Aim: To evaluate and compare the staining of a nanohybrid composite resin by coffee and turmeric powder and to determine the degree of lightening that could be achieved by using contemporary self-applied at-home products and in-office whitening techniques.
Materials and methods: Thirty-six samples of standardized dimensions (10 mm diameter, 2 mm thick disks) were fabricated using GC solare sculpt A2 shade. The color of each specimen was measured (L, a, b values) at baseline with SpectroShade Micro. Samples were randomly allocated into three groups of coffee, turmeric solution, distilled water, and placed in 50 mL of each test solution. The color of each specimen was measured (L, a, b values) after 7 days to determine the color change. Each group was further divided into four subgroups according to the whitening treatment. Subgroup A—crest 3D white toothpaste (applied twice daily for 7 days), subgroup B—Polanight (45 minutes a day for 4 days), subgroup C—polaoffice (8 minutes each for three times), and subgroup D—Shofu polishing kit (applied once). After placing all specimens in distilled water for 24 hours, the color was measured again using a spectrophotometer. The effectiveness of whitening protocols was assessed by subtracting baseline color index values from those measured after whitening.
Results: Group II (turmeric solution) showed greater color change (ΔE) after staining for 1 week. There was significant difference in color changes imparted following whitening treatments with crest 3D white toothpaste after staining with coffee and turmeric solution.
Conclusion: Within the limitations of this in vitro study, it was observed that the whitening treatment with crest 3D white toothpaste is an effective method for reversing the color changes imparted by coffee and turmeric on the nanohybrid composite resin.
Clinical significance: A composite resin stained by coffee and turmeric can be lightened to a clinically perceptible level by crest 3D white toothpaste.
Krishna P Lashkari,
Chittenahalli N Vijay Kumar,
How to cite this article:
Lashkari KP, Shukla A, Kumar CN, Sharma G. Comparative Evaluation of Efficacy of ProTaper® Universal Rotary Retreatment System for Gutta-percha Removal from Single Root Canals, Obturated with Two Different Techniques: In Vitro Cone-beam Computed Tomography Study. Cons Dent Endod J 2019; 4 (2):30-33.
Aim: To compare and evaluate the efficacy of ProTaper® Universal retreatment system (URS) files in retrieval of gutta-percha (GP) from the canals obturated with two different obturation techniques, using cone-beam computed tomography (CBCT).
Materials and methods: Fifty-two extracted maxillary central incisors fulfilling inclusion criteria were decoronated and prepared with ProTaper® rotary files till F3 file size. Specimens were randomly divided into two groups and were obturated with GP. The first group was obturated with cold lateral condensation technique and second group was obturated with thermoplasticized GP technique. The root fillings were retrieved from the canals using ProTaper® URS files. Preoperative and postoperative CBCT imaging was employed to assess the residual filling material in the canals. ITK-Snap software was used to calculate volume of filling material in the canals. Data were entered into Microsoft excel worksheet and analyzed using Statistical Package for Social Sciences, version 18.0 (SPSS Inc., Chicago, IL, USA). Descriptive statistics with percentage mean and standard deviation was computed. Independent sample t test was used to test the difference between study groups.
Results: Residual root canal fillings were detected in all specimens. The mean volume percentage of remaining filling material was 10.69% ± 3.50 and 13.70% ± 3.63 in canals obturated with cold lateral condensation and thermoplasticized GP techniques, respectively.
Conclusion: This study concluded that though ProTaper® URS failed to remove GP completely, it was more efficient in the group of root canals obturated with cold lateral condensation than the canals obturated with thermoplasticized GP technique.
Rajesh S Nair,
Mano C Angelo
The use of nickel–titanium (NiTi) alloys created a revolutionary impact in endodontic treatments. Shape memory and superelastic property of an NiTi alloy make the instrument more flexible, which improves the quality of the treatment by reducing the procedural errors. Even though these instruments show advanced metallurgical properties, it can lead to fracture due to fatigability. To improve the fracture resistance and enhance the clinical performance, various thermomechanical heat treatments had been introduced to these NiTi instruments. NiTi alloy undergoes phase transformation on heat treatment to upgrade the mechanical properties. This review article appraises the improved metallurgical properties of NiTi alloy by various thermomechanical heat treatment processes in addition with discussion of recently introduced thermomechanically altered NiTi endodontic instruments.
Radhakrishnan K Nair,
Background: During routine endodontic therapy, a clinician may encounter many procedural errors which alter the course and outcome of treatment. One of the most frequent types of procedural error is instrument separation. A separated instrument prevents complete cleaning and shaping of the root canal. Hence, every attempt must be made to retrieve the broken instrument. The clinician has to evaluate the options of attempting retrieval, and bypassing or leaving the fragment as it is. There are various instrument retrieval kits and chairside techniques available for this purpose.
Case description: The present case series describes the management of a separated rotary file and a separated bur head from the root canals of mandibular second molar and maxillary canine, respectively. A 14-year-old female patient undergoing root canal treatment in relation to 47 had an accidental breakage of ProTaper gold F2 rotary file in the apical third of distal canal of 47. Attempts were made to retrieve the instrument with ultrasonically activated files under dental operating microscope and was successfully managed. A 47-year-old female patient undergoing root canal treatment in relation to 13 had an accidental blockage of the canal with 169L carbide bur in the apical third of canal. The fractured fragment was retrieved with file braiding technique.
Conclusion: This case series has described conservative and simple techniques for removal of fractured instruments from the root canals of an anterior and posterior tooth.
Minimol K Johny,
Background: Attention to detail with an analytically trained and developed mind is undoubtedly a dental practitioner\'s most important asset to identify rare and only heard of conditions in patients. Being a field of explosive development due to new technologies, endodontics aids to provide an accurate diagnosis of the complex anatomical variations and conditions of the teeth. Radix entomolaris (RE) is the presence of an additional distolingual (DL) root in the mandibular first molars and its prevalence in the South Indian population is 13.3%. The presence of RE with middle mesial canal (MMC) in the mandibular first molar is a rare experience of the combined occurrence of two uncommon conditions requiring appropriate diagnosis and cautious management. Its management relies on the proper diagnosis and exploration of all the canals, thorough chemomechanical preparation, followed by three-dimensional (3D) obturation without hampering the original root canal anatomy. The appropriate utilization of the advanced aids of magnification and technology, such as the microscopes, loupes, and conebeam computed tomography (CBCT), coupled with the use of thermomechanically treated flexible NiTi files enhances the success in the endodontics while dealing with such rare entities. This article presents a case report of an RE with MMC which is definitely rare in occurrence and requires cautious management.
Case description: A 20-year-old female patient was diagnosed with symptomatic irreversible pulpitis with apical periodontitis on the mandibular first molar. It was identified as an RE with MMC on radiographic examination using the Clark\'s Tubeshift technique. After anesthetizing the tooth using inferior alveolar nerve block, rubber dam isolation was done. The access cavity was prepared and modified distolingually and the canal orifices were located. The MMC orifice was troughed along the groove joining mesiobuccal (MB) and mesiolingual (ML) canals using long shank burs and a sharp DG-16 explorer. The cleaning and shaping procedures were performed carefully to all six canals using NiTi files followed by the 3D obturation.
Conclusion: This case report is a precise description of the effective management of RE with MMC which is a rare entity in our ethnic group. This case was diagnosed using the Clark\'s Tubeshift technique and managed using magnifying loupe and thermomechanically treated flexible NiTi files. The advanced aids in 3D imaging such as the CBCT, spiral computed tomography (CT), and the magnifying aids such as microscopes coupled with thermoplasticized obturation can accentuate the success rate of such complex morphologies.
Mahesh C Mohan,
Manoj C Kuriakose,
Coronal fractures of the anterior teeth are a common form of dental trauma that mainly affects children and adolescents. Various treatment modalities have been practiced in the past, but reattachment of fractured fragment is considered to be the most conservative, natural, and esthetic approach. The restoration of natural teeth form, color, and alignment in these patients creates a positive social and emotional response in such patients. This paper reports on conservative management of the fracture of maxillary anterior teeth using two different approaches, namely, one with tooth fragment reattachment and other of recontouring with composite resin.
Kunjusankaran Radhakrishnan Nair,
Background: Tooth avulsion is the complete displacement of a tooth out of the alveolar socket. The lack of immediate treatment measures can result in the loss of function, esthetics, psychological and social problems, and poor quality of life. Several factors may not enable the prompt replantation of an avulsed tooth; hence, delayed replantation has emanated as an alternative to meet the esthetic, functional, and psychological demands of the patients.
Case description: This case report details the replantation of an avulsed maxillary central incisor in a 21-year-old male patient which was replanted 2 hours after the event. Extraoral root canal treatment was done before replantation and follow-up examinations were performed during 1, 3, and 6 months. The tooth remained in a stable functional position and did not reveal any pathological changes after 6 months. Both esthetic and functional outcomes were satisfactory.
Conclusion: The extent of damage to the tooth and supporting structures, emergency management, and follow-up treatment play a role in the prognosis of the avulsed tooth. The tooth was kept in saline before replantation, and 6 months follow-up showed a favorable prognosis, and further evaluation is needed to predict the long-term prognosis of the tooth.