Pravin Kumar

This study focuses on the design and optimization of a Cold Atmospheric-pressure Plasma (CAP) jet, particularly targeting plasma-mediated root canal irrigation for smear layer removal and Enterococcus faecalis disinfection. The dielectric barrier discharge (DBD)-based CAP jet, powered by a bipolar pulsed power supply, was systematically optimized by varying applied voltage, frequency, and helium gas flow rate to achieve optimal plasma parameters. The CAP jet, operating in a buoyant axisymmetric jet configuration, exhibited a transition from laminar to turbulent flow at helium flow rates exceeding 4 slpm corresponding Reynolds number of 400. Optical Emission Spectroscopy (OES) was utilised to identify species generated and determine plasma parameters, with the collisional–radiative (CR) model revealing a non-equilibrium nature characterized by electron density (ne 1013 cm-3), electron temperature (Te 0.35 eV), and plasma gas temperature (Tg 305 K) under optimized conditions (4.5 kV, 20 kHz, 4 slpm). Fifty-Six mandibular premolars divided into four groups equally were irrigated with Normal saline solution (control) and CAP jet for 2 min, 5 min and 10 min respectively. Scanning Electron Microscope (SEM) imaging and disinfection analysis demonstrated significant improvements in smear layer removal and a 5 log reduction in E. faecalis count respectively. Smear layer removal was evaluated using the Kruskal–Wallis test, followed by Dunn’s post hoc analysis, whereas differences in bacterial load reduction across various CAP treatment times were analyzed using one-way ANOVA with Tukey’s HSD test for multiple comparisons. Safety considerations for medical applications, including gas temperature, leakage currents, and ozone emissions, were also evaluated according to DIN-specification 91315 (General requirements for plasma sources in medicine). These results underscore the promising application of plasma-mediated root canal irrigation, offering minimally invasive dental procedures, providing a foundation for further development and clinical translation in endodontics.

Topical application of 0.02% Mitomycin-C (MMC) has demonstrated efficacy in reducing fibrosis in ophthalmic and laryngeal procedures. This pilot study aime

A patient presenting with a history of restricted mouth opening and deflection of the mandible after a prolonged dental procedure raises a suspicion of temporomandibular joint disorder (TMD) due to its estimated high prevalence of 29%. Muscle relaxants and routine active physiotherapy established normal range of movement and pain reduction was achieved through TENS therapy and analgesics. However, the non-subsidence of deflection prompted an initial suspicion of TMD which was overturned by MRI. The MRI evaluation revealed left side medial pterygoid abscess. It is imperative to understand that despite strong history and relevant clinical features, for the definitive diagnosis radiographic evaluation is highly contributory. Misdiagnosing TMD due to its similar presentation can have significant implications for the patient’s well-being and quality of life. The clinical features of medial pterygoid abscess including restricted mouth opening and pain can be similar to that of TMD. These abscesses are most commonly caused by odontogenic infections but can also occur as a result of septic inferior alveolar nerve block techniques. Limited literature reports of pterygoid space abscess have been described, but intramuscular and medial pterygoid abscess is an absolute rarity. Causal relationship to septic inferior alveolar nerve block further makes this case report an interesting read.

The present study aimed to assess the effectiveness of different final irrigation regimens (Cold Atmospheric Pressure Plasma Jet, MTAD, and EDTA) in removing the smear layer from intra-radicular dentin using a Scanning Electron Microscope (SEM). Eighty-four mandibular premolars were prepared with ProTaper Universal hand files and were equally divided into four groups i.e. Normal saline (control), EDTA, MTAD and CAP Plasma Jet. Prepared samples in the control, EDTA and MTAD groups were irrigated with 5 milliliters of the irrigant, and it was retained for 2 min. In the CAP Plasma Jet group, the plasma plume was directed towards the canal lumen for 2 min. The smear layer removal of all the groups was evaluated at the coronal, middle and apical thirds. Statistical analysis was performed using Kruskal-Wallis test followed by Dunn's test. Evaluation by SEM showed that the smear layer removal ability of MTAD and EDTA were significantly better than CAP Plasma Jet (p < 0.05). While CAP Plasma Jet showed results comparable to EDTA in the coronal third. In the middle and apical third of the canal, its effect was comparable to the control group (p > 0.05). MTAD and EDTA aided in better smear layer removal than the CAP Plasma Jet in the coronal, middle, and apical third of the test samples. CAP Plasma jet performed better in the coronal third.

Amanjot Kaur, Neeti Rustagi, Aparna Ganesan, Nihadha PM, Pravin Kumar, Kirti Chaudhry. JKAOMS 2022;48:167-73. https://doi.org/10.5125/jkaoms.2022.48.3.167

Background/Aims: The varied prevalence of traumatic dental injuries (TDI) in primary teeth around the globe raises a serious knowledge gap in the available literature. The aim of this study was to evaluate the prevalence of TDI in primary teeth and also to evaluate the different factors associated with TDI in primary teeth.Materials and Methods: Comprehensive searches were performed in PubMed, Embase, Google Scholar, and The Cochrane Central Register of Controlled Trials with predefined search criteria. The primary outcome was the prevalence of TDI in primary teeth, and the secondary outcomes were the factors associated with TDI in primary teeth. Qualitative analysis was done using the Newcastle‐Ottawa scale adapted for cross‐sectional studies. The random‐effect model was used for meta‐analysis, and meta‐regression analysis was done to evaluate the heterogeneity between the included studies. Meta‐analysis was done using the “meta” package of “R” language. The overall quality of evidence was assessed using GRADEpro GDT software.Results: A total of 24 cross‐sectional studies met the inclusion criteria representing 4876 TDIs in 22 839 children aged between 0 and 6 years old. The overall prevalence of TDI in primary teeth was 24.2% (95% CI: 18.24‐31.43, P = 0, I² = 99%). Falls contributed the highest number of TDI ‐ 59.3% (95% CI: 41.05‐76.40, P < .01, I² = 98%) ‐ in primary teeth. The most common type of tooth fracture in primary teeth was an enamel fracture (61.9%), and prevalence of TDI in children with incompetent lip closure was 49.4%.Conclusion: The prevalence of TDI in cross‐sectional studies of primary teeth was 24.2% with very low quality of evidence. Falls contributed the highest number of TDI in primary teeth, accounting for 59.3%. Children with incompetent lip closure have the highest prevalence (49.4%) of TDI in primary teeth.

Background: The hand and rotary instruments are used for cleaning and shaping of root canals during biomechanical preparation in primary teeth.Aim: To determine clinical differences of hand versus rotary root canal instrumentation in primary teeth.Design: Comprehensive searches were made in four electronic databases [MEDLINE (via PubMed), EMBASE, Google Scholar, and The Cochrane Central Register of Controlled Trials] till March 2020, and prospective studies that met the inclusion criteria were included. The primary outcome was instrumentation time, whereas the secondary outcomes were quality of obturation, obturation time, and clinical and radiographic success. From 604 screened studies, eleven studies qualified for meta‐analysis. The random‐effect model and generic inverse variance approach were used for meta‐analysis.Results: There was significant decrease in instrumentation time [MD–5.00 minutes (95% CI: 3.05‐6.94), P < .00001, moderate evidence quality] and obturation time [MD–0.43 minutes (95% CI: 0.15‐0.71), P = .003, low evidence quality] with rotary instrumentation. Optimal quality of obturation was achieved in significantly more number of teeth [risk ratio (RR) = 0.71(95% CI: 0.53‐0.95),P = .02, moderate to high evidence quality] with rotary instrumentation. Similar clinical and radiographic success was observed in hand and rotary instrumentation techniques.Conclusion: Significant reduction in instrumentation time of five minutes was observed using rotary instrumentation with moderate quality evidence.