Fluorosis has been reported way back in 1901. The treatment options for fluorosis are varied depending upon individual cases. This article comes from Madurai in India where its surrounding towns are fluorosis-prone zones. The purpose of this article is to report various treatment options available for dental fluorosis; this is the first time that complete full mouth rehabilitation for dental fluorosis is being reported. This article also dwells on the need for the dentists to be aware of their local indigenous pathologies to treat it in a better manner.

Objectives: The aim of this study was to evaluate which radicular radiographic features general dentists want to interpret, determine which of the radicular radiographic features general dentists interpret and which ones they miss in a diagnostic radiograph and correlate how accurately general dentists are able to interpret radiographic features. Methods: 20 general dental practitioners were selected and given 2 sets of questionnaires. The first set asked them to fill out the findings they would elucidate in a diagnostic radiograph while the second set consisted of 30 randomly selected intraoral radiographs to interpret. Results: In the first set of questionnaires, more than 50% of dentists said they would interpret periapical changes, calcification, root curvature and the number of root canals. Less than 50% said they would interpret canal morphology, open apex, resorption, fracture, number of roots and lamina dura. In the second set of questionnaires, more than 90% missed grade 1 or 2 periapical changes (according to periapical index scoring), resorption and canal calcification. More than 80% of dentists missed extra roots and root curvature buccally while no dentists were able to interpret the periodontal ligament width changes, lamina dura and canal variation (C-shape). Using a paired t-test, there was significant variation in answers between the first set and second set of questionnaires. Conclusion: It is concluded from this study that general dental practitioners are able to detect radiographic changes when they are extensive but they miss periodontal ligament width and lamina dura changes.

The aim of this study was to assess the influence of ketorolac tromethamine and dexamethasone on substance P and IL-8 expression when used as a root canal irrigant for single visit root canal treatment for acute irreversible pulpitis. A total of 42 patients with pain due to acute irreversible pulpitis in carious premolar and molar teeth were included in this study. The four irrigation groups were as follows: saline (n = 11), 3% sodium hypochlorite (n = 11), ketorolac tromethamine (n = 10) and dexamethasone (n = 10). Blood samples S1 and S2 were collected upon access opening and after canal preparation, respectively. Quantification of substance P and IL-8 were done using ELISA test. Post-operative pain was assessed by questioning the patients. The difference between S1 and S2 sample values for the four different irrigant groups was not significant. The sodium hypochlorite group had a higher mean expression of substance P and IL-8 values. Dexamethasone irrigation was more effective in controlling post-operative pain.

One of the main objectives of root canal treatment is to alleviate the pain associated with irreversibly inflamed pulps. However, some patients may have moderate to severe pain following treatment. The aim of this study was to compare and assess the effect of ketorolac tromethamine on substance P expression in the pulp and periapical tissues when used as a root canal irrigant for single-visit root canal treatment in teeth with irreversible pulpitis. Thirtysix patients were randomly allotted to three irrigant groupssaline (n = 14), 3% sodium hypochlorite (n = 11) and ketorolac tromethamine (n = 11). Pulp blood samples (S1) were collected on gaining access to the pulp, and periapical blood samples (S2) were collected after root canal preparation. Quantification of substance P was done by ELISA test. The ketorolac tromethamine group had greater reduction in substance P expression (S2). Post-operative pain levels were not significantly influenced by the different root canal irrigants.

Mandibular molar teeth with acute irreversible pulpitis pose challenges in single visit root canal treatment – (i) success of local anaesthesia and (ii) post‐operative pain. One hundred and twenty‐six patients with pain associated with carious mandibular molar teeth were enrolled. All patients were administered 10 mg of ketorolac tromethamine prior to local anaesthesia. Local anesthetics used were 2% lignocaine with 1:80 000 adrenaline and 4% articaine with 1:100 000 adrenaline. Three irrigation solutions were used – saline, 3% sodium hypochlorite and dexamethasone. Mean intra‐operative pain scores for the lignocaine and articaine groups were 4.33 (±2.58) and 4.22 (±2.88), respectively. There was a statistically significant difference (P = 0.000) in post‐operative pain incidence between the lignocaine and articaine groups with 16.7% (10 patients) and 49.2% (29 patients), respectively. Pre‐operative ketorolac tromethamine was not effective in reducing the intra‐operative pain incidence. However, it was effective in controlling post‐operative pain with lignocaine anesthetic group.