Diagnosis and Management of Fractured Teeth; Review Article

Traumatic damage to the teeth and oral tissues are the most common causes of tooth fracture. Because of their location in the oral cavity, front teeth in the upper jaw are the most commonly fractured. Sports, car accidents, and physical violence are the most prevalent causes. Cracked teeth are often diagnosed by visually inspecting the tooth (preferably utilizing microscopes). The size and form of the fracture plane are not always determined by looking at the crack line. One factor that contributes to the difficulty of effectively making an endodontic diagnosis is the inability to visualize the depth of the fracture through a clinical exam alone. Transillumination, microscopes and dyes are a useful tool for finding and diagnosis of the crack, treatment of the crack depends on the type, extend of the crack as well as the condition of the patient. In this review we’ll be looking at the diagnosis, etiology and management of fractured teeth.

Nasopalatine duct cyst: A jigsaw puzzle

For the success of endodontic treatment outcome, diagnosis plays a very important role. Endodontic diagnosis is similar to a jigsaw puzzle which cannot be made from a single isolated piece of information. Radiography plays a vital role in diagnosing dental diseases. Overcoming the major disadvantage of two dimensional imaging of superimposing the dento-alveolar structures, 3 dimensional images by Cone Beam Computed Tomography is of great help. It is very common that when radiographs show a superimposition of the incisive foramen over the apex of maxillary central incisors, mimicking apical periodontitis, unnecessary endodontic treatment or retreatment may be prescribed. Diseases of non endodontic origin that affect the tooth apex, such as Nasopalatine duct cyst, should be included in the differential diagnosis. In the present case report the role of CBCT in diagnosis is being discussed.

Endodontic Emergencies in Mumbai City during COVID-19 Lockdown and Different Phases of Unlock

The present descriptive research focused on determining the traits of patients who required endodontic treatment during the COVID-19 lockdown and various stages of unlocking in Mumbai metropolitan region. The descriptive analysis was carried out by examining the patients who were registered at Nair Hospital Dental College, Mumbai during four phases of lockdown (25 March to 31 May 2020) and eight phases of unlock (1 June 2020 to 31 January 2021). The evaluation was performed by evaluating the number of days and the overall number of patients reported for endodontic treatment for the first and subsequent visits. Each patient underwent intensive triage, which included taking their body temperature, oxygen saturation level, and travel history. The sex, age, and endodontic diagnosis of the offending tooth were also reported. The pain parameters were analyzed using a verbal numerical rating score (VNRS). During the lockdown phases, 297 patients seeking endodontic treatment visited the hospital over a total of 26 working days, and during the unlock phases, 16,195 patients visited the hospital over 189 working days. The average age of the patients that visited were 31–40 years of age (57.23%). The mean VNRS score was 5.85 ± 1.62. For both the lockdown and unlock periods, a significantly higher percentage of males visited dental school (p < 0.001). When compared to other stages, the number of patients attending during lockdown phase 4 (55.56%) and unlock phase 8 (32.35%) was the highest. The majority of endodontic emergency diagnoses were reversible pulpitis (36.5%) and symptomatic irreversible pulpitis (33.14%), all of which had higher mean VNRS (p < 0.05). Of the 49 patients that reported with COVID-19 symptoms, 11 tested positive. During the lockdown and unlock periods, 12 of the 41 treating workers tested positive. Personal protective equipment and patient screening are critical in shielding clinicians during the COVID-19 pandemic.

Knowledge, attitude and practice based survey among dentists regarding the usage of CBCT in endodontics

Cone Beam Computed Tomography is a diagnostic imaging modality that provides high quality, accurate three dimensional (3D) representations. CBCT in endodontics not only gives a three dimensional evaluation of the region of interest but also an appropriate resolution of images that help give a detailed analysis of the tooth and the surrounding alveolar anatomy. It aids in deciding the treatment plan in various fields of dentistry. CBCT has been proved as an essential diagnostic aid for endodontic practice. Since the use of ionizing radiation involves the patient’s and clinician’s safety, adequate knowledge about the appropriate usage of CBCT usage should be considered as a necessity. In endodontics, CBCT is a useful tool that helps in the diagnosis of apical periodontitis, resorptions, perforations, root canal morphology, traumatic injuries, voids. This survey was conducted among dentists. Online google forms were distributed of which 307 participants took part in the survey and the questionnaire contained 19 multiple choice questions, based on the demographic data, knowledge, attitude, practice regarding usage of CBCT in endodontics. On analysing the response to the questionnaire, it was found that the participants have overall good knowledge and were well versed regarding usage CBCT for endodontic procedures. This survey provides the reader with a clearer understanding of the appropriate and unwarranted usage of CBCT for endodontic practice. CBCT can be a powerful tool for endodontic diagnosis as well as in treatment planning and follow up.

Pictograph system for diagnosis making and data management in endodontics

ABSTRACTObjective: this questionnaire aimed to evaluate the approval of a new pictograph system for endodontic diagnosis by undergraduate and graduate students/endodontist instead of a conventional method. Methods: after a presentation to a total of 224 participants explaining the pictograph system, the participants (166 undergraduate students and 58 graduate students/endodontist) received a standardized questionnaire with three questions. The data were analyzed using the multprop macro basing on Tukey's test for multiple comparison with (P ? 0.05). The first question was to define the education level of the participants; the second question about which diagnosis method is preferred; and the third question about the intention of using one of the methods in the future. The questionnaire was realized in May 2019. The response rate was 97.7%. Results: the first question showed that 74.10% and 25.90% were undergraduate and graduate students/endodontist respectively. After statistical analysis there was no significant difference between the groups in the second and the third questions. In the second question (71.08% and 62.06%) of undergraduate and graduate student/endodontists respectively preferred the pictograph method over the conventional method. In the third question (60.24% and 51.72%) of undergraduate and graduate student/endodontists respectively showed interest in using the pictograph method in their professional career. Conclusion: the pictograph method in endodontic diagnosis is accepted by the majority of undergraduate and graduate students/endodontists. Training and experience affect the diagnosis making. KEYWORDSAdvanced dental education; Continuing dental education; Endodontics; Pictograph