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 Table of Contents  
ORIGINAL ARTICLE
Year : 2015  |  Volume : 2  |  Issue : 1  |  Page : 21-24

Postures of pediatric dentists toward endodontic standards and acceptance of novel technology in Udaipur city: A questionnaire survey


Department of Pedodontics and Preventive Dentistry, Darshan Dental College and Hospital, Udaipur, India

Date of Web Publication8-Apr-2015

Correspondence Address:
Chirag M Raiyani
Department of Pedodontics and Preventive Dentistry, Darshan Dental College and Hospital, Udaipur
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2348-2915.154640

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  Abstract 

Background: To ascertain the current clinical practice of pediatric dentists involves utilization of a variety of materials and recent technological advances. Materials and Methods: A total of 218 pediatric dentists (118 males and 100 females) were selected for the study those are registered in IDA Udaipur and surveyed using a self-administered questionnaire. Participants were divided into three groups according to their year of experience in the clinical practice. A total of 11 structured questions presented through a pilot study done among the 10% of the total participant's related to endodontic procedure were used for the study. Frequency and percentage distribution were calculated. Results: The results showed that glass bead sterilization (41.3%) was the most commonly used method for sterilization. Isolation during the pulpectomy procedure performed using cotton rolls and suction tip (40.4%). Most of them used hand instruments (58.3%) among those; K-file (42.7%) was widely used. Radiographic method (53.7%) was most common procedure for determination of working length. Single sitting pulpectomy was not commonly preferred. Conclusion:The results of this study indicated that endodontic technology and materials for pulpectomy procedures are slowly being adapted in clinical practice in India. Therefore, pediatric dentist should update their knowledge and practice with current technology.

Keywords: Attitude, pediatric dentist, pulpectomy


How to cite this article:
Raiyani CM, Arora R, Bhayya DP. Postures of pediatric dentists toward endodontic standards and acceptance of novel technology in Udaipur city: A questionnaire survey. J Dent Res Rev 2015;2:21-4

How to cite this URL:
Raiyani CM, Arora R, Bhayya DP. Postures of pediatric dentists toward endodontic standards and acceptance of novel technology in Udaipur city: A questionnaire survey. J Dent Res Rev [serial online] 2015 [cited 2020 Jun 2];2:21-4. Available from: http://www.jdrr.org/text.asp?2015/2/1/21/154640


  Introduction Top


Pediatric dentistry is one of the fastest-growing disciplines in daily clinical practice, whereas contemporary pedodontics involves the introduction of many new instruments, materials and techniques.

Pulp therapy (pulpotomy and pulpectomy) procedure is widely used in pediatric dentistry to treat the pediatric patient since many years, while attempting to prevent the vitality of the tooth or to prevent premature exfoliation of the primary teeth. [1]

First decision regarding the primary tooth should be either to preserve it or extract it. [2] Main reason for pulp therapy in primary teeth is to maintain teeth in the oral cavity for their functions such as esthetic, phonetics, and mastication. [3]

Root canal treatment is indicated when the pulp has become non-vital or irreversibly infected. [4],[5] Total elimination of microorganisms from the canal is the main goal of pulpectomy. Successful pulpectomy depends not only on specific factors such as root canal infection, complexity of root canal morphology, etc., but is also very much depend on dentist's skill and attitudes toward the pulpectomy procedure. To achieve proper canal preparation cleansing by mechanical instrumentation and irrigation of the canals are required. [6] Hence, in order to increase the chance of success of the endodontic treatment in primary teeth, substances with antimicrobial properties are often used as root canal filling materials in primary teeth. [7]


  Materials and Methods Top


The present study was conducted to know the endodontic standards and acceptance of novel technology used by a pediatric dentist in Udaipur, India. Ethical clearance latter was taken from the Ethical Committee before starting the study. A pilot study on 10% of the study population was undertaken and it served as a preliminary study to identify any organizational and technical problems, to check the feasibility and relevance of proforma, to have prior idea regarding estimate of the time taken to collect the questionnaire data. Kappa (k) and weighted kappa (kw) analysis was used to evaluate the test-retest reliability, and internal consistency was assessed by Cronbach's alpha (α) coefficient. The values were k = 0.85, kw = 0.9, α =0.76. A total 218 pediatric dentist (118 males and 100 females) those are registered in IDA Udaipur including postgraduate student and teaching staff were selected for this study. The participants were divided into three groups according to their year of experience in the clinical practice, group 1 = 25-30 years with 149, group 2 = 30-40 years with 51, group 3 = 40-50 years with 18. The selection done was random, to prevent any bias. An anonymous researcher-designed questionnaire written in English. A self-administered, structured questionnaire contained 11 questions, which related to different aspects of endodontic practice was distributed and recollected after a week. Percentages then calculated, based on the number of respondents to each question. Consent form obtained from all the participants.

Statistical analysis

Data were tabulated and analyzed using Statistical Package for the Social Sciences version 17. Frequency and percentages distributions were calculated.


  Results Top


The most of the participants used glass bead sterilizer (41.3%) for sterilization of endodontic instruments, followed by autoclave (35.8%). Very few were used Glutaraldehyde solution (14.7%) and the formalin chamber (8.3%) for sterilization. Isolation mostly was done using cotton rolls and suction tips (40.4%) by a pediatric dentist, followed by a rubber dam (33.9%) [Table 1].
Table 1: Sterilization and isolation used for pulpectomy procedure


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Most of the pediatric dentist were using hand instruments (58.3%) for the pulpectomy procedure and among those hand instruments K-file (42.7%) was widely used for canal preparation, followed by hand protaper along with K-file (34.4%) and very few pediatric dentist used H-file (7.3%) for pulpectomy procedure. Among the rotary system, protaper was most commonly used rotary instrument (22.0%) [Table 2].
Table 2: Instrument used for pulpectomy procedure


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Around half of the participants used radiographs (53.7%) for determination of working length, followed by metallic scale (21.2%) and very few were using apex locator (16.5%) for measuring working length in primary teeth. Most common intracanal irrigant used was a combination of normal saline and sodium hypochlorite (32.6%), followed by normal saline (28.4%). Rest of them used chlorhexidine gluconate (20.2%), sodium hypochlorite (10.6%) and hydrogen peroxide (8.3%) as an intracanal irrigants [Table 3].
Table 3: Method of measuring working length and intracanal irrigant used


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[Table 4] depicts that most participants used zinc oxide eugenol (46.3%) as obturating material, followed by metapex paste (31.7%). Half of participants were using miracle mix (51.4%) as a permanent filling material, followed by glass ionomer cement (22.5%).
Table 4: Obturation and permanent filling materials used for pulpectomy procedure


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The present study showed that most of the participants (49.1%) completed the pulpectomy procedure in three visits, followed by (26.6%) two visits and 15.6% completed it in single sitting [Graph 1] [Additional file 1] . All participants agreed for pulpectomy rather than extraction and according to them space maintainer was advised after the extraction if indicated.

More than half of the participants preferred giving the space maintainer between the age of 6-9 years (66.5%), followed by 3-6 years (21.5%).

According to participants, space maintainer fabrication was easier in the maxillary arch (66.3%) and around half of participants got space maintainer fabricated from labs (70.6%).


  Discussion Top


This study is the first to provide published information on the provision of endodontic standards and acceptance of novel technology by pediatric dentists in Udaipur. Throw knowledge regarding newer technology in the recent year is necessary to provide great outcome in the population.

In the present study, glass bead sterilization was commonly used sterilization method for endodontic instruments while autoclave was found to be common sterilization method in the study done by Gupta and Rai. [8]

Bander et al.,[9] found that most dentists strongly like the use of rubber dam in pediatric patient as against cotton roll and suction tip found in this study because of certain disadvantages such as extra cost, additional time for placement, lack of adequate skills or training, poor patient acceptance or inadequate education. Hand instruments were widely used for the pulpectomy procedure and among these instruments K-files were commonly used which was also seen in the study done by Nazari Moghaddam et al.[10] Determination of working length is a crucial step in endodontic treatment. Working length determination during endodontic procedure was done using radiographs and was similar to study done by Gupta and Rai. [8]

Combination of normal saline and sodium hypochlorite was common for irrigation of canal during the pulpectomy procedure. 8.3% were using hydrogen peroxide. Nowadays, various obturating material have been advocated to obdurate the prepared root-canal system in the primary teeth, each with its own claims of ease, efficiency or superiority. Sweet first discovered zinc oxide-eugenol paste as primary tooth canal filling material. [11] In present study, zinc oxide-eugenol paste was widely used as an obturating material. Similar results were found in study done by Praveen et al., [11] Sadrian and Coll, [12] Jha et al., [13] Dunston and Coll, [14] and Ramar and Mungara. [15] Miracle mix as a permanent filling material was used after the pulpectomy procedure as it must provide a high-quality seal of the prepared access cavity.

As more complexity of the root canal morphology of the primary teeth, most of the pediatric dentist completed the pulpectomy procedure in three visits. In the present study, all participants preferred the pulpectomy procedure rather than extraction, reason behind this being increased awareness regarding the importance of primary teeth. Similar results were found in the study done by Togoo et al. [3]

Most of the pedodontics preferred giving the space maintainer between the age of 6 and 9 years in the mandibular arch.


  Conclusion Top


The present study gives the insight in applications of various endodontic technologies among pediatric dentist toward pulpectomy procedures. Hand instruments still keep a key role among postgraduates for the ultherapy procedures and ZnOE still being the widely used obturing materials. The increased nuances in pediatric dentistry are to be taught and updated to the pediatric dentist through continuing dental education, programs to provide better treatment option.

 
  References Top

1.
Rabinowitch BZ. Pulp management in primary teeth. Oral Surg Oral Med Oral Pathol 1953;6:542-50.  Back to cited text no. 1
[PUBMED]    
2.
Abuabara A, Crozeta BM, Baratto-Filho F. Review of pulp therapy in primary teeth. RSBO 2012;9:474-7.  Back to cited text no. 2
    
3.
Togoo R, Nasim V, Zakirulla M, Yaseen S. Knowledge and practice of pulp therapy in deciduous teeth among general dental practitioners in Saudi Arabia. Ann Med Health Sci Res 2012;2:119-23.  Back to cited text no. 3
[PUBMED]  Medknow Journal  
4.
American Academy of Pediatric Dentistry Clinical Affairs Committee - Pulp Therapy Subcommittee; American Academy of Pediatric Dentistry Council on Clinical Affairs. Guideline on pulp therapy for primary and young permanent teeth. Pediatr Dent 2005-2006;27 7 Suppl: 130-4.  Back to cited text no. 4
    
5.
American Academy of Paediatric Dentistry. Guideline on pulp therapy for primary and young permanent teeth. Paediatr Dent 2009;31:179-86.  Back to cited text no. 5
    
6.
Carrotte P. Endodontic treatment for children. Br Dent J 2005;198:9-15.  Back to cited text no. 6
    
7.
Barja-Fidalgo F, Moutinho-Ribeiro M, Oliveira MA, de Oliveira BH. A systematic review of root canal filling materials for deciduous teeth: Is there an alternative for zinc oxide-eugenol? ISRN Dent 2011;2011:367318.  Back to cited text no. 7
    
8.
Gupta R, Rai R. The adoption of new endodontic technology by Indian dental practitioners: A questionnaire survey. J Clin Diagn Res 2013;7:2610-4.  Back to cited text no. 8
    
9.
Bander AA, Huda AT, Alhanoof AH, Rawan S, Roaa AT, Ashwaq AA, et al. The attitudes of dental interns to the use of the rubber dam and obstacles to its use. Indian J Dent 2013;4:179-183..  Back to cited text no. 9
    
10.
Nazari Moghaddam K, Mehran M, Farajian Zadeh H. Root canal cleaning efficacy of rotary and hand files instrumentation in primary molars. Iran Endod J 2009;4:53-7.  Back to cited text no. 10
    
11.
Praveen P, Anantharaj A, Venkataragahavan K, Rani P, Sudhir R, Jaya AR. A review of obturating materials for primary teeth. SRM Univ J Dent Sci 2011;2:42-44.  Back to cited text no. 11
    
12.
Sadrian R, Coll JA. A long-term followup on the retention rate of zinc oxide eugenol filler after primary tooth pulpectomy. Pediatr Dent 1993;15:249-53.  Back to cited text no. 12
    
13.
Jha M, Patil SD, Seakar S, Jogani V, Shingare P. Paediatric obturating materials and techniques. J Contemp Dent 2011;1:27-32.  Back to cited text no. 13
    
14.
Dunston B, Coll JA. A survey of primary tooth pulp therapy as taught in US dental schools and practiced by diplomates of the American Board of Pediatric Dentistry. Pediatr Dent 2008;30:42-8.  Back to cited text no. 14
    
15.
Ramar K, Mungara J. Clinical and radiographic evaluation of pulpectomies using three root canal filling materials: An in-vivo study. J Indian Soc Pedod Prev Dent 2010;28:25-9.  Back to cited text no. 15
[PUBMED]  Medknow Journal  



 
 
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  [Table 1], [Table 2], [Table 3], [Table 4]



 

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