PEDO VIRTUAL RAPID REVISION

2020

Dr. Nilesh RathiMDS, PhD, FPO

Associate ProfessorSharad Pawar Dental College

Wardha

9960100010drnileshrathi@gmail.com

The advancement in procedure, materials and the equipment is only way of improving the outcome of the treatment.

It is provides Predictable results

Comfort

Consumes less time

Generations Principle Brand Name

First Generation

Resistance based Endoradar, Dentometer

Second Generation

Impedance based Endoanalyzer, Sonoexplorer M-III

Third Generation

Frequency dependantImpedance

Propex-I, Bingo, Element

Fourth Generation

Ratio of multiple frequency of impedance

Root ZX II, Propex II

Fifth Generation

Dual Frequency ratio type E magic finder

Sixth Generation

Adaptive Apex locator

Review in Primary teeth:A Ahmad, S C Pani. Accuracy of Electronic Apex Locators in Primary Teeth: A Meta-Analysis. Int.Endod J.2015 Mar;48(3):298-307

Review:Gordon MPJ, Chandler NP. Electronic apex locators.International EndodonticJournal, 37, 425–437, 2004

Question 1

Rotary endodontics in children started in year 2000

Barr, E.S., Kleier, D.J., Barr, N.V., 2000. Use of nickel-titanium rotary files for root canal preparation in primary teeth. Pediatr. Dent.2000; 22: 77–78.

J.A. Shaw, C.B. Churchill, M.A. Iadicola. Tips and tricks for characterizing shape memory alloy wire: part 1— Differential scanning calorimetry and basic phenomena. Experimental Characterization of Active Materials Series. Oct 2008;45:55-62

Phases of NiTi - Temperature Based Change

Detwinned Martensite Twinned Martensite Austenite

Low temperature High temperature

Phases of NiTi - Stress based Changes

Austenite Detwinned Martensite Twinned Martensite

Low Stress High Stress

Helical AnglePitch

25/.04

25/.06

0 3 4 mm

.25 .43 .49

The heat treatment is the procedure of repeated cycles of heating the wire at proprietary temperature and cooling it for achieving the required properties of the wire.

The colour do not determine the properties.

The surface coating like titanium carbide is doe over the wire which imparts blue colour to it.

Maryam Kuzekanani. Nickel–Titanium Rotary Instruments: Development of the Single-FileSystems. J Int Soc Prev community medicine 2018 Sep-Oct; 8(5): 386–390.

Property Hand Endodontics Rotary EndodonticsTime Time consuming Time saving

Canal Taper Inadequate taper of canals for easy obturation

Adequate taper of canals for easy obturation

Root dentin Incomplete removal of the infected root dentin

Efficient cleaning of the infected root dentin

Canal Centricity

Canal Centricity is not maintained

Canal centricity is maintained

Root apex Apex is widened Apex is maintained narrow

Cleaning efficiency of CM wire rotary files were better in coronal, middle and apical one third of the root as compared to Protaper and K files. (Kandari et al., 2016)

Review on Pediatric rotary endodontics

Sageena George, S. Anandaraj, Jyoti S. Issac, Sheen A. John, Anoop Harris. Rotary endodontics in primary teeth – A review.The Saudi Dental Journal (2016) 28, 12–17.

Question

Rotary files prepared more conical canals in primary teeth than manual instruments. It reduced preparation time ( Musale and Mujawar,2014).

Additional reference:

Crespo, S., Cortes, O., Garcia, C., Perez, L., 2008. Comparison between rotary and manual instrumentation in primary teeth. J. Clin. Pediatr. Dent. 32, 295–298.

The ribbon shaped irregular surfaced root canal after preparation becomes conical, favoring a higher quality of the root canal filling,

and increasing clinical success. (Crespo et al., 2008)

Cleaning Efficiency

The probability of root canal deformation is reduced

due to its elastic memory and radial aspect that keeps the file

in the center of the root canal via wall support and inactive tips (Coleman et al., 1995).

Rotary files removes less root dentin than hand files in primary teeth.

Prasad Musale. Comparative assessment of dentin removal following hand and rotary instrumentation in primary molars using cone-beam computed tomography. JISPPD. 2019;37(1):80

Use of laser in endodontics:

Ivona Bago Juric, Ivica AnicThe Use of Lasers in Disinfection and Cleanliness of Root Canals: a Review. Acta Stomatol Croat 2014 Mar; 48(1): 6-15

Protocol for canal sterilization with laser in primary teeth

Zahra Bahrololoomi, Reza Fekrazad, Shiva Zamaninejad. Antibacterial Effect of Diode Laser in Pulpectomy of Primary Teeth. J Lasers Med Sci. 2017 Autumn; 8(4): 197–200.

Magnification

M Eichenberger, P Perrin, S T Ramseyer,A Lussi. Visual Acuity and Experience with Magnification Devices in Swiss Dental Practices. Operative Dentistry, 2015, 40-4, E142-E149

Orifice locating Dyes

Zahed Mohammadi, Saeed Asgary, Sousan Shalavi, Paul V. Abbott. A Clinical Update on the Different Methods to Decrease the Occurrence of Missed Root Canals. Iran Endod J. 2016 Summer; 11(3): 208–213.

Teeth Canal Fusion of canals

Maxillary First Molar MB2- 50% Fusion of distobuccal andpalatal canals- 50%

Maxillary Second Molar MB2- 77%DB2- 22 %

Fusion of distobuccal andpalatal canals- 11%

Mandibular First MolarSingle mesial canal -15%

Mandibular Second Molar Two distal canals -21 %

Sarkar et al JISPPD 2002

Teflon tape should be used as spacer in inter appointment dressing.

Temporary fillings are displaced due compressed cotton and results in failed seal with bacterial growth in cotton.

Tina Olsson, Daniael Chan, James Johnson, Avina Paranjape. In vivo microbiological evaluation of polytetrafluoroethylene and cotton as endodontic spacer materials. Quintessence international. September 2017:48(8);609-614

Intracanal Teflon was also used for the dressing

Keziban Olcay, Liviu SteIer, Hilal ErdoĞan, Sema Belli. Polytetrafluoroetylene tape as temporary restorative material: a fluid filtration study. J Istanbul Univ Fac Dent 2015;49(3):17-22.

It was found that Cavit and Cavit-W provided almost equal watertight seals, which was signicantly superior to the seal provided by Cavit-G. (Jacquot et al. 1996).

Review article:

H. J. Naoum & N. P. Chandler. Temporization for endodontics. International Endodontic Journal 2002;35:964-978,

Question 3

Early resorption of the obturating material

HOLLOW TUBE EFFECT (Goldman and Pearson)

Intracanal resorption of

the medicament

Tissue fluid into the canal

space

Infection and

Resorption of the root

HOLLOW TUBE EFFECT(Goldman M, Pearson AH, 1965)

Partial Pulpectomy

Vs

Pulpectomy

Hany Muhammod Ali AhmedEuropean Journal of General Dentistry 2014; 3 (1):3-10

Non vital pulpotomy in irreversible pulpitis

LSTR (Multiple combination

Vs

Zinc oxide with formocresol

Author Results

Prabhakar AR et al. JISPPD 2008;26 Suppl 1:S5-10

LSTR pulpotomy is a good substitute of pulpectomy

Amol kumar Lokade et JISPPD 2019; 37(2):185-191

3 Mix – MP with removal of pulp > 3 Mix – MP without removal of pulp > ChloramphenicalTetracycline with Zinc oxide

Symptomatic Irreversible Pulpitis

BiodentinPulpotomy

Vs

Pulpectomy

N A Taha S Z Abdelkhader. Outcome of full pulpotomy using biodentine in adult patientswith symptoms indicative of irreversible Pulpitis. Int Endod J 2018 Aug;51(8):819-828.

Question 4

1.Ozone box

Gregorio Martínez-Sánchez , Adriana Schwartz , Vincenzo Di Donna. Potential Cytoprotective Activity of Ozone Therapy in SARS-CoV-2/COVID-19. Antioxidants. May 2020. 6;9(5):E389.

1. UVGI (Ultraviolet germicidal irradiation)

UVC light of wavelength 254nm with

7J/cm2

.Miriam E.R. Darnella, Kanta Subbaraob, Stephen M. Feinstonea, Deborah R. Taylora.Inactivation of the coronavirus that induces severe acute respiratory syndrome, SARS-CoV. Journal of Virological Methods 121 (2004) 85–91

Personalised Endo Box

AutoclaveClean in 1%

sodium hypochloride

and saline

Use of files

Dentobizz.com

Extraoral suction

Advisory. May 2020Health and Family welfare ministry,Government of India

AIR

PURIFIER

Ultra fine HEPA Filter

HEPA H14 Filter with UV light

Plasmacluster

technology

Electron discharge with HEPA filter

Effectivefor virus

Less effectivefor virus

Doubtful for virus inaerosol

Result unpublished

Air cleaning Technologies. Ontario Health Technology Assessment Series 2005; Vol. 5, No. 17

HEPA FILTER

Infectivefor virus

Be rooted with basics when you grow

Thank You