibition against E. faecalis.

Conclusion

Two percentage metronidazole at 60-40 (calcium hydroxide-zinc oxide) concentration of the novel obturating material at 100 μl has better antibacterial properties against both S. mutans and E. faecalis.

Knowledge and awareness of forensic dentistry course among undergraduates

Forensic odontology is an expanding field within the domain of forensic sciences, where dental knowledge is applied in identification of individuals through analysis of the dental-related records. The study goal was to determine if undergraduate students were aware of the forensic dentistry course. A cross-sectional survey was initiated about the need for forensic courses in UG program. Nearly 100 students participated in this survey, data have been collected, and graph has been plotted. Data have been collected with the help of SPSS software; data have been analyzed and plotted as graph. One hundred students responded the survey; only limited people's opinions have been collected. The result varies among the students; 58% knows about the importance of forensic odontology in dentistry using Chi-square value, P = 0.09. The majority of students, who replied to this poll, had some understanding and awareness of forensic odontology in dentistry, but they need to learn more about how it is practiced.

Practice management in undergraduate dental program: The need among dental students

The objective of this study is to assess the opinion of dental students regarding the necessity for a practice management (PM) course in their curriculum. To determine the necessity of a PM course in dental programs, a series of questions was developed and given to 100 dental students. Dental students were asked a series of questions about the necessity of this course, and responses were gathered. The questionnaire included time management, patient management, teamwork, leadership quality, and other requirements of the course. According to the results, dentistry students desired that the PM curriculum cover subjects such as teamwork, confidence, the value of the PM course, time management, patient management abilities, leadership qualities, and others. Most of the responses obtained from the students agreed that the PM curriculum must be taught with the course for better management. The development of any course should be based on the need and opinion of the students who pursue the course of dentistry. Thus, this study evaluates the need for a PM course in an undergraduate (UG) dental program.

Need for practice management in undergraduate dental program - A cross sectional survey among the dentists

Advancement in technology, enhancement of knowledge, elevated expectations from the patients regarding the quality of treatment, and economic factors are emerging as challenges to dentists, which demand emerging dentists to have skills on patient management and leadership through an improved curriculum. The aim of the present study was to conduct a survey among dentists regarding the need for practice management in undergraduate dental program. A total of 100 dentists from Chennai were involved in the study. They were made to answer 15 questions which were circulated online. The obtained data were statistically analyzed using SPSS software. It is evident that the majority of the dentists emphasize on including practice management courses in the undergraduate dental program as it may be helpful for the budding dentists in their future private practices. It can be concluded that the opinion of the dentists is strong and beneficial and should be considered.

Microbial Evaluation of Root Canals after Biomechanical Preparation with Manual K-files, Manual H-files, and Kedo-SG Blue Rotary Files: An In Vivo Study

Aim

The purpose of the present study was to comparatively evaluate the efficacy of Kedo-SG blue rotary files, manual K-files, and manual H-files in eliminating the root canal microflora of primary molars.

Materials and methods

Forty-five primary molars requiring pulpectomy were included in the study. Based on type of instrumentation, the teeth were randomly assigned to one of the three groups: group A: Kedo-SG blue rotary files, group B: manual H-files, and group C: manual K-files. Sterile absorbent paper points were used for sample collection and stored in sterile Eppendorf tubes containing saline as transport medium. Culturing was done on thioglycolate agar and blood agar media for the cultivation of anaerobic and aerobic microbes, respectively, and recorded as colony-forming units (CFU) using digital colony counter. Wilcoxon signed-rank test and one-way analysis of variance (ANOVA) test were performed for statistical analysis.

Results

Postinstrumentation, 93-96% reduction of aerobic and anaerobic microbial count was recorded in group A. Whereas, it was 87-91% reduction in group B and 90-91% reduction in group C. No statistically significant difference was noted between the three groups.

Conclusion

Kedo-SG blue rotary files showed a better reduction of microbes in root canals when compared to manual instrumentation. However, there was no significant difference between manual and rotary instrumentation in microbial reduction of primary root canals.

How to cite this article

Lakshmanan L, Jeevanandan G. Microbial Evaluation of Root Canals after Biomechanical Preparation with Manual K-files, Manual H-files, and Kedo-SG Blue Rotary Files: An In Vivo Study. Int J Clin Pediatr Dent 2022;15(6):687-690.

Anti-microbial efficacy of root canal preparation in deciduous teeth with manual and rotary files: A randomized clinical trial

BACKGROUND

In a pulpectomy, the eradication of microbes from the primary root canal is accomplished through biomechanical preparation, which could be carried out with either manual or rotary instruments.

AIMS

The objective of this clinical trial was to evaluate the efficiency of manual K-files, H-files, and Kedo-S Square rotary files in reducing microbial flora after canal preparation in primary molars.

MATERIALS AND METHODS

This randomized clinical trial consisted of 45 primary molars requiring pulpectomy. The teeth were randomly allocated to one of the three groups: Group I: Manual K-files, Group II: Manual H-files, and Group III: Kedo-S Square rotary files, based on the type of instrumentation. Pre-and Post-instrumentation sampling was performed using clean absorbent paper points and kept in a clean Eppendorf tube having thioglycolate broth as the transport medium. Culturing was performed on agar media from which both aerobic and anaerobic microbial counts were estimated. Collected data were statistically analyzed using one-way analysis of variance (ANOVA) and Wilcoxon signed-rank test. Following root canal preparation, 87-89% reduction of the aerobic and anaerobic microbial load was noted in group I, whereas it was an 89-92% reduction in group II and a 93-95% reduction in group III.

RESULTS

Biomechanical preparation with Kedo-S Square rotary file showed higher efficacy in microbial reduction compared to manual instrumentation.

CONCLUSION

Manual and rotary files were equally effective in removing root canal microbes. Biomechanical preparation with a KedoS Square rotary file resulted in greater microbial efficacy. Hence In children, effective root canal cleaning in a short period of time is a major consideration.

Evaluation of Factors Influencing the Oral Health-related Quality of Life among Children with Early Childhood Caries: A Cross-sectional Study

AIM

To evaluate the factors that affect the oral health-related quality of life (OHRQoL) among children with early childhood caries (ECC).

MATERIALS AND METHODS

A total of 340 children aged between 3 and 6 who were diagnosed with ECC were enrolled in the study. Parents accompanying the children completed a questionnaire on the sociodemographic status and filled out the Early Childhood Oral Health Impact Scale (ECOHIS) for the evaluation of OHRQoL. Data were recorded, tabulated, and statistically analyzed.

RESULTS

The study population consisted of 189 (55.6%) boys and 151 girls (44.4%). A total of 96.4% had cavitated lesions; 31.2% of the children had pain at the time of evaluation. A significant association was seen between the Decayed Missing Filled Teeth (DMFT) score of the child (p < 0.001). Pain at the time of evaluation and DMFT status had a significant association with the ECOHIS (p < 0.001).

CONCLUSION

Early childhood caries was found to impact the OHRQoL. Pain, visible dental plaque, family income, and parental education were found to be determinants that affect the OHRQoL.

CLINICAL SIGNIFICANCE

Early childhood caries significantly reduces the OHRQoL of children and their families. Pain, visible dental plaque, family income, and parental education were found to influence the OHRQoL. Teaching parents the importance of oral health and preventive treatment will help prevent the occurrence of ECC.

Parental and Child Outlook on the Impact of ECC on Oral Health-related Quality of Life: A Prospective Interventional Study

AIM

To evaluate the perspectives of parents and children on the impact of early childhood caries (ECC) on the oral health-related quality of life (OHQoF).

MATERIALS AND METHODS

About 400 children aged 3-5 years were recruited for the study. About 200 children who were caries-free were the controls for the study. The remaining 200 consisted of children who were diagnosed with ECC and required dental rehabilitation under general anesthesia. Oral health-related quality of life was recorded at baseline and 6 months after intervention using the Michigan oral health-related quality of life scale. Data were analyzed and evaluated using Statistical Package for Social Sciences (SPSS) Version 25.0.

RESULTS

Children with ECC were found to have a significantly lower oral health-related quality of life compared with caries-free children, and a statistically significant difference was seen between both groups. The main concern for both parents and children at baseline was pain at the first visit when the evaluation was done. After the intervention, a significant improvement in the oral health-related quality of life was seen.

CONCLUSION

Early childhood caries was found to have detrimental effects on the oral health-related quality of life. Full-mouth rehabilitation under general anesthesia was found to bring a significant improvement in the oral health-related quality of life. The perspectives of both parents and children were found to be similar.

CLINICAL SIGNIFICANCE

Early childhood caries has an impact on the lives of children and their parents. Oral health-related quality of life was low with children suffering from ECC. Full-mouth rehabilitation under general anesthesia can significantly improve the OHRQoL of children. Continuous monitoring of the children with regular follow-ups and parental education should be enforced to prevent the relapse of ECC.

Age Determination in Children Using Camirere's Indian Specific Formula: A Radiographic Study Using Orthopantomographs

AIM

Determination of age is a pivotal part of forensic dentistry. Since many dental age determination methods are invasive, Cameriere introduced a radiographic method where age evaluation was carried out using an orthopantomogram (OPG). An adaptation of the same formula was later formulated by Rai et al. for the Indian population. The aim of the study was to assess the age and to dictate the efficiency of the Indian version of Cameriere's formula in the Chennai subpopulation.

MATERIALS AND METHODS

This study consisted of radiographs belonging to 50 individuals with an age range of 5-15 years. Radiographs were taken using the OPG and the soft copies obtained were analyzed. The variables such as seven left and right permanent mandibular teeth and the number of teeth with closed apical, and with open apical, ends of roots were examined and measured. The obtained data, after substituting in the formula was statistically analyzed using paired and unpaired t-test and Pearson's correlation coefficient test.

RESULTS

On comparing dental age and chronological age, statistically significant results were obtained on both sides of the radiograph. Between genders, both sides of the radiograph showed non-significant results. On correlating the sides, the left side showed greater accuracy in age determination compared to the right side of the OPG.

CONCLUSION

Age estimation using Indian-specified formula provides a near good estimate and hence can be a reliable method to measure the chronological age of the participants.

CLINICAL SIGNIFICANCE

The Indian version of the Cameriere's formula can be used as a rational tool to assess the age of young children and adolescents.

Reliability of Educational Content Videos in YouTubeTM about Stainless Steel Crowns

The purpose of the present study is to evaluate the quality and educational information provided on YouTube^TM about stainless steel crowns (SSC). Videos were searched for on YouTube ^TM using keywords related to stainless steel crowns in pediatric dentistry in the Google Trends application. A total of 52 videos were available. After exclusion criteria application, 22 videos were selected for the study for analysis. To classify the video content as high or low quality, a scoring system formed of seven parameters was used. For a global evaluation of the video quality, the video information and quality index were applied. Data obtained were analyzed statistically. Only a few videos explained the importance of SSCs. Most of the videos uploaded with a high number of likes were of low quality. Very few videos were of high quality. The content quality and educational quality of videos is poor and incomplete. None of the videos explained the need for the SSC and its benefits in pediatric dentistry.

Comparing the Sedative Effect of Oral and Intranasal Midazolam and their Effect on Behavior in Pediatric Dental Patients

Aim

To systematically identify and evaluate the available literature based on the sedative effect of oral midazolam compared with midazolam administered intranasally and also compare their effect on behavior of pediatric dental patients.

Objective

This systematic review compares the sedative effect and the effect on behavior with oral midazolam and intranasal midazolam.

Methods

A search was undertaken through PubMed Central, Cochrane Database of Systematic Reviews, Lilacs, Science Direct and SIGLE. All the studies included the comparison of the sedative effect of oral and intranasal midazolam. Database search identified 178 articles. 165 articles were excluded based on titles and duplication. Abstract and complete text of 13 articles were thoroughly evaluated. Four articles were included based on the inclusion criteria to meet the criteria. The selected studies analyzed the children's behavior or anxiety by oral midazolam in comparison to intranasal midazolam administration.

Results

Among the four studies included in the present review, risk of bias was high in all the articles. The high risk was obtained due to inadequate blinding of personnel and participants in the study, improper allocation concealment and inadequacy in blinding of the outcome assessment. Also, difference observed between oral and intranasal midazolam routes on behavior and sedation level in the studies included in this review was not statistically significant.

Conclusion

Studies comparing the effect on behavior of oral and intranasal midazolam in children are limited. More number of high-quality clinical trials evaluating the sedative effect and effect on behavior of oral and intranasal midazolam in pediatric dental patients is required.

How to cite this article

Kotian N, Subramanian EMG, Jeevanandan G. Comparing the Sedative Effect of Oral and Intranasal Midazolam and their Effect on Behavior in Pediatric Dental Patients. Int J Clin Pediatr Dent 2022;15(1):128-134.

Does Social Media have any Influence during the COVID-19 Pandemic? An Update

AIM

The study aimed to explore the role, impact, and influence of social media on the population during the coronavirus disease-2019 (COVID-19)pandemic.

BACKGROUND

During pandemics, communication is an important factor to disseminate the information, create awareness and provide timely updates from authorized personnel to the masses. Social media progressed to function as a mediator of transmission of information between the government and authorities and the public during the COVID-19.

REVIEW RESULTS

Though several strengths were observed yet liabilities did not go unnoticed regarding the role essayed by social media during this pandemic period. When used responsibly, these technologies can aid in the rapid dissemination of crucial facts, important scientific discoveries, and information regarding diagnosis, treatment, and follow-up as well as comparing different strategies across the world. It is recommended to follow certain fundamental standards while exchanging information on social media networks during the COVID-19 era in order to utilize these technologies responsibly and effectively.

CONCLUSION

In this research, we have made an attempt to synthesize the vital facts regarding the impact, benefits, and drawbacks of using social media during COVID-19. Eventually, the decision of evaluation, acceptance, and denial of the information received rests with the individual.

CLINICAL SIGNIFICANCE

Social media use has become intangible with health care. Instead of venturing out the negative effects, we need to focus on utilizing social media for the betterment of the public and to the advantage of the public to increase awareness levels, spread knowledge, and cooperate to tap the benefits to the maximum extent possible to prevent the disease spread.

Effect of Various Irrigant Activation Methods and Its Penetration in the Apical Third of Root Canal-In Vitro Study

OBJECTIVE

 The objective of this study was to evaluate the irrigant penetration using iohexol dye with four irrigation techniques.

METHODOLOGY

 Single-rooted premolars were recently extracted and preserved in physiological saline solution. All the samples were standardized to 16 mm. Standard endodontic access was prepared using endoaccess bur (Dentsply Maillefer, Switzerland). The initial patency was established using #10 k file (Mani, Utsunomiya, Tochigi, Japan) to the working length. The cleaning and shaping were performed using the file system ProFit S3 in the following sequence: P0 (orifice enlarger), PF1 (yellow), PF2 (red) #25, and PF3 (blue) #30. The samples were randomly allocated in concealed opaque envelopes into four groups. This was performed by a trained dentist. Fifteen samples were allocated to one group. The groups were divided as follows: Group A-conventional needle (CN), Group B-side-vented needle (SVN), Group C-manual dynamic agitation (MDA), and Group D-EndoActivator (EA). The radiopaque dye irrigant agitation/activation was performed by one operator to prevent operator bias. Following irrigation using the different techniques, digital radiographs were taken, and the measurement was taken from the apical foramen to the point where the dye had penetrated apically for each tooth and the data were entered into an Excel sheet for all the four groups.

RESULTS

 Comparing the four groups, there was a statistically significant difference among the four groups (p < 0.05), thus, favoring the alternate hypothesis. EA had resulted in better penetration of the irrigant compared with the other three groups (p < 0.05).

CONCLUSION

 It was evident that irrigant penetration was best achieved with the use of an EA followed by MDA, SVNs, and then the CN when the preparation was done till size 30 (PF3 #30) using ProFit S3 rotary file system.

Fracture Incidence of Kedo-S Square Pediatric Rotary Files: A Prospective Clinical Study

Objective  The primary focus of this clinical study was to analyze the probability of occurrence of instrument fracture after root canal preparation of primary molars with the help of Kedo-S Square pediatric rotary file.

Materials and Methods  Three experienced specialists treated 100 primary maxillary and mandibular molars (335 root canals) using a standardized protocol over 2 months. Biomechanical preparations were carried out using Kedo-S Square file, as per the suggestions given by the manufacturer. Every instrument in Group A helped handle three clinical cases, while for groups B, C and D, they helped in handling 5, 9, and 12 cases, respectively. Making use of an operational microscope, the rotary files, after being pulled out from the canal, were observed. The values were tabulated, and descriptive statistics were performed.

Results  There were two fractures (2%), of which 1 occurred in group C in the apical 1/3rd of distobuccal canal of maxillary molar, and the other occurred in group D in the apical 1/3rd of mesiobuccal canal of maxillary molar.

Conclusions  The fracture rate of Kedo-S Square rotary file is quite low. It is primarily in the buccal canals of the maxillary molars and the apical third of the root canal that the instrument has a greater probability of separation.

Assessing quality of obturation and instrumentation time using Kedo-SG blue, Kedo-SH, and reciprocating hand K-files in primary mandibular molars: A double-blinded randomized controlled trial

Background:

Pulpectomy is the treatment of choice for severely infected primary molars. The aim of the study is to evaluate the instrumentation time and obturation quality using Kedo SG blue, Kedo SH, and reciprocating hand K files in primary mandibular molars. To evaluate the instrumentation time and obturation quality using Kedo-SG blue, Kedo-SH, and reciprocating hand K-files in primary mandibular molars.

Materials and Methods:

A double-blinded randomized controlled trial was conducted on 45 mandibular molars and were randomly assigned to three experimental groups (n = 15). Group I was instrumented using Kedo-SG blue pediatric rotary files, Group II with Kedo-SH pediatric hand files, and Group III with reciprocating hand K-files. Standardized digital radiographs were taken before and after root canal instrumentation. Root canal preparation time was also recorded. Statistical analysis of the obtained data was done using SPSS software version 17.0. An intergroup comparison of the instrumentation time and the quality of obturation were done using ANOVA and Chi-square test with the level of significance set at 5%. P < 0.05 was considered statistically significant.

Results:

No significant differences were noted with regard to the quality of obturation between the three groups (P < 0.14). However, a statistically significant difference was noted in the instrumentation time between the three groups (P = 0.000). Kedo-SG blue rotary file had significantly lesser instrumentation time when compared to that of Kedo-SH hand files and reciprocating hand K-files.

Conclusion:

On comparative evaluation,Kedo-SG blue pediatric rotary file showed a marked reduction in instrumentation time, followed by Kedo-SH pediatric hand files and reciprocating hand K-files.

Evaluation of Quality of Obturation Using Two Different Rotary Files and Hand Files in Primary Teeth: A Randomized Controlled Trial

AIM AND OBJECTIVE

To estimate the obturation quality and instrumentation time on comparing traditional hand files and two rotary file types during root canal instrumentation in deciduous molars.

MATERIALS AND METHODS

Forty-five deciduous mandibular molars were taken and randomly allotted to three groups (n = 15). Group I: K-hand files, group II: ProTaper Gold rotary file, and group III: Kedo-SG Blue rotary files. Before and after root canal instrumentation, standardized digital radiography was taken and the instrumentation time was also noted. The recorded data were then subjected to statistical analysis utilizing SPSS Software version 22.0. To compare the instrumentation time and quality of obturation between the groups, a Chi-square test and ANOVA with the level of significance at 0.05 were employed.

RESULTS

There was no significant difference recorded with reference to the quality of obturation (p > 0.05). However, the difference was noticed to be statistically significant when the instrumentation time between the two rotary groups and the manual instrumentation groups was taken into account (p < 0.05). The rotary systems ProTaper Gold and Kedo-SG Blue exhibited a significantly less instrumentation time on comparing with that of the hand files.

CONCLUSION

Concerning the quality of obturation, all three file groups demonstrated almost a similar performance. However, there was a significant difference noticed in the instrumentation time with the use of manual instrumentation in comparison to rotary instrumentation in deciduous teeth.

HOW TO CITE THIS ARTICLE

Preethy NA, Jeevanandan G, Mathew MG, et al. Evaluation of Quality of Obturation Using Two Different Rotary Files and Hand Files in Primary Teeth: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2021;14(4):471-474.

Evaluation of Postoperative Pain after Pulpectomy using Different File Systems in Primary Teeth: A Systematic Review

Objective:

The purpose of this systematic review was to compare the incidence and intensity of postoperative pain after pulpectomy using different instrumentations in primary teeth.

Materials and Methods:

An extensive literature search in PubMed, Cochrane Library, Science Direct, LILAC, SIGLE, and Google Scholar was performed to identify English language articles with human subjects that evaluated the effects of different instruments on postoperative pain after pulpectomy.

Results:

The search retrieved 187 references. After screening of the abstracts and articles, based on the inclusion and exclusion criteria, a total of three articles were included in the systematic review. Of the three included studies, two of them had a moderate risk of bias and one showed a high risk of bias.

Conclusion:

The use of rotary instruments contributed to a lower incidence and intensity of postoperative pain than did the hand instruments in all the three studies. More high-quality randomized clinical trials are needed in this field in future studies to support the evidence.

Comparative Evaluation of Quality of Obturation and Its Effect on Postoperative Pain between Pediatric Hand and Rotary Files: A Double-blinded Randomized Controlled Trial

Background

One of the cardinal points to be considered during endodontic procedures in children is the measure of postoperative pain.

Aim and objective

To evaluate the quality of obturation and its effect on postoperative pain with three file systems in primary mandibular molars during 1 week follow-up.

Materials and methods

The study was conducted as a double-blinded randomized controlled trial. The participants between 6 years and 9 years old requiring a pulpectomy were recruited for the trial. Forty-five primary mandibular molars were randomly allocated into 15 teeth each in Hand K-files; Kedo-SH and Kedo-SG Blue groups. Wong Baker's FACES Pain Rating Scale was used for assessing the postoperative pain in the children for 1 week. Pearson's Chi-square test, Kruskal-Wallis test, and Mann-Whitney U test were used for analyzing the data statistically.

Results

Optimal fillings were observed more in the Kedo-SG Blue group (80.0%) compared to the other two groups (p < 0.017). On intergroup analysis, the Kedo-SG Blue group reported less postoperative pain compared to Kedo-SH group on day 1 while on day 7 no postoperative pain was experienced in either of the groups. Less postoperative pain was reported by the children in whom the canals were optimally filled compared to overfilling and underfilling.

Conclusion

Kedo-SG Blue resulted in less postoperative pain when compared to Kedo-SH and hand K-files, whereas optimally filled children experienced less postoperative pain compared to overfilling and underfilling.

Clinical significance

A felicitous pediatric dental practice includes appropriate assessment and management of postoperative pain in children. Hence, the present study is important in highlighting the affiliation of postoperative pain with quality of obturation following an endodontic intervention in children.

How to cite this article

Jeevanandan G, Govindaraju L, Subramanian EMG, et al. Comparative Evaluation of Quality of Obturation and Its Effect on Postoperative Pain between Pediatric Hand and Rotary Files: A Double-blinded Randomized Controlled Trial. Int J Clin Pediatr Dent 2021;14(1):88-96.

Comparing the Influence of Conventional and Rotary Instrumentation Techniques on the Behavior of the Children: A Randomized Clinical Trial

Background

Pulpectomy has gained popularity in the pediatric dental practice for preserving the primary teeth in its position until exfoliation. There has been a paradigm shift from using manual instrumentation to rotary instrumentation for canal preparation in primary teeth. While studies show that there is a reduction in the instrumentation time with the use of rotary instruments which in turn influences the behavior of the child, its direct effect on the behavior of the children has not been evaluated.

Aim

To compare the behavior of the children during manual and rotary instrumentation for pulpectomy in the primary molars.

Materials and methods

A single-blinded randomized clinical trial was conducted in 88 children in any one of the mandibular primary molars indicated for pulpectomy. The canal preparation was done using manual K files and rotary ProTaper (44 children in each group). The influence of these instrumentation techniques on the children was assessed with three different scales- Frankl Behavior Rating Scale; Venham Interval Rating Scale; Wong Baker FACES Pain Scale for evaluating the behavior, anxiety, and the pain experienced by the children, respectively during canal preparation.

Results

A total of 88 participants, comprising 50 females and 38 males, participated in the study. An equal distribution of the participants with respect to age (p = 0.064), gender (p = 0.389), and teeth (p = 0.877) was observed between the groups. More cooperative behavior (p < 0.001); lesser anxiety levels (p < 0.001); lower intensity of pain (p < 0.001) were recorded in the children instrumented using Rotary files.

Conclusion

The present study concludes that it is preferable to use rotary instrumentation for primary canal preparation in pediatric practice as it has a more positive influence on the behavior of the children, which eventually determines the success of the treatment.

Clinical significance

With rise in the use of rotary files for pulpectomy in primary teeth, the present paper demonstrates the influence of rotary instrumentation technique for canal preparation during pulpectomy on the behavior of the children in a dental chair. This paper throws light for the pedodontists to effectively perform pulpectomy in children with ease without leaving a psychological impact on the children.

How to cite this article

Govindaraju L, Subramanian EMG, Jeevanandan G. Comparing the Influence of Conventional and Rotary Instrumentation Techniques on the Behavior of the Children: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2021;14(S-2):S179-S185.

Comparative Evaluation of Extrusion of Apical Debris in Primary Anterior Teeth using Two Different Rotary Systems and Hand Files: An In Vitro Study

Background

The success of endodontic treatment depends on the chemomechanical preparation of the tooth. However, the debris produced during canal preparation may extrude through the apical foramen causing postoperative complications.

Aim

The aim of this study is to compare the apical debris extrusion during root canal preparation in primary anterior teeth using hand files, rotary ProTaper files, and rotary Kedo-S files.

Materials and Methods

Forty-five freshly extracted primary canine with mature apices and a single canal were randomly divided into three groups for instrumentation as follows (n = 15): Group 1: hand files; Group 2: rotary ProTaper files; and Group 3: rotary Kedo-S files. Myers and Montgomery experimental model was used for this study. Apically extruded debris collected in a preweighed Eppendorf tubes was placed in the incubator at 70°C for 5 days. The weight of the debris collected was determined by subtracting the pre- and post-instrumentation weight of the Eppendorf tubes. The data collected were analyzed using the analysis of variance and Tukey's post-hoc tests.

Results

Hand files produced more apical debris extrusion than ProTaper and Kedo-S files (P < 0.05) while Kedo-S produced the least (P < 0.05).

Conclusion

All instrumentation systems cause apical debris extrusion. Kedo-S produced less apical debris extrusion when compared to the hand files and ProTaper files.

Assessing the quality of root canal filling and instrumentation time using kedo-s files, reciprocating files and k-files

Objective: Pulpectomy is the conservative treatment approach that retains and preserves the primary tooth in the dental arch in its normal function and non-pathologic state until its exfoliation. Over the years, pulpectomy has been performed using various instrumentation techniques. The aim of this study was to compare the quality of root filing and instrumentation time using Kedo-S files, Reciprocating files and K-files in primary teeth. Material And Methods: A randomized clinical trial was performed on 45 primary molars equally distributed for instrumentation with Kedo-S files, reciprocating files and K-Files. Immediate post-operative digital radiographs were taken to evaluate the quality of root filing and root canal instrumentation time was also recorded. Results: Mean instrumentation time with Kedo-S was 75.6 seconds, reciprocating file was 190.6 seconds and K-file was 95.4 seconds. Highest optimal fill was obtained with Kedo-S file group, highest overfill was obtained with Kedo-S group and highest under fill was obtained with reciprocating file group. Conclusion: Kedo-S rotary system provides better quality of root canal filling in minimum instrumentation time.KEYWORDS Pulpectomy; Primary teeth; Root canal filling; Rotary files.

Comparison of quality of obturation and post-operative pain using manual vs rotary files in primary teeth - A randomised clinical trial

Introduction

Cleaning and shaping plays a very important role in success of root canal procedures. There are various instrumentation techniques available for root canal preparation. Recently, an exclusive rotary file for root canal preparation of primary teeth has been introduced.

Aim of the Study

The aim of this in vivo study was to compare the quality of obturation and intensity, and duration of post-operative pain between two rotary file systems with manual files during the pulpectomy of primary molars.

Materials and Methods

Forty five primary mandibular molars were included in this study, which was randomly allocated into one of the three experimental groups (n = 15). Group A: Instrumentation was done using Hand K-file; Group B: Instrumentation was done using Kedo-S rotary file system; and Group C: Instrumentation was done using K3 rotary file system. The quality of obturation was recorded as optimal, underfilled, or overfilled using standardized intraoral periapical radiographs. This study also evaluated the intensity and duration of postoperative pain at different time intervals: 6, 12, 24, 48, and 72 hours following the pulpectomy.

Results

With respect to quality of obturation, less underfilling was noticed in Kedo-S rotary files (16.7%) followed by using K3 rotary files (33.3%) and hand K files (43.3%). Kedo-S file showed the least underfilled canals (16.7%) and comparatively more overfilled canals (26.6%) and it was statistically significant (P value of 0.001 and 0.002 respectively). On comparing the intensity and duration of postoperative pain among the three groups, there was no statistically significant difference between these groups (P > 0.05).

Conclusion

Kedo-S pediatric rotary file system shows considerably better quality of obturation when compared to that of K3 rotary and hand K file systems without much of any significant difference in relevance to the post-operative pain.

Microleakage Assessment of Two Different Pit and Fissure Sealants: A Comparative Confocal Laser Scanning Microscopy Study

Introduction

Pit and fissures of permanent dentition are considered to be highly vulnerable to the adhesion of cariogenic microorganisms and consequently result in caries formation. The main problem associated with sealant failure will be microleakage. Therefore, sealants can be considered to be an effective preventive procedure for dental caries, only if it strongly bonds to the tooth, and protect the pit and fissures from the oral bacterial environment.

Aim and objective

To compare and assess the microleakage of two different pit and fissure sealants on permanent molars.

Materials and methods

A total of 20 extracted third molars were randomly divided into two groups where group I is conventional sealant and group II is hydrophilic sealant. Occlusal surfaces of permanent molars were treated with 37% orthophosphoric acid before sealant placement. Tooth samples were subjected to 0.1% rhodamine dye immersion, thermocycling, and tooth samples were sectioned and evaluated under a confocal laser microscope for dye penetration. A non-parametric test (Mann–Whitney U) was performed to compare the mean microleakage score difference between the groups.

Results

Group II (hydrophilic sealant) showed a minimum level of the microleakage score when compared to group I (conventional sealant) and was found to be statistically significant using the Mann-Whitney U test with a p value <0.05.

Conclusion

The less the microleakage, the better will be the retention of the sealant for a longer duration and cariostatic action.

How to cite this article

Prabakar J, Indiran MA, Kumar P, et al. Microleakage Assessment of Two Different Pit and Fissure Sealants: A Comparative Confocal Laser Scanning Microscopy Study. Int J Clin Pediatr Dent 2020;13(S-1):S29–S33.

Comparison of Shear Bond Strength of Three Commercially Available Esthetic Restorative Composite Materials: An In Vitro Study

Introduction

Dental caries remains to be one of the most prevalent diseases encountered in the field of dentistry. Several restorative materials have been introduced with variable properties and among them, composite restorative materials are most widely used nowadays because of their superior esthetic property as well as minimal hard tissue removal. Shear bond strength of a restorative material plays a key role in deciding the restoration’s longevity. Hence, for a better selection of the composite material, shear bond strength needs to be evaluated.

Aim

The study aim was to analyze the shear bond strength of three commercially available esthetic restorative composite materials—Dentsply Ceram X, 3M ESPE™ Filtek™ Z350 XT, and GC Solare Sculpt to the tooth surface.

Materials and methods

Thirty extracted human mandibular permanent molars that were caries-free were selected and erected in acrylic blocks. The uniform dentinal surface was exposed by cutting with a diamond disk. These were then randomly divided into three groups—groups I, II, and III based on the restorative material which was used, i.e., Ceram X, 3M ESPE™ Filtek™ Z350 XT, and Solare Sculpt, respectively. The restorative materials were applied on the dentinal surface of the prepared tooth specimens with the help of plastic molds, followed up by storing them in distilled water until they were subjected to shear bond strength testing. The collected data were examined by applying a one-way analysis of variance (ANOVA) and Turkey’s post hoc test.

Results

The Ceram X (21.6155 ± 2.20717) and Solare Sculpt (19.8747 ± 3.99732) were comparable in terms of shear bond strength values; however, they depicted significantly higher bond strength compared to 3M ESPE™ Filtek™ Z350 XT (12.8068 ± 3.99732).

Conclusion

Among the three materials compared in this study, Ceram X produced higher shear bond strength to tooth surface when compared to Solare Sculpt and 3M ESPE™ Filtek™ Z350 XT.

Clinical significance

Restoration failure continues to be a major problem taking a toll on the dentists’ time and patient satisfaction. Thus, the demand for restorative materials with better shear bond strength as well as excellent esthetics is on the rise. Thus, this particular study compares the shear bond strength of three commercial esthetic nanocomposites.

How to cite this article

Preethy NA, Jeevanandan G, Govindaraju L, et al. Comparison of Shear Bond Strength of Three Commercially Available Esthetic Restorative Composite Materials : An In Vitro Study. Int J Clin Pediatr Dent 2020;13(6):635–639.

Postoperative Pain with Hand, Reciprocating, and Rotary Instrumentation Techniques after Root Canal Preparation in Primary Molars: A Randomized Clinical Trial

AIM

The purpose of this randomized clinical trial was to evaluate the intensity and duration of postoperative pain after pulpectomy of primary teeth using three preparation techniques.

MATERIALS AND METHODS

A total of 60 patients were randomly allocated to three groups of 20 patients each, according to the root canal instrumentation techniques used. In group I, the teeth were prepared using manual NiTi K flex files till size 35. In group II, the teeth were prepared using NiTi K flex files till size 35 in reciprocating motion. In group III, the teeth were prepared using Kedo-S pediatric rotary files. After root canal preparation, the canals were obturated with endoflas paste and were restored permanently with composite filling material. The intensity and duration of postoperative pain were evaluated after 6, 12, 24, 48, and 72 hours, using a four-point pain-intensity scale.

RESULTS

There was a statistically significant difference among the groups, wherein the postoperative pain was more in NiTi K flex files used in reciprocating motion followed by manual NiTi K flex files and Kedo-S pediatric rotary files.

CONCLUSION

Postoperative pain was more with NiTi K flex files in reciprocating motion and was less with Kedo-S rotary files after root canal preparation in primary maxillary molars.

HOW TO CITE THIS ARTICLE

Jeevanandan G, Ravindran V, Subramanian EMG, et al. Postoperative Pain with Hand, Reciprocating, and Rotary Instrumentation Techniques after Root Canal Preparation in Primary Molars: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2020;13(1):21-26.

Kedo file system for root canal preparation in primary teeth

Endodontic instruments play a vital role during root canal preparation. Biomechanical preparation in primary teeth is performed using the adult endodontic files. There are various disadvantages during use of adult endodontic files in primary teeth namely the length and taper of the files. Recently, an exclusive paediatric endodontic file system has been introduced for cleaning and shaping of primary root canals. This short communication describes the use of exclusive Kedo-SH manual and Kedo-S rotary file system in primary teeth.

Comparison of quality of obturation and instrumentation time using hand files and two rotary file systems in primary molars: A single-blinded randomized controlled trial

Objective:

In permanent dentition, different rotary systems are used for canal cleaning and shaping. Rotary instrumentation in pediatric dentistry is an emerging concept. A very few studies have compared the efficiency of rotary instrumentation for canal preparation in primary teeth. Hence, this study was performed to compare the obturation quality and instrumentation time of two rotary files systems – Protaper, Mtwo with hand files in primary molars.

Materials and Methods:

Forty-five primary mandibular molars were randomly allotted to one of the three groups. Instrumentation was done using K-files in Group 1; Protaper in Group 2; and Mtwo in Group 3. Instrumentation time was recorded. The canal filling quality was assessed as underfill, optimal fill, and overfill. Statistical analysis was done using Chi-square, ANOVA, and post hoc Tukey test.

Results:

No significant difference was observed in the quality of obturation among three groups. Intergroup comparison of the instrumentation time showed a statistically significant difference between the three groups.

Conclusion:

The use of rotary instrumentation in primary teeth results in marked reduction in the instrumentation time and improves the quality of obturation.