Mandeep S Grewal - Academia.edu (original) (raw)

Papers by Mandeep S Grewal

Journal of Conservative Dentistry, 2021

Journal of Lasers in Medical Sciences, 2021

Introduction: The conventional chemomechanical procedures are ineffective in complete disinfectio... more Introduction: The conventional chemomechanical procedures are ineffective in complete disinfection of the pulp space due to the complexities of the root canal architecture. The present study aims to compare the efficacy of erbium: YAG laser-activated irrigation, sonic irrigation, and manual dynamic irrigation in the removal of the smear layer through a scanning electron microscope study. Methods: Fifty extracted single rooted mandibular premolars with single canal were used and instrumented until F3 ProTaper rotary file reached the working length. Upon the completion of the canal preparation, each specimen was irrigated with 3 mL of 4% NaOCl for 3 minutes, 3 mL saline for 1 minute and 3 mL of 17% EDTA for 3 minutes. The teeth were assigned to three experimental groups (n=15 each): manual dynamic irrigation, sonic irrigation (EndoActivator), and Er:YAG laser using an X pulse tip. Root canals were sectioned longitudinally and the smear layer at the apical, middle and coronal third was...

Journal of Dental Anesthesia and Pain Medicine, 2022

Background: This was a randomized controlled clinical trial that aimed to evaluate the anesthetic... more Background: This was a randomized controlled clinical trial that aimed to evaluate the anesthetic efficacy of 2% lidocaine combined with different concentrations of epinephrine (plain, 1:200,000 and 1:80,000) during endodontic treatment of maxillary molars with symptomatic irreversible pulpitis. Methods: The trial included 144 adult patients who were randomly allocated to three treatment groups. All patients received buccal-plus-palatal infiltration. After 10 min, pulp sensibility testing was performed using an electric pulp test (EPT). If a tooth responded positively, anesthesia was considered to have failed. In the case of a negative EPT response, endodontic access was initiated under rubber dam isolation. The success of anesthesia was defined as having a pain score less than 55 on the Heft Parker visual analog scale (HP VAS), which was categorized as 'no pain' or 'faint/weak/mild' pain on the HP VAS. Baseline pre-injection and post-injection maximum heart rates were recorded. The Pearson chi-square test was used to analyze the anesthetic success rates at 5% significance. Results: Plain 2% lidocaine and 2% lidocaine with 1:200,000 epinephrine and 1:80,000 epinephrine had anesthetic success rates of 18.75%, 72.9%, and 82.3%, respectively. Statistical analysis indicated significant differences between the groups (P < 0.001, χ 2 = 47.5, df = 2). The maximum heart rate increase was seen with 2% lidocaine solution with epinephrine. Conclusion: Adding epinephrine to 2% lidocaine significantly improves its anesthetic success rates during the root canal treatment of maxillary molars with symptomatic irreversible pulpitis.

International Journal of Current Research and Review, 2021

Background: The treatment of open apices in non-vital permanent teeth is done with apexification ... more Background: The treatment of open apices in non-vital permanent teeth is done with apexification using various materials like MTA, Biodentine and other materials. This study aimed to assess the utilization of Biodentine in apexification and large periapical lesions. Material and Methods: A male patient with the chief complaint of pain and pus discharge in the upper front tooth region. Initially, the patient was asymptomatic but eventually developed periodic swelling. On intraoral examination, it revealed the presence of porcelain fused to the metal crown in the right maxillary central and lateral incisor along with a sinus tract in the periapical region. During percussion of the tooth, it manifests positive tenderness. On radiographic examination, it shows that the root canal was incompletely obturated in both the incisors with incomplete root formation seen in the central incisor. The treatment protocol for tooth 11 and 12 was to perform root canal treatment along with apical plug formation using Biodentine. Therefore, under rubber dam access cavity was prepared and biomechanical preparation was done along with standard disinfection protocol using activation method and given intracanal medicaments. After 2-3 sittings of medicament, the apical plug formation was done in 11 along with filling of rest of the root canal with resin material. Results: In this case report the appreciating healing was seen at 3 months and 1 year follow up. Conclusion: The non-surgical conservative approach used in this case seems to be highly effective and gave astonishing results with complete healing of periapical lesion in central incisors.

Indian Journal of Health Sciences and Care, 2020

Journal of Pharmacy And Bioallied Sciences, 2021

Produção e caracterização de composto orgânico proveniente de resíduos da poda arbórea urbana Pro... more Produção e caracterização de composto orgânico proveniente de resíduos da poda arbórea urbana Producción y caracterización de compost orgánico a partir de residuos de poda de árboles urbanos

Journal of Evolution of Medical and Dental Sciences, 2021

The undesirable discoloration or pitting of teeth due to fluorosis or developmental defects like ... more The undesirable discoloration or pitting of teeth due to fluorosis or developmental defects like amelogenesis imperfecta or enamel hypoplasia pose a challenge to the clinician to cater to the aesthetic requirements of patients. Fluorosis had been reported way back in 1901. There are treatment options depending upon individual cases as follows: microabrasion / macroabrasion, bleaching, composite restoration, veneers or full crowns. For the aesthetic enhancement of stains associated with mild to moderate fluorosis enamel microabrasion is the preferred treatment. This technique involves removal of entrapped stains by rubbing of slurry containing HCl acid and an abrasive agent on the stained enamel surface. But if the depth of the defect is more then microabrasion can be done in conjunction with bleaching or bonded restorations can be done to achieve optimal aesthetics. Casein phospopeptide - Amorphous calcium phosphate (CPP – ACP) can be topically applied after microabrasion which enha...

Journal of Evolution of medical and Dental Sciences, 2021

Journal of Evolution of medical and Dental Sciences, 2021

A tooth can be broken due to many reasons, out of which deep cervical caries can be the one leadi... more A tooth can be broken due to many reasons, out of which deep cervical caries can be the one leading to destruction of the whole buccal surface of the tooth. So, to preserve such kind of tooth, root canal treatment is the ultimate treatment option followed by proper selection of the restorative means of such endodontically treated tooth. endodontically treated tooth (ETT) has loss of tooth structure and changes in physical characteristics. Therefore, proper selection of restoration for ETT is mandatory to maintain almost the same level of strength and regaining its functional abilities. The decision of doing restoration of endodontically treated teeth depends on many factors like the amount of tooth structure remaining, condition of the opposing tooth, etc. In cases of less than 50 % tooth structure remaining post and core followed by crown is the best treatment option. This article showcases a case report of treatment of anterior teeth with deep cervical caries. The posts used in th...

Journal of Evolution of Medical and Dental Sciences, 2021

In-depth knowledge of the root canal system is a major prerequisite for successful endodontic tre... more In-depth knowledge of the root canal system is a major prerequisite for successful endodontic treatment.1 The major aim of endodontic treatment is the eradication of infection and prevention of reinfection in canal. However endodontic treatment may fail because of incomplete knowledge about the anatomical variation of root canals. Most of the times the canal remains untreated because of the inability of the dentist to recognize its presence. For good prognosis of the root canal treatment, proper exploration, complete debridement, biomechanical preparation, and filling of root canal system must be done. Therefore, a dentist must be familiar with all the various possible canal configurations.2 Many times, failure of endodontic treatment may occur because the morphological variation of the tooth unfavourably affects the treatment. Pulpal inflammation can occur as a result of many factors like dental caries or trauma which causes tissue necrosis. Periapical tissue eradication develops i...

The objectives of root canal treatment are elimination of microorganisms, removal of pulpal remna... more The objectives of root canal treatment are elimination of microorganisms, removal of pulpal remnants, removal of debris, and shaping of the root canal system so that it may be obturated. The most important step in endodontic therapy is canal preparation which can be achieved by accurate working length determination. Working length determines the extent of placing the instruments into the canal, it affects the degree of pain and discomfort which the patient will experience post treatment and it plays an important role in the success of the treatment if placed within correct limits. The cementodentinal junction, where the pulp tissue changes into the apical tissue, is the ideal physiologic apical limit of WL because at this point healing is supposed to be optimal, and the wound to the periapical tissues is minimal.The apical constriction is however, histological and is impossible to locate clinically or radiographically. There are several methods of determining working length which in...

Journal of Evolution of Medical and Dental Sciences, 2020

Indian Journal of Health Sciences and Care, 2020

Indian Journal of Health Sciences and Care, 2020

World Journal of Dentistry, 2020

International Journal of Clinical Pediatric Dentistry, 2019

Aim and objectives: This in vitro study evaluated the effect of beveling of enamel on microleakag... more Aim and objectives: This in vitro study evaluated the effect of beveling of enamel on microleakage and shear bond strength of total-etch adhesive system: prime and bond NT and self-etch: adhesive system: XENO V in primary and permanent teeth. Materials and methods: A total of 120 extracted human molars (60 primary and 60 permanent) were selected for the study. For microleakage examination, a sample size of 40 was chosen. Two rectangular slots of equal dimensions were prepared on the buccal surface of each tooth and a bevel was given on either of the slots. Each slot was restored using a composite resin with prior application of the selected bonding agent following which all the samples were soaked in 1% methylene blue dye for 48 hours. Then each tooth was sectioned horizontally and evaluated. The remaining 80 samples were subjected to the shear bond strength test. Class II cavities of standard dimension were prepared and bevel was given on each sample following which selected bonding agent was applied and restored with a composite resin. The specimens were placed in a fixture and the shear bond strength was determined using the universal testing machine. Results: With respect to microleakage, the least was exhibited by beveled preparations in permanent teeth using the self-etch adhesive system and the highest shear bond strength was exhibited by beveled preparations using the total-etch adhesive system in permanent teeth. Conclusion: Beveling of enamel improved the marginal integrity and shear bond strength of self-etch and total-etch adhesive systems in both primary and permanent teeth.

Journal of Endodontics, 2016

Introduction: A separated instrument within the root canal may interfere in the successful outcom... more Introduction: A separated instrument within the root canal may interfere in the successful outcome of endodontic treatment. The retrieval of fractured instruments might compromise the remaining tooth structure and subsequently resistance to tooth fracture. The aim of this study was to compare the change in volume of root canal and dentin thickness after retrieval of separated instrument by 2 different endodontic ultrasonic tips. Methods: Each of the instruments (EMS Endochuck and ProUltra #6, #7, and #8 tips) was used to remove 40 separated rotary ProTaper F2 instruments from the mesiobuccal roots of mandibular molar under Â15 magnification. Cone-beam computed tomography analysis of the samples was done to evaluate the change in volume, dentin thickness, weight, time taken, and success. Results: Paired sample t test showed statistically significant (P < .05) difference in volume before and after instrument retrieval in both the EMS group, where the increase was 112.52%, and in the ProUltra group, where the increase was by 55.35%. Intergroup comparison showed statistically significant (P < .05) decrease in dentin thickness; it was more for EMS as compared with ProUltra. Overall decrease in the mean weight of EMS group (18.42%) was more than that of ProUltra group (9.36%). The overall success rate for removal of fractured instrument in this study was 87.5%; however, the difference in success rate was not statistically significant. The mean time taken for retrieval by ProUltra system was 63.89 minutes, whereas it was significantly less (P < .05) for EMS system (50.22 minutes). Conclusions: Removal of separated instrument with EMS resulted in more significant tooth structure loss as compared to ProUltra.

Journal of the International Clinical Dental Research Organization, 2017

Aim: To compare effect of different layering techniques on microleakage of nanofilled composites ... more Aim: To compare effect of different layering techniques on microleakage of nanofilled composites in class I restorations. Materials and Methods: 40 extracted maxillary premolar teeth were assigned to 2 different groups (Group 1 and 2) 20 teeth per group. A Class 1 cavity measuring 3mm´3mm´2mm was prepared in all the teeth. In group 1 and 2 teeth Clearfil TMSE Bond (Kurary Medical inc. Okayama, Japan) was applied. Group 1 teeth were filled with FiltekTM Z350 XT (nanocomposite) (3M ESPE, St Paul, USA) using oblique incremental technique and in Group 2 teeth were filled with FiltekTM Z350 XT (nanocomposite) (3M ESPE, St Paul, USA) using vertical incremental technique and each increment was cured for 30 seconds. Specimens were thermocycled for 1000 cycles (5/55°C,30 seconds) and immersed in 2% methylene blue dye for 24 hours. Following immersion teeth were sectioned and observed under a stereomicroscope. Results were analysed using paired “t” test and Mann–Whitney test. Results and Conclusion: The difference between the oblique group and the vertical group was found to be statistically non significant (P value >0.05) but mean microleakage was more in vertical group compared to oblique group.

National Journal of Maxillofacial Surgery, 2015

Head and neck squamous cell carcinoma is the sixth most common form of cancer worldwide and repre... more Head and neck squamous cell carcinoma is the sixth most common form of cancer worldwide and represents approximately 5% of all cancers diagnosed annually in the United States. [1] India continues to report the highest prevalence of oral cancers with 75,000-80,000 new cases of such cancers reported every year. There are about 700,000 new cases of cancers every year in India out of which tobacco-related cancers are 300,000. According to WHO 8.2 million people worldwide died from cancer in 2012, 60% of world's total new annual cases occur in Africa, Asia, and Central and South America.

Journal of Endodontics, 2015

Irreversible pulpitis (IP) commonly results in decreased anesthetic efficacy of the inferior alve... more Irreversible pulpitis (IP) commonly results in decreased anesthetic efficacy of the inferior alveolar nerve block (IANB) for mandibular molar. It has been shown that supplementary buccal and/or lingual infiltration as well as premedication with ketorolac result in improved efficacy of the IANB. One hundred fifty emergency patients who had their lower first or/and second molar diagnosed with IP participated in the study. All patients were randomly divided into 2 major IANB groups: 1 group received 4% articaine with 1:100,000 epinephrine, and the other group received 2% lidocaine with 1:80,000 epinephrine. Each group was further divided into 3 subgroups of 25 each: (1) buccal and lingual infiltration with articaine and lidocaine, respectively; (2) preoperative oral medication of ketorolac; and (3) preoperative oral medication of ketorolac followed by buccal and lingual infiltration with articaine and lidocaine, respectively. Endodontic access was initiated 15 minutes after solution deposition, and all patients were required to have profound lip numbness. Success of the anesthetic was defined as none or mild pain on endodontic access and initial instrumentation. Statistical analysis was performed using multiple-comparison analysis of variance (Kruskal-Wallis) and t tests. Articaine IANB with infiltrations plus oral ketorolac premedication significantly increased the success rate to 76%. The success rate after the administration of an articaine IANB with infiltration injections was 64%, whereas with lidocaine it was 32% (P &amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Premedication with ketorolac significantly increases the anesthetic efficacy of articaine IANB plus infiltration in mandibular molars with IP.

Journal of Conservative Dentistry, 2021

Journal of Lasers in Medical Sciences, 2021

Introduction: The conventional chemomechanical procedures are ineffective in complete disinfectio... more Introduction: The conventional chemomechanical procedures are ineffective in complete disinfection of the pulp space due to the complexities of the root canal architecture. The present study aims to compare the efficacy of erbium: YAG laser-activated irrigation, sonic irrigation, and manual dynamic irrigation in the removal of the smear layer through a scanning electron microscope study. Methods: Fifty extracted single rooted mandibular premolars with single canal were used and instrumented until F3 ProTaper rotary file reached the working length. Upon the completion of the canal preparation, each specimen was irrigated with 3 mL of 4% NaOCl for 3 minutes, 3 mL saline for 1 minute and 3 mL of 17% EDTA for 3 minutes. The teeth were assigned to three experimental groups (n=15 each): manual dynamic irrigation, sonic irrigation (EndoActivator), and Er:YAG laser using an X pulse tip. Root canals were sectioned longitudinally and the smear layer at the apical, middle and coronal third was...

Journal of Dental Anesthesia and Pain Medicine, 2022

Background: This was a randomized controlled clinical trial that aimed to evaluate the anesthetic... more Background: This was a randomized controlled clinical trial that aimed to evaluate the anesthetic efficacy of 2% lidocaine combined with different concentrations of epinephrine (plain, 1:200,000 and 1:80,000) during endodontic treatment of maxillary molars with symptomatic irreversible pulpitis. Methods: The trial included 144 adult patients who were randomly allocated to three treatment groups. All patients received buccal-plus-palatal infiltration. After 10 min, pulp sensibility testing was performed using an electric pulp test (EPT). If a tooth responded positively, anesthesia was considered to have failed. In the case of a negative EPT response, endodontic access was initiated under rubber dam isolation. The success of anesthesia was defined as having a pain score less than 55 on the Heft Parker visual analog scale (HP VAS), which was categorized as 'no pain' or 'faint/weak/mild' pain on the HP VAS. Baseline pre-injection and post-injection maximum heart rates were recorded. The Pearson chi-square test was used to analyze the anesthetic success rates at 5% significance. Results: Plain 2% lidocaine and 2% lidocaine with 1:200,000 epinephrine and 1:80,000 epinephrine had anesthetic success rates of 18.75%, 72.9%, and 82.3%, respectively. Statistical analysis indicated significant differences between the groups (P < 0.001, χ 2 = 47.5, df = 2). The maximum heart rate increase was seen with 2% lidocaine solution with epinephrine. Conclusion: Adding epinephrine to 2% lidocaine significantly improves its anesthetic success rates during the root canal treatment of maxillary molars with symptomatic irreversible pulpitis.

International Journal of Current Research and Review, 2021

Background: The treatment of open apices in non-vital permanent teeth is done with apexification ... more Background: The treatment of open apices in non-vital permanent teeth is done with apexification using various materials like MTA, Biodentine and other materials. This study aimed to assess the utilization of Biodentine in apexification and large periapical lesions. Material and Methods: A male patient with the chief complaint of pain and pus discharge in the upper front tooth region. Initially, the patient was asymptomatic but eventually developed periodic swelling. On intraoral examination, it revealed the presence of porcelain fused to the metal crown in the right maxillary central and lateral incisor along with a sinus tract in the periapical region. During percussion of the tooth, it manifests positive tenderness. On radiographic examination, it shows that the root canal was incompletely obturated in both the incisors with incomplete root formation seen in the central incisor. The treatment protocol for tooth 11 and 12 was to perform root canal treatment along with apical plug formation using Biodentine. Therefore, under rubber dam access cavity was prepared and biomechanical preparation was done along with standard disinfection protocol using activation method and given intracanal medicaments. After 2-3 sittings of medicament, the apical plug formation was done in 11 along with filling of rest of the root canal with resin material. Results: In this case report the appreciating healing was seen at 3 months and 1 year follow up. Conclusion: The non-surgical conservative approach used in this case seems to be highly effective and gave astonishing results with complete healing of periapical lesion in central incisors.

Indian Journal of Health Sciences and Care, 2020

Journal of Pharmacy And Bioallied Sciences, 2021

Produção e caracterização de composto orgânico proveniente de resíduos da poda arbórea urbana Pro... more Produção e caracterização de composto orgânico proveniente de resíduos da poda arbórea urbana Producción y caracterización de compost orgánico a partir de residuos de poda de árboles urbanos

Journal of Evolution of Medical and Dental Sciences, 2021

The undesirable discoloration or pitting of teeth due to fluorosis or developmental defects like ... more The undesirable discoloration or pitting of teeth due to fluorosis or developmental defects like amelogenesis imperfecta or enamel hypoplasia pose a challenge to the clinician to cater to the aesthetic requirements of patients. Fluorosis had been reported way back in 1901. There are treatment options depending upon individual cases as follows: microabrasion / macroabrasion, bleaching, composite restoration, veneers or full crowns. For the aesthetic enhancement of stains associated with mild to moderate fluorosis enamel microabrasion is the preferred treatment. This technique involves removal of entrapped stains by rubbing of slurry containing HCl acid and an abrasive agent on the stained enamel surface. But if the depth of the defect is more then microabrasion can be done in conjunction with bleaching or bonded restorations can be done to achieve optimal aesthetics. Casein phospopeptide - Amorphous calcium phosphate (CPP – ACP) can be topically applied after microabrasion which enha...

Journal of Evolution of medical and Dental Sciences, 2021

Journal of Evolution of medical and Dental Sciences, 2021

A tooth can be broken due to many reasons, out of which deep cervical caries can be the one leadi... more A tooth can be broken due to many reasons, out of which deep cervical caries can be the one leading to destruction of the whole buccal surface of the tooth. So, to preserve such kind of tooth, root canal treatment is the ultimate treatment option followed by proper selection of the restorative means of such endodontically treated tooth. endodontically treated tooth (ETT) has loss of tooth structure and changes in physical characteristics. Therefore, proper selection of restoration for ETT is mandatory to maintain almost the same level of strength and regaining its functional abilities. The decision of doing restoration of endodontically treated teeth depends on many factors like the amount of tooth structure remaining, condition of the opposing tooth, etc. In cases of less than 50 % tooth structure remaining post and core followed by crown is the best treatment option. This article showcases a case report of treatment of anterior teeth with deep cervical caries. The posts used in th...

Journal of Evolution of Medical and Dental Sciences, 2021

In-depth knowledge of the root canal system is a major prerequisite for successful endodontic tre... more In-depth knowledge of the root canal system is a major prerequisite for successful endodontic treatment.1 The major aim of endodontic treatment is the eradication of infection and prevention of reinfection in canal. However endodontic treatment may fail because of incomplete knowledge about the anatomical variation of root canals. Most of the times the canal remains untreated because of the inability of the dentist to recognize its presence. For good prognosis of the root canal treatment, proper exploration, complete debridement, biomechanical preparation, and filling of root canal system must be done. Therefore, a dentist must be familiar with all the various possible canal configurations.2 Many times, failure of endodontic treatment may occur because the morphological variation of the tooth unfavourably affects the treatment. Pulpal inflammation can occur as a result of many factors like dental caries or trauma which causes tissue necrosis. Periapical tissue eradication develops i...

The objectives of root canal treatment are elimination of microorganisms, removal of pulpal remna... more The objectives of root canal treatment are elimination of microorganisms, removal of pulpal remnants, removal of debris, and shaping of the root canal system so that it may be obturated. The most important step in endodontic therapy is canal preparation which can be achieved by accurate working length determination. Working length determines the extent of placing the instruments into the canal, it affects the degree of pain and discomfort which the patient will experience post treatment and it plays an important role in the success of the treatment if placed within correct limits. The cementodentinal junction, where the pulp tissue changes into the apical tissue, is the ideal physiologic apical limit of WL because at this point healing is supposed to be optimal, and the wound to the periapical tissues is minimal.The apical constriction is however, histological and is impossible to locate clinically or radiographically. There are several methods of determining working length which in...

Journal of Evolution of Medical and Dental Sciences, 2020

Indian Journal of Health Sciences and Care, 2020

Indian Journal of Health Sciences and Care, 2020

World Journal of Dentistry, 2020

International Journal of Clinical Pediatric Dentistry, 2019

Aim and objectives: This in vitro study evaluated the effect of beveling of enamel on microleakag... more Aim and objectives: This in vitro study evaluated the effect of beveling of enamel on microleakage and shear bond strength of total-etch adhesive system: prime and bond NT and self-etch: adhesive system: XENO V in primary and permanent teeth. Materials and methods: A total of 120 extracted human molars (60 primary and 60 permanent) were selected for the study. For microleakage examination, a sample size of 40 was chosen. Two rectangular slots of equal dimensions were prepared on the buccal surface of each tooth and a bevel was given on either of the slots. Each slot was restored using a composite resin with prior application of the selected bonding agent following which all the samples were soaked in 1% methylene blue dye for 48 hours. Then each tooth was sectioned horizontally and evaluated. The remaining 80 samples were subjected to the shear bond strength test. Class II cavities of standard dimension were prepared and bevel was given on each sample following which selected bonding agent was applied and restored with a composite resin. The specimens were placed in a fixture and the shear bond strength was determined using the universal testing machine. Results: With respect to microleakage, the least was exhibited by beveled preparations in permanent teeth using the self-etch adhesive system and the highest shear bond strength was exhibited by beveled preparations using the total-etch adhesive system in permanent teeth. Conclusion: Beveling of enamel improved the marginal integrity and shear bond strength of self-etch and total-etch adhesive systems in both primary and permanent teeth.

Journal of Endodontics, 2016

Introduction: A separated instrument within the root canal may interfere in the successful outcom... more Introduction: A separated instrument within the root canal may interfere in the successful outcome of endodontic treatment. The retrieval of fractured instruments might compromise the remaining tooth structure and subsequently resistance to tooth fracture. The aim of this study was to compare the change in volume of root canal and dentin thickness after retrieval of separated instrument by 2 different endodontic ultrasonic tips. Methods: Each of the instruments (EMS Endochuck and ProUltra #6, #7, and #8 tips) was used to remove 40 separated rotary ProTaper F2 instruments from the mesiobuccal roots of mandibular molar under Â15 magnification. Cone-beam computed tomography analysis of the samples was done to evaluate the change in volume, dentin thickness, weight, time taken, and success. Results: Paired sample t test showed statistically significant (P < .05) difference in volume before and after instrument retrieval in both the EMS group, where the increase was 112.52%, and in the ProUltra group, where the increase was by 55.35%. Intergroup comparison showed statistically significant (P < .05) decrease in dentin thickness; it was more for EMS as compared with ProUltra. Overall decrease in the mean weight of EMS group (18.42%) was more than that of ProUltra group (9.36%). The overall success rate for removal of fractured instrument in this study was 87.5%; however, the difference in success rate was not statistically significant. The mean time taken for retrieval by ProUltra system was 63.89 minutes, whereas it was significantly less (P < .05) for EMS system (50.22 minutes). Conclusions: Removal of separated instrument with EMS resulted in more significant tooth structure loss as compared to ProUltra.

Journal of the International Clinical Dental Research Organization, 2017

Aim: To compare effect of different layering techniques on microleakage of nanofilled composites ... more Aim: To compare effect of different layering techniques on microleakage of nanofilled composites in class I restorations. Materials and Methods: 40 extracted maxillary premolar teeth were assigned to 2 different groups (Group 1 and 2) 20 teeth per group. A Class 1 cavity measuring 3mm´3mm´2mm was prepared in all the teeth. In group 1 and 2 teeth Clearfil TMSE Bond (Kurary Medical inc. Okayama, Japan) was applied. Group 1 teeth were filled with FiltekTM Z350 XT (nanocomposite) (3M ESPE, St Paul, USA) using oblique incremental technique and in Group 2 teeth were filled with FiltekTM Z350 XT (nanocomposite) (3M ESPE, St Paul, USA) using vertical incremental technique and each increment was cured for 30 seconds. Specimens were thermocycled for 1000 cycles (5/55°C,30 seconds) and immersed in 2% methylene blue dye for 24 hours. Following immersion teeth were sectioned and observed under a stereomicroscope. Results were analysed using paired “t” test and Mann–Whitney test. Results and Conclusion: The difference between the oblique group and the vertical group was found to be statistically non significant (P value >0.05) but mean microleakage was more in vertical group compared to oblique group.

National Journal of Maxillofacial Surgery, 2015

Head and neck squamous cell carcinoma is the sixth most common form of cancer worldwide and repre... more Head and neck squamous cell carcinoma is the sixth most common form of cancer worldwide and represents approximately 5% of all cancers diagnosed annually in the United States. [1] India continues to report the highest prevalence of oral cancers with 75,000-80,000 new cases of such cancers reported every year. There are about 700,000 new cases of cancers every year in India out of which tobacco-related cancers are 300,000. According to WHO 8.2 million people worldwide died from cancer in 2012, 60% of world's total new annual cases occur in Africa, Asia, and Central and South America.

Journal of Endodontics, 2015

Irreversible pulpitis (IP) commonly results in decreased anesthetic efficacy of the inferior alve... more Irreversible pulpitis (IP) commonly results in decreased anesthetic efficacy of the inferior alveolar nerve block (IANB) for mandibular molar. It has been shown that supplementary buccal and/or lingual infiltration as well as premedication with ketorolac result in improved efficacy of the IANB. One hundred fifty emergency patients who had their lower first or/and second molar diagnosed with IP participated in the study. All patients were randomly divided into 2 major IANB groups: 1 group received 4% articaine with 1:100,000 epinephrine, and the other group received 2% lidocaine with 1:80,000 epinephrine. Each group was further divided into 3 subgroups of 25 each: (1) buccal and lingual infiltration with articaine and lidocaine, respectively; (2) preoperative oral medication of ketorolac; and (3) preoperative oral medication of ketorolac followed by buccal and lingual infiltration with articaine and lidocaine, respectively. Endodontic access was initiated 15 minutes after solution deposition, and all patients were required to have profound lip numbness. Success of the anesthetic was defined as none or mild pain on endodontic access and initial instrumentation. Statistical analysis was performed using multiple-comparison analysis of variance (Kruskal-Wallis) and t tests. Articaine IANB with infiltrations plus oral ketorolac premedication significantly increased the success rate to 76%. The success rate after the administration of an articaine IANB with infiltration injections was 64%, whereas with lidocaine it was 32% (P &amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Premedication with ketorolac significantly increases the anesthetic efficacy of articaine IANB plus infiltration in mandibular molars with IP.