Non Surgical or Medical Management of Uretric Stone: A ReviewDrHeena tiwari
This document provides a review of non-surgical medical management options for ureteral stones. It discusses dietary modifications like increasing fluid intake to at least 2 liters per day to help prevent stone recurrence. Medications that increase urinary citrate levels like potassium citrate are also used. Diuretics may help facilitate stone passage by increasing renal fluid output. Herbal formulations are another treatment approach used to prevent stone recurrence. Overall, the review examines the evidence for various lifestyle changes and pharmacological therapies that can help control pain from stones and reduce stone formation without the need for surgery.
This study evaluated the efficacy of two different root canal sealers - AH Plus and MTA Fillapex - in strengthening teeth during endodontic therapy. 75 single-rooted teeth were instrumented and divided into 3 groups: Group A used AH Plus sealer, Group B used MTA Fillapex sealer, and Group C was unfilled. Obturated teeth were embedded in resin and force was applied until fracture. Teeth filled with AH Plus required the most force (235.9N) to fracture, followed by MTA Fillapex (168.5N), with unfilled teeth fracturing at the least force (90.7N). The authors concluded that AH Plus provided greater strength than
This meta-analysis evaluates the reliability of published evidence on regenerative endodontic procedures. It summarizes clinical and radiographic findings from studies on treating non-vital immature permanent teeth using regenerative techniques. The analysis finds good success rates for tooth survival and pathology resolution, but variable results for outcomes like apex closure and root development. Regenerative procedures are improving but factors important for success remain unclear, indicating more research is needed.
This systematic review compares the success rates of Endosequence bioceramic root repair material (BCRRM), mineral trioxide aggregate (MTA), and calcium hydroxide for apexification of necrotic immature permanent teeth. 9 studies met the inclusion criteria for review. The studies found that all three materials had similar success rates in terms of clinical symptoms. However, MTA and Endosequence BCRRM formed the apical barrier faster and allowed for single visit treatment, making them superior to calcium hydroxide which took 5-20 months. Further research is needed directly comparing MTA and Endosequence BCRRM.
Comparative Effects of Chewing Gums in Oral Health: An Original ResearchDrHeena tiwari
This study assessed the effects of sugar-free chewing gum on oral health by comparing plaque index and DMFT scores between patients who chewed gum daily versus a control group. Forty patients were divided into two groups - one using sugar-free gum for 20 minutes daily and a control group. Plaque index and DMFT scores were assessed monthly for both groups. The gum group showed significantly lower plaque accumulation and fewer caries incidents compared to the control group after two months. However, the benefits decreased after longer use, possibly due to decreased compliance. The study concluded that sugar-free gum can improve oral health when used regularly as an adjunct to brushing and flossing by stimulating saliva and reducing plaque and caries risk.
Malocclusion And Deleterious Oral Habits In South Indian Adolscent Population...DrHeena tiwari
This study evaluated the prevalence of malocclusion and associated oral habits in South Indian adolescents. The researchers assessed 1000 12-15 year olds using the Dental Aesthetic Index and found that 52% had some form of malocclusion. Deleterious oral habits were present in 21.2% of subjects and those with habits were more likely to have malocclusion than those without. Specific habits like tongue thrusting and mouth breathing were correlated with traits like crowding and open bite. The study concludes that malocclusion in this population is directly linked to the presence of oral habits.
Non Surgical or Medical Management of Uretric Stone: A ReviewDrHeena tiwari
This document provides a review of non-surgical medical management options for ureteral stones. It discusses dietary modifications like increasing fluid intake to at least 2 liters per day to help prevent stone recurrence. Medications that increase urinary citrate levels like potassium citrate are also used. Diuretics may help facilitate stone passage by increasing renal fluid output. Herbal formulations are another treatment approach used to prevent stone recurrence. Overall, the review examines the evidence for various lifestyle changes and pharmacological therapies that can help control pain from stones and reduce stone formation without the need for surgery.
This study evaluated the efficacy of two different root canal sealers - AH Plus and MTA Fillapex - in strengthening teeth during endodontic therapy. 75 single-rooted teeth were instrumented and divided into 3 groups: Group A used AH Plus sealer, Group B used MTA Fillapex sealer, and Group C was unfilled. Obturated teeth were embedded in resin and force was applied until fracture. Teeth filled with AH Plus required the most force (235.9N) to fracture, followed by MTA Fillapex (168.5N), with unfilled teeth fracturing at the least force (90.7N). The authors concluded that AH Plus provided greater strength than
This meta-analysis evaluates the reliability of published evidence on regenerative endodontic procedures. It summarizes clinical and radiographic findings from studies on treating non-vital immature permanent teeth using regenerative techniques. The analysis finds good success rates for tooth survival and pathology resolution, but variable results for outcomes like apex closure and root development. Regenerative procedures are improving but factors important for success remain unclear, indicating more research is needed.
This systematic review compares the success rates of Endosequence bioceramic root repair material (BCRRM), mineral trioxide aggregate (MTA), and calcium hydroxide for apexification of necrotic immature permanent teeth. 9 studies met the inclusion criteria for review. The studies found that all three materials had similar success rates in terms of clinical symptoms. However, MTA and Endosequence BCRRM formed the apical barrier faster and allowed for single visit treatment, making them superior to calcium hydroxide which took 5-20 months. Further research is needed directly comparing MTA and Endosequence BCRRM.
Comparative Effects of Chewing Gums in Oral Health: An Original ResearchDrHeena tiwari
This study assessed the effects of sugar-free chewing gum on oral health by comparing plaque index and DMFT scores between patients who chewed gum daily versus a control group. Forty patients were divided into two groups - one using sugar-free gum for 20 minutes daily and a control group. Plaque index and DMFT scores were assessed monthly for both groups. The gum group showed significantly lower plaque accumulation and fewer caries incidents compared to the control group after two months. However, the benefits decreased after longer use, possibly due to decreased compliance. The study concluded that sugar-free gum can improve oral health when used regularly as an adjunct to brushing and flossing by stimulating saliva and reducing plaque and caries risk.
Malocclusion And Deleterious Oral Habits In South Indian Adolscent Population...DrHeena tiwari
This study evaluated the prevalence of malocclusion and associated oral habits in South Indian adolescents. The researchers assessed 1000 12-15 year olds using the Dental Aesthetic Index and found that 52% had some form of malocclusion. Deleterious oral habits were present in 21.2% of subjects and those with habits were more likely to have malocclusion than those without. Specific habits like tongue thrusting and mouth breathing were correlated with traits like crowding and open bite. The study concludes that malocclusion in this population is directly linked to the presence of oral habits.
This study evaluated digital palmar dermatoglyphic patterns in patients with oral submucous fibrosis (OSMF) and oral leukoplakia. The study included 200 patients divided into 4 groups - group I had patients with oral leukoplakia, group II had patients with OSMF, group III had patients with habits but no lesions, and group IV was a control group without habits or lesions. Fingerprints and palm prints were taken digitally and analyzed qualitatively and quantitatively. The results found an increase in whorls, palmar patterns in the I2-I3 area, total finger ridge count, total triradius count, and a decrease in atd angle and a-b ridge
This case report describes an extremely rare case of severe dilaceration (117° palatal inclination) of the root of a maxillary second premolar tooth. Trauma to primary teeth can result in developmental disturbances to permanent successor teeth, including crown and root dilaceration. Dilacerated teeth pose challenges for diagnosis, treatment planning, endodontic access, and extraction. In this case, the maxillary second premolar tooth was severely dilacerated and had to be extracted. Dilaceration is an abnormality that requires a multidisciplinary approach and modified treatment procedures.
This document discusses a study that assessed the knowledge of dental professionals (graduate and post-graduate) regarding the use of bone grafts in dentistry. A survey of 100 dental professionals found that many general dentists do not perform bone grafting and refer such procedures to specialists, as the techniques are sensitive. The study also found that around half of clinicians prefer synthetic bone substitutes like hydroxyapatite ceramic material to avoid surgery for bone grafts, based on patient preference. The document provides background information on different types of bone grafts and their properties and classifications.
An Evaluation of Short Term Success and Survival Rate of Implants Placed in F...DrHeena tiwari
An Evaluation of Short Term Success and Survival Rate of Implants Placed in Fresh Extraction Socket Post Prosthetic Rehabilitation- A Prospective Study
This review paper analyzed 1300 publications in the Journal of Maxillofacial Oral Surgery from 2009 to 2020 to evaluate trends in levels of evidence. The analysis found that case reports and narrative reviews with a level D evidence accounted for 36% of publications. The majority (35%) of articles fell under maxillofacial pathology. The percentage of higher levels of evidence (A and B) increased from 2.09% in 2009/2010 to 12.74% in 2019/2020, indicating improving research quality over time. Categorizing publications by level of evidence and topic can help refine research quality in the journal going forward.
Effectiveness of Low-Level Lasers in the Management of Recurrent Aphthous Sto...DrHeena tiwari
This study assessed the effectiveness of low-level lasers in treating recurrent aphthous stomatitis. 30 subjects with minor, major, or herpetiform aphthae were treated with lasers and their pain was evaluated using VAS scores. For all groups, pain was significantly less after 24 hours and further reduced at 72 hours compared to pre-treatment levels. At 1 week, pain scores were minimal or zero. The results demonstrated that low-level lasers provide effective pain relief and accelerated healing for recurrent aphthous stomatitis lesions.
Epidemiology of Orofacial Pain in Population of Jammu City in India: An Origi...DrHeena tiwari
This study evaluated the etiology of orofacial pain among 400 patients visiting private clinics in Jammu, India. The results showed that dental caries leading to pulpitis was the most common cause of orofacial pain, affecting 96 patients. Periodontal disease and tooth sensitivity were also significant causes. Orofacial pain was more prevalent in females aged 26-35 years. The pain most commonly worsened during sleep and evenings and lasted less than 1 hour for many subjects. This study concluded that dental caries is the primary etiology of orofacial pain in this population and treatment should be tailored based on the identified cause.
Effectiveness of Low-Level Lasers subsequent to Third Molar Surgery: An Origi...DrHeena tiwari
This study assessed the effectiveness of low-level lasers in reducing postoperative pain, swelling, and trismus following third molar surgery. 32 patients who required bilateral lower wisdom tooth removal were treated, with one side receiving laser treatment and the other serving as the control. Pain was significantly lower on the laser treated side on days 6-7, though swelling and trismus did not significantly differ between sides. The results suggest low-level lasers may help reduce pain following third molar surgery when applied immediately after surgery.
Modification of Distal Shoe- A Systematic Review & Meta AnalysisDrHeena tiwari
The document summarizes a systematic review of modifications to the distal shoe space maintainer. It analyzes 6 studies on modified distal shoe designs. The studies showed that the modifications provided stability, adjustability, and were well-accepted by patients. However, the quality of the studies was low and conclusions about the efficacy of the modifications were inconclusive due to a lack of clear reporting on outcomes. Further high-quality research is needed to establish the effectiveness of modified distal shoe space maintainers.
This document provides an overview of a new 12-part series on endodontics in the British Dental Journal. It discusses the editor's goal to update the classic textbook "Endodontics in Practice" to reflect modern research and techniques in endodontics. The series will cover the basic concepts and technical procedures of endodontics over 12 parts. While some traditional techniques are described for undergraduate education, the emphasis is on applying current knowledge of root canal anatomy and the microbial causes of disease to shape canals for thorough cleaning and 3D filling.
1) This document discusses who may benefit from orthodontic treatment, including those seeking improved aesthetics, occlusal function, or long-term dental health.
2) Some malocclusions like an overjet over 9mm or anterior crossbites can cause dental trauma or damage teeth over time if left untreated.
3) Minor malocclusions may see little overall improvement from treatment and have a high risk of relapse, so these cases should be treated with caution.
A color atlas of orofacial health and disease in children and adolescentsNay Aung
This document provides an introduction to the second edition of "A COLOR ATLAS OF OROFACIAL HEALTH AND DISEASE IN CHILDREN AND ADOLESCENTS". It lists the authors and their credentials, acknowledges contributions from colleagues, and summarizes updates and improvements made for this edition, including additional conditions covered, more illustrations, and treatment recommendations for common oral diseases in pediatric patients. The atlas is intended to assist various medical professionals in diagnosing and treating oral problems in children.
This document discusses a study that assessed awareness and knowledge of forensic odontology among dental professionals in India. The study found that most participants (93.5%) had studied forensic odontology basics in undergraduate studies. However, around 78.4% were unaware of preserving dental records for future forensic needs. While 75.3% understood signs of child abuse and 56.3% could document bite marks, most (77.9%) did not know that dentists can be expert witnesses. The study concludes there is a general lack of forensic odontology knowledge and practice among Indian dental practitioners.
This randomized clinical trial compared the survival of composite resin restorations and metal-ceramic crowns on endodontically treated teeth over a follow-up period of 1 to 5 years. 57 restorations were placed in 47 patients, with 30 being composite resin and 27 being metal-ceramic crowns. One tooth was extracted in the composite group due to root fracture. There were 8 failures in the composite group and 1 failure in the crown group, mostly due to secondary caries or restoration fracture. Metal-ceramic crowns demonstrated better clinical performance and lower need for re-intervention, but both types of restorations showed good survival rates with no significant difference.
Marginal and Internal Fit of Different Fixed Dental Prostheses: A Comparative...DrHeena tiwari
This study compared five methods for assessing the marginal and internal fit of fixed dental prostheses: the cross-sectional method, silicone replica technique, triple scan method, micro-computed tomography, and optical coherence tomography. Measurements of the marginal gap, axial gap, angle gap, and occlusal gap found statistically significant differences between the methods. The cross-sectional method and silicone replica technique showed the lowest mean values and were the most similar, while the triple scan method and optical coherence tomography also showed similarities. The study concluded that while fit values may fall within clinically acceptable ranges, differences between assessment methods should be considered.
This study compared the antifungal efficacy of various endodontic irrigants, with and without the antifungal agent clotrimazole, against Candida albicans in extracted human teeth. Teeth were inoculated with C. albicans and irrigated with sodium hypochlorite, chlorhexidine gluconate, doxycycline hydrochloride, or combinations of these with 1% clotrimazole. Colony forming units were significantly lower for sodium hypochlorite and chlorhexidine alone compared to doxycycline or the control. Adding clotrimazole increased the efficacy of all irrigants, with no significant difference between sodium hypochlorite with
This case report describes the use of mineral trioxide aggregate (MTA) in apexification of two immature permanent teeth with open apices and periapical lesions in a 14-year old patient. After cleaning and shaping the root canals, MTA was used to create an apical plug in each canal. Follow up radiographs at 6 and 12 months showed periapical healing and apical closure of the teeth. MTA is described as a promising alternative to traditional calcium hydroxide treatment for apexification due to its superior biocompatibility and ability to stimulate hard tissue formation.
This systematic review compared the success of Endosequence bioceramic root repair material (BCRRM), mineral trioxide aggregate (MTA), and calcium hydroxide for apexification of immature permanent teeth. 9 studies involving a total of over 400 potential studies were included. The studies found that while all three materials showed similar clinical success rates, MTA and BCRRM formed apical barriers faster than calcium hydroxide. More research is still needed directly comparing MTA and BCRRM.
This study evaluated digital palmar dermatoglyphic patterns in patients with oral submucous fibrosis (OSMF) and oral leukoplakia. The study included 200 patients divided into 4 groups - group I had patients with oral leukoplakia, group II had patients with OSMF, group III had patients with habits but no lesions, and group IV was a control group without habits or lesions. Fingerprints and palm prints were taken digitally and analyzed qualitatively and quantitatively. The results found an increase in whorls, palmar patterns in the I2-I3 area, total finger ridge count, total triradius count, and a decrease in atd angle and a-b ridge
This case report describes an extremely rare case of severe dilaceration (117° palatal inclination) of the root of a maxillary second premolar tooth. Trauma to primary teeth can result in developmental disturbances to permanent successor teeth, including crown and root dilaceration. Dilacerated teeth pose challenges for diagnosis, treatment planning, endodontic access, and extraction. In this case, the maxillary second premolar tooth was severely dilacerated and had to be extracted. Dilaceration is an abnormality that requires a multidisciplinary approach and modified treatment procedures.
This document discusses a study that assessed the knowledge of dental professionals (graduate and post-graduate) regarding the use of bone grafts in dentistry. A survey of 100 dental professionals found that many general dentists do not perform bone grafting and refer such procedures to specialists, as the techniques are sensitive. The study also found that around half of clinicians prefer synthetic bone substitutes like hydroxyapatite ceramic material to avoid surgery for bone grafts, based on patient preference. The document provides background information on different types of bone grafts and their properties and classifications.
An Evaluation of Short Term Success and Survival Rate of Implants Placed in F...DrHeena tiwari
An Evaluation of Short Term Success and Survival Rate of Implants Placed in Fresh Extraction Socket Post Prosthetic Rehabilitation- A Prospective Study
This review paper analyzed 1300 publications in the Journal of Maxillofacial Oral Surgery from 2009 to 2020 to evaluate trends in levels of evidence. The analysis found that case reports and narrative reviews with a level D evidence accounted for 36% of publications. The majority (35%) of articles fell under maxillofacial pathology. The percentage of higher levels of evidence (A and B) increased from 2.09% in 2009/2010 to 12.74% in 2019/2020, indicating improving research quality over time. Categorizing publications by level of evidence and topic can help refine research quality in the journal going forward.
Effectiveness of Low-Level Lasers in the Management of Recurrent Aphthous Sto...DrHeena tiwari
This study assessed the effectiveness of low-level lasers in treating recurrent aphthous stomatitis. 30 subjects with minor, major, or herpetiform aphthae were treated with lasers and their pain was evaluated using VAS scores. For all groups, pain was significantly less after 24 hours and further reduced at 72 hours compared to pre-treatment levels. At 1 week, pain scores were minimal or zero. The results demonstrated that low-level lasers provide effective pain relief and accelerated healing for recurrent aphthous stomatitis lesions.
Epidemiology of Orofacial Pain in Population of Jammu City in India: An Origi...DrHeena tiwari
This study evaluated the etiology of orofacial pain among 400 patients visiting private clinics in Jammu, India. The results showed that dental caries leading to pulpitis was the most common cause of orofacial pain, affecting 96 patients. Periodontal disease and tooth sensitivity were also significant causes. Orofacial pain was more prevalent in females aged 26-35 years. The pain most commonly worsened during sleep and evenings and lasted less than 1 hour for many subjects. This study concluded that dental caries is the primary etiology of orofacial pain in this population and treatment should be tailored based on the identified cause.
Effectiveness of Low-Level Lasers subsequent to Third Molar Surgery: An Origi...DrHeena tiwari
This study assessed the effectiveness of low-level lasers in reducing postoperative pain, swelling, and trismus following third molar surgery. 32 patients who required bilateral lower wisdom tooth removal were treated, with one side receiving laser treatment and the other serving as the control. Pain was significantly lower on the laser treated side on days 6-7, though swelling and trismus did not significantly differ between sides. The results suggest low-level lasers may help reduce pain following third molar surgery when applied immediately after surgery.
Modification of Distal Shoe- A Systematic Review & Meta AnalysisDrHeena tiwari
The document summarizes a systematic review of modifications to the distal shoe space maintainer. It analyzes 6 studies on modified distal shoe designs. The studies showed that the modifications provided stability, adjustability, and were well-accepted by patients. However, the quality of the studies was low and conclusions about the efficacy of the modifications were inconclusive due to a lack of clear reporting on outcomes. Further high-quality research is needed to establish the effectiveness of modified distal shoe space maintainers.
This document provides an overview of a new 12-part series on endodontics in the British Dental Journal. It discusses the editor's goal to update the classic textbook "Endodontics in Practice" to reflect modern research and techniques in endodontics. The series will cover the basic concepts and technical procedures of endodontics over 12 parts. While some traditional techniques are described for undergraduate education, the emphasis is on applying current knowledge of root canal anatomy and the microbial causes of disease to shape canals for thorough cleaning and 3D filling.
1) This document discusses who may benefit from orthodontic treatment, including those seeking improved aesthetics, occlusal function, or long-term dental health.
2) Some malocclusions like an overjet over 9mm or anterior crossbites can cause dental trauma or damage teeth over time if left untreated.
3) Minor malocclusions may see little overall improvement from treatment and have a high risk of relapse, so these cases should be treated with caution.
A color atlas of orofacial health and disease in children and adolescentsNay Aung
This document provides an introduction to the second edition of "A COLOR ATLAS OF OROFACIAL HEALTH AND DISEASE IN CHILDREN AND ADOLESCENTS". It lists the authors and their credentials, acknowledges contributions from colleagues, and summarizes updates and improvements made for this edition, including additional conditions covered, more illustrations, and treatment recommendations for common oral diseases in pediatric patients. The atlas is intended to assist various medical professionals in diagnosing and treating oral problems in children.
This document discusses a study that assessed awareness and knowledge of forensic odontology among dental professionals in India. The study found that most participants (93.5%) had studied forensic odontology basics in undergraduate studies. However, around 78.4% were unaware of preserving dental records for future forensic needs. While 75.3% understood signs of child abuse and 56.3% could document bite marks, most (77.9%) did not know that dentists can be expert witnesses. The study concludes there is a general lack of forensic odontology knowledge and practice among Indian dental practitioners.
This randomized clinical trial compared the survival of composite resin restorations and metal-ceramic crowns on endodontically treated teeth over a follow-up period of 1 to 5 years. 57 restorations were placed in 47 patients, with 30 being composite resin and 27 being metal-ceramic crowns. One tooth was extracted in the composite group due to root fracture. There were 8 failures in the composite group and 1 failure in the crown group, mostly due to secondary caries or restoration fracture. Metal-ceramic crowns demonstrated better clinical performance and lower need for re-intervention, but both types of restorations showed good survival rates with no significant difference.
Marginal and Internal Fit of Different Fixed Dental Prostheses: A Comparative...DrHeena tiwari
This study compared five methods for assessing the marginal and internal fit of fixed dental prostheses: the cross-sectional method, silicone replica technique, triple scan method, micro-computed tomography, and optical coherence tomography. Measurements of the marginal gap, axial gap, angle gap, and occlusal gap found statistically significant differences between the methods. The cross-sectional method and silicone replica technique showed the lowest mean values and were the most similar, while the triple scan method and optical coherence tomography also showed similarities. The study concluded that while fit values may fall within clinically acceptable ranges, differences between assessment methods should be considered.
This study compared the antifungal efficacy of various endodontic irrigants, with and without the antifungal agent clotrimazole, against Candida albicans in extracted human teeth. Teeth were inoculated with C. albicans and irrigated with sodium hypochlorite, chlorhexidine gluconate, doxycycline hydrochloride, or combinations of these with 1% clotrimazole. Colony forming units were significantly lower for sodium hypochlorite and chlorhexidine alone compared to doxycycline or the control. Adding clotrimazole increased the efficacy of all irrigants, with no significant difference between sodium hypochlorite with
This case report describes the use of mineral trioxide aggregate (MTA) in apexification of two immature permanent teeth with open apices and periapical lesions in a 14-year old patient. After cleaning and shaping the root canals, MTA was used to create an apical plug in each canal. Follow up radiographs at 6 and 12 months showed periapical healing and apical closure of the teeth. MTA is described as a promising alternative to traditional calcium hydroxide treatment for apexification due to its superior biocompatibility and ability to stimulate hard tissue formation.
This systematic review compared the success of Endosequence bioceramic root repair material (BCRRM), mineral trioxide aggregate (MTA), and calcium hydroxide for apexification of immature permanent teeth. 9 studies involving a total of over 400 potential studies were included. The studies found that while all three materials showed similar clinical success rates, MTA and BCRRM formed apical barriers faster than calcium hydroxide. More research is still needed directly comparing MTA and BCRRM.
Single step apexification with mineral trioxide aggregateAbu-Hussein Muhamad
Abstract: The completion of root development and closure of the apex occurs up to 3 years after the eruption of the tooth. The treatment of pulpal injury during this period provides a significant challenge for the clinician. The most commonly advocated medicament is calcium hydroxide, although recently considerable interest has been expressed in the use of mineral trioxide aggregate (MTA). We report a case with MTA were used successfully for one step apexification in teeth with open apex. Key words: Immature teeth, one visit apexification, Mineral Trioxide Aggregate, monoblock, artificial barrier
This study evaluated the clinical and radiographic outcomes of diode laser pulpotomy compared to formocresol pulpotomy in human primary teeth. A total of 40 teeth in 14 children were randomly assigned to receive either diode laser pulpotomy or formocresol pulpotomy. At 6-month and 12-month follow-ups, both treatments showed high clinical success rates of 100%, but the diode laser group had slightly lower radiographic success rates of 95% at 6 months and 90% at 12 months compared to 100% for the formocresol group. However, the differences in success rates between the two treatments were not statistically significant. This study suggests that diode laser pulpotomy may be an effective alternative to traditional formoc
MANAGEMENT OF OPEN APEX IN PERMANENT TEETH WITH CALCIUM HYDROXIDE PASTEAbu-Hussein Muhamad
This document reports on a case study of apexification treatment using calcium hydroxide in a permanent incisor with an open apex. A 10-year-old patient presented with pain and a history of trauma to a maxillary incisor. Radiographs showed incomplete root formation and an open apex. The tooth was treated with calcium hydroxide replacement every 3 months to induce apical closure. After 3 months, radiographs showed apical barrier formation. The canal was then obturated. Long-term follow-up of 10 years showed the treatment was successful in maintaining the tooth. The case demonstrates the ability of calcium hydroxide to promote apical closure and ensure long-term success of apexification.
This study compared the efficacy of three commercially available toothpastes for treating dentinal hypersensitivity: 1) 5% potassium nitrate, 2) 5% calcium sodium phosphosilicate, and 3) 3.85% amine fluoride. A placebo toothpaste was also included. 149 subjects were randomly assigned to use one of the four toothpastes twice daily for 6 weeks. Sensitivity was measured using air and cold water stimuli at baseline, 2 weeks, and 6 weeks. All groups showed a reduction in sensitivity scores over time. However, the calcium sodium phosphosilicate toothpaste produced significantly greater reduction in sensitivity compared to the other toothpastes and placebo after 6 weeks of use. The calcium sodium phosphosilicate
Single-Step Apexification with Mineral Trioxide Aggregate (MTA) –Case ReportsAbu-Hussein Muhamad
The completion of root development and closure of the apex occurs up to 3 years after the eruption of
the tooth. The treatment of pulpal injury during this period provides a significant challenge for the clinician.
The most commonly advocated medicament is calcium hydroxide, although recently considerable interest has
been expressed in the use of mineral trioxide aggregate (MTA). We report a case with MTA were used
successfully for one step apexification in teeth with open apex
Mineral Trioxide Aggregate (MTA) is a bioactive cement used in pediatric dentistry for vital pulp therapies like direct pulp capping and pulpotomy. It has favorable properties like biocompatibility, sealing ability, and ability to set in presence of moisture. Studies show MTA performs equal to or better than other materials for these procedures. For direct pulp capping and pulpotomy of primary teeth, MTA and calcium hydroxide are recommended. MTA also has applications in permanent teeth for direct pulp capping, partial pulpotomy, and apexification.
His eva of caoh&bond agnt in direct pulp capping/ rotary endodontic courses b...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
This document discusses various materials used for vital pulp therapy (VPT). It begins by outlining the ideal properties of a pulp capping agent, such as maintaining pulp vitality and stimulating reparative dentin formation. Classic materials like calcium hydroxide, zinc oxide-eugenol, and polycarboxylate cement are described along with their disadvantages. More recent bioactive bioceramic materials like mineral trioxide aggregate (MTA), Biodentine, and Endosequence are then discussed and compared to calcium hydroxide, with studies showing higher success rates for reparative dentin formation and less inflammation with bioceramics. The document concludes by mentioning recent advances in VPT including the
PULP REVASCULARIZATION OF A NECROTIC INFECTED IMMATURE PERMANENT TOOTH: A CAS...Abu-Hussein Muhamad
This document summarizes a case report of regenerative endodontic treatment (revascularization) of a necrotic, immature permanent tooth. Specifically:
- An 11-year-old patient presented with a necrotic tooth that had undergone previous calcium hydroxide treatment but remained immature.
- The tooth underwent cleaning and disinfection, followed by a bleeding induction technique to form a blood clot and promote revascularization. MTA was then used to seal the canal.
- Follow up radiographs at 10 and 12 months showed continued root development, thickening of root walls, and periapical healing, indicating success of the revascularization procedure.
- Revascularization represents a
This document summarizes various materials that have been used for pulp capping and pulpotomy in pediatric endodontics. It discusses the history of materials from the 1700s to present, including calcium hydroxide, mineral trioxide aggregate, corticosteroids, lasers, and various other agents. It provides the properties and mechanisms of commonly used materials like calcium hydroxide, MTA, biodentine, and compares their clinical success in pulp capping and pulpotomy procedures in both primary and permanent teeth.
The permanent teeth with open apex and large periapical lesion are diffcult to treat as a traditional root canal procedure, therefore calcium hydroxide place an important role in reducing the periapical infl ammation. Management of open apex can be done using mineral trioxide aggregate (MTA) which can be placed in apical 3-4 mm. The aim of this This case report describes the use of mineral trioxide aggregate (MTA) for management of a periapically compromised immature tooth.
Effect of Calcium Hydroxide on Deep Caries Dentin: A Clinical Studyasclepiuspdfs
Objective: The aim of this study was to evaluate the clinical efficacy of calcium hydroxide on arresting deep carious lesions in permanent teeth. Methods: A total of 190 patients aged between 15 and 55 years old were selected for this clinical study. Calcium hydroxide was applied to fully matured permanent anterior or posterior teeth clinically and radiographically after 2 weeks, 3–4 weeks, 3 months, 6 months, and 1-year follow-up. Results: The overall survival rate was 89.4%. The findings of this study showed that calcium hydroxide is effective in arresting deep carious lesions and formation tertiary dentine as well as preservation teeth vitality. Conclusion: Calcium hydroxide is effective in reducing the risk of pulp exposure in deep carious lesion.
This study investigated a strategy for long-term dentin remineralization using poly(amido amine) (PAMAM) and a rechargeable adhesive containing nanoparticles of amorphous calcium phosphate (NACP). Dentin samples were pre-demineralized and divided into four groups: control, PAMAM-treated, treated with recharged NACP adhesive, and treated with both PAMAM and recharged NACP adhesive. The PAMAM-treated samples were subjected to 77 days of fluid flow challenge to test the ability of PAMAM to remain attached. The NACP adhesive was immersed in lactic acid to exhaust its ion release, then recharged. The
Silver diamine fluoride is effective for arresting and preventing dental caries according to multiple randomized clinical trials. It outperforms fluoride varnish and is as effective or better than other treatments. Twice yearly application to cavitated lesions results in remarkable caries arrest and prevention. Long-term studies are still needed to determine if effects are maintained with less frequent application after several years. Silver diamine fluoride is very safe, with a large margin of safety based on animal studies, and no reported adverse events since its approval over 80 years ago in Japan.
This document reviews managing tooth discoloration through bleaching. It discusses the various causes of tooth discoloration, both intrinsic and extrinsic factors. A history of bleaching teeth is provided, detailing early techniques used hydrogen peroxide or sodium perborate. The toxicity of bleaching agents, particularly hydrogen peroxide, is discussed. Tables summarize the aetiology of tooth discoloration and studies reporting the success of internal bleaching techniques.
research paper (remineralization effect of diode laser, Nanoseal, and Zamzam water on initial enamel carious lesios induced around orthodontic brackets)
This document summarizes 4 studies related to oral and maxillofacial issues:
1) A study of 1,011 pediatric patients in Pakistan finding the leading cause of visits were dental problems like caries.
2) A study of 50 thalassemia patients in Pakistan finding common oral manifestations included skull bossing, depressed nose bridge, pigmentation, and proclined teeth.
3) A study in Pakistan finding post-operative complications after oral cancer treatment were not significantly different between early and late stages, but were worse for advanced stages.
4) A case study demonstrating the successful use of a single tooth dento-osseous distraction technique to manage an impacted, ankylosed can
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Success rate of Calcium Hydroxide vs Mineral Trioxide Aggregate as Apexification Agents: A Systematic Review
1. Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 6, 2021, Pages. 835-839
Received 25 April 2021; Accepted 08 May 2021.
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Success rate of Calcium Hydroxide vs Mineral Trioxide
Aggregate as Apexification Agents: A Systematic Review
1
Dr. Mukund Singh, 2
Dr. Mohammed Muzammil Khan, 3
Dr. Bongu Lakshmi Bhavya,
4
Dr. Heena Tiwari, 5
Dr. Pranav Gupta, 6
Dr. Ashish Choudhary
1
Reader, Department of Conservative dentistry and Endodontics, Rural Dental College,
Pravara Institute of Medical Sciences, LONI-413736, TALUKA RAHATA, DISTRICT
AHMEDNAGAR. mukundvir@gmail.com;
2
Specialist Pedodontist, Ministry of health, Taif, Kingdom of Saudi Arabia.
mdmuzammil.khan8@gmail.com;
3
Consultant Dental Surgeon, Divine Dental Care, Ram Nagar, Visakhapatnam, Andhra
Pradesh. laxmibhavya2695@gmail.com;
4
BDS, PGDHHM, MPH Student, Parul Univeristy, Limda, Waghodia, Vadodara, Gujrat,
India. drheenatiwari@gmail.com;
5
MDS, Consultant Endodontist & Conservative Dentist, Jalandhar, Punjab, India.
drpranavgupta7777@gmail.com;
6
Senior Research Associate, Department of Dentistry, AIIIMS Jodhpur.
dr.ashish.choudhary21@gmail.com
Corresponding Author:
Dr. Mukund Singh, Reader, Department of Conservative dentistry and Endodontics, Rural
Dental College, Pravara Institute of Medical Sciences, LONI-413736, TALUKA RAHATA,
DISTRICT AHMEDNAGAR. E mail: mukundvir@gmail.com
ABSTRACT
Background: Trauma and deep caries may require endodontic treatment in young, immature
permanent teeth which have open apices that complicate instrumentation. Hence,
apexification with materials like calcium hydroxide or Mineral trioxide aggregate (MTA) is
required to obtain an apical seal.
Aim: This study aims to compare the two materials i.e., Calcium hydroxide and MTA, used
for apexification in young, immature permanent teeth with the help of a systematic review of
studies in literature.
Source of literature: PUBMED, Medline, Cochrane and Scopus databases were searched for
terms “calcium hydroxide” and “Mineral trioxide aggregate” and “Apexification”.
Results: The radiographic and clinical evaluations of apical closure did not have statistically
significant differences but there was a significant variance in the time taken for apexification
for both the groups. MTA showed significantly faster formation of apical barrier as compared
to Calcium hydroxide.
Conclusion: Although MTA gives comparable clinical and radiographic evidence of apical
closure, it seems to be faster in formation of the apical barrier as compared to Calcium
hydroxide in immature necrotic permanent teeth.
Key words: Calcium Hydroxide, Mineral Trioxide Aggregate, Apexification.
INTRODUCTION
Traumatic injuries to immature permanent teeth pose a diagnostic and clinical challenge to
the dentist. In such cases, the clinician might need an endodontic interference for treatment
which might be complicated with instrumentation and obturation issues due to the wide canal
and thin dentinal walls.1
Endodontic treatment of such teeth is aimed at obtaining an optimal
2. Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 6, 2021, Pages. 835-839
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seal of the root-canal system. Apexification (induction of a calcific barrier at open root apex
of non-vital teeth) is a non-surgical approach for obtaining apical barrier so as to prevent
passage of toxins and bacteria into peri radicular tissue. This barrier facilitates the placement
of an appropriate root canal sealant and filling material, whilst reducing the possibility of
their extrusion into periapical tissues.2
A number of materials have been tried to induce apical
closure in the procedure of apexification. One of the premier materials was calcium
hydroxide which was initially used in dentistry by Hermann3
who first reported the use of
Calcium Hydroxide for apical closure. Calcium hydroxide being strongly basic (pH 12.5-
12.8) in nature, its mechanism of action is via dissociation of calcium and hydroxyl ions and
their effect on vital tissues leading to hard-tissue deposition and being antibacterial. The
hydroxyl group is considered to be the most important component of Calcium hydroxide as it
provides an alkaline environment, which encourages repair and active calcification. The
alkaline pH not only neutralizes lactic acid from osteoclasts, thus preventing dissolution of
the mineral components of dentine, but could also activate alkaline phosphatases that play an
important role in hard-tissue formation4
. Another experimental material, mineral trioxide
aggregate (MTA), was then introduced as a potential alternative. It was shown that MTA
promotes regeneration of the original tissues when it is placed in contact with the dental pulp
or peri radicular tissues by Torabinejad5
. It is a bioactive material that is mainly composed of
calcium and silicate which is known to conduct and induct hard tissue formation. From the
time that MTA is placed in direct contact with human tissues, it appears that the material does
the following:
1. Forms CH that releases calcium ions for cell attachment and proliferation.
2. Creates an antibacterial environment by its alkaline pH.
3. Modulates cytokine production.
4. Encourages differentiation and migration of hard tissue– producing cells.
5. Forms HA (or carbonated apatite) on the MTA surface and provides a biologic seal.6
This article aims to compare Calcium hydroxide with MTA for apexification in young,
immature permanent teeth using a systemically compiled data available in literature.
Study selection:
Controlled studies comparing calcium hydroxide and MTA in immature permanent teeth in
the process of apexification where the outcome was evaluated by clinical and radiographic
evidence for the formation of apical barrier was recorded, were included.
Inclusion Criteria
1. Study design: randomized clinical trials,
2. participants: patients with immature necrotic permanent teeth,
3. Treatment: Pulpectomy for purposes of apexification
4. Have assessed success based on clinical and radiographic outcomes, and
5. Articles published in English.
Source of articles: PUBMED, Medline, Cochrane and Scopus databases were searched for
terms “calcium hydroxide” and “Mineral trioxide aggregate” and “Apexification”.
Results:
The literature search done on the basis of the above-mentioned criteria and the rules of
inclusion yielded 5 significant studies7-11
.
The basic characteristics of these included studies are tabulated and presented in Table 1.
3. Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 6, 2021, Pages. 835-839
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1. Clinical and Radiographic success rate:
According to the study by El Meligy et al7
, the clinical and radiographic success rates for the
calcium and MTA groups were 87% and 100%, respectively where 2 out of 15 teeth in the
calcium hydroxide group showed signs of clinical as well as radiographic failure. The clinical
failure manifesting as persisting tenderness to percussion even after retreatment after 12
months. The same 2 teeth showed radiographic failure as well showing widening of lamina
dura and periapical radiolucencies even after 6 months. There was no statistically significant
difference between the 2 groups, clinically or radiographically, using the chi-square test (chi-
square=2.14; P=.16). Whereas according to Bonte et al10
the clinical effectiveness (functional
asymptomatic teeth) of the treatment at 12 months was 100% for the MTA group and 73.3%
(loss of four teeth) for the Calcium hydroxide group. The radiographic success rate was 50%
and 82.4 % in the Calcium hydroxide and MTA groups respectively. Damle et al9
showed
that all 15 teeth in the MTA group were clinically asymptomatic at twelve months follow up
(100%), while in Calcium Hydroxide group 14 teeth were asymptomatic with success rate of
93.33%. In MTA group all 15 teeth revealed calcific barrier formation, with no evidence of
periapical pathology on radiographs. In Calcium Hydroxide group, a single tooth exhibited
failure which was evident radiographically due to internal resorption which was seen at the
end of twelve months and radiographic success was calculated at 93.33%. Both these
radiographic and clinical results were evaluated statistically with Chi square test (p=0.38)
which was not significant.
2. Time required for apical barrier formation:
According to Pradhan et al8
the mean time taken for apical biological barrier formation was 3
+/- 2.9 months for MTA group and 7 +/- 2.5 months for calcium hydroxide group. Lee et al11
reported the mean duration of apical hard tissue barrier formation for MTA group (6.6 +/- 1.9
weeks) was significantly shorter than those treated with calcium hydroxide (12.2 +/- 1.6
weeks). Student t test showed significant differences in mean duration of apical barrier
formation these two groups (p < 0.001). Damle et al9
mentioned the mean time taken for
completion of lamina dura in MTA group was 4.07+/-1.49 months whereas the time period
for calcium hydroxide group was 6.43+/- 2.59 months. Unpaired t test showed the differences
in this data to be highly significant (P =0.0002).
3. Other Findings:
Bonte et al10
reported that although no new trauma occurred for either group, but cervical root
fractures occurred in 4 out of 15 Calcium hydroxide patients.
According to Lee et al11
, all of the 20 incisors treated with MTA showed a blunt root apex
and of the 20 incisors treated with calcium hydroxide, 16 exhibited a conical or nearly conical
root apex and 4 showed a blunt root apex.
DISCUSSION
In this review article we observed that the data on clinical and radiographic success is
comparably similar between Calcium hydroxide and MTA. However, the time taken for
apical barrier formation for MTA is considerably lower for MTA as compared to calcium
hydroxide. Calcium hydroxide takes a longer time for the apical closure causing increase in
the number of appointments and poor patient follow up which may lead to failures. On the
other hand, MTA treated teeth showed faster apical closure. This may be attributed to the fact
that MTA has an alkaline pH similar to Calcium hydroxide. MTA has several calcium salts in
its composition providing antimicrobial properties. Its pH is also able to activate alkaline
phosphatase. The high concentration of calcium ions increases the activity of calcium-
dependent pyrophosphatase, which promotes bone healing.12
Hence it is noteworthy that the
4. Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 6, 2021, Pages. 835-839
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MTA induced apexification demands fewer appointments and is less time-consuming.
Moreover, Calcium hydroxide may increase dentin brittleness13
when placed for long periods,
thus increasing the risk of root fracture. These findings may support the use of MTA in
apexification approaches. Among the recent studies using MTA to perform apex barrier
apposition, there is a study by Yadav et al.14
who analyzed the apexification in one visit by
placing a platelet-rich fibrin apical plug (PRF) and MTA, in which PRF was used as an apical
matrix and subsequent placement of the MTA since the fibrin rich in platelets have several
advantages, including ease of preparation and lack of biochemical manipulation of the blood,
which makes this preparation strictly autologous. PRF is also associated with slow and
continuous increase in cytokine levels. Leukocytes in the PRF act as anti-inflammatory, an
anti-infective agent, the regulator of the immune response, and provide the vascular
endothelial growth factor to promote angiogenesis. Hence, either a combination or alternative
options should be considered in a bid to achieve a better and faster endo-apical seal.
CONCLUSION
While both calcium hydroxide and MTA provide similar success rates, the shorter treatment
time with MTA may translate into higher overall success rates because of better patient
compliance.
Table 1: Systematic Review of Studies in Literature
REFERENCES:
1. Harlamb SC. Management of incompletely developed teeth requiring root canal
treatment. Australian Dental Journal 2016; 61:(1 Suppl): 95–106
2. Mackie IC. Management and root canal treatment of non-vital immature permanent
teeth. UK National Clinical Guidelines in Paediatric Dentistry. Int J Paediat Dent, 8,
289–293, 1998.
3. Hermann BW. Calcium hydroxid als mittel zum be handle und fullen. Med Diss V
Study No. of patients Age of Patients Total no. of teeth Outcome
assessment
El Meligy et al
(2006)7
15 6-12 years 30 3,6,12 months
Pradhan et al
(2006)8
20 8-15 years 20 11 months
(evaluated once
each month)
Damle et al
(2012)9
20 8-12 years 30 1,3,6,9,12
months
Bonte et al
(2014)10
34 6-18 years 30 3,6,12 months
Lee et al
(2015)11
40 6.5-10 years 40 Evaluation done
every week for
MTA and once
in 3 weeks for
CH.
5. Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 6, 2021, Pages. 835-839
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German Dissertation; 1920 Adopted from Siqueira JF Jr, Lopes HP Mechanisms of
antimicrobial activity of calcium hydroxide: a critical review, International Endodontic
Journal, 32, 361-369, 1999.
4. Mohammadi Z, Dummer PM. Properties and applications of calcium hydroxide in
endodontics and dental traumatology. Int Endod J. 2011 Aug;44(8):697-730.
5. Torabinejad M, Chivian N. Clinical applications of mineral trioxide aggregate. J Endod
1999 Mar;25(3):197-20.
6. M. Parirokh, M. Torabinejad Mineral trioxide aggregate: a comprehensive literature
review–Part III: Clinical applications, drawbacks, and mechanism of action. J Endod,
2010 (36):400-413
7. El-Meligy OA, Avery DR. Comparison of apexification with mineral trioxide aggregate
and calcium hydroxide. Pediatr Dent 2006; 28: 248–253.
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management of teeth with unformed apices with mineral trioxide aggregate and calcium
hydroxide. J Dent Child. 2006; 73: 79–85.
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evaluation of mineral trioxide aggregate and calcium hydroxide paste. J Clin Pediatr
Dent 2012; 36: 263–268.
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non-vital immature permanent teeth: a randomized clinical trial comparison. Clin Oral
Investig 2015; 19: 1381–1388.
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evaluation of endodontic treatments for immature necrotic permanent teeth based on
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Dent. 2017 May;27(3):217-227.
13. Andreasen JO, Farik B, Munksgaard EC. Long-term calcium hydroxide as a root canal
dressing may increase risk of root fracture. Dent Traumatol 2002;18: 134–137.
14. Yadav P, Pruthi PJ, Naval RR, Talwar S, Verma M. Novel use of platelet-rich fibrin
matrix and MTA as an apical barrier in the management of a failed revascularization
case. Dent Traumatol.2015;31:328-31.