Journal of Operative Dentistry & Endodontics

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2023 | January-June | Volume 8 | Issue 1

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Original Article

Ashish S Bhadane, Nishant K Vyavahare, Dipali Y Shah, Niranjan Desai, Akash S Kale, Simran K Chaudhari

Effect of Multiple Glide Path Files on Apical Debris Extrusion in Severely Curved Mesial Roots of Mandibular Molars: An In Vitro Study

[Year:2023] [Month:January-June] [Volume:8] [Number:1] [Pages:4] [Pages No:1 - 4]

Keywords: Debris extrusion, Glide path, HyFlex GPF, PathFile

   DOI: 10.5005/jp-journals-10047-0131  |  Open Access |  How to cite  | 

Abstract

Introduction: A glide path preparation prevents the fracture of endodontic files and maintains a centered root canal configuration. This study aimed to evaluate and compare the amount of apically extruded debris following the use of various glide path files in severely curved root canals. Materials and methods: Of the 112 extracted human mandibular molar teeth collected, 40 teeth with severely curved mesial roots were selected. The mesial roots of the teeth were sheared off at the cementoenamel junction and pre-weighed Eppendorf tubes were attached to the roots. The specimens were randomly divided into four experimental groups according to canal preparation (n = 10): Group I- HyFlex GPF glide path files; group II- Rotary pathfile; group III- Manual K File glide path; group IV– No glide path preparation. HyFlex CM rotary file system was used to complete the biomechanical preparation of all the specimens up to size 25/06. using 8 mL of distilled water as an irrigant. Eppendorf tubes were then stored in an incubator to calculate the weight of extruded debris, after evaporation. Data comparison was done by applying ANOVA followed by post hoc Tukey's test (p < 0.05). Results: There was no statistically significant difference between the rotary glide path groups, but there was a significant difference between debris extruded using rotary glide path file groups as compared to the manual glide path and without glide path file groups. Conclusion: Rotary glide path files caused less debris extrusion than glide path preparation with manual K-files and without glide path preparation in severely curved canals.

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Original Article

Anand Sherwood, Rahul Baskar, Divyameena Bommiah, Melvin G Edwin, Sathvika Kanesalingavelan, Suresh K Boominathan

Clinical Performance of Combined Microabrasion, Home Bleaching and Resin Infiltration for the Esthetic Management of Stained Fluorotic Teeth

[Year:2023] [Month:January-June] [Volume:8] [Number:1] [Pages:6] [Pages No:5 - 10]

Keywords: Esthetic management, Fluorosis, Home bleaching, Microabrasion, Original research, Resin infiltration

   DOI: 10.5005/jp-journals-10047-0130  |  Open Access |  How to cite  | 

Abstract

Background: India is among one of the most affected countries in the world with over 62 million people suffering from dental fluorosis. The development of economic and conservative treatments for the management of these otherwise disease-free teeth is crucial to the dental health temperament of India. In the present study, we have analyzed the combined clinical performance of microabrasion, home bleaching, and resin infiltration to mask stained fluorotic teeth. Materials and methods: A clinical trial was conducted in Madurai where 101 fluorosis-stained anterior teeth were assessed for CIE L*a*b* values using standardized treatment photographs. Statistical analysis was done using SPSS software. Results: Through the results of our study, we observed a statistically significant (p ≤ 0.05) difference in the pre- and post-treatment b* values of the stained areas. The mean ΔE value also significantly (p ≤ 0.05) reduced from 7 to 4.5 following bleaching and then further reduced to 3.008 following resin infiltration. No significant difference was seen in the b* values for the unstained points even after bleaching and resin infiltration. Conclusion: The current study presents the concept that fluorosis can be successfully managed using the minimally invasive combination of microabrasion, home bleaching, and resin infiltration. Microabrasion aids in the absorption of the bleaching agent which subsequently reduces yellowish-brown stains, while the resin in filtrant masks the white opacities on the enamel surface. This novel three-step combination thus eliminates the need for more time-consuming and invasive techniques such as veneers and crowns.

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REVIEW ARTICLE

Niveditha Balamurali, Rathna Piriyanga, Geeth Deepika, Azhagu Abirami, Anand Sherwood

Sodium Hypochlorite Interaction with Other Root Canal Irrigants: A Systematic Review

[Year:2023] [Month:January-June] [Volume:8] [Number:1] [Pages:6] [Pages No:11 - 16]

Keywords: Endodontic irrigants, Ethylenediaminetetraacetic acid, Root canal disinfection, Sodium hypochlorite

   DOI: 10.5005/jp-journals-10047-0129  |  Open Access |  How to cite  | 

Abstract

Background: The root canal system is essential for successful endodontic treatment, demanding effective irrigation and disinfection. Sodium hypochlorite, valued for its low viscosity, serves as a versatile agent with lubricating, antimicrobial, and pulp tissue dissolving properties. However, its increasing concentration correlates with heightened antibacterial efficacy and tissue dissolution, accompanied by increased toxicity. Combined root canal irrigant use is common to address individual limitations, necessitating an understanding of their chemical interactions and potential effects. Methods: This systematic review adheres to PRISMA guidelines, with a registered protocol on PROSPERO. A thorough search strategy encompassed PubMed, Science Direct, and Google Scholar, focusing on English-language articles published from 2003 to 2023. Duplicate removal utilized Zotero, while title/abstract screening employed Rayyan online software. Two authors conducted full-text reviews and data extraction, addressing inclusion and exclusion criteria and resolving discrepancies through discussion. Results: The review explores the chemical interactions of sodium hypochlorite with various agents, including chlorhexidine, alexidine, ethylenediaminetetraacetic acid (EDTA), citric acid, etidronate, octenidine, MTAD, Q mix and select natural products. Each interaction is analyzed for its implications on root canal treatment, encompassing potential benefits and adverse effects. Conclusion: Understanding the interactions between sodium hypochlorite and diverse root canal irrigants is crucial for optimizing treatment outcomes. The review synthesizes current literature to provide insights into the complex interplay of these agents, facilitating informed decision-making in endodontic practice.

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REVIEW ARTICLE

Joy Shoba, Minu Koshy, Subha Anirudhan, Thendral Kalaichelvan

Effective Strategies to Manage the Clinically Challenging Hot Tooth: A Review

[Year:2023] [Month:January-June] [Volume:8] [Number:1] [Pages:6] [Pages No:17 - 22]

Keywords: Anesthesia, Intraligamentary, Intraseptal, Lidocaine, Premedication, Tetrodotoxin-resistant sodium channels

   DOI: 10.5005/jp-journals-10047-0128  |  Open Access |  How to cite  | 

Abstract

Orofacial pain management requires successful and effective pain control measures. Intraoral local anesthetic administration is considered a safe and routine technique in dentistry but it becomes a significant challenge for endodontists to achieve profound anesthesia especially when dealing with “hot” tooth with irreversible pulpitis. Multiple factors have been implicated in the failure of local anesthesia in hot tooth which includes an incorrect technique of injection, variation in the foramina position, accessory innervations activation of nociceptors, and upregulated tetrodotoxin-resistant sodium (TTRx) channels. The standard technique for pulpal anesthesia is the inferior alveolar nerve block (IANB), but it has a failure rate of 30–80% in teeth with symptomatic pulpitis. Inadequate anesthesia can cause discomfort for both the patient and the clinician. But proper pain management restores faith and changes patients’ emotional appeal throughout the procedure. Various strategies proposed to overcome the anesthetic failure include premedication, alternative anesthetics, supplementary injections, epinephrine ratio changes, anesthetic solution volume adjustments, acupuncture, and cryotherapy.

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