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Chopra A, Sharma S, Kumar V, Chawla A, Jain S, Logani A. Influence of the restoration after pulpotomy on the strength of electrical stimulus reaching the pulp space: An in vitro investigation. J Conserv Dent 2023; 26:338-343. [PMID: 37398868 PMCID: PMC10309130 DOI: 10.4103/jcd.jcd_67_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/10/2023] [Accepted: 03/22/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction The study evaluated the influence of coronal restoration after pulpotomy on the strength of electrical stimulus reaching the radicular pulp using an electric pulp test (EPT). Materials and Methods The pulp tissue from ten freshly extracted mandibular premolar teeth was removed and replaced with an electroconductive gel. The cathode probe of Powerlab was inserted into the pulp space and the anode probe was attached to the EPT handpiece. The EPT probe coated with electro-conducting material was positioned in the middle third of the buccal crown surface. The EPT stimulus reaching the pulp space of an intact tooth at 40 numerical readings was recorded. The tooth was removed from model and endodontic access was made. The 2-mm thick mineral trioxide aggregate was placed at the cementoenamel junction followed by composite resin restoration. The experimental setup was re-established and postpulpotomy EPT stimulus data were recorded. The data collected were compared using the Wilcoxon signed-rank test. Results There was a statistically significant difference (P = 0.038) between observed between the strength of EPT stimulus reaching the pulp space in prepulpotomy (mean 91.18 ± 101.02 V and median 25.79 V) and postpulpotomy (mean 58.49 ± 77.13 V and median 13.75 V) tooth samples. Conclusion The placement of the restoration and pulp capping agent after pulpotomy dampens the strength of EPT stimulus reaching the pulp canal space.
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Affiliation(s)
- Aakanksha Chopra
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Sidhartha Sharma
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Kumar
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Amrita Chawla
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Suman Jain
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Logani
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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Wolf TG, Krauß-Mironjuk A, Wierichs RJ, Briseño-Marroquín B. Influence of embedding media on the accuracy of working length determination by means of apex locator: an ex vivo study. Sci Rep 2021; 11:3340. [PMID: 33558636 PMCID: PMC7870820 DOI: 10.1038/s41598-021-82942-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 01/27/2021] [Indexed: 11/17/2022] Open
Abstract
The aim of this research was to determine ex vivo the influence on accuracy of five different embedding media, for investigative and educational purposes, and one electronic apex locator. 110 human extracted mature roots of permanent single-rooted human teeth were used. The roots were embedded in alginate, stick sponge, 2% agar–agar and 6% and 12% gelatin. The actual working length to the physiological foramen was determined under a stereo-microscope (16 ×) and the electronic working lengths with the Elements Diagnostic Unit and a K-file ISO 10. The accuracy ranges of the accumulated measurements, when allowing a ± 0.5 mm tolerance, went from 98.2% (6% and 12% gelatin), 93.7% (alginate), 92.8% (2% agar–agar) to 91.7% (sponge). The exact measurements at the physiological foramen ranged from 80.0% (6% gelatin), 76.5% (2% agar–agar), 71.8% (12% gelatin), 68.2% (alginate) to 64.5% (sponge). Although relatively seldom (n = 24), measurements with deviations of more than ± 0.5 mm were also observed; thus, the accuracy of the working length determination results per se can be considered as clinically acceptable. The results of this research allow a recommendation of the investigated embedding media for electronic working length determination models for educational and research purposes in endodontics.
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Affiliation(s)
- Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland. .,Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes-Gutenberg-University Mainz, Mainz, Germany.
| | - Anna Krauß-Mironjuk
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes-Gutenberg-University Mainz, Mainz, Germany
| | - Richard Johannes Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Benjamín Briseño-Marroquín
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.,Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes-Gutenberg-University Mainz, Mainz, Germany
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Hanafi A, Donnermeyer D, Schäfer E, Bürklein S. Perception of a modular 3D print model in undergraduate endodontic education. Int Endod J 2020; 53:1007-1016. [PMID: 32220071 DOI: 10.1111/iej.13299] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/20/2020] [Indexed: 11/30/2022]
Abstract
AIM To evaluate a modular 3D print training dental model with embedded human teeth and electronic working length determination for undergraduate endodontic education. METHODOLOGY Cone-beam volume tomography data of a human skull were transferred into stereolithographic (STL) data, and a customizable modular 3D print model with individually removable sextants and teeth was generated for the use in commercially available phantom heads. Each of sixty-eight students performed a complete root canal treatment on an extracted human tooth. Working lengths were determined with electronic apex locators (EAL) and verified radiographically. Subsequently, an evaluation was carried out with regard to the difficulty of the working steps access cavity preparation, working length determination, root canal preparation/irrigation and canal filling, and these steps were compared to commonly used benchtop models. Additionally, the agreement of electronic and radiographic working length determination was assessed and analysed statistically with the chi-square test. RESULTS A total of 68 teeth (20 incisors, 26 premolars and 22 molars) with 127 root canals were treated. In total, 87% of the students considered the modular 3D print model considerably more demanding than the conventional benchtop model. Overall, 96% felt better prepared for the clinical situation, 92% felt markedly reduced stress levels during endodontic practice in the subsequent clinical courses, and 93% of the students suggested the model should be used in future preclinical endodontic training. The preradiographic use of EAL resulted in 85% of the cases having radiographically acceptable working length determination within 0-2 mm from the radiographic apex. Readings more than 2 mm from the apex or beyond were significantly more common in molars than in premolars and incisors (P < 0.05). CONCLUSIONS The vast majority of students rated the modular 3D print training model positively despite it being more demanding. They also recommended its use in preclinical teaching and training. The model allowed a more realistic simulation of the clinical situation with a simultaneous use of EALs and led to reduced stress levels in endodontic treatment in the subsequent clinical courses.
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Affiliation(s)
- A Hanafi
- Private Office, Gelsenkirchen, Germany
| | - D Donnermeyer
- Department of Periodontology and Operative Dentistry, University of Münster, Münster, Germany
| | - E Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany
| | - S Bürklein
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany
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Affiliation(s)
- Jörg Philipp Tchorz
- University Medical Center Freiburg; Faculty of Dentistry, Department of Operative Dentistry and Periodontology; Freiburg Germany
| | - Elmar Hellwig
- University Medical Center Freiburg; Faculty of Dentistry, Department of Operative Dentistry and Periodontology; Freiburg Germany
| | - Markus Jörg Altenburger
- University Medical Center Freiburg; Faculty of Dentistry, Department of Operative Dentistry and Periodontology; Freiburg Germany
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Widbiller M, Ducke S, Eidt A, Buchalla W, Galler KM. A training model for revitalization procedures. Int Endod J 2017; 51 Suppl 4:e301-e308. [DOI: 10.1111/iej.12765] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 03/16/2017] [Indexed: 12/01/2022]
Affiliation(s)
- M. Widbiller
- Department of Conservative Dentistry and Periodontology; University Hospital; Regensburg Germany
| | - S. Ducke
- Department of Conservative Dentistry and Periodontology; University Hospital; Regensburg Germany
| | - A. Eidt
- Department of Conservative Dentistry and Periodontology; University Hospital; Regensburg Germany
| | - W. Buchalla
- Department of Conservative Dentistry and Periodontology; University Hospital; Regensburg Germany
| | - K. M. Galler
- Department of Conservative Dentistry and Periodontology; University Hospital; Regensburg Germany
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Abstract
Objectives: To provide an overview of the general curricula in preclinical endodontic training from 6 established dental schools in Saudi Arabia. Methods: This study was conducted in January 2014 including only schools that had more than 2 groups of student graduates prior to the study. We included 2 dental schools from the Central region, one from Qassim region, one from the Makkah region (west), one from Abha region (south west), and one from the eastern region. An internet-based questionnaire was sent to the course directors of preclinical endodontics department of the 6 schools. The survey comprised 20 questions that examined various aspects of preclinical endodontics. Results: It was demonstrated that a significant number of faculty members had Doctor of Philosophy (PhD) degrees (n=21), Master’s degrees (n=15), and Saudi board certifications (n=8). We determined that the faculty to student ratio varied from 2:1 to 8: 1 among the colleges. The participating dental schools were found to teach the Step Back, as well as the Step Down techniques for root canal preparation. Five of the 6 schools implemented the use of nickel titanium rotary instruments. All dental schools predominantly used radiographs as the means of the working length determination. Conclusion: The curriculum for preclinical endodontics in Saudi Arabia is comparable to that followed in most European countries. A more comprehensive survey is needed that would involve more schools to formulate generalized guidelines for preclinical endodontic training in Saudi Arabia.
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Affiliation(s)
- Udaya Narayanaraopeta
- Department of Restorative Dental Sciences, College of Dentistry, University of Dammam, Dammam, Kingdom of Saudi Arabia. E-mail.
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Wolgin M, Wiedemann P, Frank W, Wrbas KT, Kielbassa AM. Development and Evaluation of an Endodontic Simulation Model for Dental Students. J Dent Educ 2015. [DOI: 10.1002/j.0022-0337.2015.79.11.tb06034.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Michael Wolgin
- Centre for Operative Dentistry, Periodontology, and Endodontology; University of Dental Medicine and Oral Health; Danube Private University; Krems Austria
| | - Paul Wiedemann
- Centre for Operative Dentistry, Periodontology, and Endodontology; University of Dental Medicine and Oral Health; Danube Private University; Krems Austria
| | - Wilhelm Frank
- Centre for Preclinical Education; Department of Biostatistics; University of Dental Medicine and Oral Health; Danube Private University; Krems Austria
| | - Karl-Thomas Wrbas
- Centre for Operative Dentistry, Periodontology, and Endodontology; University of Dental Medicine and Oral Health; Danube Private University; Krems Austria
- Department of Operative Dentistry and Periodontology; Center for Dental Medicine; Medical Center University of Freiburg; Albert-Ludwigs-University; Freiburg Germany
| | - Andrej M. Kielbassa
- Centre for Operative Dentistry, Periodontology, and Endodontology; University of Dental Medicine and Oral Health; Danube Private University; Krems Austria
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Tchorz JP, Brandl M, Ganter PA, Karygianni L, Polydorou O, Vach K, Hellwig E, Altenburger MJ. Pre-clinical endodontic training with artificial instead of extracted human teeth: does the type of exercise have an influence on clinical endodontic outcomes? Int Endod J 2014; 48:888-93. [DOI: 10.1111/iej.12385] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 09/24/2014] [Indexed: 11/27/2022]
Affiliation(s)
- J. P. Tchorz
- Faculty of Dentistry; Department of Operative Dentistry and Periodontology; University Medical Centre; Freiburg Germany
| | - M. Brandl
- Faculty of Dentistry; Department of Operative Dentistry and Periodontology; University Medical Centre; Freiburg Germany
| | - P. A. Ganter
- Faculty of Dentistry; Department of Operative Dentistry and Periodontology; University Medical Centre; Freiburg Germany
| | - L. Karygianni
- Faculty of Dentistry; Department of Operative Dentistry and Periodontology; University Medical Centre; Freiburg Germany
| | - O. Polydorou
- Faculty of Dentistry; Department of Operative Dentistry and Periodontology; University Medical Centre; Freiburg Germany
| | - K. Vach
- Department of Medical Biometry and Statistics; Institute of Medical Biometry and Medical Informatics; University Medical Centre; Freiburg Germany
| | - E. Hellwig
- Faculty of Dentistry; Department of Operative Dentistry and Periodontology; University Medical Centre; Freiburg Germany
| | - M. J. Altenburger
- Faculty of Dentistry; Department of Operative Dentistry and Periodontology; University Medical Centre; Freiburg Germany
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Tchorz JP, Ganter PA, Woelber JP, Stampf S, Hellwig E, Altenburger MJ. Evaluation of an improved endodontic teaching model: do preclinical exercises have an influence on the technical quality of root canal treatments? Int Endod J 2013; 47:410-5. [PMID: 23889696 DOI: 10.1111/iej.12162] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 07/02/2013] [Indexed: 11/29/2022]
Abstract
AIM To investigate whether the preclinical application of an electronic root canal length measurement device (ERCLMD) leads to more accurate working length (WL) determinations in a preclinical endodontic course and if this exercise effects the technical quality of root canal procedures when treatments are performed on patients for the first time. METHODOLOGY Root canal treatments performed by two consecutive groups of third year students (group 1: n = 39, group 2: n = 44) were compared in the preclinical course and when root canal treatments were performed on patients in the following term. Two different teaching models were applied in the preclinical endodontic course. WL in group 1 was determined with radiographs only. The teaching model applied in group 2 allowed the application of an ERCLMD. When treatments were performed on patients, both groups used the same technique to determine WL. It was first determined using an ERCLMD and verified radiographically. Master cone and root filling lengths were evaluated using radiographs, and comparisons between both groups were made using Fischer's exact test. RESULTS Root fillings performed by students of group 2 were more often classified as acceptable. This observation was made in the preclinical endodontic course and when treatments were performed on patients. CONCLUSIONS The application of an ERCLMD in combination with radiographs is more accurate to determine WL than radiographs alone. Students practiced the use of ERCLMDs with the new model and benefited from this experience when performing their first root canal treatments on patients.
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Affiliation(s)
- J P Tchorz
- Department of Operative Dentistry and Periodontology, Faculty of Dentistry, University Medical Centre, Freiburg, Germany
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