Publications by authors named "Ajinkya M Pawar"

37 Publications

Diagnostic Accuracy of Pulp Vitality Tests and Pulp Sensibility Tests for Assessing Pulpal Health in Permanent Teeth: A Systematic Review and Meta-Analysis.

Int J Environ Res Public Health 2022 Aug 4;19(15). Epub 2022 Aug 4.

Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, India.

The current systematic review and meta-analysis was carried out to compare the diagnostic accuracy of pulp vitality and pulp sensibility tests in assessing pulpal health. PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, Google Scholar and Open Grey databases were searched and after assessing eligibility criteria the data were extracted. True-positive, false-positive, true-negative, false-negative, sensitivity and specificity values were extracted or calculated if not presented. Quality of studies was evaluated based on the QUADAS 2 tool. Meta-analysis was performed in MetaDTA (v2.0; Shinyapps, RStudio PBC, Boston, MA, USA) and Review Manager 5.3 (RevMan web; The Cochrane Collaboration, London, UK). Ten articles were included for qualitative synthesis and five for meta-analysis. The pooled diagnostic odds ratio for pulse oximeter (PO), electric pulp tester (EPT), cold test (CT) and heat test (HT) was 628.5, 10.75, 17.24 and 3.47, respectively. Pairwise comparison demonstrated a higher pooled mean sensitivity and specificity with PO compared with EPT. Comparison between PO and CT and between PO and HT also demonstrated a higher pooled mean sensitivity and specificity for PO. Summary points on receiver operating characteristic curves confirmed the ability of PO to correctly screen negatives in presenting patients as compared to EPT, CT and HT but no study was rated as good on quality assessment. PO can be considered as the most accurate diagnostic method as compared to EPT, CT and HT. This review provides information about the reliability and diagnostic accuracy of using pulp vitality and sensibility tests for assessing pulp status.
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http://dx.doi.org/10.3390/ijerph19159599DOI Listing
August 2022

The Multifaceted Influence of COVID-19 on Indian Dentists: A Cross-Sectional Survey.

Psychol Res Behav Manag 2022 1;15:1955-1969. Epub 2022 Aug 1.

Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlingga, Surabaya City, East Java, 60132, Indonesia.

Introduction: COVID-19 has had a new challenge on dental workers, radically altering clinical and personal management. The cross-sectional survey sought to examine and comprehend the influence of COVID-19 on Indian dentistry practitioners.

Methods: A 38-item questionnaire-based survey was communicated to Indian dental practitioners through a web-based form (Google form). The questionnaire was categorized into four sections: (i) Personal protective equipment (PPE), (ii) dental treatments, (iii) auxiliary management, and (iv) personal impact. The findings were examined and studied in order to comprehend the repercussions of COVID-19. The questionnaire was completed by 513 of the 1129 dentists to whom it was delivered.

Results: For the current questionnaire, a response rate that we received was 45.44%. When compared to the pre-pandemic era, the use of PPE has increased dramatically (95.7%). The use of PPE alleviated dental practitioners' and patients' doubts about viral transmission. The epidemic prompted the Ministry of Health and Family Welfare (MoHFW) to issue specific recommendations for dental treatments, which were followed by 92.5% of dentists. The majority of dentists reported a considerable impact on both financial and mental health concerns. Teleconsulting and distant learning gained greater prominence. The COVID-19 epidemic affected the lives of dental professionals both within and outside of the dental setting, as well as the auxiliary.

Conclusion: COVID-19 has left a trail of devastation in its aftermath. Dentists were affected both emotionally and professionally. Dentists rapidly and uniformly followed the revised recommendations.
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http://dx.doi.org/10.2147/PRBM.S370637DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9355021PMC
August 2022

The relationship between parents' oral hygiene knowledge and children with Down Syndrome's oral hygiene via OHI-S.

F1000Res 2022 31;11:374. Epub 2022 Mar 31.

Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashtra, 400008, India.

Down Syndrome (DS) is a genetic disorder that causes structural, functional anomalies, and intellectual disability. The common oral hygiene problems found in DS children are gingivitis, periodontal problems, pain, infection, and problems with the masticatory system. This study explored the relationship between parents' oral hygiene knowledge and oral hygiene of children with DS.   This was an observational analytical study. To assess parents' oral hygiene knowledge, a questionnaire consisting of 25 questions was distributed to 100 parents whose DS children in POTADS (Down Syndrome Parents Association) Surabaya. To assess the DS children's oral hygiene, dental exams were performed to calculate the individual Oral Hygiene Index-Simplified (OHI-S) scores by dividing the sum of the individual debris and calculus scores by six (the number of teeth examined). The data were analysed using regression analysis. There was a significant and strong inverse relationship between parents' oral hygiene knowledge and DS children's oral hygiene. Parents' oral hygiene knowledge affected DS children's oral hygiene. The results of the regression analysis indicated that a 1% increase in parents' knowledge caused a reduction in the OHI-S score to 7.377. A significant inverse relationship between parents' oral hygiene knowledge and DS children's oral hygiene was observed in this study. Further studies could be conducted to determine other variables that my influence both parents' oral hygiene knowledge and DS children's oral hygiene.
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http://dx.doi.org/10.12688/f1000research.87848.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9280112.2PMC
August 2022

COVID-19 Contraction Among Dental Healthcare Workers in the Department of Conservative Dentistry and Endodontics - A Retrospective Analysis During the Pandemic.

Risk Manag Healthc Policy 2022 22;15:1243-1252. Epub 2022 Jun 22.

Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashtra, 400008, India.

Introduction: The COVID-19 pandemic has led to major challenges for the healthcare sector across the globe including dental healthcare workers (DHCWs) due to the increased risk of transmission of virus during aerosol-generating procedures. We conducted the present retrospective analysis determining the risk of contraction of COVID-19 infection among DHCWs since the outbreak of the pandemic for a year (March 2020 through March 2021) in Mumbai.

Methods: In total, 18,058 patients visited the Nair Hospital Dental College for dental treatment related to the Department of Conservative Dentistry and Endodontics during the assessed year. All the patients were subjected to intensive triage, which included recording their body temperature, oxygen saturation level, travel, and COVID-19 exposure history.

Results: A total of 26 DHCWs were responsible for attending and treating the patients with all the standard infection control measures. Seventy-four (0.40%) patients out of 18058 were referred for a nasal rapid antigen test (RAT) on giving a positive affirmation about COVID-19 like symptoms when screened at the triage. Of those 74 patients referred, 20 reported a positive nasal rapid antigen test and the infection was confirmed by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). Among 26, 9 (34,7%) DCHWs were found to have contracted the infection during the assessed year.

Conclusion: The analysis found that the risk of COVID-19 infection contraction amongst the DHCWs is considerably less. This could be attributed to the intensive triage and the preventive measures taken while rendering treatment.
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http://dx.doi.org/10.2147/RMHP.S368076DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9234192PMC
June 2022

Oral Tissue Involvement and Probable Factors in Post-COVID-19 Mucormycosis Patients: A Cross-Sectional Study.

Healthcare (Basel) 2022 May 13;10(5). Epub 2022 May 13.

Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, Maharashtra, India.

The primary goal of this study was to assess the prevalence of oral involvement and, secondarily, the likely variables in patients with confirmed COVID-19 accompanied by mucormycosis infection. The study design was a cross-sectional descriptive sort that was performed at a tertiary centre. The non-probability convenience sampling approach was used to determine the sample size. Between May 2021 and July 2021, all patients who presented to our tertiary care centre with suspected mucormycosis were considered for the investigation. The research only included individuals with proven mucormycosis after COVID-19. The features of the patients, the frequency of intraoral signs/symptoms, and the possible variables were all noted. Of the 333 COVID-19-infected patients, 47 (14%) were diagnosed with confirmed mucormycosis. The mean (SD) age of the patients was 59.7 (11.9) years. Of the 47 patients with confirmed mucormycosis, 34% showed sudden tooth mobility, 34% expressed toothache, 8.5% reported palatal eschar, 34% presented with jaw pain, 8.5% had tongue discoloration, and 17% had temporomandibular pain. About 53% of the patients were known cases of type 2 diabetes mellitus, 89% of patients had a history of hospitalization due to COVID-19 infection, 89.3% underwent oxygen support therapy, and 89.3% were administered intravenous steroids during hospitalization due to COVID-19 infection. About 14% of the suspected cases attending the mucormycosis out-patient department (OPD) had been confirmed with definite mucormycosis. Oral involvement was seen in 45% of cases of CAM (COVID-associated mucormycosis). The most frequent oral symptoms presented in CAM were sudden tooth mobility and toothache. Diabetes and steroids were the likely contributing factors associated with CAM.
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http://dx.doi.org/10.3390/healthcare10050912DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9141919PMC
May 2022

Herbal Medications in Endodontics and Its Application-A Review of Literature.

Materials (Basel) 2022 Apr 25;15(9). Epub 2022 Apr 25.

Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, 90133 Palermo, Italy.

Herbal products are gaining popularity in dental and medical practice nowadays due to their biocompatibility, higher antimicrobial activity, antioxidant and anti-inflammatory properties. Herbal medicine has experienced rapid growth in recent years due to its beneficial properties, ease of availability, and lack of side effects. As pathogenic bacteria become more resistant to antibiotics and chemotherapeutic agents, researchers are becoming more interested in alternative products and treatment choices for oral diseases. As a result, natural phytochemicals separated from plants and utilized in traditional medicine are suitable substitutes for synthetic chemicals. The aim of this review article is to list and understand several herbal alternatives that are currently accessible for use as efficient endodontic medicaments. The herbal products used in endodontics have several advantages, including safety, ease of use, increased storability, low cost, and a lack of microbial tolerance. However, preclinical and clinical testing and interactions with other materials and adverse effects are required for these herbal products.
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http://dx.doi.org/10.3390/ma15093111DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9101381PMC
April 2022

Comparative evaluation of the effect of two pulpal medicaments on pain and bleeding status of mandibular molars with irreversible pulpitis post-failure of inferior alveolar nerve block: a double-blind, randomized, clinical trial.

PeerJ 2022 13;10:e13397. Epub 2022 May 13.

Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlingga, Surabaya City, East Java, Indonesia.

Background: Complete relief of pain due to irreversible pulpitis is challenging to obtain with analgesic medications. The high incidence of an inferior alveolar nerve block (IANB) failure makes it difficult for practitioners to perform endodontic treatment without implementing other anesthetic techniques, especially mandibular molars. The aim of this study was to compare efficacies of two different quantities of paraformaldehyde based pulpal medicaments to relieve the pain and control hyperemic pulp post-failure of IANB and supplementary technique in patients experiencing this symptomatic irreversible pulpitis in the permanent mandibular tooth.

Method: Eighty-two participants with severe pain pre-operatively (Heft Parker Visual Analogue Scale, VAS > 114 mm) were enrolled, and pain responses were recorded at different time intervals using the Heft Parker visual analogue scale. To the patients experiencing pain even after the administration of the standard IANB and supplemental intraligamentary injection, one of the two paraformaldehyde based pulpal medicaments was placed in the pulp chamber and sealed. Participants were recalled after 24-48 h (second visit) to assess pain and bleeding reduction.

Results: Results showed a significant decrease in pain severity and bleeding score post medicament placement ( < .05). Hence judicious use within a recommended period, pulpal medicaments can be considered safe.

Conclusion: Paraformaldehyde based pulpal medicament can be used as an alternative to manage pain in patients having severe irreversible pulpitis and hyperalgesia.
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http://dx.doi.org/10.7717/peerj.13397DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9109695PMC
May 2022

Shape and anatomical relationship of the mental foramen to the mandibular premolars in an Indian sub-population: a retrospective CBCT analysis.

Restor Dent Endod 2022 Feb 13;47(1):e1. Epub 2021 Dec 13.

Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, Korea.

Objectives: This study assessed the shape and anatomical relationship of the mental foramen (MF) to mandibular posterior teeth in an Indian sub-population.

Materials And Methods: In total, 475 existing cone-beam computed tomography records exhibiting 950 MFs and including the bilateral presence of mandibular premolars and first molars were assessed. Images were evaluated 3-dimensionally to ascertain the position, shape, and anatomical proximity of MFs to mandibular teeth. The position and shape of MFs were measured and calculated. The Pythagorean theorem was used to calculate the distance between the root apex of the mandibular teeth and the MF.

Results: MFs exhibited a predominantly round shape (left: 67% and right: 65%) followed by oval (left: 30% and right: 31%) in both males and females and in different age groups. The root apices of mandibular second premolars (left: 71% and right: 62%) were closest to the MF, followed by distal to the first premolars and mesial to the second premolars. The mean vertical distance between the MF and the nearest tooth apex calculated on sagittal sections was 2.20 mm on the right side and 2.32 mm on the left side; no significant difference was found according to sex or age. The distance between the apices of the teeth and the MF was ≥ 4 mm (left; 4.09 ± 1.27 mm and right; 4.01 ± 1.15 mm).

Conclusions: These findings highlight the need for clinicians to be aware of the location of the MF in treatment planning and while performing non-surgical and surgical endodontic procedures.
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http://dx.doi.org/10.5395/rde.2022.47.e1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8891471PMC
February 2022

Can Type of Instrumentation and Activation of the Final Irrigant Improve the Obturation Quality in Oval Root Canals? A Push-Out Bond Strength Study.

Biology (Basel) 2022 Jan 1;11(1). Epub 2022 Jan 1.

Division of District Early Intervention Centre, Department of Dentistry, Thane Civil Hospital, Thane 400601, India.

To appraise the outcome of file systems and activation of the final irrigant on the push-out bond strength of root fillings in oval canals. Single-rooted mandibular premolars ( = 180) with oval canals were divided into three groups ( = 60) for instrumentation: ProTaper Next (PTN), WaveOne (WO), and Self-adjusting File (SAF). The specimens were further divided into subgroups ( = 20) and subjected to final irrigation with activation by EndoActivator or passive ultrasonic irrigation or without activation. Then, the specimens were again subdivided ( = 10) and obturated with gutta-percha and AH Plus (GP-AH) or C-Point with EndoSequence bioceramic sealer (C-EBC). One-millimeter-thick horizontal slices were cut from the apical third of the root, 5 mm from the apex, and subjected to push-out bond strength (BS) testing. Specimens for which SAF was used exhibited higher BS values than those for which PTN or WO was used ( < 0.05). Activation of the final irrigation did not affect the BS of the root fillings. Root fillings made of C-EBC presented a higher BS than those made of GP-AH ( < 0.05). Adhesive failure was more common with specimens instrumented using PTN and WO. Root canals instrumented with SAF, showed the highest bond strength values for both root filling materials. The C-EBC produced significantly higher bond strength values than those of the GP-AH.
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http://dx.doi.org/10.3390/biology11010059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8773160PMC
January 2022

Deficiencies in Root Canal Fillings Subsequent to Adaptive Instrumentation of Oval Canals.

Biology (Basel) 2021 Oct 21;10(11). Epub 2021 Oct 21.

Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlingga, Surabaya 60132, Indonesia.

The purpose of this study was to explore the influence of instrumentation and the potential for debris deposition using XP-endo shaper plus (XP-SP) and full-sequence SAF (F-SAF) on the adaption of thermoplastic root canal fillings in oval canals. Following the manufacturer's instructions, ninety human permanent mandibular incisors with a single oval canal 6 mm from the apex (verified using pre-operative CBCT scanning) were instrumented with XP-SP and F-SAF. Obtura III Max apparatus was used for root canal obturation without the use of a root canal sealer. The roots were then sectioned 6 mm from the apex and examined with a digital stereomicroscope at x25 magnification to assess the root canal fillings. The F-SAF was associated with a significantly higher ( < 0.01) percentage of entire adaptation of the root fillings (76%) compared to the XP-SP (57%). Furthermore, the XP-SP group was also associated with higher ( < 0.01) defective obturation with debris at 17% and with voids at 26%. However, the F-SAF had lower percentages of defective obturations (7% with debris and 17% with voids). The quality of obturation of oval canals instrumented using full-sequence SAF was better.
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http://dx.doi.org/10.3390/biology10111074DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8615090PMC
October 2021

Three-dimensional semi-automated volumetric assessment of the pulp space of teeth following regenerative dental procedures.

Sci Rep 2021 11 9;11(1):21914. Epub 2021 Nov 9.

Department of Clinical Dentistry, Walailak University International College of Dentistry, Walailak University, Bangkok, 10400, Thailand.

The volumetric change that occurs in the pulp space over time represents a critical measure when it comes to determining the secondary outcomes of regenerative endodontic procedures (REPs). However, to date, only a few studies have investigated the accuracy of the available domain-specialized medical imaging tools with regard to three-dimensional (3D) volumetric assessment. This study sought to compare the accuracy of two different artificial intelligence-based medical imaging programs namely OsiriX MD (v 9.0, Pixmeo SARL, Bernex Switzerland, https://www.osirix-viewer.com ) and 3D Slicer ( http://www.slicer.org ), in terms of estimating the volume of the pulp space following a REP. An Invitro assessment was performed to check the reliability and sensitivity of the two medical imaging programs in use. For the subsequent clinical application, pre- and post-procedure cone beam computed tomography scans of 35 immature permanent teeth with necrotic pulp and periradicular pathosis that had been treated with a cell-homing concept-based REP were processed using the two biomedical DICOM software programs (OsiriX MD and 3D Slicer). The volumetric changes in the teeth's pulp spaces were assessed using semi-automated techniques in both programs. The data were statistically analyzed using t-tests and paired t-tests (P = 0.05). The pulp space volumes measured using both programs revealed a statistically significant decrease in the pulp space volume following the REP (P < 0.05), with no significant difference being found between the two programs (P > 0.05). The mean decreases in the pulp space volumes measured using OsiriX MD and 3D Slicer were 25.06% ± 19.45% and 26.10% ± 18.90%, respectively. The open-source software (3D Slicer) was found to be as accurate as the commercially available software with regard to the volumetric assessment of the post-REP pulp space. This study was the first to demonstrate the step-by-step application of 3D Slicer, a user-friendly and easily accessible open-source multiplatform software program for the segmentation and volume estimation of the pulp spaces of teeth treated with REPs.
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http://dx.doi.org/10.1038/s41598-021-01489-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8578625PMC
November 2021

Efficacy of 4% articaine 2% lidocaine in mandibular and maxillary block and infiltration anaesthesia in patients with irreversible pulpitis: a systematic review and meta-analysis.

PeerJ 2021 24;9:e12214. Epub 2021 Sep 24.

Department of Conservative Dentistry & Endodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India, Mumbai, India.

Objective: The goal of this systematic review and meta-analysis is to determine the performance of 4% Articaine 2% Lidocaine for mandibular and maxillary block and infiltration anaesthesia in patients with irreversible pulpitis (IP).

Methods: PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, Google Scholar, and Open Gray were used to conduct a thorough literature search. A manual search of the reference lists of the publications found was also carried out. Two reviewers critically evaluated the papers for inclusion and exclusion criteria, and data extraction was done on the selected publications. The Cochrane Collaboration Tool and the Minors checklist were used to assess the quality of the selected studies for randomised controlled trials (RCTs) and non-randomised studies, respectively. The RevMan software was used to perform a meta-analysis of the pooled data and subgroups according to the technique of anaesthetic solution delivery, as well as a sensitivity analysis ( < 0.05).

Results: A total of twenty-six papers were included in the qualitative synthesis, with twenty-two of them being included in the meta-analysis. There were fifteen studies with a low potential for bias, three with a moderate potential for bias, and seven with a high potential for bias. The combined results of the 19 trials in the tooth level unit revealed that 4% articaine had a success rate 1.37 times greater than 2% lidocaine for mandibular teeth (RR, 1.37; 95% CI [1.17-1.62];  = 0.0002). For the maxillary buccal infiltration method, the combined results from the three trials revealed that 4% articaine resulted in a success rate 1.06 times greater than 2% lidocaine (RR, 1.06; 95% CI [0.95-1.2];  = 0.3). Excluding subgroups with a single study in sensitivity analysis for mandibular teeth revealed a substantial improvement in the success rate of the articaine group in treating IP when compared to the lidocaine group.

Conclusion: The findings of this meta-analysis back up the claim that articaine is more effective than lidocaine in providing anaesthesia in patients with IP. PROSPERO Registration No.: CRD42020204606 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020204606).
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http://dx.doi.org/10.7717/peerj.12214DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8475541PMC
September 2021

Endodontic Emergencies in Mumbai City during COVID-19 Lockdown and Different Phases of Unlock.

Int J Environ Res Public Health 2021 Jul 8;18(14). Epub 2021 Jul 8.

Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlingga, Surabaya City 60132, Indonesia.

The present descriptive research focused on determining the traits of patients who required endodontic treatment during the COVID-19 lockdown and various stages of unlocking in Mumbai metropolitan region. The descriptive analysis was carried out by examining the patients who were registered at Nair Hospital Dental College, Mumbai during four phases of lockdown (25 March to 31 May 2020) and eight phases of unlock (1 June 2020 to 31 January 2021). The evaluation was performed by evaluating the number of days and the overall number of patients reported for endodontic treatment for the first and subsequent visits. Each patient underwent intensive triage, which included taking their body temperature, oxygen saturation level, and travel history. The sex, age, and endodontic diagnosis of the offending tooth were also reported. The pain parameters were analyzed using a verbal numerical rating score (VNRS). During the lockdown phases, 297 patients seeking endodontic treatment visited the hospital over a total of 26 working days, and during the unlock phases, 16,195 patients visited the hospital over 189 working days. The average age of the patients that visited were 31-40 years of age (57.23%). The mean VNRS score was 5.85 ± 1.62. For both the lockdown and unlock periods, a significantly higher percentage of males visited dental school ( < 0.001). When compared to other stages, the number of patients attending during lockdown phase 4 (55.56%) and unlock phase 8 (32.35%) was the highest. The majority of endodontic emergency diagnoses were reversible pulpitis (36.5%) and symptomatic irreversible pulpitis (33.14%), all of which had higher mean VNRS ( < 0.05). Of the 49 patients that reported with COVID-19 symptoms, 11 tested positive. During the lockdown and unlock periods, 12 of the 41 treating workers tested positive. Personal protective equipment and patient screening are critical in shielding clinicians during the COVID-19 pandemic.
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http://dx.doi.org/10.3390/ijerph18147314DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303879PMC
July 2021

New classification for pulp chamber floor anatomy of human molars.

J Conserv Dent 2020 Sep-Oct;23(5):430-435. Epub 2021 Feb 10.

Department of Conservative Dentistry and Endodontics, TPCT's Dental College and Hospital, Navi Mumbai, Maharashtra, India.

Comprehensive knowledge of the entire root canal system is an essential prerequisite for successful routine endodontic treatments. The internal and external morphological configurations of roots and root canals are quite complex. Thus, several classifications have been put forth by researchers to appropriately understand the distinguishable features of root and root canal systems of multirooted teeth. Until now, the researchers have proposed new classification systems for a thorough understanding of the root canal systems, mainly concentrating on the root canal anatomy and anomalies. Moreover, with the advent of newer digital imaging systems, these classifications are more reproducible and relevant. They have further gained importance for the clinicians by acting as an aid in decision-making based on evidence-based dentistry. However, these classifications are primarily focused on the root canals, but none have assessed the anatomy of the pulp chamber floor. This review article delineates a novel Pawar and Singh molar pulp chamber floor classification© for the anatomy of maxillary and mandibular molars to ease the clinician's skills and further increase the prevailing literature for the benefit of researchers.
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http://dx.doi.org/10.4103/JCD.JCD_477_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066677PMC
February 2021

Apical debris extrusion during instrumentation of oval root canals in primary teeth using manual versus motorized files: an ex vivo study.

Sci Rep 2021 02 16;11(1):3859. Epub 2021 Feb 16.

Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlangga, Jl. Moestopo 47, Surabaya, Jawa Timur, Indonesia.

This study aimed to assess the apical extrusion of debris during instrumentation of primary canines using three endodontic file types. Forty-five extracted primary canines were randomly assigned to three instrumentation groups (n = 15): Hand K-files; and the motorized Kedo-S files and XP-endo Shaper files. The apically extruded debris produced during the procedure was collected and dried in pre-weighed Eppendorf tubes, and the mass of debris was calculated. The time required for the endodontic procedure was also recorded. Analysis of variance (ANOVA) and Tukey's post hoc test were used with a significance level set at 5%. XP-endo Shaper and Kedo-S files extruded significantly less debris compared with hand K-files with means of 0.84 ± 0.31 and 1.20 ± 0.67 mg respectively, compared to 2.13 ± 0.31 mg (p < 0.0001). No significant difference was found between the two motorized files. Less time was required to complete the procedure with the XP-endo Shaper compared to the hand K-files (p < 0.0001) and Kedo-S files (p < 0.0001). Within the limitations of the present study, it may be concluded that motorized files extruded less debris and required less instrumentation time compared to traditional K-files, which could benefit paediatric patients with root canal treatment needs.
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http://dx.doi.org/10.1038/s41598-021-83522-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7887259PMC
February 2021

Effect of Adaptive, Rotary, and Manual Root Canal Instrumentation in Primary Molars: A Triple-Armed, Randomized Controlled Clinical Trial.

Biology (Basel) 2021 Jan 10;10(1). Epub 2021 Jan 10.

Department of Endodontology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 69978, Israel.

This clinical trial focused on collating the instrumentation time and quality of root canal obturation in primary molars treated with three instrumentation techniques: adaptive, rotary, and manual. A triple-armed, randomized controlled clinical trial was performed on 75 primary molars requiring pulpectomy treatment, divided into three groups ( = 25 per group). The teeth in Group 1 were instrumented with an adaptive technique (XP-endo Shaper, FKG Dentaire, La Chaux-de-Fonds, Switzerland), Group 2 with pediatric rotary files (Kedo-S; D1 and E1), and Group 3 with a manual technique (hand K-files). The apical size of the final instrumentation was maintained at #30 for all groups. Instrumentation time and the grade of the root canal obturation were evaluated. Instrumentation duration was recorded, employing a digital stopwatch from the insertion of the first file until the completion of final irrigation. Obturation quality was assessed using radiographs. The criteria taken as a reference for obturation were: optimal (1 mm short of the apex), underfilled (2 mm short of the apex), or overfilled (beyond the apex). The use of an adaptive technique was associated with the lowest instrumentation time ( < 0.0001) when used for instrumenting primary molars and with the highest root canal filling quality of the three groups. The application of the new concept of adaptive instrumentation for pulpectomy of primary molars was a favorable technique, considering the significant reduction in instrumentation time and better obturation.
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http://dx.doi.org/10.3390/biology10010042DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7827152PMC
January 2021

Root canal configuration and root wall thickness of first maxillary premolars in an Israeli population. A Cone-beam computed tomography study.

Sci Rep 2020 01 16;10(1):434. Epub 2020 Jan 16.

Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College and Hospital, Mumbai, Maharashtra, India.

Anatomical features of first maxillary premolars may greatly affect endodontic and following restorative treatments. The aim of this study was to evaluate root canal configuration and root wall thickness of first maxillary premolars using a preexisting CBCT database. A CBCT database of 400 first maxillary premolar was used to study canal configuration, presence of furcation-facing groove on the buccal root and root wall thickness. Root wall thickness was measured from axial CBCT slices at three critical points of the root: The most coronal part of the furcation-facing groove in the buccal root, when present, the CEJ level of the palatal root and 5 mm apically to the CEJ level of the palatal root. Vertucci Type IV configuration was the most common among all teeth, but in single-rooted teeth, Vertucci Type II was predominant. The mean thickness of the buccal root in the area of a furcation-facing groove was 1.1 (±0.2) mm, but in 39% of the cases, it was thinner than 1 mm. The mean thickness of the palatal root at 5 mm from the CEJ was 1.1 (±0.2), but in 28% of the cases, it was thinner than 1 mm. Thickness of root dentin walls of first maxillary premolars varies and may be limited at critical points in both buccal and palatal roots. In case the patient has a previous CBCT scan it may be useful for planning treatment of first maxillary premolars, in order to recognize and avoid potential risks such as furcation-facing groove, thin dentin walls in critical areas and presence of Type II Verucci canal, all of which may dictate less invasive procedures, using smaller files.
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http://dx.doi.org/10.1038/s41598-019-56957-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6965655PMC
January 2020

Dentinal defects induced by 6 different endodontic files when used for oval root canals: an comparative study.

Restor Dent Endod 2019 Aug 29;44(3):e31. Epub 2019 Jul 29.

Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, Korea.

Objectives: To compare the formation of dentinal defects using stainless-steel hand K-files (HFs), rotary files, reciprocating files, and Self-Adjusting File (SAF), when used for oval root canals.

Materials And Methods: One hundred and forty extracted human mandibular premolar with single root and oval canal were selected for this study. Oval canals were confirmed by exposing to mesio-distal and bucco-lingual radiographs. Teeth with open apices or anatomic irregularities were excluded. All selected teeth were de-coronated perpendicular to the long axis of the tooth, leaving roots segments approximately of 16 mm in length. Twenty teeth were left unprepared (control), and the remaining 120 teeth were divided into 6 groups ( = 20) and instrumented using HF (size 40/0.02), Revo-S (RS; size 40/0.06), ProTaper NEXT (PTN; size 40/0.06), WaveOne (WO; size 40/0.09), RECIPROC (RC; size 40/0.06), and the SAF (2 mm). Roots were then sectioned 3, 6, and 9 mm from the apex, and observed under stereomicroscope, for presence of dentinal defects. "No defect" was defined as root dentin that presented with no visible microcracks or fractures. "Defect" was defined by microcracks or fractures in the root dentin.

Results: The control, HF, and SAF did not exhibit any dentinal defects. In roots instrumented by RS, PTN, WO, and RC files exhibited microcracks (incomplete or complete) in 40%, 30%, 55%, and 50%, respectively.

Conclusions: The motor-driven root canal instrumentation with rotary and reciprocating files may create microcracks in radicular dentine, whereas the stainless-steel hand file instrumentation, and the SAF produce minimal or less cracks.
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http://dx.doi.org/10.5395/rde.2019.44.e31DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6713082PMC
August 2019

Canal Transportation and Centering Ability in Long Oval Canals: A Multidimentional Analysis.

J Endod 2019 Oct 29;45(10):1242-1247. Epub 2019 Aug 29.

Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain.

Introduction: The purpose of this study was to evaluate and compare the centering ability and canal transportation of the ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland) and Self-adjusting File (SAF; ReDent-Nova, Ra'anana, Israel) systems in long oval root canals using cone-beam computed tomography imaging.

Methods: Fifty-six fully formed single-rooted mandibular premolars were selected with a buccolingual canal size 2 to 2.5 times the mesiodistal size at 5 mm from the apex, ranging from a 0°-10° canal curvature with a 5- to 6-mm radius. The teeth were divided into 2 groups (n = 28) and prepared with PTN or SAF according to the manufacturers' instructions. Cone-beam computed tomographic images were taken in the same position before and after instrumentation using modeling wax. The centering ability and canal transportation were calculated at 3, 6, and 9 mm from the apex in both mesiodistal and buccolingual directions. The mean and standard deviation were calculated, and the Student t test was used for comparative analysis.

Results: significant difference for canal transportation was observed mesiodistally at 9 mm from the apex (P < .05) where the PTN shaved more dentin in 1 direction. A significant difference for the centering ability was observed at 6 mm buccolingually from the apex (P < .05) where the PTN was less centered in the canal compared with the SAF.

Conclusions: Both SAF and PTN were shown to be safe for being used in long oval canals. SAF resulted in less transportation at the coronal third in the mesiodistal direction and more centered at the middle third in the buccolingual direction compared with PTN.
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http://dx.doi.org/10.1016/j.joen.2019.07.007DOI Listing
October 2019

Efficacy of compared to , , and sodium hypochlorite when used as root canal irrigants against and : An antimicrobial study.

J Conserv Dent 2018 Nov-Dec;21(6):642-645

Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India.

Aim: The aim is to test the antimicrobial activity of , (neem), and (curcumin) as a root canal irrigant, against and using agar diffusion test. Sodium hypochlorite (NaOCl) served as a standard control for comparisons.

Materials And Methods: The bacterial strains of and culture were grown overnight (18-20 h) in the brain heart infusion broth at 37°C and inoculated in Mueller-Hinton agar plates. Antibacterial inhibition was assessed using agar well-diffusion method using the methanolic extracts of the three plants to be tested and NaOCl. Bacterial inhibition zone around each well was recorded. The results were tabulated and analyzed statistically for significance.

Results: The novel showed significantly higher zone of inhibition against ( < 0.0001) compared to the experimental irrigants. Against , it exhibited similar results as that shown by NaOCl ( > 0.05).

Conclusion: Zones of inhibition exhibited by novel herbal agent were higher against and similar against , when compared to NaOCl.
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http://dx.doi.org/10.4103/JCD.JCD_118_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6249952PMC
December 2018

Improved survival with continuation of statins in bacteremic patients.

SAGE Open Med 2018 21;6:2050312118801707. Epub 2018 Oct 21.

Department of Pharmacy Practice, College of Pharmacy, The University of Rhode Island, Kingston, RI, USA.

Objectives: Varying statin exposures in bacteremic patients have different impacts on mortality. Among patients with adherent statin use, we sought to evaluate the impact of statin continuation on inpatient mortality in bacteremic patients.

Methods: A retrospective cohort study was conducted using Optum Clinformatics with matched Premier Hospital data (October 2009-March 2013). Patients with a primary diagnosis of bacteremia and 6 months of continuous enrollment prior to the admission, receiving antibiotics at least 2 days of antibiotics during the first 3 days of admission, were selected for inclusion. Furthermore, patients demonstrating adherent statin use based on 90 days of continuous therapy prior to admission were included. We then compared those continuing statin therapy for at least the first 5 days after admission and those not continuing during the admission.

Results: Simvastatin (53.2%) and atorvastatin (33.8%) were the most commonly used statins among the 633 patients who met our inclusion and exclusion criteria. Propensity score adjusted Cox proportional hazards regression models demonstrated significantly lower inpatient mortality among those continuing statin therapy compared with those not continuing (n = 232 vs 401, adjusted hazard ratio 0.25, 95% confidence interval 0.08-0.79).

Conclusion: Among patients adherent to their statin therapy prior to a bacteremia hospitalization, continued statin use after admission increased survival by 75% compared with those not continuing.
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http://dx.doi.org/10.1177/2050312118801707DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198392PMC
October 2018

Optimal duration for continuation of statin therapy in bacteremic patients.

Ther Adv Infect Dis 2018 Sep 17;5(5):83-90. Epub 2018 May 17.

Department of Pharmacy Practice, College of Pharmacy, The University of Rhode Island, Kingston, RI, USA Veterans Affairs Medical Center, Providence, RI, USA Brown University School of Public Health, Providence, RI, USA.

Background: Evidence suggests statins may improve survival in patients with bloodstream infections. However, there is no consensus on optimal timing and duration of exposure.

Objectives: To quantify statin therapy duration associated with decreased mortality in bacteremic statin users.

Methods: We conducted a case-control study using OptumClinformatics™ with matched Premier hospital data (1 October 2009-31 March 2013). Cases who died during the hospitalization were matched 1:1 to survivors on disease risk scores (DRSs). Post-admission statin therapy duration was evaluated in patients with at least 90 days of pre-admission continuous statin use. Classification and regression tree (CART) analysis was conducted to identify the optimal duration of statin continuation which provided the lowest inpatient mortality. Logistic regression was used to calculate the odds of mortality.

Results: We included 58 DRS matched pairs of cases and controls: 47 patients (41%) continued statin therapy during the hospital admission, 15 (32%) cases and 32 (68%) controls. The CART analysis partitioned the continuation of statin therapy at ⩾2 days, representing lower mortality for patients who continued statins for 2 days or more and higher mortality for patients who did not continue or remained on statins for only 1 day. Inpatient mortality was 76% lower among those with at least 2 days of continued statin use (odds ratio 0.24, 95% confidence interval 0.11-0.55).

Conclusion: Among matched cases and controls with at least 90 days of baseline statin use prior to the admission, the continuation of statins for at least 2 days after admission demonstrated a survival benefit among bacteremic patients.
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http://dx.doi.org/10.1177/2049936118775926DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6136116PMC
September 2018

Resistance to fracture of teeth instrumented using novel EndoStar E5 rotary versus ProTaper NEXT and WaveOne file systems.

J Conserv Dent 2018 Jan-Feb;21(1):52-56

Department of Surgical Sciences, College of Dentistry, Ajman University, Ajman, UAE.

Aim: The current study compared the fracture resistance of samples instrumented by two rotary files and a reciprocating file, obturated with gutta-percha and AH Plus.

Materials And Methods: A total of 60 freshly extracted mandibular premolar teeth with single roots and single canals were acquired and decoronated at or below the cementoenamel junction. The samples were randomly divided into four groups ( = 15). Group 1 control (noninstrumented/obturated), and for Groups 2-4 root canal instrumentation was done by EndoStar E5 (EE5), ProTaper NEXT (PTN), and WaveOne, respectively. Following instrumentation, the samples were obturated using gutta-percha cones and AH Plus sealer using lateral compaction. A week later, vertical load was applied to the specimen's canal in each group until fracture. The loads required for fracture were recorded and statistically analyzed.

Results: The mean loads required to fracture (Newton; N) for the four groups were; 388.54 (±29.93), 310.35 (±26.05), 328.40 (±20.67), and 278.54 (±34.16). The loads exhibited highly significant difference ( < 0.0001; analysis variance). The following Tukey's test confirmed, both samples in Groups 2 and 3 required similar loads for fracture ( > 0.05) and significantly higher than Group 4 ( < 0.01).

Conclusion: The samples instrumented by EE5 and PTN exhibit similar fracture resistance.
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http://dx.doi.org/10.4103/JCD.JCD_216_16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852936PMC
April 2018

Social Media Impact of the Food and Drug Administration's Drug Safety Communication Messaging About Zolpidem: Mixed-Methods Analysis.

JMIR Public Health Surveill 2018 Jan 5;4(1):e1. Epub 2018 Jan 5.

Program On Regulation, Therapeutics, And Law, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.

Background: The Food and Drug Administration (FDA) issues drug safety communications (DSCs) to health care professionals, patients, and the public when safety issues emerge related to FDA-approved drug products. These safety messages are disseminated through social media to ensure broad uptake.

Objective: The objective of this study was to assess the social media dissemination of 2 DSCs released in 2013 for the sleep aid zolpidem.

Methods: We used the MedWatcher Social program and the DataSift historic query tool to aggregate Twitter and Facebook posts from October 1, 2012 through August 31, 2013, a period beginning approximately 3 months before the first DSC and ending 3 months after the second. Posts were categorized as (1) junk, (2) mention, and (3) adverse event (AE) based on a score between -0.2 (completely unrelated) to 1 (perfectly related). We also looked at Google Trends data and Wikipedia edits for the same time period. Google Trends search volume is scaled on a range of 0 to 100 and includes "Related queries" during the relevant time periods. An interrupted time series (ITS) analysis assessed the impact of DSCs on the counts of posts with specific mention of zolpidem-containing products. Chow tests for known structural breaks were conducted on data from Twitter, Facebook, and Google Trends. Finally, Wikipedia edits were pulled from the website's editorial history, which lists all revisions to a given page and the editor's identity.

Results: In total, 174,286 Twitter posts and 59,641 Facebook posts met entry criteria. Of those, 16.63% (28,989/174,286) of Twitter posts and 25.91% (15,453/59,641) of Facebook posts were labeled as junk and excluded. AEs and mentions represented 9.21% (16,051/174,286) and 74.16% (129,246/174,286) of Twitter posts and 5.11% (3,050/59,641) and 68.98% (41,138/59,641) of Facebook posts, respectively. Total daily counts of posts about zolpidem-containing products increased on Twitter and Facebook on the day of the first DSC; Google searches increased on the week of the first DSC. ITS analyses demonstrated variability but pointed to an increase in interest around the first DSC. Chow tests were significant (P<.0001) for both DSCs on Facebook and Twitter, but only the first DSC on Google Trends. Wikipedia edits occurred soon after each DSC release, citing news articles rather than the DSC itself and presenting content that needed subsequent revisions for accuracy.

Conclusions: Social media offers challenges and opportunities for dissemination of the DSC messages. The FDA could consider strategies for more actively disseminating DSC safety information through social media platforms, particularly when announcements require updating. The FDA may also benefit from directly contributing content to websites like Wikipedia that are frequently accessed for drug-related information.
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http://dx.doi.org/10.2196/publichealth.7823DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5775485PMC
January 2018

Influence of root canal obturation using gutta-percha with three different sealers on root reinforcement of endodontically treated teeth. An comparative study of mandibular incisors.

J Conserv Dent 2017 Jul-Aug;20(4):241-244

Department of Prosthodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India.

Aim: The purpose of this study was to evaluate the vertical force required to fracture mandibular incisor teeth, obturated using gutta-percha with three different sealers.

Materials And Methods: Seventy-five extracted mandibular incisors with intact and fully formed apices, exhibiting single root and canal were acquired. The teeth were decoronated obtaining a root segments of 15 mm and were divided into five groups ( = 15). Group 1: left uninstrumented and unfilled (negative control). For groups 2-5, samples were instrumented using Protaper NEXT (X1 and X2). Group 2: left unobturated (positive control). Groups 3-5 were obturated using lateral compaction by gutta-percha and three sealers (AH Plus, Apexit, and EndoSequence BioCeramic™). All the samples were prepared for fracture testing and vertical load was applied till fracture. Statistical analysis was performed using ANOVA and Tukey's test, for the data recorded of the force required in Newton (N).

Results: The load required to fracture exhibited a significant difference. The intergroup analysis revealed, samples obturated using bioceramic sealer exhibited higher fracture resistance ( < 0.01).

Conclusion: The use of gutta-percha and a root canal sealer reinforces the root dentin, leading to increased fracture resistance against vertical forces. Bioceramic sealer group in them exhibited better results.
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http://dx.doi.org/10.4103/JCD.JCD_233_16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721505PMC
December 2017

Extrusion of Debris from Primary Molar Root Canals following Instrumentation with Traditional and New File Systems.

J Contemp Dent Pract 2017 Nov 1;18(11):1040-1044. Epub 2017 Nov 1.

Department of Endodontology, Faculty of Dentistry, The University of Hong Kong, Hong Kong.

Introduction: To assess the amount of debris extruded apically during instrumentation of distal canals of extracted primary molars by three instrument systems [ProTaper Universal (PTU), ProTaper NEXT (PTN), and self-adjusting file (SAF)] compared with conventional stainless steel hand K-files (HF, control).

Materials And Methods: Primary mandibular molars (n = 120) with a single distal canal were selected and randomly divided into four groups (n = 30) for root canal instrumentation using group I, HF (to size 0.30/0.02 taper), group II, PTU (to size F3), group III, PTN (to size X3), and group IV, SAF. Debris extruded during instrumentation was collected in preweighed Eppendorf tubes, stored in an incubator at 70°C for 5 days and then weighed. Statistical analysis was performed by one-way analysis of variance (ANOVA), followed by Turkey's post hoc test (p = 0.05).

Results: All the groups resulted in extrusion of debris. There was statistically significant difference (p < 0.001) in the debris extrusion between the three groups: HF (0.00133 ± 0.00012), PTU (0.00109 ± 0.00005), PTN (0.00052 ± 0.00008), and SAF (0.00026 ± 0.00004).

Conclusion: Instrumentation with SAF resulted in the least debris extrusion when used for shaping root canals of primary molar teeth.

Clinical Significance: Debris extrusion in primary teeth poses an adverse effect on the stem cells and may also alter the permanent dental germ. Debris extrusion is rarely reported for primary teeth and it is important for the clinician to know which endodontic instrumentation leads to less extrusion of debris.
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http://dx.doi.org/10.5005/jp-journals-10024-2172DOI Listing
November 2017

Effect of glide path preparation on apical extrusion of debris in root canals instrumented with three single-file systems: An comparative study.

J Conserv Dent 2017 Mar-Apr;20(2):110-114

Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India.

Aim: The aim of this study was to test the effect of new protocol of glide path preparation by 20/0.04 rotary file on apical extrusion of debris when instrumenting fine curved mesial canals in mandibular molars with Self-adjusting File (SAF) and compare it to a glide path prepared by 20/0.02 hand K-file and rotary OneShape (OS) and reciprocating WaveOne (WO) file instrumentation.

Materials And Methods: Sixty mandibular molars with curved mesial roots were selected and randomly divided into three groups ( = 20) for instrumentation. In two groups, glide path was prepared using 20/0.02 K-file for instrumentation by OS (size 25/0.06 taper) and WO (size 25/0.08 taper) files; in the remaining group, 20/0.04 rotary file was used for glide path preparation and instrumented by SAF (1.5 mm). The debris extruded during instrumentation was collected in preweighed Eppendorf tubes and stored in an incubator at 70°C for 5 days. Tubes containing the dry extruded debris were then weighed. One-way analysis of variance (ANOVA) was applied to the weights obtained, followed by Tukey's test for multiple comparison.

Results: The mean debris (g) extruded apically was 0.000651 ± 0.000291, 0.000823 ± 0.000319, and 0.000473 ± 0.000238 for Group 1 (20/0.02 + OS), Group 2 (20/0.02 + WO), and Group 3 (20/0.04 + SAF), respectively. The groups exhibited a significant difference ( < 0.01; ANOVA). Group 3 resulted in least debris extrusion compared to Groups 1 and 2 ( < 0.01; Tukey's test).

Conclusion: Glide path prepared to size 20/0.04 and SAF 1.5 mm instrumentation produce less debris in curved mesial canals of mandibular molars, compared to glide path established by 20/0.02 and instrumentation by OS and WO files.
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http://dx.doi.org/10.4103/0972-0707.212235DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5564236PMC
September 2017

Preservation of root canal anatomy using self-adjusting file instrumentation with glide path prepared by 20/0.02 hand files versus 20/0.04 rotary files.

J Conserv Dent 2017 Mar-Apr;20(2):81-85

Department of Orthodontics and Dentofacial Orthopaedics, Hitkarini Dental College and Hospital, Jabalpur, Madhya Pradesh, India.

Objectives: To compare the relative axis modification and canal concentricity after glide path preparation with 20/0.02 hand K-file (NITIFLEX) and 20/0.04 rotary file (HyFlex™ CM) with subsequent instrumentation with 1.5 mm self-adjusting file (SAF).

Materials And Methods: One hundred and twenty ISO 15, 0.02 taper, Endo Training Blocks (Dentsply Maillefer, Ballaigues, Switzerland) were acquired and randomly divided into following two groups ( = 60): group 1, establishing glide path till 20/0.02 hand K-file (NITIFLEX) followed by instrumentation with 1.5 mm SAF; and Group 2, establishing glide path till 20/0.04 rotary file (HyFlex™ CM) followed by instrumentation with 1.5 mm SAF. Pre- and post-instrumentation digital images were processed with MATLAB R 2013 software to identify the central axis, and then superimposed using digital imaging software (Picasa 3.0 software, Google Inc., California, USA) taking five landmarks as reference points. Student's -test for pairwise comparisons was applied with the level of significance set at 0.05.

Results: Training blocks instrumented with 20/0.04 rotary file and SAF were associated less deviation in canal axis (at all the five marked points), representing better canal concentricity compared to those, in which glide path was established by 20/0.02 hand K-files followed by SAF instrumentation.

Conclusion: Canal geometry is better maintained after SAF instrumentation with a prior glide path established with 20/0.04 rotary file.
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http://dx.doi.org/10.4103/0972-0707.212231DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5564249PMC
September 2017

Cone-beam computed tomography analysis of accessory maxillary ostium and Haller cells: Prevalence and clinical significance.

Imaging Sci Dent 2017 Mar 21;47(1):33-37. Epub 2017 Mar 21.

Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India.

Purpose: This study aimed to evaluate the prevalence of Haller cells and accessory maxillary ostium (AMO) in cone-beam computed tomography (CBCT) images, and to analyze the relationships among Haller cells, AMO, and maxillary sinusitis.

Materials And Methods: Volumetric CBCT scans from 201 patients were retrieved from our institution's Digital Imaging and Communications in Medicine archive folder. Two observers evaluated the presence of Haller cells, AMO, and maxillary sinusitis in the CBCT scans.

Results: AMO was observed in 114 patients, of whom 27 (23.7%) had AMO exclusively on the right side, 26 (22.8%) only on the left side, and 61 (53.5%) bilaterally. Haller cells were identified in 73 (36.3%) patients. In 24 (32.9%) they were present exclusively on the right side, in 17 (23.3%) they were only present on the left side, and in 32 (43.8%) they were located bilaterally. Of the 73 (36.3%) patients with Haller cells, maxillary sinusitis was also present in 50 (68.5%). On using chi-square test, a significant association was observed between AMO and maxillary sinusitis in the presence of Haller cells.

Conclusion: Our results showed AMO and Haller cells to be associated with maxillary sinusitis. This study provides evidence for the usefulness of CBCT in imaging the bony anatomy of the sinonasal complex with significantly higher precision and a smaller radiation dose.
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http://dx.doi.org/10.5624/isd.2017.47.1.33DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5370250PMC
March 2017

Maxillofacial trauma patterns associated with external auditory canal fractures: Cone beam computed tomography analysis.

Dent Traumatol 2017 Aug 27;33(4):276-280. Epub 2017 Apr 27.

Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India.

Background/aims: There is a paucity of literature on external auditory canal (EAC) fractures secondary to maxillofacial trauma, with most of the literature on EAC fractures consisting of isolated case reports. To the authors' best knowledge, this is the first study to use cone beam computed tomography to evaluate the EAC region. The aim of this study was to assess the prevalence of external auditory canal (EAC) fracture following maxillofacial trauma and to evaluate the association between EAC fracture and other maxillofacial fractures and the region of trauma.

Materials And Methods: One hundred patients were prospectively evaluated over 6 months from February to August 2016. The patients were referred for CBCT regarding temporomandibular joint or condylar fractures following maxillofacial trauma. Two observers (both experienced radiologists) assessed the EAC and associated fractures in the maxillofacial region.

Results: External auditory canal (EAC) fracture was confirmed in 32% of the patients. Of the EAC fractures, 68.75% and 31.25% were associated with mandibular fractures and non-mandibular fractures, respectively. Of the EAC fractures, 68.75% were single fractures and 31.25% of patients had multiple comminuted fractures. Significant association was observed on cross-tabulation of the fractured region and region of trauma with the presence of EAC fracture using chi-square test.

Conclusion: External auditory canal (EAC) fracture is associated with maxillofacial fractures with increased incidence in mandibular fractures compared to non-mandibular fractures.
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http://dx.doi.org/10.1111/edt.12336DOI Listing
August 2017
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