South African Dental Journal

Harmonious togetherness

Use of antibacterial nanoparticles in Endodontics

Several root canal irrigants and medicaments are available to combat endodontic pathogens. However, evidence of complete elimination of these pathogens by the use of these solutions is not recorded in the literature. The possible development of resistant bacterial species is one of the problems related to the efficacy of the currently available irrigants and medicaments. In addition, the complex anatomy of the root canal system allows endodontic pathogens to be hidden in areas inaccessible to the action of the irrigating preparations. This is further enhanced by the protective layer that is formed by the remnants of pulp tissue, dentin powder and dead cells which inhibit the antibacterial activity of the root canal irrigants and medicaments. Antimicrobial nanoparticles show promising effect against resistant pathogens in pharmaceutical science as a result of their unique physio-chemical properties. Unlike traditionally used antimicrobial agents, these nanoparti-cles destroy bacterial cells through multiple mechanisms. The concept of using nanoparticles in endodontics as a new treatment modality was developed recently and their antibacterial efficacy against endodontic pathogens was evaluated by several researchers in many in vitro studies. This article reviews some of the currently available literature on laboratory studies that evaluated the efficacy of nanoparticles against endodontic pathogens.

Radix Entomolaris: Literature review and case report

Lodox® digital imaging - A tool for dental identification in single and mass fatality situations

Lodox®Statscan™ is a relatively recent addition to the field of post- mortem radiology and imaging in forensic dentistry and forensic medicine. A number of cases were encountered where victims who could not undergo visual identification were positively identified by comparing their post mortem Lodox® images with their ante-mortem dental records. A brief description is provided of how Lodox®Statscan™ images can be of benefit in cases where visual identification is not feasible or must be validated by another method of post-mortem identification. The digital images also provide a permanent record of the dentition of the deceased for future reference. The emphasis of this article is on the Lodox®Statscan™ as a screening tool for cases which are suitable for dental identification, especially in mini-mass fatality and mass fatality situations, which is a potent new possibility in the field of dental identification. The use of these full body low dosage digital radiographic images for the purposes of dental identification has not been reported in the literature previously.

Management of necrotic pulp of immature permanent incisor tooth: A regenerative endodontic treatment protocol: case report

It is possible that a paradigm shift may be in the offing in the approach to treatment of immature teeth with necrotic pulp, away from traditional apexification procedures and to a biologically-based endodontic protocol intended to produce regeneration, based on the deliberate introduction of bleeding into the canal space to provide a scaffold and allow the ingress of stem cells. METHODS: A patient presented with a maxillary right central incisor tooth with an open apex and periapical radiolucency. The tooth was irrigated with sodium hypochlorite and then dressed with tri-antibiotic paste consisting of ciprofloxacin, metronidazole and amoxicillin. At a subsequent visit a blood clot was produced in the canal by irritating periapical tissues and the canal then sealed with mineral trioxide aggregate and glass ionomer cement. RESULTS: The patient was pain free, the draining sinus was resolved in two weeks, root maturation continued and apical closure occurred after two months. The tooth became responsive to cold pulp vitality testing. CONCLUSIONS: Continued root growth invoked by regenerative endodontics may reduce the risks of fracture and premature tooth loss otherwise associated with traditional CaOH2 apexification procedures. Randomised, prospective clinical trials and long term studies are required before the technique becomes standard practice.

Insights into a comparison of three different cements on the push-out bond strength of a glass-fibre post

One of the main causes of failure of fibre posts is de-bonding of the post in the prepared post space. The adhesive properties of total etch adhesive cements were assessed by comparing the performance of cements using self-etching adhesive resins, to verify which system provided the best retentive capabilities with a double tapered post system. Extracted maxillary central incisors were endodontically treated and randomly divided into three groups: the Calibra (Dentsply), RelyX Ultimate (3M ESPE) and Panavia F2.0 (Kuraray) groups. RelyX Ultimate produced significantly the highest de-bond stress values (p<0.05) in the overall performance, as well as in the coronal, middle and apical sections of the tooth. Thus RelyX Ultimate with self-etching adhesive reliably can be used for post cementation with a double tapered post system in endodontically treated anterior teeth.

Local anaesthetics in dentistry - Part 2: Choice of local anaesthetic agent

Maxillofacial radiology case 149

Social Media and Dentistry: Part 8: Ethical, legal, and professional concerns with the use of internet sites by health care professionals

What's new for the clinician? Summaries of and excerpts from recently published papers