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BACKGROUND: Various techniques have been employed to enhance the root canal disinfection rate using sodium hypochlorite (NaOCl) as an irrigant. Photon initiated photo-acoustic streaming using lasers is a newer method of endodontic disinfection. AIM: The aim of this study is to evaluate and compare the efficacy of photo-initiated photoacoustic streaming and conventional irrigation technique using 2.5% NaOCl for root canal disinfection in primary teeth. SETTING AND DESIGN: Laboratory setting and ex-vivo design. MATERIALS AND METHODS: Twenty extracted primary teeth were selected in which Enterococcus faecalis incubation was done in the root canals and bacterial counts were obtained before the intervention. The teeth were randomly allocated into two groups. Group I samples were irrigated with conventional syringe method using 2.5% NaOCl and Group II samples were irrigated using photon-initiated photo-acoustic streaming method with erbium-doped yttrium aluminum garnet laser (wavelength - 2940 nm). Postintervention samples were obtained, and bacterial colony count was done. Wilcoxon Signed- Ranks Test and Mann-Whitney test were applied to test the intragroup and intergroup differences in the bacterial counts. RESULTS: Postintervention results showed no bacterial growth in the canals irrigated using Laser (P = 0.004) whereas, fewer bacterial colonies were observed in NaOCl group (P = 0.005). There was statistically significantly higher reduction in E. faecalis counts in Laser Activated irrigation (LAI) group compared to NaOCl group (P < 0.05). CONCLUSION: Total elimination of E. faecalis counts was obtained by the use of laser activated NaOCl irrigation in the infected root canals, hence, it can be considered as an effective method for pediatric endodontic disinfection.

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BACKGROUND: Laser photobiomodulation (LPBM), also called Low Level Laser Therapy (LLLT), has shown potential to reduce the pulpal inflammation and to preserve the dental pulp vitality, thereby improving healing. Lasers being minimally invasive, safe, and patient friendly prompt its application in pediatric dentistry. AIM: The aim of this study was to evaluate and compare the clinical and radiographic success rates of LPBM and formocresol pulpotomy at 9 months post intervention in human primary molars. MATERIALS AND METHODS: A randomized controlled, split-mouth study design was followed involving children aged 4-7 years with at least two primary molars indicated for pulpotomy. Sixty-eight eligible primary molars were randomly allocated to two interventions - formocresol pulpotomy (Group I) and LPBM pulpotomy (Group II). STATISTICAL ANALYSES: Chi-square test was used for statistical analysis fixing significance level at P ≤ 0.05. RESULTS: There was no statistically significant difference in the clinical success rates between the formocresol group (97.05%) and the photobiomodulation group (94.1%) (χ2 = 0.34, P = 0.55); however, the radiographic success rate was significantly high in the laser group (94.1%) compared to the formocresol group (58.82%) (χ2 = 11.76, P = 0.001). CONCLUSION: LPBM could be a viable nonpharmaceutical alternative for formocresol pulpotomy in human primary teeth.

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Reactive hyperplasias are a group of lesions often seen in the oral mucosa, especially on the gingiva, in association with local irritation or trauma. Peripheral ossifying fibroma (POF) is a common reactive lesion, almost always affecting the tooth-bearing areas of the oral cavity. It is most often encountered in young adults but extremely rare in patients below 10 years of age. Here, we report a unique presentation of peripheral ossifying fibroma affecting the anterior mandible in a three-month-old infant. We also highlight the role of laser in the management of such lesions.

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AIM AND OBJECTIVE: To compare r oot microcrack formation after r oot canal preparation using ProTaper Next in r otation or forward r eciprocation and Waveone gold in r everse r eciprocating motion. MATERIALS AND METHODS: Buccal r oots of 60 maxillary premolars with mature apices were selected, for different instrumentation techniques and divided into three groups. Coronal access was achieved and the canals were confirmed for apical patency. The canals were then instrumented using the following instrumentation techniques: ProTaper Next in r otation or forward r eciprocation or Waveone gold in r everse reciprocation. The tooth was then subjected to sectioning using a diamond saw under water cooling and then was visualized under the stereomicroscope for dentinal microcrack. RESULTS: The results showed that the maximum dentinal microcrack formed at apical 3 and 6 mm was in Waveone gold in reverse reciprocation followed by ProTaper Next in forward reciprocation and rotation. However, the p value was found to be not significant at 3 and 6 mm (p value-0.082 and 0.23). CONCLUSION: Nickle titanium rotary instruments tend to induce varied degrees of root dentinal damage during canal instrumentation. ProTaper Next files in rotation as well as forward reciprocation presented with minimal microcrack defects when compared with Waveone gold. CLINICAL SIGNIFICANCE: Root canal preparation, when performed by manual or engine-driven techniques, has shown to produce structural defects in the root dentin. One of the causes of failures in root canal treatment is because of fracture in the dentin that occurs due to these procedures. Though all the motion kinematics caused microcracks in this study, it was seen that rotational motion produced the least structural damage to the dentin.

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AIM: To evaluate the effect of instrumentation kinematics on debris extrusion by comparing the amount of apically extruded debris after canal preparation using ProTaper next in continuous rotation as well as forward reciprocating motion and WaveOne gold in reverse reciprocating motion. MATERIALS AND METHODS: We randomly divided ninety buccal roots of maxillary bicuspids with fully formed apices into three groups. After achieving the coronal access, the patency of the root canals was established with a size 10 K file. The canals were then instrumented using ProTaper next in continuous rotation or in a forward reciprocating motion and WaveOne gold in reverse reciprocating motion. Eppendorf tubes were used to collect the debris extruded through the apical foramen. The tubes were placed in a -80° freezer for 8 hours and then in a lyophilizer for 24 hours. The quantity of the apically extruded debris was assessed by subtracting the weights of Eppendorf tubes before and after instrumentation. The analysis was done using a one-way ANOVA test and the Bonferroni test to compare the groups. RESULTS: The mean weight of extruded debris with WaveOne gold in reverse reciprocation was significantly lower than ProTaper next in forward reciprocation and ProTaper next in continuous rotation (p value = <0.001). CONCLUSION: WaveOne gold in reverse reciprocation was associated with a significantly lower amount of apical extrusion of debris than ProTaper next rotary files in forward reciprocation and continuous rotation. CLINICAL SIGNIFICANCE: According to the results of this study, reciprocating instrumentation technique was associated with a less amount of debris extrusion compared to continuous rotation.

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BACKGROUND: In health terms, consuming fluoride is well recognised to be a double-edged sword. Consumption of optimal amounts is beneficial to health, however an excess constitutes a health hazard. OBJECTIVES: To assess the prevalence of skeletal fluorosis in fishermen from the Kutch coast, Gujarat, India. MATERIALS AND METHOD: A descriptive cross-sectional survey was conducted on 653 fishermen from the Kutch District, Gujarat, India, from October 2014 to December 2014. Clinical skeletal fluorosis was assessed using three diagnostic tests. Drinking water fluoride concentrations in different regions of the study area were determined. General information regarding age, gender and adverse habits were also collected. The Chi square test was used for comparisons and the confidence level and critical p-value were set at 95% and 5% respectively. RESULTS: Fluoride concentrations in water from the study area ranged between 3.4-6.9 ppm. The prevalence of skeletal fluorosis was 30.3%, out of which, the majority of the subjects had mild skeletal fluorosis (18.4%). This condition was found to be significantly associated with age and gender along with tobacco and alcohol consumption; depending on the habit's duration. CONCLUSION: Being a public health problem in the fishermen community, skeletal fluorosis requires a-priori attention. Measures for preventing this disease should be undertaken on a communitywide basis.

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Several treatment modalities for neurodegenerative diseases or tumors of the central nervous system involve invasive delivery of large molecular weight drugs to the brain. Despite the ample record of experimental studies, accurate drug targeting for the human brain remains a challenge. This paper proposes a systematic design method of administering drugs to specific locations in the human brain based on first principles transport in porous media. The proposed mathematical framework predicts achievable treatment volumes in target regions as a function of brain anatomy and infusion catheter position. A systematic procedure to determine the optimal infusion and catheter design parameters that maximize the penetration depth and volumes of distribution will be discussed. The computer simulations are validated with agarose gel phantom experiments and rat data. The rigorous computational approach will allow physicians and scientists to better plan the administration of therapeutic drugs to the central nervous system.

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