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Jaggi P, Mulay S, Tandale A, Jadhao R, Joshi P, Aras S, Krishnakumar K, Krishna V. Comparative Evaluation of Debris Extrusion, Remaining Dentin Thickness and Fracture Resistance of Endodontically Treated Teeth Using Rotary and Reciprocating Endodontic File Systems: An In Vitro Study. Cureus 2023; 15:e42290. [PMID: 37609092 PMCID: PMC10441161 DOI: 10.7759/cureus.42290] [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] [Accepted: 07/22/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Preventing the apical extrusion of debris during instrumentation is of paramount importance to reduce the occurrence of flare-ups in endodontically treated teeth. Furthermore, an essential requirement for the longevity and strength of an endodontically treated tooth and its ability to resist fracture is the preservation of residual dentin thickness during instrumentation. The aim of this study was to compare the amount of debris extrusion, remaining dentin thickness at the coronal third, middle third, apical third, and the fracture resistance of the teeth using rotary (TruNatomy; Dentsply Sirona, Charlotte, NC) and reciprocating (WaveOne Gold; Dentsply Sirona) endodontic file systems. METHODS An in vitro study included 52 single-rooted, oval canal shaped teeth that underwent exploration and initial cleaning with a no. 15 K-file. The prepared canals were then randomly assigned to two groups: Group I, with instrumentation with the TruNatomy rotary file (n=26) and Group II, with instrumentation with the WaveOne Gold reciprocating file. Parameters like debris extrusion, remaining dentin thickness, and fracture resistance were evaluated in both the groups. Analysis was performed using a paired t-test for the assessment of difference between groups and one-way ANOVA test followed by the post-hoc Tukey test for difference between the coronal, middle and apical third for each study group. RESULTS The results revealed no significant difference (t=0.454, p=0.652) between the TruNatomy rotary file and WaveOne Gold reciprocating file in apical extrusion of debris after their use in root canal therapy. For the remaining dentin thickness, a significant difference was present between the TruNatomy rotary file and WaveOne Gold reciprocating rotary file at the coronal (t=5.766, p<0.0001) and middle (t=3.690, p=0.001) levels. The mean fracture resistance was significantly more (t=15.877, p<0.0001) with the TruNatomy rotary file compared to the WaveOne Gold reciprocating rotary file. CONCLUSION The TruNatomy rotary file system outperformed the WaveOne Gold reciprocating file system in terms of maintaining the remaining dentin thickness and providing improved fracture resistance. Nevertheless, debris extruded apically was comparable between the TruNatomy rotary file system and the WaveOne Gold reciprocating file system.
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Affiliation(s)
- Prakriti Jaggi
- Department of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, IND
| | - Sanjyot Mulay
- Department of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, IND
| | - Anita Tandale
- Department of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, IND
| | - Renuka Jadhao
- Department of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, IND
| | - Poonam Joshi
- Department of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, IND
| | - Sanket Aras
- Department of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, IND
| | - Karishma Krishnakumar
- Department of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, IND
| | - Vamshi Krishna
- Department of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, IND
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Bnaiyan AH, Altinawi MK, Lazkani T, Alzoubi H. Evaluation Time and Efficacy of Root Canal Rotary Preparation in Primary Teeth: An In-Vitro Study. Cureus 2022; 14:e24558. [PMID: 35664392 PMCID: PMC9148183 DOI: 10.7759/cureus.24558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 11/05/2022] Open
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Ahmad MZ, Sadaf D, MacBain MM, Merdad KA. Effect of mode of rotation on apical extrusion of debris with four different single-file endodontic instrumentation systems: Systematic review and meta-analysis. AUST ENDOD J 2022; 48:202-218. [PMID: 35255170 DOI: 10.1111/aej.12612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 12/20/2021] [Accepted: 02/13/2022] [Indexed: 01/19/2023]
Abstract
This systematic review and meta-analysis evaluated whether single-file endodontic instrumentation systems with the reciprocating type of motion are responsible for more debris extrusion than single-file endodontic instrumentation systems with the full rotational type of motion. Electronic and manual searches were performed following the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analysis - PRISMA. We included studies comparing rotary (Neoniti and/ OneShape) versus reciprocating (WaveOne and/ Reciproc) systems. We evaluated the quality of studies and performed statistical analysis using R-Project software. Eight studies of high quality were included to perform the meta-analysis. Subgroup analysis was also done. The overall risk of bias was too low. In conclusion, single-file reciprocating systems tend to generate more extrusion of debris than single-file rotary systems.
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Affiliation(s)
- Muhammad Zubair Ahmad
- Restorative Dentistry Department, College of Dentistry in Ar Rass, Qassim University, Ar Rass, Saudi Arabia.,Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Durre Sadaf
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Marcy McCall MacBain
- Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK
| | - Khalid A Merdad
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Sundar S, Varghese A, Datta KJ, Natanasabapathy V. Effect of guided conservative endodontic access and different file kinematics on debris extrusion in mesial root of the mandibular molars: An in vitro study. J Conserv Dent 2022; 25:547-554. [PMID: 36506635 PMCID: PMC9733558 DOI: 10.4103/jcd.jcd_273_22] [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: 05/10/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 12/15/2022] Open
Abstract
Background Guided conservative endodontic access is a novel technique and the influence of such access cavities on apical debris extrusion (ADE) can have a significant effect on postoperative pain. Objective This study compared ADE and preparation time (PT) in the mesial canals of the mandibular first permanent molars in different access cavity designs and the amount of sodium hypochlorite in the extruded debris using attenuated total reflection-Fourier transform infrared spectrometer (ATR-FTIR). Materials and Methods Human mandibular first permanent molars (N = 72) were selected and randomly divided into six groups (n = 12) based on type of cavity design and files used: Group 1, Conservative Access Cavity [ConsAC])-WaveOne Gold; Group 2, ConsAC-Mtwo; Group 3, ConsAC-XP-endo shaper; Group 4, Traditional Access Cavity [TradAC])-WaveOne; Group 5, TradAC-Mtwo; and Group 6, TradAC-XP-endo shaper. All the ConsAC were prepared with a customized template fabricated using cone beam computed tomography. ADE evaluation was done using the Myers and Montgomery set up. All the instruments were used according to the manufacturers' instructions, followed by a final irrigation using Endoactivator. The time taken for preparation was calculated using a digital watch. Five samples in each group was taken and subjected to ATR-FTIR analysis. Results There was no significant difference between the groups with respect to ADE (P > 0.05). Whereas, a statistically significant difference was seen in PT between the TradAC and ConsAC (P < 0.05). Using ATR-FTIR, it was found that all the samples of extruded debris had the presence of sodium hypochlorite. Conclusions All instrumentation systems produced ADE irrespective of access cavity design. The time taken for preparation of canals in ConsAC was significantly longer compared to TradAC. Clinical Relevance ADE can translate clinically as postoperative pain. Assessing the ADE in ConsAC could shed light on the type of file systems that can be used in such cavities in order to minimize postoperative pain clinically.
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Affiliation(s)
- Sathish Sundar
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research University, Chennai, Tamil Nadu, India,Address for correspondence: Dr. Sathish Sundar, Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research University, No. 1, Alapakkam Main Road, Maduravoyal, Chennai - 600 095, Tamil Nadu, India. E-mail:
| | - Aswathi Varghese
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research University, Chennai, Tamil Nadu, India
| | - Krithika J. Datta
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Velmurugan Natanasabapathy
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research University, Chennai, Tamil Nadu, India
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Nabavizadeh M, Shokouhi MM, Kheirandish M, Sahebi S, Sadatshojaee N, Abbaszadegan A. A Comparison of the Apical Extrusion of Debris during the Preparation of Root Canal with Medin, RaCe, and ProTaper Rotary Systems. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2021; 22:193-197. [PMID: 34514067 PMCID: PMC8417540 DOI: 10.30476/dentjods.2020.84776.1100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 07/20/2020] [Accepted: 09/12/2020] [Indexed: 11/19/2022]
Abstract
Statement of the Problem: The extrusion of intracanal debris is one of the challenging problems related to almost all root canal preparation systems, which may cause flare-ups and impairment in the healing process. Purpose: This study was conducted to evaluate the amount of apically-extruded debris during root canal preparation using Medin (MEDIN Co., Czech Republic) rotary system compared with
two common rotary systems, including ProTaper (Dentsply Maillefer., Switzerland) and RaCe (FKG Dentaire, Switzerland). Materials and Method: In this in vitro study, Sixty mandibular premolars with single canal were randomly assigned to three groups (n=20). The root canals were prepared with Medin, ProTaper,
and RaCe rotary instruments based on their manufacturers’ instructions. The debris were collected into pre-weighted Eppendorf tubes. The weight of the extruded debris was
calculated by subtracting the pretreatment weight of the vials. Data were analyzed using the Kruskal-Wallis test at a 5% significance level. Results: Medin instrument caused significantly less debris extrusion in comparison with ProTaper and RaCe (p< 0.05). The differences between the ProTaper and RaCe rotary
systems were not statistically significant (p= 0.752). Conclusion: Within the limitations of this in vitro study, Medin rotary system produced less apical extrusion than ProTaper and RaCe.
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Affiliation(s)
- Mohammadreza Nabavizadeh
- Oral and Dental Disease Research Center, Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Mehdi Shokouhi
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojgan Kheirandish
- Dental Student, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Safoora Sahebi
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nooshin Sadatshojaee
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Abbaszadegan
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Apical Extrusion of Debris During Root Canal Preparation With Different Brands of ProTaper System. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2021. [DOI: 10.52547/jrdms.6.4.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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KELEŞ A, Uzunoğlu Özyürek E, Uysal S, Tuncel B, Uyanik Ö, Nagaş E. Comparison of Apically Extruded Debris Associated with Different Nickel–Titanium Systems. CUMHURIYET DENTAL JOURNAL 2019. [DOI: 10.7126/cumudj.507866] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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8
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Barbosa-Ribeiro M, Arruda-Vasconcelos R, Fabretti FL, Silva EJNL, De-Deus G, Gomes BPFA. Evaluation of Apically Extruded Debris Using Positive and Negative Pressure Irrigation Systems in Association with Different Irrigants. Braz Dent J 2018; 29:184-188. [PMID: 29898066 DOI: 10.1590/0103-6440201801750] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 12/11/2017] [Indexed: 11/21/2022] Open
Abstract
This study evaluated the amount of apically extruded debris after chemo-mechanical preparation (CMP) using positive and negative pressure irrigation systems [Conventional irrigation (CI) and EndoVac (EV)] in association with different irrigants [6% Sodium Hypochlorite (NaOCl), 2% Chlorhexidine gel + saline solution (CHXg + SS), 2% Chlorhexidine solution (CHXs) or Saline solution (SS)]. Eighty mandibular premolars with single root canals were selected and randomly assigned into 8 groups (n = 10) according to the irrigation system and the irrigant used during CMP: G1 (EV + NaOCl), G2 (EV + CHXg + SS), G3 (EV + CHXs), G4 (EV + SS), G5 (CI + NaOCl), G6 (CI + CHXg + SS), G7 (CI + CHXs) and G8 (CI + SS). Reciproc® R25 files (25/.08) were used during the CMP and the extruded debris from each tooth was collected in pre-weighted Eppendorf tubes and dried. The average weight of debris was assessed using a microbalance, and the data were statistically analyzed using ANOVA and the post hoc Tukey's test (a = 0.05). All groups were associated with debris extrusion. EV was the irrigation system with less extruded debris (p < 0.05). No differences were observed regarding the irrigant when EV was used. When CI was used, CHXg + SS were associated with lower debris extrusion (p < 0.05). It was concluded that no irrigation protocol succeeded in preventing debris extrusion. EV resulted in lower levels of debris extrusion than CI. The use of CHXg + SS resulted in lower debris extrusion.
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Affiliation(s)
- Marlos Barbosa-Ribeiro
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State UNICAMP - Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Rodrigo Arruda-Vasconcelos
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State UNICAMP - Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Fabio L Fabretti
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State UNICAMP - Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Emmanuel J N L Silva
- Department of Integrated Clinical Procedures, Division of Endodontics, UERJ - Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Department of Endodontics, School of Dentistry, UNIGRANRIO - Universidade Grande Rio, Rio de Janeiro, RJ, Brazil
| | - Gustavo De-Deus
- Department of Endodontics, School of Dentistry, UNIGRANRIO - Universidade Grande Rio, Rio de Janeiro, RJ, Brazil.,Department of Endodontics, UFF - Universidade Federal Fluminense, Rio de Janeiro, RJ, Brazil
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State UNICAMP - Universidade Estadual de Campinas, Piracicaba, SP, Brazil
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Zhang C, Liu J, Liu L. The influence of ProTaper and WaveOne on apically extruded debris: A systematic review and meta-analysis. J Conserv Dent 2018; 21:474-480. [PMID: 30294105 PMCID: PMC6161523 DOI: 10.4103/jcd.jcd_82_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background: Apically extruded debris produced during root canal preparation can induce postoperative inflammation and subsequent failure of root canal treatment. Therefore, debris production must be reduced to improve the outcome of root canal treatment. Aim: This study aimed to provide a theoretical basis for the improvement of root canal treatment by comparing the difference in the amount of apically extruded debris produced during the root canal preparation of extracted human teeth with ProTaper Universal (PTU), ProTaper Next (PTN), and WaveOne (WO). Materials and Methods: On March 30, 2017, three researchers searched five electronic databases (PubMed/Medline, Cochrane, Science Direct Online, Embase, and Web of Science) with no time limitations. Only articles written in English were retrieved, and 150 articles were obtained. Then, the three researchers independently selected articles in accordance with previously established inclusion and exclusion criteria, and inconsistent results were discussed. Data were analyzed through meta-analysis for standardized mean difference (SMD). Results: Eight studies met the inclusion criteria and were subjected to qualitative analysis. Four articles showed that PTU produced higher amounts of apical debris than WO; two articles showed that PTU produced lower amounts of apical debris than WO; and three articles showed that PTN produced lower amounts of apical debris than WO. Moreover, one article demonstrated that PTU produced higher amounts of apical debris than PTN. A meta-analysis showed that PTU and WO did not produce significantly different amounts of apically extruded debris: SMD = −0.26, Z = 0.50 (P > 0.05). PTU produced lower amounts of apically extruded debris than WO: SMD = −4.98, Z = 2.79 (P < 0.05). However, results were significantly heterogeneous among all the included studies (I2= 97%). No significant difference was found between PTU and WO in the amounts of apically extruded debris: SMD = 0.47, Z = 1.06 (P > 0.05). Conclusion: Currently available evidence shows that PTN can produce lower amounts of apical debris than WO (P < 0.05). Moreover, the amounts of apically extruded debris produced by PTU and WO are not significantly different (P > 0.05). Nevertheless, given the limited number of studies reviewed, a definitive conclusion cannot be reached.
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Affiliation(s)
- Chen Zhang
- Department of Oral Medical, Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Jun Liu
- Department of Orthodontics, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lingshuang Liu
- Department of Endodontics, Affiliated Hospital of Qingdao University, Qingdao, China.,Department of Oral Medical, Qingdao University, Qingdao, China
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Saha SG, Gupta RK, Bhardwaj A, Misuriya A, Saha MK, Nirwan AS. Comparison of the incidence of postoperative pain after using a continuous rotary system, a reciprocating system, and a Self-Adjusting File system in single-visit endodontics: A prospective randomized clinical trial. J Conserv Dent 2018; 21:333-338. [PMID: 29899640 PMCID: PMC5977786 DOI: 10.4103/jcd.jcd_336_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Aim: The aim of this study is to compare the incidence of postoperative pain using the ProTaper Next (PTN), WaveOne Gold (WOG), and Self-Adjusting File (SAF) systems. Materials and Methods: Two hundred and fourteen patients with irreversible pulpitis were selected for single-visit endodontics. The teeth were blindly assigned to three groups based on the instrumentation system used: Group A (PTN), Group B (WOG), and Group C (SAF). Participants were asked to note the incidence of the pre- and postoperative pain on a visual analog scale at different time intervals. Paired t-test and one-way ANOVA were used along with post hoc Tukey's test. Results: The greatest mean pain in Group A (PTN) and Group B (WOG) was found to be maximum in the first 24 h with a significant reduction in pain at the subsequent observation time points of 48 h, 72 h, and 7 days. Group C (SAF) showed minimum pain followed by Group B followed by Group A which showed comparatively higher pain scores even at the end of 7 days. Conclusions: In single-visit endodontics, SAF system may prove to be a better system compared with PTN and WOG as it produces minimal postoperative pain, thus improving the overall acceptance of endodontic treatment.
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Affiliation(s)
- Suparna Ganguly Saha
- Department of Conservative Dentistry and Endodontics, College of Dental Science and Hospital, Indore, Madhya Pradesh, India
| | - Rudra Kumar Gupta
- Department of Conservative Dentistry and Endodontics, College of Dental Science and Hospital, Indore, Madhya Pradesh, India
| | - Anuj Bhardwaj
- Department of Conservative Dentistry and Endodontics, College of Dental Science and Hospital, Indore, Madhya Pradesh, India
| | - Abhinav Misuriya
- Department of Conservative Dentistry and Endodontics, College of Dental Science and Hospital, Indore, Madhya Pradesh, India
| | - Mainak Kanti Saha
- Department of Prosthodontics, College of Dental Science and Hospital, Indore, Madhya Pradesh, India
| | - Amit Singh Nirwan
- Department of Oral and Maxillofacial Surgery, College of Dental Science and Hospital, Indore, Madhya Pradesh, India
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