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Cureus May 2024Introduction Irrigation of the root canal system is a vital step in endodontic treatment aimed at disinfecting the canal. The efficacy of irrigation can be improved by...
Introduction Irrigation of the root canal system is a vital step in endodontic treatment aimed at disinfecting the canal. The efficacy of irrigation can be improved by various irrigation agitation methods. One such novel method of interest is the manual dynamic agitation (MDA) technique. However, the effect of MDA on postoperative pain as compared to needle irrigation (NI) with sodium hypochlorite has been scarcely explored. This study aimed to compare the effects of NI and MDA techniques on postoperative pain in teeth with symptomatic irreversible pulpitis. Materials and methods This quasi-experimental study was conducted at the Department of Operative and Paediatric Dentistry, Fauji Foundation Dental Hospital, over four months after gaining ethical approval. One hundred and sixty-eight participants diagnosed with symptomatic irreversible pulpitis were enrolled in the study through the purposive sampling technique. The participants were divided into two groups based on the irrigation technique used: Group A (NI) and Group B (MDA). Postoperative pain was recorded after six hours, 24 hours, 48 hours, and seven days using the 0-100mm visual analog scale (VAS). The VAS scores were compared using an independent sample t-test. Results Out of 168 participants, 48.2% were in Group A and 51.2% in Group B. The study found that VAS pain scores for Group B (MDA) were significantly lower at six hours, 24 hours, 48 hours, and seven days as compared to Group A (NI), with a -value less than 0.001. Conclusion This study shows that the MDA technique leads to decreased postoperative pain both immediately after endodontic treatment and a week later as compared to the NI technique. Hence, the use of MDA can aid in controlling postendodontic pain and, therefore, ensure smoother recovery and increased patient satisfaction.
PubMed: 38947708
DOI: 10.7759/cureus.61331 -
Cureus May 2024Dental anatomy exhibits considerable variation with the presence of additional canals being a common occurrence. The upper second molar typically presents with three...
Dental anatomy exhibits considerable variation with the presence of additional canals being a common occurrence. The upper second molar typically presents with three canals and three roots; however, variations such as the existence of an extra canal or a root can pose challenges during endodontic treatment. Maxillary molar is characterized by an additional canal located within the palatal root, often exhibiting complex configurations and variations in morphology. Access refinement is critical to gaining adequate visibility and facilitating instrumentation. Meticulous exploration of the pulp chamber floor and careful examination of radiographs from different angles are essential for accurate diagnosis. Careful negotiation and cleaning of the extra canal with appropriate files and irrigants are essential to remove pulp tissue and debris effectively. Furthermore, obturation of the canal space with biocompatible materials is crucial to ensure a three-dimensional seal and prevent bacterial ingress. Clinically, the inability to detect and treat the extra palatal canal can lead to persistent infection, incomplete debridement, and compromised treatment outcomes. This case report delves into the significance of this anatomical variation, diagnostic modalities, and effective management strategies.
PubMed: 38947704
DOI: 10.7759/cureus.61266 -
Cureus May 2024The management of teeth with open apices poses unique challenges in endodontics, requiring effective strategies to promote continued root development and maintain pulp...
The management of teeth with open apices poses unique challenges in endodontics, requiring effective strategies to promote continued root development and maintain pulp vitality. This abstract explores the utilization of bioactive materials in the treatment of open apices, specifically focusing on their role in achieving optimal outcomes. Bioactive materials, such as Biodentine (Septodont, Saint-Maur-des-Fossés, France), have gained prominence for their favourable physiochemical properties, biocompatibility, and ability to stimulate dentinogenesis. The application of a bioactive material as an apical plug not only addresses immediate concerns but also contributes to long-term health and stability. This abstract reviews relevant literature, discusses clinical cases, and emphasizes the importance of tailoring treatment plans to the individual characteristics of open apex cases. The findings underscore the promising role of bioactive materials in reshaping the landscape of endodontic interventions for teeth with open apices, highlighting their potential to enhance both clinical and radiographic success.
PubMed: 38947694
DOI: 10.7759/cureus.61296 -
Cureus May 2024To analyze the effects of the maxillary second molar and third molar eruption stages on the distalization of first molars with a modified palatal anchorage plate (MPAP)...
Effect of Second and Third Molar Eruption Stages on First Molar and Maxillary Arch Distalization With Modified Palatal Anchorage Plate and Beneslider: A 3D Finite Element Analysis.
AIM
To analyze the effects of the maxillary second molar and third molar eruption stages on the distalization of first molars with a modified palatal anchorage plate (MPAP) and Beneslider using three-dimensional (3D) finite element analysis.
MATERIALS AND METHOD
Six finite element models (FEMs) of individual maxillary molar distalization and six FEM models of en-masse maxillary arch distalization (EMAD) at different stages of the maxillary molar eruption were created from cone-beam computed tomography (CBCT) images of the maxillary complex, and 3D displacements of the maxillary first and second molars were evaluated with MPAP and Beneslider.
RESULTS
On individual molar distalization, Beneslider showed first molar distal translation during the second and third molar follicular stages, while MPAP showed distal tipping of the first molar. With EMAD, either of the appliances showed distal tipping of the first molars. There was palatal rolling and extrusion of the first molars. The second molar showed buccal drifting with intrusion, and the incisors showed palatal displacement along with extrusion.
CONCLUSIONS
Second and third molar eruption stages had no adverse influence on first molar and en-masse maxillary arch distalization. Beneslider showed distal translation of the first molar, while distal tipping was seen with MPAP.
PubMed: 38947589
DOI: 10.7759/cureus.61403 -
Journal of Indian Prosthodontic Society Jul 2024Studies have not been done to evaluate the peri-implant stress exerted by materials(like PEEK and resin matrix ceramics) in different osseointegration conditions. To...
AIM
Studies have not been done to evaluate the peri-implant stress exerted by materials(like PEEK and resin matrix ceramics) in different osseointegration conditions. To investigate the effect of different occlusal materials on peri-implant stress distribution with different osseointegration condition using finite element analysis.
SETTINGS AND DESIGN
Eighteen different 3D FEA models of implant fixed with abutment were created involving 6 different occlusal materials (Heat cured temporary acrylic resin (PMMA), Bis-GMA, PEEK, Lithium disilicate, Resin matrix ceramics and translucent Zirconia) and different osseointegrated conditions (50%, 75%, 100%).
MATERIALS AND METHODS
Models were subjected to loading vertically and obliquely followed by evaluation of stress distribution.
STATISTICAL ANALYSIS USED
The results of the simulation obtained were analysed in terms of Von mises, maximum principal and minimal principal stresses using descriptive stastistics.
RESULTS
PMMA (40.14 MPa on vertical loading and 66 MPa on oblique loading) resulted in the highest stresses and lithium disilicate (24 MPa on vertical loading and 52.40 MPa on oblique loading) resulted in least stresses among all the crown materials. Upon oblique loading, von Mises stress increases except for translucent zirconia and lithium disilicate (52.444 MPa on 50%, 47.733 MPa on 75%, and 43.973 MPa on 100% osseointegration). Minimal principal stress values decreased with increase in osseointegration upon oblique loading for PMMA, BisGMA, and PEEK.
CONCLUSION
Translucent zirconia and lithium disilicate offer a better stress transmission. Minimal principal stress values of PEEK and BisGMA decreased with increasing osseointegration.
Topics: Finite Element Analysis; Osseointegration; Dental Materials; Dental Implants; Zirconium; Humans; Dental Porcelain; Ceramics; Materials Testing; Stress, Mechanical; Dental Stress Analysis; Polymethyl Methacrylate; Polymers
PubMed: 38946514
DOI: 10.4103/jips.jips_424_23 -
Journal of Indian Prosthodontic Society Jul 2024Temporomandibular disorders (TMD) comprise ailments involving the jaw joint (temporomandibular joint) and its associated anatomical structures. The complexity involved... (Review)
Review
AIM
Temporomandibular disorders (TMD) comprise ailments involving the jaw joint (temporomandibular joint) and its associated anatomical structures. The complexity involved in TMD is primarily due to its broad spectrum of conditions, clinical signs and symptoms variability, and multifactorial etiology. Considering the above, the present study was performed to help understand the prevailing knowledge and awareness of TMD among Indian dentists in the context of the new specialty "orofacial pain".
SETTINGS AND DESIGN
Questinnaire study and review.
MATERIALS AND METHODS
The questionnaire was distributed using a web-based portal nationwide among Indian dentists. Dentists were invited to participate, clearly stating that the intent and purpose of the questionnaire was to record the existing knowledge and awareness concerning temporomandibular disorders among Indian dentists. The questionnaire was segregated into three sections: pathogenesis, diagnosis, and management of TMDs. The questions were recorded using a Likert three-point scale (1=agree; 2=disagree; 3=not aware). 310 dentists participated in the survey, among which 105 were general dentists (BDS [Bachelor of Dental Surgery] graduates), and 205 were dentists with specialist training (MDS [Masters of Dental Surgery] graduates).
STATISTICAL ANALYSIS USED
The results obtained from the study participants was used to calculate the percentage and frequency, following which tabulations were made based on graduate type and clinical experience. The values obtained from all three sections were recorded, and the responses were analysed using Pearson's Chi-Square test with statistical significance kept at P < 0.05.
RESULTS
Results of the study disclosed that only 58.1% of general dentists and 46.8% of specialists were confident in handling temporomandibular disorder patients. Splint therapy was the preferred treatment modality for general dentists, whereas dentists with specialist training preferred occlusal rehabilitation.
CONCLUSION
The results of the current survey indicate that Indian dentists lack sufficient training in dental schools on all three sections and face difficulty diagnosing and treating TMDs.
Topics: Humans; Dentists; Health Knowledge, Attitudes, Practice; India; Practice Patterns, Dentists'; Surveys and Questionnaires; Temporomandibular Joint Disorders
PubMed: 38946513
DOI: 10.4103/jips.jips_573_23 -
Journal of Indian Prosthodontic Society Jul 2024The aim of this study was to evaluate the effect of proanthocyanidin and C. sinensis-polyphenols on microtensile bonding properties of prepared teeth with resin-modified... (Comparative Study)
Comparative Study
Comparison of microtensile bond strength of prepared teeth treated with proanthocyanidin, Camellia sinensis - Polyphenols, and metal crowns luted with resin-modified glass ionomer cement: An in vitro study.
AIM
The aim of this study was to evaluate the effect of proanthocyanidin and C. sinensis-polyphenols on microtensile bonding properties of prepared teeth with resin-modified glass ionomer cement (GIC).
SETTING AND DESIGN
This was an in vitro study.
MATERIALS AND METHODS
Seventy-eight maxillary premolars were selected and mounted into auto-polymerizing acrylic resin blocks. The samples were prepared and metal crowns were fabricated. The samples were randomly divided into three groups. Samples under Group 1 were not treated with any of the extracts and followed conventional bonding protocol. Samples under Group 2 and Group 3 were treated with proanthocyanidin and C. sinensis-polyphenols, respectively. After dentin treatment, these samples were luted to metal crowns using resin-modified GIC. Universal testing machine was used to measure the load at which the crowns were debonded and microtensile bond strength in MPa was calculated.
STATISTICAL ANALYSIS
The results were statistically analyzed using one-way ANOVA and post hoc Tukey HSD.
RESULTS
Samples treated with C. sinensis polyphenols (Group 3) had maximum bond strength followed by Group 2, where the samples were treated with proanthocyanidin.
CONCLUSION
C. sinensis polyphenols due to their anti-proteolytic and antioxidant properties showed improved bond strength compared to proanthocyanidin, a cross-linking agent, followed by conventional bonding protocol.
Topics: Proanthocyanidins; Tensile Strength; Glass Ionomer Cements; Polyphenols; Humans; Crowns; Dental Bonding; Camellia sinensis; In Vitro Techniques; Resin Cements; Plant Extracts; Dental Stress Analysis
PubMed: 38946512
DOI: 10.4103/jips.jips_127_24 -
Journal of Indian Prosthodontic Society Jul 2024The aim of this study is to evaluate the influence of occlusion on body posture and plantar arch pressure. (Observational Study)
Observational Study
AIM
The aim of this study is to evaluate the influence of occlusion on body posture and plantar arch pressure.
SETTINGS AND DESIGN
An Observational analysis to Analyze the Influence of Occlusion on Plantar Pressure and Body Posture.
MATERIALS AND METHODS
A total of 30 asymptomatic subjects were selected for the study including 18 females and 12 males from age group 22 years to 28 years with a mean age of 24.83 years. Each subject underwent evaluation of occlusion at MIP using a Digital Occlusal analyzer (T-Scan III). At this point, the subjects were made to stand on a mat scan which consisted of a large postural platform sensor and a computer that displayed the plantar pressure data. The computer connected to the T Scan displayed the occlusal pressure analysis. This was followed by an evaluation of body posture using a posture grid where the photographs were taken and an evaluation of the frontal and lateral photos was done using the APECS - posture analysis app.
STATISTICAL ANALYSIS USED
Statistical package for social sciences (SPSS) for windows version 22.0 Released 2013, Armonk, N Y: IBM Corp., was used to perform Statistical Analysis. A chi-square test was applied for qualitative variables to find the association. Paired t-test was applied to compare the changes in the quantitative parameters in eye-open and eye-closed conditions. The level of significance was set at 5%.
RESULTS
As observed from the results, occlusion for 40% of the subjects, where n = 12, was dominant on the right side. Occlusion for 23.3% of subjects, where n = 7, was dominant on the left side. Whereas, for 36.7% of subjects, where n = 11, the pressure distribution was almost equal on both sides. The inclination of body posture for 23.3% of subjects, where n = 7, was towards the right side. The inclination of body posture for 50% of subjects, where n = 11, was towards the left side. And, the inclination of body posture for 26.7% of subjects, where n = 8, was neutral i.e., balanced on the right and left side. Plantar pressure for 6.7% of subjects, where n = 2, was dominant on the right side. Plantar pressure for 36.7% of subjects, where n = 11, was dominant on the left side. Whereas, for 56.7% of subjects, where n = 17, the plantar pressure distribution was almost equal on both sides.
CONCLUSION
On correlating the three parameters, it was found that occlusion for most of the subjects dominated on the right side, while body posture and plantar pressure dominated on the contralateral i.e., left side.
Topics: Humans; Male; Female; Posture; Adult; Pressure; Young Adult; Foot; Dental Occlusion
PubMed: 38946511
DOI: 10.4103/jips.jips_497_23 -
Journal of Indian Prosthodontic Society Jul 2024Occurrence of denture stomatitis and prosthesis breakage are common problems faced by elderly people wearing removable dentures. To overcome this, several attempts are...
AIM
Occurrence of denture stomatitis and prosthesis breakage are common problems faced by elderly people wearing removable dentures. To overcome this, several attempts are made to improve the denture material by addition of antimicrobials without compromising original properties. The aim of the study was to evaluate flexural strength and microhardness of self-cured polymethyl methacrylate (PMMA) denture base resin after addition of Vaccinium macrocarpon (commonly called as cranberry), extract as antimicrobial, at varying proportions.
STUDY SETTING AND DESIGN
Experimental in vitro study.
MATERIALS AND METHODS
Frozen cranberry fruits were subjected to extraction process in the presence of aqueous solvents. Lyophilized extract was added in proportions of 0, 0.5, 1.0, 1.5, and 2.0 dry wt/wt % into polymer of self-cure PMMA denture base resin. Based on cranberry inclusion, the study comprised one control (0%) and four test groups (0.5%-2%) with total of 100 samples. A three-point bending test for flexural strength was done for fifty study samples (n = 10). Surface of fractured samples was analyzed using a scanning electron microscope (SEM). Microhardness was determined using Vickers hardness test.
STATISTICAL ANALYSIS USED
One-way statistical ANOVA test was done to find the difference between groups, followed by Tukey's post hoc test for multiple pairwise comparison.
RESULTS
Flexural strength ranged from 66.80 to 69.28 MPa, and a statistically insignificant difference was observed between groups (P > 0.05). SEM evaluation showed uniformly dispersed strands of cranberry extract in PMMA matrix. With higher concentration, less voids were seen. Vickers microhardness value significantly decreased from 15.96 in the control group to 14.57 with 2% cranberry addition (P < 0.05).
CONCLUSION
Incorporation of cranberry extract into self-cure PMMA denture base resin, up to 2 dry wt %, did not decline the flexural strength. However, there was a significant decrease in Vickers microhardness values when compared against the control group (0% cranberry inclusion).
Topics: Polymethyl Methacrylate; Hardness; Flexural Strength; Vaccinium macrocarpon; Plant Extracts; Materials Testing; Humans; Denture Bases; Dental Materials; Anti-Infective Agents; In Vitro Techniques
PubMed: 38946510
DOI: 10.4103/jips.jips_25_24 -
Journal of Indian Prosthodontic Society Jul 2024Assessment of occlusion changes during laboratory phase of relining is essential to evaluate the occlusal discrepancies that could get incorporated in the denture with...
AIM
Assessment of occlusion changes during laboratory phase of relining is essential to evaluate the occlusal discrepancies that could get incorporated in the denture with the use of different relining materials. Since the long term stability and functional success of the denture is heavily influenced by occlusion, an In-vitro study to assess these changes after relining is warranted. The aim of the study is to evaluate the changes in occlusion during laboratory phase of relining procedure.
SETTINGS AND DESIGN
This is an in vitro study with a total of 30 specimen.
MATERIALS AND METHODOLOGY
A total of 30 maxillary standardized dentures were fabricated after mounting on a semi adjustable articulator. These samples will be divided into three groups based on the relining material used (Autopolymerizing resin, Heat-cure resin, Tissue conditioner). The vertical dimension, Centric contact points and eccentric contact points were measured before and after relining.
STATISTICAL ANALYSIS USED
The variables were tested to see if they had a normal distribution using the Shapiro-Wilk test. Parametric distribution was seen for ECP leading to further comparison using one way analysis of variance (ANOVA). Non-parametric distribution was found while testing the VD, CCP leading to adoption of Kruskal-wallis test for comparison of groups. Dunn Bonferroni test was done for VD since results were significant.
RESULTS
The results of this in-vitro study showed statistically significant difference with respect to change in vertical dimension in all groups pre and post relining (P = 0.005). The centric contact points showed lesser variation in position when comparing the pre to the post relining phase with the use of autopolymerising resins, whereas heat cure resins and tissue conditioners showed statistically significant difference in the centric point contacts post relining. No statistically significant changes were seen in eccentric occlusion post relining in all groups. Tissue conditioners showed minimum mean changes in eccentric contacts.
CONCLUSION
Within the limitations of this study, the use of autopolymerising resins depicted the most stable results with respect to occlusion, for relining of dentures.
Topics: Humans; In Vitro Techniques; Dental Occlusion; Denture Retention; Dental Materials; Denture Liners
PubMed: 38946509
DOI: 10.4103/jips.jips_363_23