CASE REPORT: We present a case report on management of an electrosurgery induced osteonecrosis involving maxillary alveolus of left premolars.
DISCUSSION: Inadvertent contact of the electrosurgery tip on bone can result in necrosis making it necessary to remove the sequestrum and graft the defect. Platelet rich fibrin in combination with bone grafts have been well documented to provide successful periodontal regeneration.
CLINICAL IMPLICATIONS: Our aim of presenting this report is to create awareness among the health care providers regarding electrosurgical injuries. To our knowledge, this is the first time platelet rich fibrin has been used in the management of intraoral electrosurgical injury. Combining bone grafts with platelet rich fibrin is a good alternative as it can be done with relative ease and predictable outcome.
METHODOLOGY: The trial is reported according to the Preferred Reporting Items for RAndomized Trials in Endodontics (PRIRATE) 2020 guidelines. The protocol was registered at the clinical trial registry (India) (CTRI/2019/06/019818). In total, 160 patients, assigned to four groups, received orally either 20 mg piroxicam, 20 mg prednisolone, 4 mg dexamethasone or a placebo 60 min before root canal treatment. Patients recorded their postoperative pain intensity at 6, 12, 24, 48 and 72 h using a 10-cm visual analogue scale. Intergroup comparison was performed using Kruskal-Wallis tests with post hoc analysis using Dunns test. Incidence of pain was analysed using chi-square tests. A P value 0.05). One patient in the piroxicam group reported gastritis, whereas no adverse effects were recorded in other groups.
CONCLUSION: Preoperative oral administration of a single dose of 4 mg dexamethasone, 20 mg piroxicam or 20 mg prednisolone reduced the incidence and severity of postoperative pain following single-visit root canal treatment compared to a placebo in patients with symptomatic irreversible pulpitis and symptomatic apical periodontitis up to 24 h. The odds of postoperative pain at 24 h for patients premedicated with 4 mg dexamethasone or 20 mg piroxicam or 20 mg prednisolone were 5.3 times, 3.4 times and 2.5 times less compared to the placebo, respectively.
MATERIALS AND METHODS: A split mouth clinical trial employed 198 children, who received these sealants on their lower permanent first molars. Retention was assessed 6 monthly and caries annually STATISTICAL ANALYSIS: Chi-square tests were utilized to analyze the retention rate and the incidence of dental caries between the two groups. Kaplan-Meier survival analysis plotted the cumulative survival percentage of partially, and fully retained sealants and the survival of dentin carious free pits and fissures among both the groups. A linear binary logistical regression analysis calculated the odds ratio.
RESULTS: A statistical significant difference was observed in the retention rate between these sealants at every follow-up stage. The cumulative survival percentage of ART and resin sealants was calculated to be 30.9 and 37.5% by the end of 2 years. The Kaplan-Meier analysis showed no significant difference with regard to the survival of dentin carious free pits and fissures. The odds ratio for this trial was 0.747 (95% confidence interval: 0.493-1.13) CONCLUSION: Resin sealants fared better than ART sealants in the field of retention. However, no significant differences were observed with regard to fissure caries prevention by the end of the study period.