How to cite this article:
Kourti E, Strakas D, Pantelidou O, Tolidis K. Smear Layer Removal by Means of Erbium, Chromium:Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) Laser Irradiation from Apical Third of Mesial Root Canals. Cons Dent Endod J 2021; 6 (1):1-5.
Aim and objective: Evaluation of Er,Cr:YSGG laser (2780 nm) efficiency in removing smear layer from the apical third of mesial roots of first lower molars at different power settings.
Materials and methods: Forty-two mesial root canals of first mandibular molars (type II Vertucci) were divided into four groups. Two teeth were used as control group. All teeth were mechanically instrumented up to size 25/0.08, followed an irrigation protocol with saline. Then, the experimental groups were irradiated by Er,Cr:YSGG laser. Four different output powers were tested, namely 1.25, 1.5, 2, and 2.5 W was used to irradiate the roots in group I (G1), group II (G2), group III (G3), and group IV (G4), respectively. Control group (n = 2) was instrumented as experimental groups but not irradiated. Teeth were observed under SEM. Results were statistically analyzed with the Kruskal–Wallis test and Mann–Whitney test.
Results: None of the tested groups succeeded in removing completely the smear layer from apical dentinal walls. The results showed no statistically significant differences between laser groups in removing the smear layer from the apical third of lower molars. Group III (2 W) showed better outcomes but it was not statistically significant.
Conclusion: The outcome of the present study showed that laser-assisted smear layer removal with an Er,Cr:YSGG laser with the tested parameters is not predicable for the apical third of root canals.
Clinical significance: The presence of the chelating factor may play an important role in the mechanism of laser-assisted removal of the smear layer from the root apical third. Further research needs to be performed to find the optimal irradiation protocol.
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Gondi D, Gonapa P, Rathod T, Yelloji P, Arjun C. Comparative Evaluation of Microhardness of Radicular Dentin by Using Different Herbal Extracts (Azadirachta indica, Morinda citrifolia, Green Tea) as Root Canal Irrigant: An In Vitro Study. Cons Dent Endod J 2021; 6 (1):6-10.
Aim and objective: To evaluate the effect of different herbal extracts such as Azadirachta indica, Morinda citrifolia, and green tea on the microhardness of radicular dentin and compare the effects of these herbal extracts with 2.5% sodium hypochlorite and saline.
Materials and methods: In all selected 60 single-rooted, human permanent teeth, standardized access opening and working length determination were done. Later, instrumented to the apical size of 30 (F3) with ProTaper universal using saline. Each tooth was sectioned longitudinally using a low-speed diamond disc into two halves. Then, one-half without any defects was selected and embedded horizontally in auto-polymerizing acrylic resin, by exposing their dentin. The dentine surfaces on either side of the root canal lumen of these mounted specimens were flattened and smoothened with series of ascending grades of silicon carbide abrasive paper and finally polished with a composite polishing kit and 0.1-mm alumina suspension on a rotary felt disk. Then, all teeth were divided into five groups (n = 12) group I: saline, group II: 2.5% sodium hypochlorite, group III: A. indica, group IV: M. citrifolia, and group V: green tea, based on final irrigant. Initial and posttreatment microhardness was recorded using Vickers microhardness tester at coronal, middle, and apical third.
Results: Group II and group IV showed statistical significance (p < 0.05) between initial and posttreatment values, while group I, group III, and group V, had no significance (p > 0.05). In comparison between group II and group IV, no significant difference was seen.
Conclusion: Among herbal extracts, M. citrifolia leads to structural changes in radicular dentin due to demineralizing effect on root canal dentin.
Background and objectives: Regenerative treatment of immature teeth leads to continued root maturation thereby restores the physiologically functional pulp-dentin complex. The present systematic review is conducted to evaluate the efficacy of regenerative endodontic treatment by induced periapical bleeding (IPB) in the regeneration of immature necrosed permanent teeth with an open apex.
Materials and methods: This review was conducted in adherence to PRISMA standards and was registered in PROSPERO with registration number CRD42018091574. We graded the methodological quality of the studies using Cochrane\'s tool of risk of bias in nonrandomized studies–of interventions (ROBINS-I).
Results: In total, 200 studies were identified for screening, and nine studies were eligible. The quality assessment rated one study as strong, three studies (33.3%) as fair, and five studies (55.6%) as poor. The number of study participants ranged from 17 to 118 (total n = 394), with a mean of 43.8. Four studies showed 100% clinical success with IPB. The radiographic success ranged from 60 to 100%.
Conclusion: All of the included studies showed IPB treatment resulted in increased root length, progressive thickening of the dentinal walls, and narrowing of the canal space. Induced periapical bleeding is the best treatment of choice for immature permanent teeth with pulpal necrosis.
Abraham Ashwin Eugine,
K Radhakrishnan Nair,
How to cite this article:
Eugine AA, Saji S, Nair KR, Geetha P, Sreepooja C. Retreatment of a Chronically Infected Mandibular Molar with Missed Middle Mesial Canal: A Case Report. Cons Dent Endod J 2021; 6 (1):19-22.
Aim and background: A major cause of the failure of root canal therapy is the inability to locate and treat all the canals of the root canal system. Magnification and ultrasonics are valuable aids in negotiating missed canals. In case of root canal failures with long-standing lesions, a combination of non-surgical retreatment followed by a surgical approach would be more beneficial.
Case description: This case report describes the management of a mandibular molar with a missed middle mesial canal. The canal was negotiated with the help of magnification and ultrasonics. Since it was a long-standing lesion, a surgical intervention was done after the completion of non-surgical retreatment.
Conclusion: Untreated root canals may have a direct impact on the prognosis of root canal treatment resulting in chronic periapical infection. Development in techniques and armamentarium has led to successful identification and instrumentation of missed canals. A surgical approach for a long-standing lesion ensures complete healing.
K Radhakrishnan Nair,
Aim and background: Complicated crown-root fractures constitute a major share of all dental injuries, most commonly affecting the maxillary anterior teeth. The main objective while treating complicated crown fracture involves pain management and immediate restoration of function and esthetics. When the fractured segments are closely approximating, root canal treatment followed by reattachment of the fractured segment with fiber post reinforcement is a suitable option. This technique provides excellent esthetics as it maintains the original contacts and contour, translucency, alignment, surface texture, and position of the teeth.
Case description: A 27-year-old male reported to the clinic immediately following a road traffic accident. Clinical and radiographic examination revealed a complicated oblique fracture that was extending subgingivally in the palatal aspect in relation to 21 and 22. It was decided to perform a single visit root canal treatment followed by reattachment of the fractured segment using fiber-reinforced post. A midline diastema was noted following the attachment of the fractured segment which was corrected using direct composite resin restoration.
Conclusion: The presented case demonstrates conservative management of complicated crown root fracture involving 21 and 22 by reattachment using fiber-reinforced post followed by midline diastema correction using composite resin.
Faisal MA Gaffoor,
C Sabari Girish
Intraoral administration of local anesthesia is inevitable for most of the procedures in endodontics. It may be accompanied by ocular complications that are reasonably rare and transient in nature but can cause discomfort for both the patient and the clinician. Most literatures have reported complications that occurred ipsilateral to the injection site. Very rarely contralateral disturbances of eyes are reported. This case series reports two cases in which one case was followed by ptosis, pain, and discomfort of an eye after administering an inferior alveolar nerve block. The other was immediately followed by twitching, pain, and discomfort of an eye after the maxillary infiltration technique. Complete recovery was achieved without any interventions. In this article, we are reporting multiple cases of contralateral complications along with a scientific explanation for this phenomenon and its prevention and management.
Key messages: Although contralateral ocular complications are transient, potential sequelae including blindness should be considered. Measures like initial aspiration, slow injection of anesthetic solution, usage of a 25-G needle, and management of patient anxiety reduce the chance of ocular complications.