Journal of Conservative Dentistry
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   2017| January-February  | Volume 20 | Issue 1  
    Online since June 28, 2017

 
 
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ORIGINAL RESEARCH ARTICLES
Efficacy of two rotary retreatment systems in removing Gutta-percha and sealer during endodontic retreatment with or without solvent: Acomparative invitro study
Moushmi Chalakkarayil Bhagavaldas, Abhinav Diwan, S Kusumvalli, Shiraz Pasha, Madhuri Devale, Deepak Chowdary Chava
January-February 2017, 20(1):12-16
DOI:10.4103/0972-0707.209075  PMID:28761246
Objectives: The aim of this invitro study was to compare the efficacy of two retreatment rotary systems in the removal of Gutta-percha(GP) and sealer from the root canal walls with or without solvent. Materials and Methods: Forty-eight extracted human mandibular first premolars were prepared and obturated with GP and AH Plus sealer. Samples were then randomly divided into four groups. GroupI was retreated with MtwoR rotary system without solvent, GroupII was retreated with MtwoR rotary system with Endosolv R as the solvent, GroupIII with D-RaCe rotary system without solvent, and GroupIV with D-RaCe rotary system and Endosolv R solvent. The cleanliness of canal walls was determined by stereomicroscope(×20) and AutoCAD software. Kruskal–Wallis test and Mann–Whitney U-test were used to compare the data. Results: Results showed that none of the retreatment systems used in this study was able to completely remove the root canal filling material. D-RaCe with or without solvent showed significantly(P>0.05) less filling material at all levels compared to MtwoR with/without solvent. Conclusion: Within the limitation of the current study, D-RaCe rotary retreatment system is more effective in removing filling material from root canal walls when compared to MtwoR rotary retreatment system.
  11 8,114 632
Retrievability of calcium hydroxide intracanal medicament with three calcium chelators, ethylenediaminetetraacetic acid, citric acid, and chitosan from root canals: An invitro cone beam computed tomography volumetric analysis
Ramya Raghu, Geethu Pradeep, Ashish Shetty, PM Gautham, PG Puneetha, T V. Satyanarayana Reddy
January-February 2017, 20(1):25-29
DOI:10.4103/0972-0707.209068  PMID:28761249
Aim: This study compared the amount of aqueous-based and oil-based calcium hydroxide remaining in the canal, after removal with two different chelators 17% EDTA, 20% Citric acid and 0.2% Chitosan in combination with ultrasonic agitation. Methods and Material: Cleaning and shaping of root canals of 28 mandibular premolar was done and canals were filled either with Metapex or Ca(OH)2mixed with distilled water. Volumetric analysis was performed utilizing cone beam-computed tomography (CBCT) after seven days of incubation. Ca(OH)2was removed using either 17% EDTA, 20% Citric acid or 0.2% Chitosan in combination with ultrasonic agitation. Statistical analysis used: Volumetric analysis was repeated and percentage difference was calculated and statistically analyzed using Kruskal-Wallis and Mann-Whitney U test. Results: All the three chelators failed to remove aqueous-based as well as oil-based Ca(OH)2completely from the root canal. Aqueous-based Ca(OH)2was easier to be removed than oil-based Ca(OH)2. 0.2% Chitosan in combination with ultrasonics performed better than 17% EDTA and 20% citric acid in removal of Ca(OH)2. Conclusion: Combination of 0.2% Chitosan and ultrasonic agitation results in lower amount of Ca(OH)2remnants than 17% EDTA, 20% Citric acid irrespective of type of vehicle present in the mix.
  8 7,098 370
Determining predictability and accuracy of thermal and electrical dental pulp tests: An invivo study
Avinash Ramchandra Salgar, Shishir H Singh, Rajesh S Podar, Gaurav P Kulkarni, Shashank N Babel
January-February 2017, 20(1):46-49
DOI:10.4103/0972-0707.209067  PMID:28761253
Introduction: Pulp sensitivity testing, even with its limitations and shortcomings, has been and still remains a very helpful aid in endodontic diagnosis. Pulp sensitivity tests extrapolate pulpal health from the sensory response. The aim of the present study was to identify the sensitivity, specificity, positive and negative predictive values(NPVs) of thermal and electrical tests of pulp sensitivity. Materials and Methods: Pulp tests studied were two cold and heat tests respectively and electrical test. Atotal of 330 teeth were tested: 198 teeth with vital pulp and 132 teeth with necrotic pulps(disease prevalence of 40%). The ideal standard was established by observing bleeding within the pulp chamber. Results: Sensitivity values of the diagnostic tests were 0.89 and 0.94 for cold test, 0.84 and 0.87 for the heat tests, and 0.75 for electrical pulp test and the specificity values of the diagnostic tests were 0.91 and 0.93 for the cold tests, 0.86 and 0.84 for the heat tests, and 0.90 for electrical pulp test. The NPVs were 0.91 and 0.96 for the cold tests, 0.89 and 0.91 for the heat tests, and 0.84 for electrical pulp test. The positive predictive values were 0.89 and 0.90 for the cold tests, 0.80 and 0.79 for the heat tests and 0.88 for electrical pulp test. The highest accuracy(0.9393) was observed with cold test(icy spray). Conclusions: The cold test done with icy spray was the most accurate method for sensitivity testing.
  7 5,880 385
ORIGINAL ARTICLES
Comparison of efficiency of ethylenediaminetetraacetic acid, citric acid, and etidronate in the removal of calcium hydroxide intracanal medicament using scanning electron microscopic analysis: An in-vitro study
Sherin Jose Chockattu, BS Deepak, K Mallikarjun Goud
January-February 2017, 20(1):6-11
DOI:10.4103/0972-0707.209079  PMID:28761245
Context: Being integral to root canal therapy, obturation can be performed adequately only after the removal of intracanal medicament. One technique involves the use of chelating agents such as ethylenediaminetetraacetic acid(EDTA) and citric acid. Etidronic acid, a relatively new chelator, has smear layer removal ability and lesser dentinal erosion. It is untested in calcium hydroxide(Ca[OH]2) medicament removal. Aim: The aim of this study was to compare the efficiency of irrigation protocols(EDTA, citric acid, and etidronate) in Ca(OH)2removal. Materials and Methods: Forty-five single-rooted mandibular premolars were decoronated, instrumented, and filled with Ca(OH)2. After 7days incubation, Ca(OH)2was removed by three irrigation protocols(Group-I: 17% EDTA; Group-II: 10% citric acid; and Group-III: 18% etidronate). Roots were split and analyzed(scanning electron microscope, ×1500). Chelator solution pH was tested. Data were analyzed by Kruskal–Wallis ANOVA and Mann–Whitney U-test. Results: Group-III(coronal-third) and Groups-I and II(middle-third) had highest cleanliness scores; Groups-II and III(apical-third) had lowest scores. Comparing the thirds, all groups showed difference in scores. pH of Groups-I, II, and III were 6.8, 1.4, and 0.3, respectively. Conclusion: The solution pH of citric acid and etidronate impacts their Ca(OH)2removal efficiency in different ways: the highly alkaline pH of Ca(OH)2increases citric acid pH toward neutrality, where it becomes an inefficient chelator; on the contrary, high acidity of etidronate compensates for its weaker chelation. Etidronate may not require 5min duration for Ca(OH)2removal due to the likelihood of dentinal erosion.
  6 5,061 307
ORIGINAL RESEARCH ARTICLES
Apical extrusion of debris in four different endodontic instrumentation systems: Ameta-analysis
J Sylvia Western, Daniel Devaprakash Dicksit
January-February 2017, 20(1):30-36
DOI:10.4103/0972-0707.209066  PMID:28761250
Background All endodontic instrumentation systems tested so far, promote apical extrusion of debris, which is one of the main causes of postoperative pain, flare ups, and delayed healing. Objectives Of this meta-analysis was to collect and analyze invitro studies quantifying apically extruded debris while using Hand ProTaper(manual), ProTaper Universal(rotary), Wave One(reciprocating), and self-adjusting file(SAF; vibratory) endodontic instrumentation systems and to determine methods which produced lesser extrusion of debris apically. Methodology An extensive electronic database search was done in PubMed, Scopus, Cochrane, LILACS, and Google Scholar from inception until February 2016 using the key terms “Apical Debris Extrusion, extruded material, and manual/rotary/reciprocating/SAF systems.” A systematic search strategy was followed to extract 12 potential articles from a total of 1352 articles. The overall effect size was calculated from the raw mean difference of weight of apically extruded debris. Results Statistically significant difference was seen in the following comparisons: SAFConclusions Apical extrusion of debris was invariably present in all the instrumentation systems analyzed. SAF system seemed to be periapical tissue friendly as it caused reduced apical extrusion compared to Rotary ProTaper and Wave One.
  6 5,041 291
A comparative evaluation of the effect of 8% and 17% ethylenediaminetetraacetic acid exposure for 1min and 10min on the fracture resistance of endodontically treated roots: An invitro study
Shreetha Bhandary, Sapna Kakamari, Raghu Srinivasan, Mahesh Martur Chandrappa, Farhat Nasreen, Pramod Junjanna
January-February 2017, 20(1):21-24
DOI:10.4103/0972-0707.209073  PMID:28761248
Objective: The objective of this study was to evaluate the effect of 8% and 17% ethylenediaminetetraacetic acid(EDTA) exposure for 1min and 10min on the fracture resistance of endodontically treated roots. Methodology: Sixty human single-rooted teeth were decoronated and divided into six groups(n=10). Canal preparation was carried out except in negative control group, using the ProTaper rotary file system. Final irrigation was performed using distilled water, 17% EDTA for 1min and 10min, 8% EDTA for 1min and 10min. Thereafter, roots were obturated with ProTaper F3 Gutta-percha points and AH Plus sealer using a single-cone technique. The specimens were loaded vertically at 1mm/min crosshead speed until vertical root fracture occurred. Results were evaluated statistically with one-way analysis of variance and post hoc Tukey test. Results: Analysis of results showed that the unprepared roots showed the highest fracture resistance and roots irrigated with 17% EDTA for 10min showed the lowest fracture resistance. The mean fracture resistance of unprepared roots, roots irrigated with 8% EDTA for 10min and 17% EDTA for 1min was significantly higher than roots irrigated with 8% EDTA for 1min, 17% EDTA for 10min and distilled water. Conclusion: From a clinical viewpoint, if EDTA has to be used, it is safer to use higher concentration for a shorter application time or a low concentration with a longer application time. Prolonged use of high concentrations of EDTA might increase the risk of root fracture.
  5 3,239 245
Comparison of radiopacity of different composite resins
Pinar Gul, Fatma Çaglayan, Nilgün Akgul, Hayati Murat Akgul
January-February 2017, 20(1):17-20
DOI:10.4103/0972-0707.209071  PMID:28761247
Background: The radiopacity of composite resins has been considered as an important requirement, improving the radiographic diagnosis. Aim: The present study aimed to compare the radiopacity of eight different composite materials using an aluminum step wedge. Materials and Methods: Eight different composite resins were used in this study. The samples were prepared using a stainless steel mold (2×8), and a 2-mm-thickness horizontal section was obtained from the freshly extracted molar tooth. Three different radiographs were taken by establishing standard conditions. Mean gray values were obtained by taking three measurements from each step of both the tooth and the aluminum step wedge, and the aluminum thickness equivalents were calculated. Statistical analysis was performed using one-way variance analysis and Tukey's test(P<0.05). Results: All aluminum thickness equivalents were found to be higher than those of the enamel and dentin, except Clearfil Majesty Esthetic(2.23mm±0.52mm) and Filtek Silorane(3.67mm±0.15mm)(P<0.05). The Clearfil Majesty Posterior (8.50mm±0.10mm) and Arabesk Top(8.17mm±0.06mm) were found to be the most radiopaque composites. Conclusion: All composite resin materials tested in this study were confirmed to the International Standards Organization 4049 standards. However, since radiopacity is not the only criterion for clinical use, it is a better approach to take all other properties of the materials into consideration.
  4 3,787 234
Additive effect of photoactivated disinfection on the antibacterial activity of QMix2in1 against 6-week Enterococcus faecalis biofilms: An invitro study
Deepa Vaid, Nimisha Shah, Dwij Kothari, Priyanka Bilgi
January-February 2017, 20(1):41-45
DOI:10.4103/0972-0707.209072  PMID:28761252
Background: Evaluation of the additive effect of photodynamic therapy(PDT) on the antibacterial activity of 2.5% sodium hypochlorite(NaOCl) and QMix against 6-week Enterococcus faecalis biofilms contaminated root canals. Aims: To establish the most suitable irrigant for eradication of 6-week E.faecalis biofilms. Settings and Design: In vitro study. Materials and Methods: A 6-week E.faecalis (ATCC 29212) biofilm was formed in 190 extracted teeth that were subsequently subjected to irrigation protocols as follows. Group A1: normal saline, Group A2: 2.5% NaOCl, Group A3: QMix, Group B1: normal saline and photoactivated disinfection (PAD), Group B2: 2.5% NaOCl and PAD, Group B3: QMix and PAD, Group C: no irrigation. For PAD, irradiation was done three times for 5 s each with 10 s interval on continuous mode with a 980nm diode laser. Samples from the root canals were collected and plated onto brain heart infusion agar plates to determine the colony-forming unit/ml. Statistical Analysis Used: One-way ANOVA, post hoc Tukey's honest significant difference test. Results: Maximum percentage of disinfection(99%) was seen in GroupB2(NaOCl with PDT), which was similar to GroupsA2(97.6%) and B3(98.8%)( P<0.0001). Conclusions: NaOCl with PDT gave maximum disinfection.
  4 3,025 174
ORIGINAL ARTICLES
Substantivity of hypochlorous acid-based disinfectant against biofilm formation in the dental unit waterlines
Irfana Fathima Shajahan, Deivanayagam Kandaswamy, L Lakshminarayanan, R Selvarajan
January-February 2017, 20(1):2-5
DOI:10.4103/0972-0707.209076  PMID:28761244
Objective: The purpose of the study was to examine the substantivity of a new disinfectant against biofilm formation in the dental unit waterlines. Materials and Methods: Twenty dental units were selected for the study and divided into two groups: GroupA(dental unit waterlines treated with the disinfectant) and GroupB(untreated dental unit waterlines). Biofilm formation was monitored in both groups by removing the one dental unit waterline from each group for the period of 10days. One inch of the dental unit waterline tube was cut at random site, and the inner lumen of the cut sections was analyzed using the scanning electron microscope(SEM)(TESCAN VEGA3 SBU). Results: On examination, SEM images showed that there was no slime layer or bacterial cells seen in cut section for the period of 7days in the treated dental waterlines, which means that there is no evident of biofilm formation. In the untreated dental unit waterline cut section, slime layer was observed from day 1. Conclusion: Disinfectant solution was proved to be effective for 7days against biofilm formation. This technique could be used as a valid method for disinfection of dental unit waterlines.
  3 3,644 166
CASE REPORTS
Surgical management of lateral incisor with typeII dens invaginatus and a periapical pathosis: Acase report with 1-year follow-up
V Naga Lakshmi, K Madhu Varma, Girija S Sajjan, Tanikonda Rambabu
January-February 2017, 20(1):54-57
DOI:10.4103/0972-0707.209077  PMID:28761255
Dens invaginatus is a relatively common dental malformation resulting from an infolding of enamel organ into the dental papilla varying in depth into the tooth tissues. Complex morphological anatomy associated with the pulpal pathology presents inaccessibility to completely remove the necrotic pulp tissues and hence poses challenges in rendering endodontic treatment. Acombination of nonsurgical and surgical management in treating such cases is advisable depending on the presented variations. The present case reports the surgical endodontic treatment of an immature maxillary lateral incisor with typeII dens invaginatus and periapical pathology.
  1 2,255 175
ORIGINAL RESEARCH ARTICLES
The effect of a dentin desensitizer on the shear bond strength of composite to dentin using three different bonding agents: An invitro study
Eeshan Arub Mushtaq, Vijay Mathai, Rajesh Sasidharan Nair, JeyaBalaji Mano Christaine Angelo
January-February 2017, 20(1):37-40
DOI:10.4103/0972-0707.209069  PMID:28761251
Objective: The effect of dentin desensitizer Systemp on the shear bond strength of composite resin to dentin using three different bonding agents, i.e., Prime & BondNT, Xeno V+, and Futurabond DC were evaluated. Materials and Methods: Sixty recently extracted human premolars were divided into six groups of ten teeth each. The superficial dentin was etched with 37% phosphoric acid. In GroupsI, II, and III, Prime & Bond NT, Xeno V+, and Futurabond DC, respectively, were applied to dentin and composite placed. Following application of dentin desensitizer Systemp in GroupsIV, V, and VI, Prime & Bond NT, Xeno V+, and Futurabond DC, respectively, were applied to dentin and composite placed. The shear bond strength was evaluated. Data obtained were statistically analyzed using one-way analysis of variance, post hoc, and Dunnett's test. Results: Following application of dentin desensitizer Systemp, mean shear bond strength increased when Prime & Bond NT bonding agent was used while it decreased for Xeno V+and Futurabond DC bonding agents. Conclusion: Within the limitations of this invitro study, it was observed that following application of dentin desensitizer Systemp, mean shear bond strength may increase or decrease depending on the bonding agents used.
  1 3,591 336
CASE REPORTS
Root canal treatment of a fused mandibular incisor using cone-beam computed tomography as a diagnostic aid
Maura Cristiane Orçati Dorielo, Alcides Gonini-Junior, Durvalino de Oliveira, Renata Tarnoschi Bordignon, Alvaro Henrique Borges
January-February 2017, 20(1):58-61
DOI:10.4103/0972-0707.209078  PMID:28761256
Tooth fusion consists of the union of crowns by the enamel and/or dentin. We describe a case of a patient who presented with a fistula in the apical portion of teeth 32 and 33. Clinically, tooth 32 showed increased crown width in relation to other teeth in the same arch. Radiographic examination evidenced fusion of tooth 32 with a possible supernumerary tooth. Cone-beam computed tomography was used to confirm the radiographic findings and revealed incomplete apex formation of the supernumerary tooth. The fused tooth was subjected to root canal treatment. Calcium hydroxide was used as intracanal medication, changed for every 30days, for 4months. Subsequently, the mesial canal received an apical plug of mineral trioxide aggregate mixed with distilled water. At 2years of follow-up, the tooth showed signs of tissue repair.
  - 2,389 156
EDITORIAL
Editorial Message
Aditya Mitra
January-February 2017, 20(1):1-1
DOI:10.4103/JCD.JCD_194_17  PMID:28761243
  - 2,086 103
SHORT COMMUNICATION
Mandibular second molar exhibiting a unique “Y-” and “J-” “shaped” root canal anatomy diagnosed using cone-beam computed tomographic scanning: Acase report
Saumya-Rajesh Parashar, R Dinesh Kowsky, Velmurugan Natanasabapathy
January-February 2017, 20(1):50-53
DOI:10.4103/0972-0707.209074  PMID:28761254
This article aims to report a unique case with aberrant root canal anatomy exhibiting “Y-” and “J”-shaped canal pattern in a mandibular second molar. Anatomic complexities may pose challenges for endodontic treatment. Before performing endodontic treatment, the clinician should be aware of the internal anatomy of the tooth being treated and should recognize anatomic aberrations if present. Presence of unusual anatomy may call for modifications in treatment planning. This report describes in detail about a mandibular second molar tooth associated with two paramolar tubercles having a peculiar “Y-” and “J-”shaped canal anatomy detected with the aid of cone beam computed tomography, which has never been reported in the dental literature. The proposed treatment protocol for the endodontic management of the same has also been discussed.
  - 3,159 175
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