Showing papers in "Journal of Conservative Dentistry in 2013"
TL;DR: A review and discussion of the strategies available for use of platelet rich fibrin as healing aid in dentistry is presented in this article, where the aim is to review and discuss the strategies of using platelet-rich fibrins as a healing aid.
Abstract: Aim: The aim is to review and discuss the strategies available for use of platelet rich fibrin as healing aid in dentistry. Background: Platelet rich fibrin (PRF) is a fibrin matrix in which platelet cytokines, growth factors, and cells are trapped and may be released after a certain time and that can serve as a resorbable membrane. Choukroun and his associates were amongst the pioneers for using PRF protocol in oral and maxillofacial surgery to improve bone healing in implant dentistry. Autologous PRF is considered to be a healing biomaterial, and presently, studies have shown its application in various disciplines of dentistry. Materials and Methods: By using specific keywords, electronic search of scientific papers was carried out on the entire PubMed database with custom range of 5 years. The electronic search yielded 302 papers; based on inclusion and exclusion criteria which were specifically predetermined, 72 papers were identified as suitable to the inclusion criteria and the remaining 230 papers were excluded. After adding three more selected papers through hand search, full text of all the articles retrieved and review was done. By pooling the extracted data from selected papers, the reviewed data was synthesized. Conclusion: Recently by showing good promising results with use of the PRF, it has proved to have a good prospect for its use as healing aid in various aspects of the dentistry.
186 citations
TL;DR: Caution should be taken while condensing restorative materials over furcation repair materials in the presence of blood contamination, as push-out bond strength increased with time.
Abstract: Purpose: Few studies have comparatively evaluated the push-out bond strength of different calcium silicate-based materials (CSMs) used in furcal perforation repair. The objective of this in vitro study was to comparatively evaluate the push-out bond strength of commercially available CSMs used as furcation repair materials, in the presence of blood contamination. Materials and Methods: Furcal perforations were made in 120 molars and were divided on the basis of the repair material used (ProRoot MTA, Biodentine, and MTA Plus), blood contamination, and duration of setting time (24 h vs. 7 days). Push-out bond strength was measured and analyzed by three-way analysis of variance (ANOVA) test. Results: Push-out bond strength increased with time. The 24-h push-out strength of MTA was less than that of Biodentine. Blood contamination affected the push-out bond strength of MTA Plus irrespective of the setting time. Conclusion: Caution should be taken while condensing restorative materials over furcation repair materials.
107 citations
TL;DR: All the three experimental groups showed a statistically significant amount of remineralization, however, because of the added benefit of fluoride (NaF 0.2%), CPP-ACPF (Tooth Mousse-Plus®) and TCP-F showed marginally more amount ofRemineralizing enamel surface on which artificial caries lesion had been created.
Abstract: Introduction: Remineralization as a treatment procedure has received much attention from clinicians. The objective of this in vitro study was to find out the efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF), and tricalcium phosphate fluoride (TCP-F) in remineralizing enamel surface on which artificial caries lesion had been created. The changes were analyzed using DIAGNOdent® (KaVo) and scanning electron microscope (SEM). Materials and Methods: A total of 52 premolars and 24 molars were selected and classified into four groups of 13 premolars and 6 molars in each: I (CPP-ACP), II (CPP-ACPF), III (TCP-F), and IV (artificial saliva). All the samples were assessed using DIAGNOdent at the baseline and after demineralization and remineralization. Ten samples were randomly selected from each group baseline after demineralization and after remineralization for surface evaluation using SEM. Results: Statistical analysis showed that all the experimental groups had a significantly higher amount of remineralization except for group IV. Conclusion: All the three experimental groups showed a statistically significant amount of remineralization. However, because of the added benefit of fluoride (NaF 0.2%), CPP-ACPF (Tooth Mousse-Plus® ) and TCP-F showed marginally more amount of remineralization than did CPP-ACP (Tooth Mousse® ). Remineralization efficacy was TCP-F > CPP-ACPF > CPP-ACP.
89 citations
TL;DR: In this review article, the current best evidence with regard to VPT using calcium-enriched mixture (CEM) cement in human permanent/primary teeth is discussed and a strategy based on a search using keywords for CEM cement as well as VPT was applied.
Abstract: Worldwide, casecontrol studies have revealed that the treatment outcomes of root canal therapy (RCT) are generally favorable; however, the overall epidemiological success rate of RCT in the general population is relatively low. On the other hand, vitality of dental pulp is a key factor in the long-term prognosis of permanent teeth; in recent years, vital pulp therapy (VPT) has received significant consideration as it has been revealed that the inflamed pulp has the potential to heal. In this review article, the current best evidence with regard to VPT using calcium-enriched mixture (CEM) cement in human permanent/primary teeth is discussed. A strategy based on a search using keywords for CEM cement as well as VPT was applied.
72 citations
TL;DR: It is hypothesize that the use of PRF in conjunction with HA crystals might have accelerated the resorption of the graft crystals and would have induced the rapid rate of bone formation.
Abstract: Periapical inflammatory lesion is the local response of bone around the apex of tooth that develops after the necrosis of the pulp tissue or extensive periodontal disease. The final outcome of the nature of wound healing after endodontic surgery can be repair or regeneration depending on the nature of the wound; the availability of progenitor cells; signaling molecules; and micro-environmental cues such as adhesion molecules, extracellular matrix, and associated non-collagenous protein molecules. The purpose of this case report is to add knowledge to the existing literature about the combined use of graft material [platelet rich fibrin (PRF) and hydroxyapatite (HA)] and barrier membrane in the treatment of large periapical lesion. A periapical endodontic surgery was performed on a 45 year old male patient with a swelling in the upper front teeth region and a large bony defect radiologically. The surgical defect was filled with a combination of PRF and HA bone graft crystals. The defect was covered by PRF membrane and sutured. Clinical examination revealed uneventful wound healing. Radiologically the HA crystals have been completely replaced by new bone at the end of 2 years. On the basis of the results obtained in our case report, we hypothesize that the use of PRF in conjunction with HA crystals might have accelerated the resorption of the graft crystals and would have induced the rapid rate of bone formation.
61 citations
TL;DR: It was shown that Neem leaf extract was highly efficient to 5.25% NaOCl in reducing Enterococcus faecalis and Candida albicans within the root canals when compared with other extracts.
Abstract: Context: Sodium hypochlorite is the most commonly used irrigant but it has disadvantage like high cytotoxicity. So there is a need to find an alternative to 5.25% Sodium hypochlorite against microorganism Enterococcus faecalis and Candida albicans. Literature has shown that these 5 extracts namely Terminalia chebula, Myristica frangrans, Aloe barbadensis, Curcuma longa and Azadaricta indica has good properties which can be used as a potential endodontic irrigant. Aims: To evaluate the antimicrobial efficacy of various herbal extracts namely Curcuma longa (CL), Azadiracta indica (AI), Aloe barbadensis (AV), Myristica fragrans (MF) and Terminalia chebula (TC) as endodontic irrigant against Enterococcus faecalis and Candida albicans using real-time quantitative polymerase chain reaction (qPCR). Materials and Methods: Eighty-four teeth were extracted and suspended with Enterococcus faecalis and Candida albicans. A preliminary study was first performed to determine the minimum inhibitory concentration of extracts. The irrigating groups were divided into five herbal groups and 2 control groups. After irrigating the teeth the remaining microbial load was determined using qPCR. Statistical Analysis Used: Statistical analysis was performed using Oneway Anova/Kruskal-Wallis test with post-hoc Tukey's HSD and was statistically significant ( P Results: It was shown that Neem was highly efficient to 5.25% NaOCl in reducing Enterococcus faecalis and Candida albicans within the root canals when compared with other extracts. Conclusions: Neem leaf extract has a significant antimicrobial efficacy against Enterococcus faecalis and Candida albicans compared to 5.25% sodium hypochlorite.
58 citations
TL;DR: There was a marked difference in periapical healing, apical closure and dentinal wall thickening of teeth treated by revascularization with PRP.
Abstract: Loss of pulp vitality in an immature permanent tooth arrests root development. This leads to tooth with open apex and weak lateral dentinal walls. Management of such necrotic teeth with immature roots poses several treatment challenges. The documented study was performed to evaluate and compare apexogenesis induced by revascularization, with and without platelet rich plasma (PRP) in non-vital, immature anterior teeth. Three patients having bilateral, non-vital, immature maxillary central incisors with apical periodontitis were recruited after institutional ethical clearance. Subsequent to chemo-mechanical preparation, revascularization with and without PRP was randomly induced in either of the tooth. The cases were followed-up clinically and radiographically at 6 and 12 months. There was a marked difference in periapical healing, apical closure and dentinal wall thickening of teeth treated by revascularization with PRP.
57 citations
TL;DR: The antibacterial activity of these two main root canal irrigants against Enterococcus faecalis is discussed using the agar diffusion and direct contact methods and the possible modulating factors responsible for inconsistent findings among different studies are discussed.
Abstract: Complete debridement and disinfection of the root canal system are fundamental requirements for successful endodontic treatment. Despite the morphological challenges of the internal root anatomy, root canal irrigants play an important role in the optimization of the root canal preparation, which is essentially a chemo-mechanical procedure. Enterococcus faecalis is one of the most resistant microorganisms that dominants the microbial ecosystem of persistent periradicular lesions in retreatment cases. For that reason, many in vitro and in vivo studies evaluated and compared the antibacterial activity of sodium hypochlorite and chlorhexidine at varying concentrations using different experimental models against this microorganism. However, many controversies with regard to the ideal irrigant and concentration do in fact exist. Hence, this review aims to discuss the antibacterial activity of these two main root canal irrigants against Enterococcus faecalis using the agar diffusion and direct contact methods and the possible modulating factors responsible for inconsistent findings among different studies. In addition, the disinfection potential of both chemical agents on gutta percha and Resilon cones are also discussed. The source of this review was conducted through an electronic literature search using PubMed database from December 1997 until December 2011, which analyze the related laboratory investigations of both irrigants, published in major endodontic journals.
55 citations
TL;DR: Enamel surfaces treated with the CPP-ACP paste exhibited the least lesion depths followed by the enamel surfaces treating with the fluoridated tooth paste and control group respectively.
Abstract: Background: Dental caries remains the most common dental disease facing mankind. Prevention of initiation and interruption in progression of early lesions are the desirable modes of caries management. There is a scope for agents, which may be used to enhance anti - caries activity. This need has redirected research to develop novel preventive agents that can act as an adjunct to fluoride or independent of it. Casein Phosphopeptide - Amorphous Calcium Phosphate (CPP-ACP) is one such agent that has been proposed to have anti cariogenic properties. Aim: The purpose of this in vitro study was to evaluate the effect of paste containing CPP-ACP, MI Paste, on enamel remineralization. Materials and Methods: This study consisted of 30 samples embedded in orthodontic resin with either the buccal or lingual surface exposed. The samples were assigned to either a CPP-ACP containing paste; Fluoridated toothpaste; or a control group. The groups were then subjected to cycling in a demineralizing solution and a remineralizing solution. Groups II and III received prior application of MI paste and Fluoridated toothpaste respectively followed by cycling in a demineralizing solution and a remineralizing solution. Following 14 days of cycling, the samples were sectioned and examined using confocal microscopy. The lesion depth, were evaluated. Statistical Analysis: Image Proplus software was used to analyze the images. The values were statistically evaluated using one - way ANOVA and Scheffe's Test. Results and Conclusion: Within the limitations of the study it was concluded that enamel surfaces treated with the CPP-ACP paste exhibited the least lesion depths followed by the enamel surfaces treated with the fluoridated tooth paste and control group respectively.
53 citations
Journal Article•
48 citations
TL;DR: Propolis can be used as an effective antifungal agent similar to that of sodium hypochlorite, although long-term in vivo studies are warranted, according to the results of this study.
Abstract: Introduction: Endodontic infections are polymicrobial in nature. Candida albicans is the most common fungus isolated from failed endodontic cases. The constant increase in antibiotic resistant strains and side-effects caused by synthetic drugs has prompted researchers to look for herbal alternatives such as propolis, Morinda citrifolia and Azadirachta indica (Neem) etc., since, the gold standard for irrigation, i.e., sodium hypochlorite has many disadvantages. Materials and Methods: Extracted human mandibular premolars were biomechanically prepared, vertically sectioned, placed in tissue culture wells exposing the root canal surface to C. albicans grown on Sabouraud Dextrose Agar to form a biofilm. At the end of 2 days, all groups were treated with test solutions and control for 10 min and evaluated for Candida growth and number of colony forming units. The readings were subjected to statistical analysis using analysis of variance and post hoc Tukey tests. Results: Sodium hypochlorite and propolis groups exhibited highest antimicrobial efficacy against C. albicans with no statistically significant difference. It was followed by the A. indica (Neem) group. M. citrifolia had limited antifungal action followed by the negative control group of saline. Conclusion: According to the results of this study, propolis can be used as an effective antifungal agent similar to that of sodium hypochlorite, although long-term in vivo studies are warranted.
TL;DR: The root canal treatment requires proper knowlegde of variations in root canal morphology in order to recognise, disinfect and seal all portal of exit with proper diagnosis using newer modes, modification in access preparation, use of operating microscope, enhanced methods of disinfecting and sealing of all canals.
Abstract: Introduction: The success of root canal therapy depends on the locations of all the canals, thourough debridement and proper sealing. At times the clinicians are challenged with variations in morphology of root canal. This review article attempts to list out all the variations of permanent mandibular first molar published so for in the literature. Materials and Methods: An exhaustive search was undertaken using PUBMED database to identify published literature from 1900 to 2010 relating to the root canal morphology of permanent first molar by using key words. The selected artcles were obtained and reviewed. Results: Total ninty seven articles were selected out of which 50 were original article and forty seven were case reports. The incidence of third canal in mesial root was 0.95% to 15%. The incidence of three rooted mandibular first molar was 3% to 33%. Only ninety cases reported with c-shape canal configuration. Incidence of Taurodintism without congenital disorder was very rare. Conclusion: The root canal treatment requires proper knowlegde of variations in root canal morphology in order to recognise, disinfect and seal all portal of exit. This can be accomplished with proper diagnosis using newer modes, modification in access preparation, use of operating microscope, enhanced methods of disinfecting and sealing of all canals.
TL;DR: The teachers’ overall knowledge with respect to the emergency management of the traumatic injuries was deficient and significant differences were found in the knowledge of teachers before and after the informative promotion.
Abstract: Aim: To assess awareness of school teachers concerning the emergency management of traumatized teeth. Materials and Methods: This is a prospective intervention study conducted with 1000 teachers (500 urban, 500 rural) randomly selected from the entire government and private, primary (elementary) as well as secondary (high) schools of Nellore district of Andhra Pradesh, India. Study was carried out in three phases; the first phase being an initial survey conducted to assess the existing knowledge of teachers on management of traumatic injuries by using self-administered questionnaire. This was followed by a comprehensive informative promotion regarding the initial management of the traumatic dental injuries for the teachers. A post-promotion follow-up review was conducted 3 months later to evaluate the effect of the informative promotion, using the same set of questionnaires. Study was completed over a period of 9 months. Statistical Methods: Data analysis was done using SPSS software version 14.0, and Chi-square test was used to compare the knowledge of teachers prior to and after the informative promotion. The level of significance was set at P ≤ 0.05. Results: The teachers' overall knowledge with respect to the emergency management of the traumatic injuries was deficient and significant differences were found in the knowledge of teachers before and after the informative promotion. Conclusion: Informative promotion programs to improve the knowledge and awareness of this group of community, who are generally the first line of assistance in case of dental trauma in schools, are mandatory.
TL;DR: Curcuma longa can be used as intracanal medicament in endodontic failure cases and showed larger zones of microbial inhibition than C. longa that were statistically significant and highly significant when compared to T. ammi and calcium hydroxide.
Abstract: Aim and Objectives: This in vitro study was designed to comparatively evaluate the antimicrobial efficacy of Curcuma longa (turmeric - T 1 -10%, T 2 -20%); Tachyspermum ammi (ajwain - A 1 -10%, A 2 -20%); chlorhexidine (CHX) gluconate gel (hexigel - 1%); and calcium hydroxide (10%) as intracanal medicaments against Enterococcus faecalis. Materials and Methods: Agar plates were prepared using brain-heart infusion (BHI) agar. Cultures of E. faecalis were grown in BHI broth at 37°C. Well diffusion method was used to derive results. Plates were inoculated for 72 h at 37°C and microbial zones of inhibition were recorded. Statistical analysis was performed with repeated measures analysis of variance. Results: C. longa (T 2 -20%) and CHX gluconate gel (hexigel - CHX-1%) showed larger zones of microbial inhibition than C. longa (T 1 -10%) that were statistically significant (P Conclusion: C. longa can be used as intracanal medicament in endodontic failure cases.
TL;DR: CPP – ACP showed the better remineralizing potential than the other two agents and there was no statistical significant difference between f-TCP and CSP groups.
Abstract: Aim: The aim of this study was to evaluate the remineralizing potential of three different remineralizing agents (GC tooth Mousse, Clinpro tooth crθme and SHY-NM) on demineralized tooth surfaces using micro CT and microhardness. Materials and Methods: Forty five freshly extracted mandibular premolars were collected and enamel specimens were prepared. The samples were assigned to three groups with fifteen specimens in each group. The specimens were then demineralized using McInne's demineralizing solution in two cycles. After that, remineralization was carried out in two cycles for 30 days using Casein phosphopeptide - Amorphous calcium phosphate (CPP - ACP), 0.21% sodium fluoride - Tricalcium phosphate (f-TCP) and Calcium Sodium Phosphosilicate (CSP) containing tooth pastes for groups I, II, III respectively. The specimens were evaluated for Linear attenuation co-efficient using micro CT (Scanco TM ) and Vicker's Micro Hardness (Schimadzu TM ) testing at different time periods. The results were tabulated and statistically analysed. Results: It was observed that all the three remineralizing agents used in the study significantly increased the Linear Attenuation Co-efficient and Vicker's hardness number values of the enamel specimens following 15 days and 30 days application. Conclusion: CPP - ACP showed the better remineralizing potential than the other two agents and there was no statistical significant difference between f-TCP and CSP groups.
TL;DR: A case report of surgical management of a large cystic lesion using Biodentine™ as retrograde filling material which has not been reported in literature so far is presented.
Abstract: Injury to anterior teeth is a common event. It requires a treatment approach that assures the complete biologic healing and functional restoration of the tooth or teeth involved. A cystic lesion, which is unable to heal nonsurgically, heals well with surgical intervention and use of mineral trioxide aggregate (MTA) as retrograde filling has been reported in literature. Another material with largely improved handling properties; Biodentine™ (Septodont, St. Maurdes Fossιs, France) was introduced in 2011. It is a calcium silicate based material and manufacturers claim that it can be used for crown and root dentin repair treatment, repair of perforations or resorptions, apexification, and root end fillings. This article presents a case report of surgical management of a large cystic lesion using Biodentine™ as retrograde filling material which has not been reported in literature so far. Eighteen months radiographic follow-up exhibited completely healed cystic lesion.
TL;DR: Statistical analysis showed that MO and MOD cavity preparations significantly reduced the fracture resistance of sound teeth, and Groups 7 and 6 presented the highest fracture resistance values.
Abstract: Aim: Endodontic treatment generally reduces the fracture resistance of teeth. The purpose of this study was to evaluate the fracture resistance and the mode of fracture of endodontically treated human premolars with different amounts of remaining tooth structure. Materials and Methods: Seventy non-carious human premolars were randomly assigned into 7 groups. Group 1 (ST) did not receive any preparation. The teeth in groups 2-7 received root canal treatment and different preparations. Group 2 (MO-NF): Mesio-occlusal preparation without filling; Group 3 (MOD-NF): Mesio-occluso-distal preparation without filling; Group 4 (MO-F): Mesio-occlusal preparation with direct composite restoration (Z250); Group 5 (MOD-F): Mesio-occluso-distal preparation with direct composite restoration (Z250); Group 6 (CC-D): Mesio-occluso-distal preparation with cusp reduction and direct composite restoration (Z250); Group 7 (CC-InD): Mesio-occluso-distal preparation with cusp reduction and indirect composite restoration (Gradia GC). The fracture resistance (N) was assessed under compressive load in a universal testing machine (Zwick) perpendicular to the occlusal surface at a cross-head speed of 1 mm/min, and the mode of fracture was assessed under stereomicroscope. Statistical analysis: Data was analyzed by Kruskal - Wallis and Mann - Whitney tests and the mode of fracture was analyzed by Chi-square test (P Results: Statistical analysis showed that MO and MOD cavity preparations significantly reduced the fracture resistance of sound teeth. Direct composite restorations can improve the fracture resistance, and Groups 7 and 6 presented the highest fracture resistance values. Conclusions: Teeth with adhesive restorations showed significantly higher fracture resistance values as compared with the non-restored ones.
TL;DR: Filtek Z350 XT with Mylar strip exhibited least surface roughness, followed by Filtek Z250, Dyract XT and Fuji II LC, which was determined by Perthen Perthometer S6P profilometer.
Abstract: Aim: To determine the surface roughness of esthetic restorative materials after finishing and polishing. Materials and Methods: All 60 specimens were divided into four groups. Group I: Nanocomposite, Z 350 XT (3M ESPE, USA); Group II: Microhybrid composite, Z 250 (3M ESPE, USA); Group III: Compomer, Dyract XP (LD Caulk/Dentsply, USA); and Group IV: Resin modified glass ionomer cement (GIC), Fuji II LC (GC, Japan). Each group was again divided into three subgroups. Subgroup A: Sof-Lex (3M ESPE); Subgroup B: Super-Snap Rainbow finishing and polishing kit (Shofu INC, Japan); and Subgroup C: Control Mylar strip. Surface roughness was determined by Perthen Perthometer S6P profilometer. Result: Filtek Z350 XT showed minimum surface roughness followed by Filtek Z250, Dyract XT and Fuji II LC. Super-Snap exhibited less surface roughness than Sof-Lex polishing systems. Statistical Analysis: One-way analysis of variance (ANOVA) followed by multiple post hoc comparisons using least square difference method and unpaired t-test was used. Conclusion: Filtek Z350 XT with Mylar strip exhibited least surface roughness.
TL;DR: CHX with or without CH was more effective than CH alone against all the tested micro-organisms and showed higher antimicrobial effect against facultative anaerobes and Candida spp.
Abstract: Aim: To compare the antimicrobial efficacy of calcium hydroxide (CH), 2% chlorhexidine gel (CHX) and a combination of both, on obligate anaerobes, facultative anaerobes and Candida spp . Materials and Methods: 90 single rooted permanent teeth were included in the study. After complete disinfection and access opening, the first microbiological pre-treatment sample (S1) was collected. After completion of instrumentation, a post-instumentation sample (S2) was taken and the teeth were divided into three groups: Group I: CH, Group II: 2% CHX, Group III: 2% CHX with CH. After 1 week, a post-medication sample (S3) was collected. Results: All three medicaments were effective in the elimination of obligate anaerobes. CHX and combination showed higher antimicrobial effect against facultative anaerobes and Candida spp . in comparison with CH. But there was no statistical significant difference between Group II and Group III. Conclusion: CHX with or without CH was more effective than CH alone against all the tested micro-organisms.
TL;DR: The study demonstrated that stem cells existed in deciduous and permanent pulp tissue and showed almost a similar expression pattern profile for variety of antigens tested.
Abstract: Aims and objectives: Isolation, characterization and differentiation of dental pulp stem cells (DPSCs) and stem cells from exfoliated human deciduous teeth (SHED). Methods: The pulp tissue was digested in collagenase and cultured in DMEM Dulbecco's Modified Eagle's Media). The stem cells were identified and isolated. Surface characterization of cells was done with flow cytometer using surface markers. An immuno cytochemistry analysis was done. Differentiation potential was analyzed using various differentiation markers. Results: Flow cytometry analyses for various CD markers showed similar results for both DPSCs and SHED. The cells showed positive expression for pluripotent, ectodermal and mesodermal markers. Cells differentiated into osteoblasts and adipocytes. Conclusion: The study demonstrated that stem cells existed in deciduous and permanent pulp tissue. The stem cells present in pulp tissue can be isolated, cultivated and expanded in vitro. Both DPSCs and SHED show almost a similar expression pattern profile for variety of antigens tested.
TL;DR: Micro-leakage is not affected by the application of either conventional or new-generation flowable composite resin as an intermediate material between composite resin and dental substrates.
Abstract: Aim: To evaluate the effect of application a new-generation bulk-fill flowable composite resin as an intermediate material between composite resin and dental substrates on micro-leakage in Class V composite restorations. Materials and Methods: A total of 144 Class V cavities were prepared in 72 human molars. Specimens were then randomly distributed among three groups according to adhesive system applied (Group 1: Clearfil SE Bond; Group 2: Adper Easy One; Group 3: Adhesive 200T), and each group was divided into three subgroups according to liner material used (Group A: No liner-control group; Group B: Aelite Flo LV, low viscosity microhybrid composite; Group C: Smart dentin replacement). All cavities were restored using resin composite (Aelite LS, low shrinkage posterior composite). Specimens were stained with 0.5% basic fuchsin and evaluated dye penetration. Results: There was no significant difference in dye penetration was found between the control and the experimental groups. Conclusions: Micro-leakage is not affected by the application of either conventional or new-generation flowable composite resin as an intermediate material between composite resin and dental substrates.
TL;DR: The pathogenesis of tooth resorption and various forms of internal Resorption along with some clinical cases are described.
Abstract: Resorption is a pathologic process that often eludes the clinician with its varied etiologic factors and diverse clinical presentations. The key cells involved in tooth resorption are odontoclasts which are multinucleated cells that produce resorption lacunae. Resorption can be classified as internal and external resorption. Internal resorption has been described as a rare occurrence as compared to external resorption. This article describes the pathogenesis of tooth resorption and various forms of internal resorption along with some clinical cases. Early diagnosis is the key factor in the successful management of resorptive lesions.
TL;DR: These clinical and laboratory results suggested that CPP-ACP containing cream had a slight remineralization effect on the WSL in the 3-month evaluation period however, longer observation is recommended to confirm whether the greater change in WSLs is maintained.
Abstract: Introduction: To promote the remineralization by ionic exchange mechanism instead of invasive techniques many remineralizing agents can be used. Objective: To evaluate the remineralization effects of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on white spot lesions (WSLs) and its inhibitory effect on Streptococcus mutans colonization. Materials and Methods: The study group consisted of 60 subjects exhibiting at least 1-WSL. Subjects were randomly divided into 2 groups: A test group using CPP-ACP cream (GC-Tooth Mousse, Leuven, Belgium) and a control group using only fluoride containing toothpaste for a period of 3-month. Baseline WSLs were scored using DIAGNOdent device (KaVo Germany) and the saliva samples were collected to measure S. mutans counts. After the 3-month period the WSLs were again recorded and the saliva collection was repeated. Result: DIAGNOdent measurements were increased by time (P = 0.002) in the control group and no statistically significant difference (P = 0.217) was found in the test group by the 3-month period. In both groups, the mutans counts were decreased in the 3-month experimental period. Conclusion: These clinical and laboratory results suggested that CPP-ACP containing cream had a slight remineralization effect on the WSL in the 3-month evaluation period however, longer observation is recommended to confirm whether the greater change in WSLs is maintained.
TL;DR: The adhesiveness quality to root dentin promoted by newer methacrylate resin-based obturation systems like Resilon/Epihany SE and EndoREZ is compromised even when teeth with simple anatomic features were obturated under well-monitored laboratory conditions.
Abstract: Aim: To evaluate and compare the push-out bond strengths of three obturation materials; Gutta-percha/AH Plus, Resilon/Epiphany self-etch (SE) and EndoREZ obturation system to intraradicular dentin. Materials and Methods: Sixty single-canal anterior teeth were prepared and assigned to experimental groups (n = 20), designated as Group I: Gutta-percha/AH Plus, Group II: Resilon/Epiphany SE and Group III: EndoREZ sealer/EndoREZ points.After obturation, each tooth was prepared for push-out assessment with root slices of 2 mm thickness using universal testing machine. Statistical Analysis: Two way analysis of variance and Scheffe's test. Results: Gutta-percha/AH Plus root fillings showed significantly highest bond strength. Also, root segment location did not have a significant influence on bond strength. Conclusion: The adhesiveness quality to root dentin promoted by newer methacrylate resin-based obturation systems like Resilon/Epihany SE and EndoREZ is compromised even when teeth with simple anatomic features were obturated under well-monitored laboratory conditions.
TL;DR: QMix™ 2 in 1 was shown to be less toxic to the rat subcutaneous tissue than 3% NaOCl, 2% CHX, and 17% EDTA and analyzed statistically by analysis of variance and Tukey's test.
Abstract: Aim: To evaluate the biocompatibility of a new root canal irrigant Q mix™ 2 in 1 in comparison to 0.9% sterile saline, 3% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), and 17% ethylenediaminetetraacetic acid (EDTA). Materials and Methods: Six circles were drawn on the dorsal skin of 24 male Wistar Albino rats, leaving 2cm between each circle. Using a syringe, 0.1mL of each root canal irrigant was injected subcutaneously into five circles. In the sixth circle, the needle of an empty syringe was introduced into the skin, but no irrigant was injected (control group). Evaluations were done at 2 hours, 48 hours, 14 days, and 30 days postprocedure. Tissue samples were excised, embedded in paraffin blocks, and 3 μm thick sections were obtained and stained with hematoxylin and eosin. The areas of inflammatory reaction were evaluated. From each tissue sample, five sections presenting the greatest inflammatory reactions were examined under a light microscope, and analyzed statistically by analysis of variance (ANOVA) and Tukey's test. Results: At the two-hour examination period, all the irrigants showed a slight increase in the number of inflammatory cells, at 48 hours, the number of inflammatory cells were increased significantly, and after 14 and 30 days, they were decreased gradually. Qmix™ 2 in 1 showed a smaller number of inflammatory cells than other irrigants tested. Conclusion: QMix™ 2 in 1 was shown to be less toxic to the rat subcutaneous tissue than 3% NaOCl, 2% CHX, and 17% EDTA.
TL;DR: Under the conditions of this study, the use of preoperative medication did improve the anesthetic efficacy of IANB for the treatment of teeth diagnosed with irreversible pulpitis but not significantly.
Abstract: Background: The purpose of this prospective, randomized, double-blind, placebo-controlled study was to compare the effect of the administration of preoperative ibuprofen, ketorolac, combination of etodolac with paracetamol and combination of aceclofenac with paracetamol versus placebo for the potential increased effectiveness of the inferior alveolar nerve block [IANB] anesthesia. Materials and Methods: A total of 100 endodontic emergency patients in moderate to severe pain diagnosed with irreversible pulpitis of a mandibular posterior tooth randomly received, in a double-blind manner, either a drug or placebo 30 minutes before the administration of a conventional IANB. Cold testing was done before administration of anesthesia to determine level of pain using Heft-Parker Visual Analogue Scale (VAS) score. Success was defined as no pain or pain (VAS) on access or initial instrumentation. Results: Overall success was 54% for all the groups. Success was highest (70%) for the ketorolac group, 55% for both ibuprofen group and combination of aceclofenac with paracetamol group, 50% for combination of etodolac with paracetamol group, and 40% for the placebo group. Conclusions: Under the conditions of this study, the use of preoperative medication did improve the anesthetic efficacy of IANB for the treatment of teeth diagnosed with irreversible pulpitis but not significantly.
TL;DR: Neem is effective in preventing adhesion of E. faecalis to dentin and significantly less bacteria were found adhering to the samples treated with Neem followed by NaOCL, GT, MC, Saline.
Abstract: Aim: The aim of this study was to assess the antibacterial efficacy of three different herbal irrigants against Enterococcus faecalis. Materials and Methods: Single rooted teeth were extracted due to orthodontic and periodontal reasons. The teeth were then inoculated with E. faecalis. The teeth were randomly divided into three experimental groups and two control groups of six samples each. Group 1 specimens were treated with 5.2% sodium hypochlorite (NaOCL) for 30 min followed by 5 mmol/L Ethylenediaminetetraacetic acid (EDTA) for 5 min and saline as final irrigant. Group 2 specimens were treated with and 5.2% NaOCl for 30 min as final irrigant. Group 3 were treated with Morinda citrifolia (MC) for 30 min as final irrigant. Group 4 were treated with Azadiracta indica (AI) as final irrigant. Group 5 were treated with green tea (GT) for 30 min as final irrigant. The dentin specimens were carefully spread onto a microscope slide and stained with BacLight and examined in a confocal laser scanning microscope set to monitor fluorescein isothiocyanate and propidium iodide. A total of nine fields were examined for each treatment and the bacteria presented were counted. Statistical Analysis: Using the one-way ANOVA with multiple comparison, significantly less bacteria were found adhering to the samples treated with Neem followed by NaOCL, GT, MC, Saline. Results: AI treatment produced the maximum reduction in adherence of E. faecalis to dentin (9.30%) followed by NaOCl (12.50%), GT (27.30%), MC (44.20%) and saline (86.70%). Conclusion: Neem is effective in preventing adhesion of E. faecalis to dentin.
TL;DR: The mean push-out bond strengths were higher for Groups I and III where Variolink II resin cement was used for luting the fiber post, which is based on the total etch adhesive approach, compared with Group I and Group III, which had significantly higher values.
Abstract: Introduction: The concept of using a post for the restoration of teeth has been practiced to restore the endodontically treated tooth. Metallic posts have been commonly used, but their delirious effects have led to the development of fiber-reinforced materials that have overcome the limitations of metallic posts. The use of glass and quartz fibers was proposed as an alternative to the dark color of carbon fiber posts as far as esthetics was concerned. Debonding is the most common failure in fiber-reinforced composite type of posts. This study was aimed to compare the push-out bond strength of a self-adhesive dual-cured luting agent (RelyX U100) with a total etch resin luting agent (Variolink II) used to cement two different FRC posts. Materials and Methods: Eighty human maxillary anterior single-rooted teeth were decoronated, endodontically treated, post space prepared and divided into four groups (n = 20); Group I: D.T. light post (RTD) and Variolink II (Ivoclare vivadent), Group II: D.T. light post (RTD) and RelyX U100 (3M ESPE), Group III: Glassix post (Nordin) and Variolink II (Ivoclare vivadent) and Group IV: Glassix post (Nordin) and RelyX U100 (3M ESPE). Each root was sectioned to get slices of 2 ± 0.05-mm thickness. Push-out tests were performed using a triaxial loading frame. To express bond strength in megapascals (Mpa), load value recorded in Newton (N) was divided by the area of the bonded interface. After testing the push-out strengths, the samples were analyzed under a stereomicroscope. Results: The mean values of the push-out bond strength show that Group I and Group III had significantly higher values than Group II and Group IV. The most common mode of failure observed was adhesive between dentin and luting material and between post and luting material. Conclusions: The mean push-out bond strengths were higher for Groups I and III where Variolink II resin cement was used for luting the fiber post, which is based on the total etch adhesive approach. In most of the samples, failure was observed between cement-dentine interface, followed by post-cement interface, which shows difficulty in bonding between post-cement-dentine interface.
TL;DR: The antibacterial activity of these herbal extracts is found to be comparable with that of conventional irrigants both on the biofilm and planktonic counterparts.
Abstract: Introduction: The Enterococcus faecalis biofilm in the root canal makes it difficult to be eradicated by the conventional irrigants with no toxicity to the tissues. Hence, plant products with least side effects are explored for their use as irrigants in the root canal therapy. Aim: To evaluate and compare the antibacterial efficacy of Mangifera indica L. kernel (mango kernel) and Ocimum sanctum L. leaves (tulsi) extracts with conventional irrigants (5% sodium hypochlorite (NaOCl) and 2% chlorhexidine) against E. faecalis dentinal biofilm. Materials and Methods: Agar diffusion and broth microdilution assay was performed with the herbal extracts and conventional irrigants (2% chlorhexidine and 5% NaOCl) against E. faecalis planktonic cells. The assay was extended onto 3 week E. faecalis dentinal biofilm. Results: Significant reduction of colony forming units (CFU)/mL was observed for the herbal groups and the antibacterial activity of the herbal groups was at par with 5% NaOCl. Conclusions: The antibacterial activity of these herbal extracts is found to be comparable with that of conventional irrigants both on the biofilm and planktonic counterparts.