Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

Medscape

Introduction Defects in the maturation stage of amelogenesis result in a normal volume of enamel but insufficient mineralization, called hypomineralization. Molar-incisor hypomineralization (MIH), amelogenesis imperfecta and dental fluorosis (DF) are examples of such defects. Objective To evaluate the effectiveness of the treatments applied to the different forms of dental hypomineralization. Materials and methods PubMed, Scopus, Cochrane Library, Web of Science, and Embase were screened. The research was limited to studies published in English, Spanish, and Portuguese, until May 30, 2018. The research question was formulated following the Population, Intervention, Comparison, Outcome strategy. The quality of the methodology of each article was evaluated employing the Cochrane Handbook for Systematic Reviews. Results From the initial research, 7895 references were obtained, of which 33 were included in the systematic review. The following treatments were reported: desensitizing and remineralizing products, resin infiltration, restorations, fissure sealants, tooth bleaching, enamel microabrasion and calcium, and vitamins supplements. Conclusions Although the results are suggestive, there is a clear need for a greater uniformity of the methodologies, thus allowing for the development of clinical guidelines. Nevertheless, it was possible to identify several effective treatments for teeth with MIH (arginine pastes or fluoride varnishes) and DF (tooth bleaching and/or enamel microabrasion). Clinical significance Because MIH, amelogenesis imperfecta, and DF are commonly seen in dental daily practice, it is extremely important to analyze the literature regarding its treatment.

Dental hypomineralization treatment: A systematic review

Objectives
Dental fluorosis leads to esthetic deviation and varies from nonpitted white opacities, dark brown stains to pitting or structural breakdown of enamel surface. Treatment for fluorosis depends on the severity of condition and includes both noninvasive methods and invasive methods. Recently resin infiltration has been proposed as an alternative treatment for nonpitted fluorosis. This study was done to evaluate the esthetic changes in nonpitted fluorosis stains when treated with resin infiltration, in-office bleaching and combination therapies.

Materials and methods
The present study is a randomized, single blinded controlled trial with four parallel arms with 1:1 allocation ratio. The intervention arms included bleaching with 35% hydrogen peroxide, resin infiltration, resin infiltration with increased infiltration time and a combination approach of bleaching and infiltration. Immediate esthetic changes were evaluated for two parameters including, ‘Change in esthetics’ and ‘Improvement in opacities/stains’ using a VAS scale by two independent observers. Kruskal-Wallis test and Mann-Whitney U-test were done for intergroup comparisons.

Results
Best results for both the parameters were observed among patients treated with resin infiltration with increased infiltration time. Mann-Whitney U test revealed significantly better results for resin infiltration groups (alone or combination with bleaching) as compared to bleaching alone (P < .001).

Conclusions
Resin infiltration procedure with tailored etching times and increased infiltration time exhibited best results in terms of change in esthetics and improvement in stains.

Clinical significance
White and brown opacities due to fluorosis have always been a concern for esthetics. In our study, resin infiltration technique with tailored etching times and increased infiltration time exhibited best immediate esthetic improvement for nonpitted fluorotic opacities and stains. These esthetic outcomes reaffirm the applicability of RI technique for nonpitted fluorosis, which was originally advocated only for white spot lesions due to early caries. This will in turn help the dentists to plan the esthetic management of nonpitted fluorosis in a micro-invasive manner.

Comparative evaluation of esthetic changes in nonpitted fluorosis stains when treated with resin infiltration, in‐office bleaching, and combination therapies

Purpose To investigate the recurrence rate of cementoblastomas for different variables aside from the clinical/radiologic features. Methods An electronic search was undertaken in November/2016. Eligibility criteria included publications having enough clinical/radiological/histological information to confirm the diagnosis. Results 141 publications (258 cementoblastomas) were included. There was an equal sex distribution. There was a high prevalence in the second/third decades of life, in the posterior regions, and in mandibular first molars. Lesions were commonly associated with bone expansion (74.9%), presence of clinical symptoms (70.2%), vital teeth (78%), root resorption (59.8%). Observations not as frequent: cortical bone perforation (16.3%), inferior displacement of the mandibular canal (23.6%). Treatment was reported for 229 cases. Twenty (11.8%) out of 170 recurred. Preservation of the involved teeth and location seem to not influence the recurrence rate, but there was a 687% higher probability (odds ratio 7.875; p  = 0.048) of recurrence for lesions associated with bone expansion, and a 217% higher probability (odds ratio 3.173; p  = 0.023) of recurrence for lesions presenting cortical bone perforation. Conclusions Although the recurrence rate of cementoblastomas is not as high as previously believed, it is a relevant phenomenon (11.8%). The presence of bone expansion and cortical bone perforation seem to influence the recurrence rate.

Cementoblastoma: An updated analysis of 258 cases reported in the literature.

We reviewed the literature to evaluate: a) The compliance of randomized clinical trials (RCTs) on bleaching with the CONSORT; and b) the risk of bias of these studies using the Cochrane Collaboration risk of bias tool (CCRT). We searched the Cochrane Library, PubMed and other electronic databases, to find RCTs focused on bleaching (or whitening). The articles were evaluated in compliance with CONSORT in a scale: 0 = no description, 1 = poor description and 2 = adequate description. Descriptive analyses of the number of studies by journal, follow-up period, country and quality assessments were performed with CCRT for assessing risk of bias in RCTs. 185 RCTs were included for assessment. More than 30% of the studies received score 0 or 1. Protocol, flow chart, allocation concealment and sample size were more critical items, as 80% of the studies scored 0. The overall CONSORT score for the included studies was 16.7 ± 5.4 points, which represents 52.2% of the maximum CONSORT score. A significant difference among journal, country and period of time was observed (p < 0.02). Only 7.6% of the studies were judged at “low” risk; 62.1% were classified as “unclear”; and 30.3% as “high” risk of bias. The adherence of RCTs evaluating bleaching materials and techniques to the CONSORT is still low with unclear/high risk of bias.

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Randomized clinical trials of dental bleaching - Compliance with the CONSORT Statement: a systematic review.

Aims and Objectives: Infection control and modes of sterilizations are the key factors to avoid cross transmission of infection in the field of dentistry. Transmission of disease or infection is noted with improper sterilization of reused instruments. Dental burs are the most important tool in any endodontic or conservative procedures of teeth involving tooth contouring, restorative filling procedures and endodontic procedures. Hence, the present study is undertaken to assess the efficacy of different methods of sterilization or decontamination which are routinely used in dental clinics.

Materials and Methods: For the present study 96 round diamond burs were selected and divided into 6 groups. These burs were used for the access cavity preparation to get contamination and subjected for bacteriological culture. After getting base line date burs were subjected to manual scrubbing, hot air oven, glass bead sterilizer, ultrasonic cleaner and autoclave to get post decontamination data.

Results: The study revealed that mean colony forming units/ml of Streptococcus mutans decreased maximum for autoclave with 80% reduction, for Lactobacilli 76% reduction and for Candida albicans maximum reduction seen for glass bead sterilizer with 74%.

Conclusion: Findings of our study revealed that none of the methods used were found to be absolutely efficacious in the decontamination of dental burs. However, among the experimental groups used in the present study, autoclave was found to be the relatively best method.

Decontamination methods used for dental burs - a comparative study.

Background: The ideal maxillary injection should produce a rapid onset of profound pulpal anesthesia for multiple teeth from a single needle penetration. The main objective is to compare the efficacy of articaine 4% and lidocaine 2% and to compare anterior middle superior alveolar nerve block (AMSANB) and infraorbital nerve block (IONB) for anesthesia of maxillary teeth. Materials and Methods: Forty patients undergoing root canal treatment of maxillary anteriors and premolars were included and randomly divided into four groups of ten each. Group I: patients receiving AMSANB with articaine, Group II: Patients receiving IONB with articaine, Group III: Patients receiving AMSANB with lidocaine, Group IV: Patients receiving IONB with lidocaine. The scores of onset of anesthesia and pain perception were statistically analyzed. Results: Onset of action was fastest for articaine with AMSANB and slowest for lidocaine with IONB by Tukey's test. A significant change was observed in the electrical pulp test readings at onset and at 30 min by paired t-test. All patients experienced mild pain during the procedure recorded by visual analog scale. Conclusion: Articaine 4% proved to be more efficacious than lidocaine 2%, and AMSANB was more advantageous than IONB in securing anesthesia of maxillary anteriors and premolars.

A comparative evaluation of anesthetic efficacy of articaine 4% and lidocaine 2% with anterior middle superior alveolar nerve block and infraorbital nerve block: An in vivo study

Aim The aim of the study was to evaluate esthetic improvement with the use of 35% hydrogen peroxide clinical bleaching as related to the different grades of enamel fluorosis in vivo and to study adverse effect of clinical bleaching with 35% hydrogen peroxide on teeth and gingiva. Materials and methods A total of 60 children of different grades of fluorosis were included in the study. With 35% hydrogen peroxide-based dual activated bleaching system, in-office vital teeth bleaching was carried out for each subject. Clinical evaluation for improvement in esthetics, effect on teeth and gingiva were performed for each child during preoperative, immediate postoperative and later 6 months postoperative period. For evaluation and comparison, all the collected data were subjected to statistical analysis. Results Although in all the subjects, partial shade relapse was seen over a period of time, good homogeneous and esthetic results were seen in very mild and mild cases. A total of 35% hydrogen peroxide in-office bleaching has no adverse effect on teeth and gingiva. Conclusion Comparing all the three groups who participated in the study, 35% hydrogen peroxide in-office bleaching seems to be very effective in very mild and mild forms of fluorosis. Clinical significance In very mild and mild forms of fluorosis, in-office vital tooth bleaching with 35% hydrogen peroxide is the most conservative and effective approach in esthetic improvement.

/pdf/use-of-clinical-bleaching-with-35-hydrogen-peroxide-in-4qjz07ermb.pdf

Use of clinical bleaching with 35% hydrogen peroxide in esthetic improvement of fluorotic human incisors in vivo.

A 54 year old female patient reported to the Department of Conservative Dentistry and Endodontics, with the chief complaint of dull aching pain in the lower right front teeth region since one month. History of present illness revealed intermittent pain with hot and cold stimuli for the past three months. Past dental history revealed asymptomatic, endodontically treated right mandibular first premolar. The patient’s medical history was noncontributory.

Mandibular Canine with Two Roots and Two Root Canals - A Rare Case.

Objectives: The aim of this study is to evaluate and compare the antibacterial efficacy of Thymus vulgaris, Salvadora persica, Acacia nilotica, Calendula arvensis, and 5% sodium hypochlorite against Enterococcus faecalis. Methodology: Herbal extracts of T. vulgaris, S. persica, A. nilotica and C. arvensis were prepared. Tryptone soya broth was used to grow E. faecalis and agar plates were prepared. The tested solutions (Group A: 5% NaOCl, Group B: 20% T. vulgaris, Group C: 12.5% S. persica, Group D: 10% A. nilotica, Group E: 10% C. arvensis) were added to the wells made on agar media. Agar diffusion test was performed. Plates were incubated at 37°C for 24 h. Bacterial zones of inhibition were recorded. Results: The data were analyzed statistically by Analysis of Variance (ANOVA) and post hoc comparison by Tukey's t-test. The highest zone of inhibition against E. faecalis was shown by 5% NaOCl, followed by 10% C. arvensis, 20% T. vulgaris and 10% A. nilotica showed similar comparable antibacterial activity. The least zone of inhibition was showed by S. persica. Conclusion: 5% NaOCl showed the maximum antibacterial activity, and herbal products demonstrated significant antibacterial activity against E. faecalis and can be employed as an alternative to NaOCl.

A comparative evaluation of the antibacterial efficacy of Thymus vulgaris, Salvadora persica, Acacia nilotica, Calendula arvensis, and 5% sodium hypochlorite against Enterococcus faecalis: An in-vitro study.

Santosh Hugar

Papers

Decontamination methods used for dental burs - a comparative study.

A comparative evaluation of anesthetic efficacy of articaine 4% and lidocaine 2% with anterior middle superior alveolar nerve block and infraorbital nerve block: An in vivo study

Use of clinical bleaching with 35% hydrogen peroxide in esthetic improvement of fluorotic human incisors in vivo.

Mandibular Canine with Two Roots and Two Root Canals - A Rare Case.

A comparative evaluation of the antibacterial efficacy of Thymus vulgaris, Salvadora persica, Acacia nilotica, Calendula arvensis, and 5% sodium hypochlorite against Enterococcus faecalis: An in-vitro study.