Aim: To manufacture a clinical simulation apparatus for the undergraduates' endodontic radiography teaching Objectives: • To provide a model for teaching of parallax method using Kelly's forcep • To provide a model for undergraduates to practice radiographic localization employing parallax method. • To allow students to practice taking radiographs in a way that simulates the clinical situations with a good diagnostic quality Methods: Impressions of a dentate arch (maxillary and mandibullary) were used to form a stone cast. A section of the cast, in the area where the natural teeth were to be placed, is sectioned and removed. Three maxillary extracted teeth (canine, first and second premolar) were selected and mounted with acrylic resin at the sectioned area. The resin was cured in a light box. The arches were mounted in a phantom head with a placement of rubber cheek. The first premolar was isolated with rubber dam. The intraoral holder (Kelly's forcep) was attached to a robotic arm. The students were taught the correct angulations of the x-ray cone for the paralleling technique and parallax method using Kelly's forcep during root canal treatment. Results: All students managed to complete the exercise and were considered competent when they produced acceptable quality of radiographs. Conclusion: The model described was improvised from a model that has been used during the past 2 years for undergraduates' endodontic courses. It has been well accepted as it simulates the clinical situation more closely than was possible previously.
This study aimed to detect the presence of enterococci in the root canals of untreated and treated teeth with periapical disease and to compare this to their presence in the saliva and in the immediate surgical environment during root canal treatment. Using an aseptic technique, 33 samples were obtained from 27 untreated and 6 previously treated teeth associated with apical periodontitis. Reduced Transport Fluid (RTF) was used as transport medium. Saliva samples and areas in the surgical environment were also sampled. These were performed prior to chemo-mechanical debrjdement and obturation for every case. The saliva was diluted to 10- J and was plated on Bile Aesculin Azide (BEA) agar whereas the rest of the samples were plated on Bile Aesculin (BE) agar. These plates were then incubated aerobically at 37°C for 48 hours. All the colony types that blackened the agar were sub-cultured to obtain pure isolates and tested on 6.5% sodium chloride (NaCI). Growth on this medium was Gram stained for further confirmation of cell morphology. Gram positive cocci isolated from previous positive test were identified as enterococci. Enterococci were recovered from untreated cases only; from 2 teeth (in 2 patients) prior to chemo-mechanical debridement, from 3 teeth (in 3 patients) prior to obturation and I from saliva sample. A 'total of 5 samples from 5 different patients were positive for enteroco•cci. Sampling in the immediate surgical environment revealed a low occurence in the range of3.0% (1/33) to 15_2% (5/33). In conclusion, the occurence of enterococci in patients and the immediate surgical environment was low number.
Thirty extracted mandibular premolars were randomly divided into 3 groups. Canals were cleaned, obturated and the teeth incubated. Guttapercha removal was performed using: Hedström files with xylene (Group 1); ProFile® alone (Group 2) and combination of both (Group 3). Time required to remove the gutta-percha was recorded. Postoperative radiographs were taken. Specimens were split longitudinally and photographed. Amount of gutta-percha left at coronal, middle and apical thirds was calculated by computer (QWIN software) and the photographs were also evaluated visually by two endodontists. Results showed that the combined technique was fastest in removing gutta-percha. Radiographically, more residual was left in Group 2. Although computer analysis also showed more residual was left in Group 2, they were in a small percentage and there were no significant differences (P>0.05, SPSS paired-samples T test) among groups. Although there were significant differences between the two evaluators in their scoring, both generally agreed (Kappa’s analysis= 0.64) there was more guttapercha residual in Group 2 compared to Group 3 in the apical thirds. Although the differences in efficacy of guttapercha removal among these techniques were not significant, the use of ProFile® increased the speed of the procedure. The combined technique showed the most superior efficacy in gutta-percha removal.
Background: Majority of root canal treatment in Malaysia was provided by general dental practitioner. The purpose of this study was to evaluate the knowledge and practice (canal’s preparation, use of materials) by them. Methods: A questionnaire was structured and distributed to 120 registered general dental practitioners in selected areas in Perak, Johor and Klang Valley regarding the provision of root canal therapy in their practices. The questionnaires were hand delivered and collected after 1 to 2 weeks. Results: Reply rate was 95% (n=114). The result demonstrated that 62% respondents indicated that they performed the root canal therapy (RCT) themselves. Out of these only 26% included molars in the treatment. Three quarters of them (77%) used step-back technique and 54% used stainless steel instruments to prepare the canals. The majority of the respondents (69%) used calcium hydroxide as intracanal medicaments. Only 30% used rubber dam for isolation whereas the rest used cotton rolls. The numbers of routine radiographs taken were two for anterior teeth and three for molar. Half of the respondents indicated that they usually completed the RCT for the anterior tooth within two visits whereas three visits were needed for the molar tooth. The results were analyzed descriptively. Conclusions: This study indicates that most of the general dental practitioners’ do not comply with quality standards guidelines such as use of rubber dam as isolation. Cotton roll was the most popular isolation method. In spite of this, most of the respondents tend to update their knowledge and practices with current techniques and materials.
This study aimed to evaluate the coronal microleakage of different thickness of different restorative materials (glass ionomer cement (GIC, GC Gold Label 2), composite restoration (SDR, Dentsply Sirona) and (Filtek Z350 XT, 3M ESPE)) used as final restoration in endodontically treated teeth. 72 sound maxillary incisors were used. Following instrumentation, all canals were obturated with gutta-percha (Dentsply Maillefer) and Roth sealer (Roth International Ltd). After 2mm of gutta-percha removal below cemento-enamel junction, the crown was cut until length of 6mm from the gutta-percha to the incisal edge was achieved. The teeth were divided into four experimental groups (n=18) and access restorations were placed in different thickness combinations. Group 1 (G1): 2mm SDR + 4mm Filtek; Group 2 (G2): 4mm SDR + 2mm Filtek; Group 3 (G3): 2mm GIC + 2mm SDR + 2mm Filtek; Group 4 G4): 6mm SDR. All samples were thermocycled (500 thermal cycles between 5o and 55o C and dwell time of 30s), coated with nail varnish leaving 1mm margin around the filling material, immersed in 2% Rhodamine B solution and sectioned longitudinally. The dye penetration was observed under a stereomicroscope (Olympus SZX7) with 1.25x magnification. The data were analysed using Kolmogorov-Smirnov test, ANOVA test and post-hoc Tukey’s HSD test. There was significant difference of microleakage among all groups. G1 showed least microleakage but with no significant difference between G1 and G3 (p=0.513) and G1 and G4 (p=0.477). G2 showed significant microleakage compared to G1, G3 and G4 (p
The objectives of this study were to assess the practice of molar root canal treatment (RCT) among general dental practitioners (GDPs), confidence level of GDPs in performing molar RCT and to identify factors that influence their confidence in managing molar RCI. One hundred questionnaires were distributed to GDPs in Kuala Lumpur and Selangor. Fifty questionnaires were delivered by mail and the remaining fifty were hand-delivered. All data was coded and verified. Fiftysix OOPs rcsponded to the questionnaires. Only fortyfive questionnaires were accepted (n=45) as eleven OOPs had never performed molar RCI. Most of the OOPs followed the standard quality guidelines while performing molar RCT except for vitality testing (36.4%) and rubber dam usage (27.3%). In this study, 100% of the GDPs were confident in making diagnosis of perinidicular diseases and 95.4% were confident in performing molar RCT from history taking until obturation. Patients' tolerance and availability of instruments and materials (97.7%) were two factors that most influence the GDPs' confidence level. The. least influcncing factor was undergraduate training (78.1 %). Attending seminars and lectures on endodontic, large number of molar teeth treated for ReT, patLents' affordability to pay for RCT and postgraduate training also influencc GDPs' confidence to a certain degree. From this study, it can be concluded that majority of OOPs complied standard quality guidelines except for vitality testing and rubber dam usage. Most of them were confident in performing molar RCT and were greatly influenced by the availability or"instruments and materials in their clinic and patients' tolerance in receiving molar RCI.