Irradiation Time of Photodynamic Therapy to the Number of Lactobacillus acidophilus

Lactobacillus acidophilus (L. acidophilus) is one of the etiological agents for dental caries and dominant in the deep carious lesion. L. acidophilus has also been identified in persistent root canal infection and also related to the failure of endodontic treatment. Photodynamic therapy is a therapeutic process involving the combination of a nontoxic photosensitizer and a light source. The excited photosensitizer reacts with reactive oxygen species (ROS), which induce injury and death of the microorganism. This study aimed to prove the effect of irradiation time of photodynamic therapy to the number of L. acidophilus. Fortytwo Eppendorf tubes were treated with 0.5 ml L. acidophilus distributed into seven groups. Group 1 as the control group received no treatment. Groups 2, 3, 4, 5, 6 and 7 were treated with a combination of 0.5 ml toluidine blue O (TBO) as a photosensitizer and 630 nm photoactivated (Fotosan®) exposure time for 10, 20, 30, 40, 50 and 60 sec. Then, all were stored in an incubator of 37ºC for 48 h. Later, the colony-forming unit (CFU) was counted for each group. There were significant differences in the number of L. acidophilus in CFU of the various irradiation times. The longer the photodynamic therapy irradiation was, the lesser the number of live L. acidophilus became. At 50 sec and 60 sec irradiation, none of the L. acidophilus was found alive.

Characteristics of the Deep Carious Lesions of Primary and Permanent Molars Using IOPA Radiographs

Aim: To determine the site and pattern of deep carious lesion & its consequences on coronal and radicular structures radiographically in primary molars & first permanent molars using IOPA radiographs. Materials and methods: It consisted of 200 IOPA of Deep carious of Maxillary & mandibular of primary (n=100) and permanent molars(n=100) X-rays are collected. IOPA radiographs of Deep carious lesion involving only dentin with radiolucency reaching the inner 1/3 of dentin, clinically cavitated that is RC5 Of the ICMMS criteria were taken. Blinded Radiographic evaluation was done by two persons to rule out inter examiner variability. Results: In primary molars IOPA there was statistically significant difference in Carious adjacent tooth whereas in permanent molars IOPA there was statistical difference in Diffused pattern and lost tooth structures. When compared primary and permanent molars diffused pattern and lost tooth structure showed statistically significant difference. Conclusion: The deep carious lesions definitely lead to loss of crown structure over a period of time and also capable of spread of caries to adjacent teeth due to food impaction & inadequate oral hygiene. Hence leading to loss of function and arch length.

Attitudes And Behavior Of Dentists Regarding Management Of Deep Carious Lesion

Objective: To assess the attitude and behavior of dentists for the management of deep carious lesions. Study Design and Setting: It was a cross sectional based study conducted at six dental institutes of Karachi from both government and private sectors. Methodology: The included participants were the dental graduates and post graduates working in different specialties of dentistry. Whereas graduates and post graduates not affiliated with any institution were excluded from the study. The Questionnaire comprises of two parts, first part was composed of participant’s demographic details and academic qualification, while the second part comprised of clinical scenarios regarding management of deep carious lesions. Results: From the 250 distributed questionnaires, 218 dentists returned the questionnaire giving a satisfactory response rate of 87.2%. There were 28% male and 72%% female dentists. The majority of dentists were aged between 25-35 years old. Complete caries removal was the management of choice by 72.5% of dentists for deep carious lesions. Conclusion: Complete caries removal was the most preferred treatment modality when the risk of dental pulpal exposure associated with caries excavation is low. However when the risk is high, step-wise excavation was preferred procedure by half of the participants.

Case Report: Immediate pain relief after partial pulpotomy of cariously exposed young permanent molar using mineral trioxide aggregate and root maturation, with two years follow-up

Carious exposure of immature first permanent molar is a widespread issue faced in paediatric dentistry. This may be the result of the early eruption of this molar, so parents may think it is replicable to the rest of the deciduous teeth. Preserving pulp vitality is the primary goal in treating those teeth to allow maturation of roots both in length and width. Mineral trioxide aggregate (MTA) is considered a perfect dressing material for pulpotomy (both partial and complete) due to its bio computability and sealing property. We present a case that describes treatment and two years follow-up of a symptomatic immature first permanent molar with a deep carious lesion. For treatment, we started with anaesthesia and rubber dam isolation. After that, the carious lesion was removed, and we performed partial pulpotomy, then applied MTA-Angelos on the fresh wound. Moistened cotton then was lightly packed over MTA for 15 minutes to allow initial setting, followed by application of glass ionomer and final restoration with composite. The following day, the tooth was asymptomatic with the patient reporting pain relief. After three months follow-up, the tooth normally responds to thermal test. After 12 months, a periapical radiograph of the tooth showed root maturation, and after 24 months also, the tooth was clinically and radiographically successful. MTA partial pulpotomy should be considered in the treatment of symptomatic young permanent teeth.

Use of BRIX-3000 Enzymatic Gel in Mechanical Chemical Removal of Caries: Clinical Case Report

Less traumatic alternative methods for removal of decayed tissue has been developed. A non-invasive technique, which consists of applying a proteolytic substance that softens the infected dentin tissue and preserves healthy tooth tissue was released in the market. Thus, this work intended to describe a clinical case of caries removal using BRIX 3000 papaine-based enzymatic gel. A 6-year-old male patient attend to a Univesity Dental Clinic complaining of painful sensitivity during mastication. After examination, acute deep carious lesion was found in dental elements 64 and 65. The caries removal procedure was performed for both teeth without anesthesia, under relative isolation, following the principles of atraumatic restorative treatment - ART. The gel was taken into the cavity and leaved to act for 2 minutes and the infected tissue was excavated. Caries lesion was then detected below the OM cusp with undercut enamel, needing to enlarge the cavity in the occlusal region with rotating cutting instruments and reapply the gel. After the second application, all the infected tissue had been removed and the teeth restoration with chemical ionomer cement was performed. At the end of the treatment, the discomfort during the performed procedure was asked to the patient using the Wong-Baker Face Scale. The child pointed to score 1, indicating mild pain for both treatments. It can be concluded that the use of enzymatic papaine gel-based was an efficient alternative for caries removal, easy to use, and preserve to the maximum the dental structure healthy, showing promise to be used as atraumatic caries removal technique.Keywords: Dental Caries. Papain. Pediatric Dentistry.ResumoMétodos alternativos menos traumáticos para remoção de cárie vem sendo desenvolvidos. Uma técnica não invasiva, que consite na aplicação de uma substância proteolítica que amolece a dentina infectada e preserva o tecido dental hígido foi lançado no mercado. Sendo assim, este trabalho visa relatar um caso clínico de remoção da lesão de cárie através do gel enzimático a base de papaína, BRIX-3000. Paciente do gênero masculino, 6 anos, compareceu à Clínica Odontológica Universitária com queixa de sensibilidade dolorosa durante a mastigação. Após avaliação, constatou-se lesão cariosa profunda aguda nos elementos dentais 64 e 65. O procedimento de remoção de cárie foi realizado sem anestesia e sob isolamento relativo, seguindo os princípios do tratamento restaurador atraumático (ART). O gel foi levado à cavidade, deixado agir por 2 minutos e realizado a escavação do tecido infectado. Foi detectado lesão de cárie abaixo da cúspide OM com esmalte socavado, necessitando de ampliação da cavidade na região oclusal com instrumentos cortantes rotatórios e reaplicação do gel. Após a segunda aplicação, todo o tecido infectado foi removido e realizada a restauração dos dentes com cimento de ionômero químico. Ao final do tratamento, foi aplicado a escala de faces de Wong-Baker. A criança apontou score 1, indicando dor leve para ambos os tratamentos. Pôde se concluir que a utilização do gel enzimático a base de papaína é uma alternativa eficiente para remoção do tecido cariado, de fácil utilização, preservando ao máximo a estrutura dental sadia, sendo promissor para ser utilizado na técnica atraumática de remoção da cárie.Palavras-chave: Cárie Dentária. Papaína. Odontopediatria.