Role of Endodontic Biofilms

Biofilms are highly structured, hydrated microbial communities containing sessile cells embedded in a self-produced extracellular polymeric matrix (containing polysaccharides, DNA and other components). The formation of biofilms might facilitate certain survival and virulence characteristics under some situations. Several mechanisms have been postulated in the biofilm antimicrobial resistance, which includes; slow penetration of the antimicrobial agent into the biofilm, changes in the chemical micro-environment within the biofilm leading to zones of slow or no growth, adaptive stress responses and presence of a small population of extremely resistant “persister” cells. Biofilm biology has become an expanding field of research and the knowledge accumulated suggests that organisms growing in biofilms develop properties different to those dwelling in the planktonic stage. This review article covers the concept of biofilms and its role in endodontic infections.

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Clinical Tips

For more accurate location of inferior alveolar nerve block injection, we can estimate it from a good quality panoramic x-Ray (OPG) by observing the tram lines traces of the inferior alveolar canal till it starts from the mandibular foramen and relate this to the level of the lower posterior dentition or the upper posterior dentitions. In case it was higher up the ramus, that needs giving the injection little higher than usual the technique is quiet easy, fast but giving surprising results. We all know that the signs and symptoms of total failure of IAN block is the complete absence of any numbness from both the lip and the tongue is the injection side confirmed by objective tests i.e., by the dentist and partial failure will be presented by numbness only in the tongue side Figure: 1,2 shows how this could be

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Management of Neglected Severe Early Childhood Caries in a Six Year Old Female Child: A Three Year Follow Up

Early childhood caries is a virulent form of dental caries, characterized by an overwhelming infectious challenge associated with unusual dietary practices. This case report is of a child with severely mutilated deciduous teeth and carious lesion affecting smooth surfaces of permanent teeth. Following caries risk assessment; the patient was educated in relation to oral hygiene practices and treated with latest techniques to facilitate eruption guidance for permanent teeth. So this paper emphasizes on multidisciplinary management and treatment of severe Early Childhood Caries (S-ECC).

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Middle Mesial Canal in Mandibular First Molars: A Micro-CT Study

Objectives: The aim of this study was to investigate the presence and the incidence of a third canal in the mesial root of permanent mandibular first molars by using microcomputed tomography (micro-CT) and to describe the morphology of mandibular first molar’s root canal anatomy.
Methods: A total of 100 extracted mandibular first molars were randomly collected. Teeth were scanned by using micro-CT device (SkyScan 1074, Aartselaar, Belgium). These images were reconstructed three-dimensionally by using software NRecon (SkyScan 1074, Kontich, Belgium). After constructing, three-dimensional images exhibiting the shape of the roots were analyzed by using 3D-Doctor software programme (v.3.5 Able Software Corp, Lexington,MA). Thereafter, the number of the middle mesial canals, were evaluated.
Results: The results of this study indicate that a middle mesial canal present in 12% of mandibular first molars. Among these middle mesial canals two were independent canals, ten were confluent canals.
Conclusion: Micro-CT is a promising research tool for three dimensional evaluation of tooth morphology and provides detailed information on the configuration of root canals. In this study, 12% of mandibular first molars had a middle mesial canal which is significantly important from a clinical point of view. The possibility of additional canal in the mesial root should be anticipated in mandibular first molars.

Endodontics: Current Trends, New Horizons…

The utilization of new technological advances and materials in clinical endodontics is heading on a new era “ahead of the curve”. The outline of endodontic practice and clinical concepts are changing rapidly. The use of calcium hydroxide as an intra-canal by almost 80% of the general practitioners and endodontists for necrotic pulps and even for the routine dressings has replaced the old classics and increased the success rate with the introduction of efficient rotary engines, systems and various rotary tips, manual preparation has became less used and is the preferred technique in the endodontic offices. Routine use rubber-dam use in the world and saliva isolation techniques has contributed to aseptic conditions very much. Newer anesthetic techniques like Gow-Gates, Akinosi, intra pulpal techniques and devices the pain management in endodontics has improved. Electronic apex locators, introduction of mineral trioxide aggregate (MTA), IRM, the use of very sophisticated adhesives for restorations and glass-ionomers for coronal sealing based on the studies show the importance of the preventing coronal leakage following the root canal treatments for success, new condensation and compaction techniques has decreased the endodontic failures.

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