Complexities in endodontics: A case series

There are cases in the endodontic treatment which are a real challenge. There are teeth with different anatomies of the root canals of different teeth and their treatment. There are most of the cases which are sevely carious and has lost more than 50% of the tooth structure. Patients usually lose their teeth because these problems. The aim of this study is to investigate several cases with different root canal anatomies like in open apex with blunderbuss canals in maxillary central incisors or mandibular premolar and molars with severly decayed crown tooth structures and their management. one case with severly decayed lower mandibular premolar i.e 45, one case of maxillary first molar with severly decayed crown structure i.e 16, a case of severly decayed mandibular first molar i.e 36, Three Cases of maxillary central incisors with immature open apex and blunderbuss canals w.r.t 21. Results are observed after several years. In performing a root canal treatment on such teeth, one should appreciate the complexity of the root canal system, canal obliteration and configuration, and the potential for regenerating the original anatomy of the tooth either Endodontic or Post Endodontic. Knowledge of the phenomenon of the complexity of the root canal system, canal obliteration and configuration, and the potential for regenerating tooth anatomies with the help of rebond fibres, MTA and Composite restorations, this will improve the medical practice of the general dental practitioner.

Aesthetic dental challenges for the paediatric patient

Advancements in material science have contributed greatly towards aesthetic dentistry. However, achieving satisfactory aesthetics for children in the developing dentition poses unique challenges. Challenges include, but are not limited to: (1) patient co-operation; (2) optimum moisture control; (3) continuing gingival maturation and bone growth; and (4) the increased need for minimally invasive and non-irreversible techniques to maintain future treatment options. This article addresses the common paediatric dental aesthetic challenges of uncomplicated crown fractures (ie those confined to enamel and dentine), localized, discrete enamel opacities and intrinsic discolouration of anterior, root canal-treated teeth. Treatment techniques and helpful tips for the general dental practitioner are presented. CPD/Clinical Relevance: This article focuses on common dental aesthetic challenges that present in the paediatric dental population and suggests methods to manage this effectively in primary and secondary care.

KNOWLEDGE AND ATTITUDE TOWARDS NEW CLASSIFICATION: PERIODONTAL DIAGNOSIS AND TREATMENT AMONG DENTAL PRACTITIONER IN MAHARASHTRA AND MADHYA PRADESH INDIA

This study is to compare the knowledge of general dental practitioner towards the New Periodontal Classification 2017.Comparision was done based on the questionair answered by different dental practitioner in Maharashtra & Madhya Pradesh,India.questions were related to the diagnosis , treatment options ,referal to periodontists and requirement of further Continuing Dental education in terms of New Classification.

An update on indirect prosthodontic materials and their manufacturing techniques

Innovations in the fabrication of removable partial dentures depend not only on the development of new materials, but also on the availability of manufacturing techniques that can be applied to a dental environment. Many of these new materials have limited clinical evaluations, hence it can be difficult for the general dental practitioner to confidently determine which materials to use. The introduction of any new material into clinical practice often requires practitioners to go through a learning curve to make the most of the material and employ it most appropriately. This article provides an update on the materials available for removable partial dentures and discusses the advantages and disadvantages to enable the GDP to make an evidence-based decision. CPD/Clinical Relevance: It is important that clinicians are aware of the alternative materials to conventional acrylic and cobalt chrome.

COVID-19 Pandemic: The Urgent Dental Hub experience from a primary care perspective

In response to the nationwide lockdown on 23 March 2020 in the UK, urgent dental hubs (UDHs) were established in the community to provide emergency dental care. Consecutive referrals to a primary care UDH were prospectively analysed over a one-month period, from 18 May 2020 to 18 June 2020. Of 400 referrals received, the most common were in relation to pain (87%). In 63% neither a radiograph nor photograph was provided with the referral. Seventy percent of patients were telephone triaged within 24 hours of receipt of referral. Fifty-three percent of referrals were accepted for face-to-face treatment, of which 69% were treated by extraction. Of rejected referrals (n=179; 45%), 79% were due to symptoms having settled or being manageable by the time of triage. A small number of referrals were redirected for specialist care. Referrals that were accepted were more likely to have been prescribed antibiotics and less likely to have been referred by the general dental practitioner (GDP) they regularly saw (p <0.01). Patients that were older and those that identified themselves as not having a regular GDP were less likely to have been referred to an UDH. The quality of referrals was poor and there may be a role for virtual consultations moving forwards. We found pre-referral antimicrobial prescriptions were high and a confused public health message may have been sent.

Porosity Distribution in Single Cone Root Canal Fillings Performed by Operators with Different Clinical Experience: A microCT Assessment

The objective of this study was to assess the porosity distribution of BioRoot RCS/single gutta-percha point root-canal fillings performed by a general dental practitioner and endodontist. Fourteen plastic models of maxillary premolars with two roots were selected and shaped with HyFlex EDM instruments to a size 40/0.04 taper and randomly divided into two experimental groups. A total of 14 canals in each group were obturated by two different operators with one HyFlex EDM size 40 gutta-percha point and BioRoot RCS sealer. The specimens were scanned with a high-resolution micro-computed tomography scanner, and the porosity of the fillings at the coronal, middle, and apical thirds of the root canals was qualified and quantified. The differences between groups and root-canal thirds were compared using Mann–Whitney, Friedman, and Wilcoxon tests with the significance level set at p < 0.05. The highest number of pores was observed in the apical third of root-canal fillings in both groups; however, the porosity distribution between the two groups was not significantly different in the apical and middle thirds (p > 0.05). Statistically significant differences were determined only in the coronal third (p < 0.05). The predominance of open pores was detected in all root-canal thirds and groups, with no significant differences in the number of open pores between the coronal and middle thirds (p > 0.05).

The importance of periodontal screening in children. A case report

The British Society of Periodontology, in collaboration with the British Society of Paediatric Dentistry, published guidelines in 2012 for the periodontal screening of children and adolescents. The guidelines recommended a simplified Basic Periodontal Examination (BPE) of six teeth for children aged 7–17 years. This is further modified for ages 7–11, using codes 0–2 from the 0–4 BPE adult chart. An unusual case of an 11-year-old boy who attended his general dental practitioner for a check-up is reported. Periodontal screening led to the detection of 13-mm pockets associated with the two mandibular first permanent molars that required surgical intervention and multidisciplinary care. CPD/Clinical Relevance: This case report highlights the importance of paediatric periodontal screening in both primary and secondary care.