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Theories of marketing register a shift from the paradigm of involving customers for production calls to a more profound relationship between producers and customers. For this purpose, Customer Relationship Management (CRM) has widely been used in organizations to manage, retain and satisfy the customers, but seldom used for the recurrent interaction for value creation. The present study proposes using CRM process with system dynamic perspectives for the recurrent interaction of value creation. CRM is a highly split setting and has come to mean different things to different people, so as it evolves with second order cybernetics it will help to open new horizon of success for organizations. This paper aims to fill this gap and pave the way through a prototypical towards a better understanding of the mechanisms Viable System Model (VSM) of CRM for value creation. [ABSTRACT FROM AUTHOR]

Occlusal reduction has been widely used after root canal treatment to reduce post treatment pain and flare up. The objective of the present study was to compare the effect of occlusal reduction on frequency of post-operative pain relief, following an endodontic instrumentation in patients with irreversible pulpitis. A randomized controlled trial was conducted in the Out patients Department of Operative Dentistry, Islamic International Dental Hospital, Islamabad from August 2015 to January 2016. Hundred adult volunteers presented for endodontic treatment of vital teeth with history of irreversible pulpitis, tenderness to percussion, Moderate to severe pain and fulfilling the inclusion criteria. In the first appointment Biomechanical preparation of the canals were performed and the canals were dressed with calcium hydroxide paste before sealing the access cavity with a temporary restorative material. The patients were randomly divided into two groups, the occlusal reduction (OR) group and the no occlusal reduction (NOR) group with 50 patients in each group. The patients of both groups were instructed to complete the VAS at 24hrs after the procedure to rate their pain as mild, moderate or severe and were asked to bring the Performa along at the next scheduled appointment. All the data collected was entered and analyzed using statistical package for social sciences(SPSS version 10). Chi-square test was used for qualitative variable(frequency of post-operative pain ,gender) and independent sample T-test for quantitative variable(age). Results were statistically not significant (p>0.05) showing there was no effect of occlusal reduction on post-operative pain relief after endodontic instrumentation in patients with irreversible pulpitis. [ABSTRACT FROM AUTHOR]

This study was performed to evaluate the ability of Dentaport Root ZX to determine the working length accurately. Apex locators are considered to be one of the latest innovations that have made the outcome of the endodontic treatment more predictable. Seventy-two extracted teeth were used in present study and standard access cavities were prepared in all the teeth. Working length was first determined using direct method. The root canal length measured by direct method i.e. direct length (DL) showed a mean of 14.92 ±1.107mm and std.deviation of 1.107. For in vitro working of Dentaport Root ZX an apparatus was designed which used normal saline as the conducting medium to ensure free movement of ions between electrodes of electronic apex locator (EAL). Working length was then measured electronically using Dentaport Root ZX and noted as Electronic length (EL). EL showed a mean of 14.69 ±1.137mm and std.deviation of 1.137. Out of 72 extracted teeth that were used in present study the difference between DL and EL was insignificant (p-value < 0.05) which proves the accuracy of Dentaport Root ZX in determination of working length. [ABSTRACT FROM AUTHOR]

Endodontic therapy carried out on vital pulps is associated with an increased incidence and intensity of pain. Various intra-canal medicaments are proposed to reduce post-operative pain after Root canal treatment. The objective of the study was to determine the frequency of post-operative pain after use of intra-canal dexamethasone in root canal treatment of vital teeth when compared with the Prednisolone. One hundred and twenty patients (with age range between 18-50 years) were randomly divide into two equal group. One group received Decadron (dexamethasone 4mg/ml) intravenous solution as intra-canal medicament, and the 2nd group received prednisolone acetate solution 2.5% in aqueous suspension obtained as commercial preparation. After 24 hours Post-operative pain was marked on Visual Analog Scale. There was statistically significant difference (p<0.05) between dexamethasone and prednisolone groups, with dexamethasone being more effective in reducing post-operative pain. [ABSTRACT FROM AUTHOR]

There are a number of dental anomalies and congenital absence of the teeth is relatively more common. These can cause the patient to seek treatment because of esthetic concern. The aim of this study was to determine the frequency of agenesis of maxillary permanent lateral incisors. A total of 364 outdoor patients, both male and female, were included in the study from age 12 to 40 years. The data was collected and entered in a proforma and was analyzed by using SPSS 17.0. The results showed that only 1.6% of patients had congenitally missing permanent maxillary lateral incisors, with equal distribution within each gender i.e. male 1.7% and in female 1.6%. It was found that all cases have missing permanent maxillary lateral incisors unilaterally with no bilateral distribution. It was concluded that prevalence of congenitally missing maxillary lateral incisor is very low in our population. [ABSTRACT FROM AUTHOR]

Endodontic treatment is traditionally performed in multiple visits however, single-visit treatment has gained acceptance due to recent invention of nickel-titanium systems and improvement in irrigation and disinfection techniques. The objective of this study was to compare the frequency and severity of post-obturation pain after one-visit and two-visit root canal treatment on permanent teeth with non-vital pulps. Four hundred forty patients were divided into group 1 and 2. Single visit treatment was done in group 1 patients and two-visit treatment was performed in group 2 patients. Verbal descriptor scale (VDS) was used to measure post-operative pain. Mean pain score was 1.94 and 1.53 in group 1 and 2 respectively. The result was statistically insignificant. [ABSTRACT FROM AUTHOR]

The growing demand for esthetic restorations has driven the dentists to provide composite resin restorations even in the posterior class I situations. In these load bearing locations of the teeth, composite resins are subjected to a very thorough biodynamic testing which revealed some of their shortcomings. Persistent postoperative sensitivity has been recognized to be a reason for failure of these restorations. The objective of this study was to determine the frequency of postoperative sensitivity in posterior class I composite restorations placed in cavities less than or equal to a 3 mm depth. A total of 292 cavities were restored without any protective liners or base by one of the authors in an academic environment which were followed up at 48 hours for an objective cold test. The frequency of postoperative sensitivity was around 13% and no statistically significant relationship was found between patient age and tooth type (p value > 0.000). While the cavity depths were limited the buccolingual widths remained unchecked and in some cases resulted in considerable occlusal table correction. This may be the reason for a greater postoperative sensitivity in the present study. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate the pre-clinical operative dentistry course from a student's viewpoint in order to monitor the academic environment and give recommendations for improvement. A questionnaire was completed by second year dental students on the last lecture day of the year. The questionnaire consisted of questions evaluating different aspects of the course. 46 out of 50 students completed the questionnaire. The course was considered by almost all to be of benefit. Opinion was divided regarding formal assessment in the final professional examination. Quality of teaching was reported to be good although teaching sessions were perceived to be disorganized and prone to repetition. Exercises on plaster models were widely condemned. Improvements in pre-clinical teaching can be brought about by a more structured course, adding more topics and assigning more faculty to supervise the exercises. [ABSTRACT FROM AUTHOR]

The purpose to publish these case reports is to show the effectiveness of single visit endodontics in teeth with acute apical abscess. Infected non-vital teeth in two patients were treated with single visit RCT along with incision and drainage of the abscess in the same appointment. Follow up of both the patients showed relief of symptoms to remarkable extent in the evening of treatment day. Radiographs showed significant periapical bone healing after 3 months in both patients. [ABSTRACT FROM AUTHOR]

Articaine is fast becoming the anesthesia of choice for many endodontists across the globe. Before it completely replaces the" gold standard" lidocaine its anesthetic efficacy for dental use must be determined accurately. The objective of this study was to compare the anesthetic efficacy of articaine with lidocaine for buccal infiltration in patients with acute irreversible pulpitis. Seventy-six patients with acute irreversible pulpitis of maxillary first premolar were randomly selected. Patients receiving 1.7 ml of 2% lidocaine with 1:100,000 epinephrine injection (group 1) and those receiving 1.7 ml of 4% articaine wtih 1:100,0000 (group 2) were asked to rate their pain level on visual analogue scale (VAS) before receiving the anesthesia. Success was defined as mild or no pain on endodontic access or initial instrumentation based on the readings of visual analogue scale. Statistically no significant difference in the anesthetic efficacy of articaine and lidocaine as buccal infiltration agents was found. Hence, articaine hydrochloride has comparable anesthetic efficacy to that of lidocaine. [ABSTRACT FROM AUTHOR]

For successful endodontic outcome, correct working length has to be determined. The third generation apex locators claim to be accurate regardless of physiologic root resorption. The objective of the study was to determine in vitro the accuracy of Dentaport ZX (third generation apex locator) in determining the working length of primary molars with root resorption. Thirty-two extracted primary molars with root resorption were obtained for this study. After ascertaining the direct working length, Dentaport ZX was used to determine the working length of roots of primary molars with root resorption. The Dentaport ZX was 86.9% accurate in determining working length within ±0.0mm of coronal limit of resorbed primary molar root when compared with direct method. The accuracy of Dentaport ZX in measuring working length in primary molars was high and was not affected by physiologic root resorption. [ABSTRACT FROM AUTHOR]

Premedication with non-steroidal anti-inflammatory drugs before administrating inferior alveolar nerve block (IANB) for mandibular posterior teeth with irreversible pulpitis is becoming popular as it is believed to increase the success of anesthesia. The objective of this study is to compare the effect of preoperative oral medication of Lornoxicam and Ibuprofen on frequency of success of inferior alveolar nerve block in patients with irreversible pulpitis. 120 patients were divided into two groups. Sixty patients in group A received Lornoxicam and patients in group B were given Ibuprofen (Brufen) one hour before the IANB. Pain was recorded using Visual Analog Scale during endodontic access cavity preparation and instrumentation. There was statistically no significant difference in the success rate of local anesthesia in patients with acute irreversible pulpitis of mandibular posterior teeth with premedication of ibuprofen and lornoxicam. [ABSTRACT FROM AUTHOR]

Acquisition of accurate tooth preparation skills is one of the basic learning outcomes in the Operative Dentistry Curriculum. Ability to evaluate oneself accurately is also one of the learning objectives of a competency based education. The aim of this study was to determine the accuracy of self evaluation of students of second year BDS compared to their instructor when asked to assess their crown preparations for the first time. Sixty students of second year BDS of the Islamic International Dental College were asked to evaluate their anterior porcelain crown preparations according to a ten-point checklist. Each point was measured out of ten. On average the students overrated themselves compared to their senior teacher by 2.7 marks. [ABSTRACT FROM AUTHOR]

The purpose of this study is to interpret the interobserver accordance in the analytical interpretation of apical periodontitis on the digital radiograph, which is a measure of the reliability of this radiological technique. This study was conducted in the Operative dentistry unit of Islamic International Dental Hospital(IIDH), in which 100 digital radiographs taken with the Soredex Digora(R) Optime were selected for observation by 3 specialists endodontic, 3 endodontic second-year residents, and 3 BDS final year students independently. The apical status was assessed using the periapical index(PAI). All data were statistically analyzed using SPSS version 23. Fleiss kappa factual test is utilized to evaluate the degree of agreement among numerous raters. The complete Fleiss kappa result for the 9 raters observation is 0.54(P <.001). This result is in the moderate range(0.4 to 0.6) for the 9 raters observation. The result obtained from this study has shown that in dental radiology direct digital imaging is a reliable, long lasting technique for diagnostic and endodontic treatment planning phases [ABSTRACT FROM AUTHOR]