A Comparative Evaluation of Pushout Bond Strength of Comprehensive Techniques for Intracanal Rehabilitation of Structurally Compromised Roots: An In Vitro Study
[Year:2020] [Month:January-June] [Volume:5] [Number:1] [Pages:5] [Pages No:1 - 5]
DOI: 10.5005/jp-journals-10047-0086 | Open Access | How to cite |
Statement of problem: The restoration of teeth with flared canals and thin dentinal walls has been challenging as the weak radicular structure can be prone to fracture. Materials and methods: Thirty freshly extracted maxillary central incisors adhering to inclusion criteria were selected and decoronated. Canals were made compromised by preparing with peso reamers. Sectional obturation was performed using the rolled cone gutta-percha (Prime Dental, India) technique along with AH Plus sealer (Dentsply). Randomly, the samples were divided into three groups. Group I—Fiber post (DT light post, Bisco, USA) + flowable composite (Tetric N Flow, Ivoclar Vivadent, USA), group II—Biological post + dual cure resin cement (Rely X, 3M, USA), and group III—Smart dentin replacement (SDR, Dentsply, USA) as post material. Two transverse sections of thickness of 1 mm were obtained, from the coronal third and the middle third of the canal from each sample. The pushout bond strengths were measured using a universal testing machine (Instron, Norwood, USA). Results: Group III scored the highest mean with statistical significance compared to groups II and I. Groups II and I showed less pushout bond strength with no statistically significant difference. Conclusion: Smart dentin replacement is a better material for intracanal rehabilitation of teeth with flared canals in terms of pushout bond strength when compared with other groups. DT light post + flowable composite could be used to reinforce weakened roots and is least technique sensitive. Depending on the clinical situation and the availability of doomed teeth, biological post may be preferred.
Pulp Canal Obliteration: A Review
[Year:2020] [Month:January-June] [Volume:5] [Number:1] [Pages:6] [Pages No:6 - 11]
DOI: 10.5005/jp-journals-10047-0085 | Open Access | How to cite |
Pulp canal obliteration (PCO) is a condition characterized by the pronounced deposition of hard tissue along the internal walls of the root canal that fills most of the pulp system leaving it narrowed and restricted. Teeth with PCO usually present with a yellowish or greyish discoloration. Different factors have been attributed to cause PCO. However, the exact pathogenesis of pulp obliteration still remains unclear. When the tooth is asymptomatic, the clinician is usually confronted with a dilemma of whether endodontic treatment should be initiated in such teeth or it should be delayed until clinical symptoms or radiographic signs of periapical disease develop. Endodontic treatment of teeth with PCO is often challenging. The possibility of iatrogenic errors during conventional approach using ultrasonics under dental operating microscope (DOM) are relatively high. Guided endodontics has recently gained popularity as a successful treatment option for PCO as it overcomes the drawbacks of the conventional approach. Additionally, the use of cone-beam computed tomography (CBCT) helps in the assessment of the extent and degree of obliteration three dimensionally and also aids in early identification of periapical lesion.
Ergonomics and its Impact on Musculoskeletal Disorder among Dental Surgeons: A Literature Review
[Year:2020] [Month:January-June] [Volume:5] [Number:1] [Pages:6] [Pages No:12 - 17]
DOI: 10.5005/jp-journals-10047-0089 | Open Access | How to cite |
The word ergonomic in dentistry evolved around mid-20th century. Ergonomics is defined as an integrative knowledge in organizing the labor activity that makes up a job. Due to lack of adequate knowledge about the ergonomic importance and future health issues of poor ergonomic practice, dentistry faces a serious threat. Work-related musculoskeletal disorder (MSD) is one of the major occupational health challenges faced by industrial countries and is major cause of loss of working days and high labor cost. Ergonomics takes into consideration the type of work done and provides a healthy environment for the operator, thereby enhancing the ease of work and preventing work-related MSD. Work-related health issues due to improper posture can be combated by successful application on ergonomics. Thus, by applying the basic principle of ergonomic along with the new trends available in the field of dentistry, one can prevent the development of MSD.
Risk of Airborne Infection and Transmission-based Precautions in Dental Setting
[Year:2020] [Month:January-June] [Volume:5] [Number:1] [Pages:7] [Pages No:18 - 24]
DOI: 10.5005/jp-journals-10047-0090 | Open Access | How to cite |
In the current scenario of constant emergence and re-emergence of infectious diseases around the world, the dental fraternity must be well aware of the basic principles that govern infection prevention, and control to ensure preparedness and safe dental practice. Most dental procedures involve the use of one or more devices that generate spatter and aerosol. The dental aerosols may carry water, saliva, mucous, microorganisms, debris, calculus, blood, respiratory secretion, and/or metallic trace elements from restorative materials and possess a potential risk of disease transmission through inhalation to both the dental healthcare personnel (DHCP) and patients. Standard precautions taken during routine dental practice adequately protect the dental team and patients from the direct and contact-based transmission, but these precautions may not be sufficient to prevent airborne transmission of infectious diseases. Although the limited available evidence estimates the risk of airborne transmission in a dental setting to be low, it should not be underestimated. This narrative review aims to review the quantity, characteristic features, pathogenicity of aerosols produced in the dental settings, the associated risks, and precautions to be followed.
Infection Control and Preventive Guidelines against COVID-19 in Dentistry
[Year:2020] [Month:January-June] [Volume:5] [Number:1] [Pages:14] [Pages No:25 - 38]
DOI: 10.5005/jp-journals-10047-0092 | Open Access | How to cite |
Globally, a new public health disease has emerged threatening the world. Due to the spread of 2019 novel coronavirus which is named as 2019-nCoV and causes severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Virus is found to be zoonotic, originating in bats and further transmitted to humans through yet unknown intermediary transmitters or channels in Wuhan, Hubei province of China and discovered in December 2019. This novel coronavirus (COVID-19) is highly infectious and now human-to-human transmission is rampant. The coronavirus was recently found in saliva of infected patients after taking their swabs. In this point-of-view article, we discuss the potential of transmission of this virus via the droplets of saliva emitted when the infected person opens his or her mouth. This study has been especially focused on such scenarios arising in the dental practice setup. There seems to be high risk of transmission of novel coronavirus via contact with droplets and aerosols generated during dental clinical procedures. Here, we will be exploring such transmission scenarios and recommend the infection control measures during dental practice to block the person-to-person transmission routes in dental clinics and hospitals.
Concentrated Growth Factor, Platelet-rich Fibrin, Mineral Trioxide Aggregate as Direct Pulp-capping Agents: Case Reports
[Year:2020] [Month:January-June] [Volume:5] [Number:1] [Pages:6] [Pages No:39 - 44]
DOI: 10.5005/jp-journals-10047-0087 | Open Access | How to cite |
Background: Direct pulp capping is a procedure in which the exposed vital pulp is covered with a protective dressing or a base placed directly over the site of exposure in an attempt to preserve the pulp vitality. The most visible reparative response to pulp exposure is the deposition of reparative dentin, which is affected by pulp-capping material. Recently, platelet concentrates like concentrated growth factor (CGF) and platelet-rich fibrin (PRF) are being used in various fields in dentistry due to their regenerative properties. They can be used as pulp-capping agents, as the growth factors present in these platelet concentrates can stimulate dental pulp cells and stimulate odontoblastic differentiation, leading to reparative dentin formation. Case description: Direct pulp capping was carried out in mandibular molars, with radiographic evidence of deep caries approximating pulp chamber and with no evidence of periapical pathology. The pulp exposure of 0.5–1 mm was capped with CGF/PRF/mineral trioxide aggregate (MTA), over which glass ionomer cement (GIC) liner was placed and final restoration was performed with light cure composite (Tetric N Ceram, Ivoclar Vivadent). Patients were evaluated clinically after 3 months, to check for pulp vitality using cold and electric pulp testing, periodontal probing depth, mobility, pain, and tenderness to percussion. Cone-vbeam computed tomography (CBCT) evaluation was carried out after 3 months, to assess dentin bridge formation. Conclusion: Platelet-rich fibrin and CGF were found to be promising pulp-capping agents and their clinical efficacy was comparable to MTA. Clinical significance: The promising results of platelet concentrates as direct pulp-capping agents opens a new avenue for vital pulp therapy procedures.
Management of Crown-root Fractures: A Report of Two Cases
[Year:2020] [Month:January-June] [Volume:5] [Number:1] [Pages:6] [Pages No:45 - 50]
DOI: 10.5005/jp-journals-10047-0088 | Open Access | How to cite |
Maxillary anteriors are the most commonly affected teeth in dental traumatic injuries. Crown-root fracture is one type of traumatic injury with several treatment modalities existing for management. One of them is the reattachment of the fractured fragment in a suitable condition. Fragment reattachment provides immediate esthetics and function and is also less time-consuming procedure. If the fragment is lost, other alternatives such as direct and indirect restorations may be considered. The purpose of this report is to present two cases describing the management of complicated crown-root fractures of maxillary anterior teeth treated with a multidisciplinary approach.
Hereditary Disorders of Dentin: Dentinogenesis Imperfecta Type II and Dentin Dysplasia Type II
[Year:2020] [Month:January-June] [Volume:5] [Number:1] [Pages:5] [Pages No:51 - 55]
DOI: 10.5005/jp-journals-10047-0091 | Open Access | How to cite |
Dentin is a mineralized tissue in tooth, produced from odontoblasts, that differentiates from the mesenchymal cells of dental papilla. Hereditary dentin defects are broadly classified into two types, namely, dentinogenesis imperfecta (DGI – type I and II) and dentin dysplasia (DD – type I and II). DGI is an autosomal dominant hereditary disorder, and DD is a rare hereditary disturbance of dentin formation that affects both the primary and the permanent dentition. The purpose of this report was to present a case of DGI–type II and a case of DD–type II to highlight the importance of diagnosing hereditary dentin disorders.
Management of Crown Fractures by Reattachment with Minimal Intervention Approach
[Year:2020] [Month:January-June] [Volume:5] [Number:1] [Pages:6] [Pages No:56 - 61]
DOI: 10.5005/jp-journals-10047-0093 | Open Access | How to cite |
Aim: The case series aims to manage dental trauma by reattaching with the patient's own tooth fragment. Background: Crowns of anterior teeth and posterior teeth break due to trauma and biting hard objects. Reattachment of fractured tooth fragments by various techniques offers many advantages over other treatments, especially restoration of the esthetics, function, shape, texture, and translucency of the surface. Case description: The present case series describes three clinical cases of reattachment in which two were done in permanent maxillary central incisors with an uncomplicated and complicated crown fracture and the third case was reattachment of fractured mesiopalatal cusp of maxillary first molar. Clinical significance: Besides being conservative, fragment reattachment evokes an immediate positive psychological response from the patient.