Browsing by Author "Chakradhar, A"
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Publication A Comparative Evaluation of Removal of Intracanal Calcium Hydroxide with Endoactivator System and Mechanical Instrumentation with K File, Using Two Irrigating Solutions: an in Vitro Study(Kathmandu University, 2018) Acharya, N; Poudel, D; Chakradhar, AABSTRACT Background Calcium Hydroxide [Ca(OH)2] is widely used intracanal medicament in endodontics due to its antimicrobial activity against persistent microorganisms. Although routine use of calcium hydroxide is highly recommended, its removal at the time of canal obturation is equally important and challenging because its remnant might prevent the sealer penetration into dentinal tubules, potentially interact with zinc oxide eugenol sealers making them brittle and granular, and adversely affect the bonding of resin sealer adhesion thus significantly increasing the apical leakage of root canal treated teeth. Removal of intracanal calcium hydroxide is performed usually with different irrigants in combinations with ultrasonic, sonic, hand or rotary instruments. Objective The objective of this study is to evaluate the efficacy of Endoactivator system and mechanical instrumentation with K files using two irrigants for removal of intracanal Ca(OH)2. Method Forty extracted single rooted human mandibular premolars were collected and divided into two groups of 20 samples each (N=40; Group A: 1-20; Group B: 21-40). All samples were decoronated, instrumented, irrigated, dried and filled with Ca(OH)2 paste. Samples were stored in a humidor for a week and were instrumented with conventional k-file (Group A) and Endoactivator system (Group B). A radiograph was taken to evaluate the remnants of intracanal medicament. Result Overall there is not any statistically significant difference on any method of intracanal calcium hydroxide removal (p=0.45). However, on section wise comparison of efficacy of Ca(OH)2 removal, Endoactivator seems to be more effective than hand files on apical section (p=0.047). There is no statistically significant difference on coronal and middle segments between two methods (p=0.99). Conclusion The efficacy of removal of calcium hydroxide medicament from overall canal by conventional method and endoactivator system is similar though endoactivator system seems to be relatively more efficient on apical portion of root. KEY WORDS Calcium hydroxide, Endoactivator, Intracanal, SonicPublication Cone-Beam Computed Tomographic Study of the Internal Anatomy of Lower Anterior Teeth(Kathmandu University, 2024) Nepal, M; Chakradhar, A; Pradhan, SP; Khadka, J; Tripathi, R; Bali, HABSTRACT Background A thorough knowledge of the root and canal morphology and their possible variations are essential for successful endodontic treatment. Methods like staining and clearing techniques, cross sectional method can provide precise information on root canal systems, however, these methods are invasive. Cone-beam computed tomography (CBCT) is the 3-dimensional scans of the maxillofacial skeleton that best visualizes canal morphology and helps in identifying additional canals and roots in vivo. Objective To investigate the root canal configuration of mandibular anterior teeth using Cone- beam computed tomography. Method A total of 2910 CBCT images, comprising 970 central incisors, lateral incisors, and canines each from 485 patients were assessed. The following assessments were made: (1) The number of roots and root canals (2) Canal configuration according to Vertucci’s classification (3) Bilateral occurrences for variations. Also, the gender and age of patients were noted. Result The study revealed mandibular anterior teeth predominantly had 1 root with Type I (79.79%, 77.11%, 91.34%) canal configuration followed by type III (20.2%, 22.67%, 5.15%) in central, lateral and canine respectively. Almost 90% incisors had symmetry in the canal configurations. No statistical correlation was found between the gender and root canal configurations. Type III canal configurations in canines were present more in elder age group. Conclusion Clinicians must be aware that each tooth may display a different number of roots and types of canal configurations. During endodontic treatment, presuming lower anterior teeth with single root and single canal may lead to missed canals and consequently, treatment failure. KEY WORDS Cone-beam computed tomography, Internal anatomy, Mandibular anterior teethPublication Radiographic Assessment of Occurrence of Pulp Stones in Molars of Selected Adult Nepalese Populations at Tertiary Care Center(Kathmandu University, 2021) Acharya, N; Chakradhar, A; Kafle, DABSTRACT Background Pulp stones or “denticles” are a frequent finding in coronal and radicular pulp of primary and permanent dentition. These discrete calcified bodies can be seen in a healthy, diseased and sometimes even in an unerupted tooth. These calcifications are mostly present in molars as free, attached or embedded to dentine of pulp chamber or root canals. Objective To determine the occurrence of pulp stones in molars of selected adult Nepalese population using radiographs and assess the association of its occurrence gender and arch wise. Method A descriptive cross-sectional study was performed using orthopantomogram of total 380 patients (190 male and 190 females) of age group ranging from 16-30 years by convenience sampling. Data were collected through the examination of both hard and soft copies of radiographs under magnification. Pulp stones were scored as present or absent and their association with gender and dental arch were recorded. Descriptive statistics and chi square test was performed to see the prevalence and to compare the occurrence of pulp stone respectively. Result Out of 380 radiographic samples, pulp stones were present in 41.05% of the samples. The occurrence of pulp stones were found to be higher in females than in males, although the difference was not statistically significant (p=0.060).The total number of teeth with pulp stones was 238 and 61 in maxillary and mandibular arches respectively, with statistically significant difference (p<0.001). Conclusion The overall occurrence of pulp stone was found to be 41.05%. It was observed more in females (45.78%) than in males (37%) and more frequently located in maxillary molars (29.2%) than in mandibular molars (8.2%). KEY WORDS Denticles, Molars, Nepalese population, Prevalence, Pulp stonesPublication Self-confidence Level among Intern Dentists in Performing Endodontic Treatment Procedures in Nepal(Kathmandu University, 2021) Chakradhar, A; Humagain, M; Acharya, N; Pradhan, S; Poudel, PABSTRACT Background Endodontics is considered as one of the most difficult and stressful disciplines in dentistry. This might be due to the complex anatomical variations, recent advances in equipment, technology, materials and lack of self-confidence. Objective To determine the self-confidence level among the intern dentists in performing endodontic procedures from six different colleges of Kathmandu University, Nepal. Method A descriptive cross-sectional study was conducted among 145 intern dentists. The online questionnaire regarding confidence level (5 point Likert scale) in different endodontic procedures and difficulty level (easy, ok and difficult) with respect to teeth was distributed. For descriptive purpose, frequency and percentage for each response were calculated. Result Dental interns were confident in performing majority of the normal endodontic procedures, however, they showed less confidence in performing difficult steps like rubber dam application for anterior (74, 51%) and posterior tooth (91, 62.7%), use of electronic apex locator (89, 61.4%), using rotary files (114, 78.6%), management of flare-ups (86, 59.4%), assessment of quality of post-endodontic treatment (85, 58.5%), recall periods (75, 51.6%) and performing post and core (82, 56.6%). Likewise, upper first molars (84, 57.9%) and second molars (104, 71.7%) were found to be the most difficult teeth to treat. Conclusion It can be concluded that majority of the dental interns were confident in performing basic endodontic procedures, however, they were found to have low confidence in performing difficult steps. Further training and exposure should be incorporated to increase their confidence level. KEY WORDS Confidence level, Endodontic procedures, Intern dentists, Kathmandu University