Ex-Vivo Evaluation of X-Ray Horizontal Angle for Separating the Canals of Four-Canal First Mandibular Molars

INTRODUCTION: A variety of mesial and distal projections have been suggested for separating the canals in a multi-canaled root. But there is no general agreement on the best angulation for each tooth. The purpose of this study was to evaluate the X-ray horizontal angle for separating the canals of four-canal first mandibular molars. MATERIALS AND METHODS: Forty four-canaled mandibular molars were selected. After preparation of coronal access cavities, files were inserted into the root canals and the specimens were radiographed at 10, 15, 20, 25 degrees mesial and distal horizontal angulations. Apices and canals were evaluated. Chi-square test was used for statistical analysis. RESULTS: Although 10° and 15° mesial and distal angulations were best for the most obvious apices manifestation (P<0.001), it was found that 20° mesial angulation is significantly better than the other cone angulations (P<0.001) for separating the root canals. CONCLUSION: 20° mesial angulation improved detection of both the canals and canal terminus visibility

Evaluation of X-ray protective shielding used in dental offices in Kerman, Iran, in 2014

BACKGROUND AND AIM: Protective equipment, such as lead aprons and thyroid shields, is effective in reducing patient radiation. This study was conducted for evaluation the use of thyroid shields and lead aprons in dental offices, in Kerman, Iran, in June 2014. METHODS: In this descriptive-analytical study, 106 dental offices with active X-ray machines were evaluated in Kerman. The information was recorded on a data sheet consisting of eight questions in three fields of the rate of the use of lead aprons, thyroid shields and taking part in radiation protection courses. Data were evaluated using frequency distribution and chi-squared test. RESULTS: In this study, 12.3% of clinics were equipped with lead aprons but only 5.7% used them for all the patients. Only 10.4% of Kerman Dental Clinics had thyroid shields. Approximately, 9.7% of Kerman dentists had participated in continuous retraining courses on radiation protection. There was a significant relationship between clinics equipped with lead aprons with more job experience. CONCLUSION: The results showed that the rate of the use of lead aprons and thyroid shields in dental clinics equipped with X-ray machines in Kerman is not sufficient and is far from the international standards. Therefore, it is suggested that radiation protection equipment be promoted and oral and dental radiologists be responsible for the use of such equipment in their clinics. KEYWORDS: Patient Protection; Radiation; Dentist

General Dental Practitioners’ Concept towards Using Radiography and Apex-Locators in Endodontics

Introduction:Despite being the gold standard as well as a routine technique in endodontics, radiographic working length (WL) determination owns many drawbacks. Electronic apex-locators (EALs) are recommended to complement radiographies. The aim of this study was to evaluate the perceptions of Iranian general dental practitioners (GDPs) towards using radiography and EAL. Methods and Materials: Three hundred and ninety one GDPs attending the 53th Iranian Dental Association Congress completed a questionnaire focusing on the use of radiography and EALs during the various stages of root canal treatment. The data was analyzed with the chi-square test with the level of significance set at 0.05. The results were then calculated as frequencies and percentages. Results: More than half of the GDPs reported using radiographs as the sole method for WL determination. A total of 30.4% of the practitioners were using the combined approach during root canal therapy of a single-rooted tooth, while 38.9% used this method in multi-rooted teeth. Approximately half of the respondents would not order follow-up radiographies after root canal treatment. Conclusion: Radiography continues to be the most common method for WL determination in Iran

Comparative Antimicrobial Efficacy of Eucalyptus Galbie and Myrtus Communis L. Extracts, Chlorhexidine and Sodium Hypochlorite against Enterococcus Faecalis

Introduction: The aim of this study was to evaluate the antimicrobial effect of Eucalyptus galbie and Myrtus communis L. methanolic extracts, chlorhexidine (CHX) and sodium hypochlorite (NaOCl) on Enterococcus faecalis (E. faecalis) as the predominant species isolated from infected root canals. Methods and Materials: One hundred twenty mandibular premolars were randomly divided into 8 groups: Eucalyptus galbie (E. galbie) 12.5 mg/mL, Myrtus communis L. (M. communis L.) 6.25 mg/mL, 0.2% CHX, %2 CHX, 2.5% NaOCl, 5.25% NaOCl, positive and negative control group. Sampling was performed using paper points (from the root canal space lumen) and Gates-Glidden drills (from the dentinal tubules); then colony forming units (CFU) were counted and analyzed using the Kruskal-Wallis test, followed by Mann Whitney U test. The level of significance was set at 0.05. Results: All irrigants reduced more than 99% of bacteria in root canal. In the presence of M. communis L. and E. galbie, the bacterial count in dentin were significantly more than CHX and NaOCl groups (P<0.05) except 0.2% CHX in 200 µm and 400 µm depths (P>0.05). Conclusion: Although 5.25% NaOCl was the most effective irrigant, all agents exerted acceptable antimicrobial activity against E. faecalis.Keywords: Antibacterial Agent; Eucalyptus; Myrtus; Root Canal Therap

Preferred Materials and Methods Employed for Endodontic Treatment by Iranian General Practitioners

Introduction: The aim of this study was to gather information on the materials and methods employed in root canal treatment (RCT) by general dental practitioners (GDPs) in Iran. Methods and Materials: A questionnaire was distributed among 450 dentists who attended the 53th Iranian Dental Association congress. Participants were asked to consider demographic variables and answer the questions regarding the materials and methods commonly used in RCT. Descriptive statistics were given as absolute frequencies and valid percentages. The chi-square test was used to investigate the influence of gender and the years of professional activity for the employed materials and techniques. Results: The response rate was 84.88%. The results showed that 61.5% of the participants did not perform pulp sensitivity tests prior to RCT. Less than half of the general dental practitioners (47.4%) said that they would trace a sinus tract before starting the treatment. Nearly 16% of practitioners preferred the rubber dam isolation method. Over 36% of the practitioners reported using formocresol for pulpotomy. The combined approach of working length (WL) radiographs and electronic apex locators was used by 35.2% of the practitioners. Most of the respondents used K-file hand instruments for canal preparation and the technique of choice was step-back (43.5%), while 40.1% of respondents used NiTi rotary files, mostly ProTaper and RaCe. The most widely used irrigant was normal saline (61.8%). Calcium hydroxide was the most commonly used inter appointment medicament (84.6%). The most popular obturation technique was cold lateral condensation (81.7%) with 51% using zinc oxide eugenol-based sealers. Conclusions: The majority of Iranian GDPs who participated in the present survey do not comply with quality guidelines of endodontic treatment

Effectiveness of amlexanox and adcortyl for the treatment of recurrent aphthous ulcers

Background: Recurrent aphthous stomatitis (RAS) is a common condition that affects approximately 20% of the general population. The ulcers can interfere with speech and eating and cause significant pain and discomfort. This study aimed to evaluate the efficacy of Amlexanox and Adcortyl in the treatment of aphthous ulcers. Material and Methods: In this randomized double blind clinical trial with sequential patient entry, a total of 40 patients who presented with aphthous ulcers were included. Patients were received Amlexanox or Adcortyl four times daily for 7 days. Patients were evaluated for pain, lesion size, and tingling at one day, three days, five days and seven days follow-ups. The treatment effects were then evaluated using the Wilcoxonâ Mannâ Whitney (WMW) test. Values of p<0.05 were considered significant. Results: No significant differences in pain score, tingling and lesion size were observed on similar days between Amlexanox and Adcortyl groups. In both groups, reduction in the assessed variables was significant between days 1-3, 3-5, and 5-7 (p < 0.001). Conclusions: This study indicated that Amlexanox as well as Adcortyl was effective in relieving pain and reducing the lesion size during the treatment of aphthous ulcers

The use of re-surgery in the treatment of teeth with severe sensitivity in the buccal mucous membrane: A case report with 75 months follow-up

BACKGROUND AND AIM: A periapical endodontic surgery is an alternative treatment when teeth are not responding to conventional treatment and endodontic re-treatment. CASE REPORT: The following case report presents a clinical case of maxillary right and left central incisors with unsatisfying endodontic surgery and severe sensitivity in the buccal mucous membrane. Radiographic examination revealed several fragments of amalgam as root-end filling material, surrounded by a periapical radiolucent area. The chosen treatment plan was to perform endodontic retreatment. Symptoms persisted in spite of the gutta-percha removal and calcium hydroxide intracanal medication. Hence, periradicular re-surgery was performed. However, deep tissue penetrated amalgam particles were difficult to explore and could not be removed completely. The root-end filling was done with mineral trioxide aggregate (MTA), and the lesion was subjected to histologic analyses. The treatment was successful due to the absence of painful symptoms and due to periapical bone repair after 75 months follow-up. CONCLUSION: MTA can be used successfully in the situations with failed previous periradicular surgery with amalgam. KEYWORDS: Amalgam; Apicectomy; Mineral Trioxide Aggregate; Periapical Re-surgery; Root End Filling Materia

Prevalence of Upper Extremity Musculoskeletal Disorders in Dentists: Symptoms and Risk Factors

Aim. The purpose of the present research was to examine the factors that lead to musculoskeletal disorders in dentists by assessing their posture using RULA method. Materials and Methods. In this cross-sectional study, 130 dentists (84 male and 46 female) participated. The posture of the subjects during their normal workload was recorded by using the RULA method, and the range of musculoskeletal pains by using the Nordic Musculoskeletal Questionnaire (NMQ), and individual and professional data was assessed by a demographics questionnaire. All tests were performed at the P<0.05 level. Results. Assessment of the physical status of the subjects showed that 82.8% of subjects were at high risk of musculoskeletal disorders. The majority of musculoskeletal pains were in the neck (55.9%) and the shoulder (43.8%). Moreover, 68.9% of the subjects had experienced pain at least once over the last year. Significant relationships were observed between musculoskeletal pain and daily work hours P=0.07 and number of patients P=0.02, but the pain was not significantly associated with BMI and experience. Conclusion. The present findings showed that unsuitable posture of dentists during work has a considerable effect on musculoskeletal disorders. Therefore, further investigation is required to avoid the detrimental effects of wrong posture

The use of re-surgery in the treatment of teeth with severe sensitivity in the buccal mucous membrane: A case report with 75 months follow-up

BACKGROUND AND AIM: A periapical endodontic surgery is an alternative treatment when teeth are not responding to conventional treatment and endodontic re-treatment. CASE REPORT: The following case report presents a clinical case of maxillary right and left central incisors with unsatisfying endodontic surgery and severe sensitivity in the buccal mucous membrane. Radiographic examination revealed several fragments of amalgam as root-end filling material, surrounded by a periapical radiolucent area. The chosen treatment plan was to perform endodontic retreatment. Symptoms persisted in spite of the gutta-percha removal and calcium hydroxide intracanal medication. Hence, periradicular re-surgery was performed. However, deep tissue penetrated amalgam particles were difficult to explore and could not be removed completely. The root-end filling was done with mineral trioxide aggregate (MTA), and the lesion was subjected to histologic analyses. The treatment was successful due to the absence of painful symptoms and due to periapical bone repair after 75 months follow-up. CONCLUSION: MTA can be used successfully in the situations with failed previous periradicular surgery with amalgam

A modification of a previous model for inflammatory tooth pain: Effects of different capsaicin and formalin concentrations and ibuprofen

BACKGROUND AND AIM: This study aimed to solve the problems faced with the previous model of inflammatory tooth pain in rats. METHODS: After cutting 2 mm of the distal extremities, the polyethylene crowns were placed on the mandibular incisors. In contrast to the original model, we used flow composite instead of wire in order to maximize the retention of crowns. Different concentrations of capsaicin (10, 25 and 100 mg/ml) and formalin were administrated into the cavities under the crowns. The algesic agent-induced behaviors were evaluated. RESULTS: The modified model had no liquid leakage. Furthermore, composite allowed the crowns to remain for a longer period of time. Capsaicin 25, 100 mg/ml and formalin applications induced significantly more painful stimulation compared with control groups (P < 0.001). These responses were significantly reduced by the administration of ibuprofen, 20 minutes prior to the capsaicin 100 mg/ml injection. CONCLUSIONS: This model seems to be adequate for long-term pain related experiments in which fluid leakage elimination is important. KEY WORDS: Odontalgia, Capsaicin, Formalin, Model, Ra