PurposeA key factor affecting the success of endodontic treatment is correct determination of root canal working length (WL). The purpose of this in vivo study was to compare the accuracy of Propex II and iPex II electronic apex locator (EAL) in determining the WL under clinical conditions, to that of radiographic working length (RWL) using stainless steel (SS) and nickel–titanium (NiTi) hand files.Patients and methodsThirty-seven patients, with 60 anterior teeth (60 canals) scheduled for endodontic treatment participated in this study after ethical approval. Electronic working length (EWL) was determined by the Propex II and iPex II according to manufacturer’s instructions using SS Hand K-files and NiTi Hand files. RWL was determined after EWL determination. The results obtained with each EAL with SS and NiTi files were compared with RWL. Data was analyzed statistically at a significance level of p < 0.05. Interclass correlation coefficient was calculated.ResultsStatistical analysis revealed no significant difference between the EALs, indicating similar accuracies between them with respect to accuracy in determining the WL (p > 0.05). No significant difference was found between the EWL and RWL and between SS and NiTi files for WL determination (p > 0.05) as well. The result also displayed a high intraclass correlation coefficient between the RWL and EWL measurement methods.ConclusionUnder the in vivo clinical conditions of this study, both Propex II and iPex II were similar to the RWL determination technique showing high correlation to RWL. Both are clinically acceptable EAL for WL determination and both SS hand K-file and NiTi file can be used interchangeably without compromising the WL during treatment.
Background. Time elapsed between trauma and treatment greatly influences the prognosis of traumatic dental injuries (TDIs). The aim of this study was to analyze clinical and radiographic findings related to complications of TDIs among patients seeking delayed treatment of such injuries. Materials and Methods. 123 permanent teeth with a history of previous TDIs were included in the study. Clinical findings analyzed were the type of fracture, type and number of injured teeth, crown discoloration, and pulpal status of the injured tooth (pulpal diagnosis). The radiographic findings analyzed included pulp canal obliteration (PCO), root resorption (RR), and periapical radiolucency (PR). Statistical analysis included descriptive analysis. Results. Tooth discoloration was the most common presenting complaint (53.65%), while fall (48.78%) was the most frequent cause of trauma. The range of time duration between trauma and presentation for treatment was 5 months to 30 years (average time 12.82 years). Pulp necrosis (PN) was the most common complication (90.24%). Almost half of the teeth with PN had fracture injury and discoloration along with a high frequency of PR (78.37%). Even teeth with a normal appearance were found to have a high incidence of PN (76.92%) and PR (53.84%). The crown discoloration was the second most frequent finding (48.78%). Many teeth (41.66%) with vital pulp were also discolored. Most of the teeth (79.31%) with yellowish discoloration and all teeth with brownish discoloration were nonvital. A high frequency of PN (90%) and PR (78.33%) was found in teeth with discoloration. PR was the most common radiographic finding (69.10%), while PCO and RR were observed in 17.88% and 21.13% of teeth, respectively. Conclusion. The findings of this study support the fact that delayed treatment of TDIs leads to increased complications. PN was the most common complication followed by tooth discoloration, RR, and PCO among patients seeking delayed treatment after TDIs.
Introduction: C-shaped canal configuration is mostly found in the mandibular second molar. The morphological characteristic of a C-shaped canal is the presence of a fin or web connecting the individual canal, making it difficult for cleaning, shaping, and obturation. The objective of this study was to find out the prevalence of C-shaped canal in mandibular second molar among cases of Cone Beam Computed Tomography in tertiary care hospitals. Methods: The descriptive cross-sectional study was conducted in the department of conservative dentistry and endodontics of tertiary care hospitals from 20th June 2020 to 20th December 2020 after receiving ethical approval from the Nepal Health Research Council on 19 June 2020. Cone-beam computed tomography images of 199 mandibular second molars with completely formed roots were used. Teeth with orthodontic braces, root resorption, root canal filling, and post were excluded from the study. The research was conducted taking a tooth as a unit. Convenience sampling was done. Statistical analysis was done by using Statistical Package for Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: The prevalence of C-shaped canal according to this study is 25 (12.6%) (7.99-17.21 at 95% Confidence Interval). Conclusions: The findings of the study conclude that C-shaped configuration is quite frequent in mandibular second molar among cases of Cone Beam Computed Tomography. A careful pre-operative radiographic evaluation may be helpful for diagnosing C-shaped configuration prior to root canal treatment.
Background: Immediate treatment of an injured tooth is the most significant factor for preserving pulp vitality. Treatment provided immediately after traumatic dental injury significantly improves the prognosis of a traumatized tooth by reducing the risk of complications. Similarly, proper treatment can lead to satisfactory outcomes. The objective of this study was to evaluate the type of treatments provided to the patients with dental trauma and the time elapsed between dental injury and arrival for treatment. Methods: A retrospective study was conducted including 170 patients (128 males and 42 females) who received treatment for traumatic dental injury during a period between January 2016 and December 2019. The time elapsed between dental trauma and treatment, and the clinical treatments provided were recorded form a review of past records. Data analysis was performed using descriptive statistical methods. Results: The time elapsed between trauma and treatment was found to range from 1 to 75 hours. (Average time 14.7 hours). An early arrival for treatment of dental trauma within 24 hours was observed among most of the patients (76.46%) in this study. The most commonly provided treatment was composite resin restoration (38.78%). Likewise, the second most frequently provided treatment was root canal treatment (29.08%). Overall splinting was provided in 44 teeth (12.18%), while repositioning along with splinting was performed in 43 teeth (11.91%). Conclusions: On the basis of the results of this study it can be concluded that, most of the patients with traumatic dental injuries arrived for treatment early and restoration was the most common treatment provided followed by root canal treatment.
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