A Spectrophotometric comparative evaluation of the sealing ability of various perforation repair materials with a novel eggshell modified GIC.

Objectives: The objective of this study was to evaluate and compare the sealing ability of mineral trioxide aggregate (MTA), Biodentine, glass ionomer cement, and glass ionomer cement modified with Chicken Eggshell Powder when used as furcation perforation repair material. Materials and Methods: In the present study, 80 human lower first molars were used. Collected teeth had no caries or restoration, and none had fused roots. Every molar had an endodontic access cavity made utilizing a high-speed, long-shank round bur for the initial entry and an Endo-Z for lateral extension and finishing the cavity walls. Each canal's orifice was covered with a temporary filling material. The pulpal floor and cavity walls of every molar were thoroughly coated with two successive coats of clear nail polish. A significant perforation was made between the orifices to the furcation area using a high-speed long shank round bur #4. The perforation centered between the mesial and distal orifice. They were divided into four experimental groups: Group I: 20 molars were repaired using MTA, Group II: 20 molars with Biodentine, Group III: 20 molars were repaired with glass ionomer cement, and Group IV was repaired using glass ionomer cement modified with 7% chicken eggshell powder. Moist cotton pellets were placed over the repair materials, and molars were kept in 100% humidity for 24 h to allow materials to set. Then, according to each group, molars were put in Petri dishes. Methylene blue dye was applied inside the access cavity of all samples for 24 h. Molars were placed under running tap water for 30 min to remove all residues of methylene blue, and then varnish was removed with a Parker blade #15 and polishing discs. Molars were placed in vials containing 1 mL of concentrated (65 wt%) nitric acid for 3 days. Vials were centrifuged at 14,000 rpm for 5 min. The supernatant from each sample was transferred in a quantity of 200 L to a 96-well plate. Sample absorbance was read by an automatic microplate spectrophotometer at 550 nm using concentrated nitric acid as a blank. Statistical analysis was performed using one-way analysis of variance. When the analysis of variance test was significant, the pairwise comparison of the means was done using a Duncan post hoc test. The significance level was set at P < 0.05. Statistical analysis was performed with SPSS 14.0 (SPSS Inc., Chicago, IL, USA) for Windows (Microsoft, Redmond, WA, USA). Results: The highest dye absorbance was seen in Group III, followed by Groups IV, II, and I. Conclusion: Within the limitations of study it was concluded that maximum sealing ability was seen in Biodentine followed by MTA, Glass Ionomer Cement modified with 7% Chicken Eggshell powder and Glass Ionomer Cement.

Micro-computed tomographic analysis of the marginal adaptation of a calcium silicate-based cement to radicular dentin after removal of three different intracanal medicaments - An in vitro study.

CONTEXT: This study focuses on the marginal adaptation of a calcium silicate-based cement to the root dentin after retrieval of different intracanal medicaments. AIM: This study compared the marginal adaptation of a calcium silicate-based cement to radicular dentin in the apical third of the root canal following the use of three different intracanal medicaments. MATERIALS AND METHODS: Forty single-rooted premolar teeth (n = 40) were decoronated 13 mm above the root apices; then, 3 mm of the root tips were resected to standardize the root length. Orthograde cleaning and shaping were done using the rotary files and apical enlargement using peeso reamers. Depending on the intracanal medicament used, the samples were equally divided into four groups: Group 1 - control, Group 2 - Metapex, Group 3 - triple antibiotic paste (TAP), and Group 4 - calcium hydroxide with Propolis. Subsequently, the medicament was removed and a 3 mm apical barrier of BiodentineTM was placed and later scanned using an ex vivo micro-computed tomography scanner. STATISTICAL ANALYSIS USED: One-way ANOVA F-test and Tukey's post hoc test were used. RESULTS: Maximum adaptation was seen in control group (0.65) > Propolis (1.47) > TAP (4.37) > Metapex (5.25); a high statistically significant difference between the four groups was found (P < 0.001) with regard to the external voids between BiodentineTM and radicular dentin. CONCLUSION: On comparison of the marginal adaptation of Biodentine to root canal dentin following the use of three different intracanal medicaments, maximum adaptation was seen in Group 1, followed by Group 4, Group 3, and Group 2.

Spectrophotometric analysis of the color stability of white mineral trioxide aggregate in contact with four different irrigating solutions - An in vitro study.

AIMS: This study aims to compare the color stability of white mineral trioxide aggregate (wMTA) in contact with four irrigating solutions. SETTINGS AND DESIGN: Original research study. SUBJECTS AND METHODS: Fifty cylindrical discs of wMTA, 10 mm in diameter and 2 mm in height were prepared using a mold. Samples were incubated at a temperature of 37°C and at 100% humidity for the material to reach its optimal mechanical properties. The samples were divided into 6 groups: Group A: dry (n = 5); Group B: distilled water (DW) (n = 5); Group C: 5% sodium hypochlorite (NaOCl) (n = 10); Group D: 2% chlorhexidine gluconate (CHX) (n = 10); Group E: 17% aqueous ethylene diamine tetra-acetic acid (EDTA) (n = 10); Group F: 0.2% Chitosan (n = 10) Each disc was immersed into the irrigating solution for a period of 24 h. All the specimens were photographed using a digital camera before and after immersion. The assessment of color change of each disc of wMTA was conducted by a spectrophotometer. The Commission Internationale de l'eclairage system was used to calculate the differences in color. STATISTICAL ANALYSIS USED: Statistical Package for the Social Sciences version 16.0 (Chicago, IL, USA) at a significance level of P < 0.05 was used. RESULTS: All groups except group A exhibited discoloration of wMTA. The mean values for change in color was highest with Group D, followed by Group C, F, E, B, and group A. Only Group B when compared to group A did not show any statistically significant difference (P = 0.948) whereas all the other four groups showed a highly statistically significant difference (P < 0.001). CONCLUSIONS: 2% CHX causes maximum discoloration of wMTA followed by 5% NaOCl, 0.2% Chitosan and least discoloration with 17% aqueous EDTA and DW.

Scanning electron microscopic evaluation of smear layer removal at the apical third of root canals using diode laser, endoActivator, and ultrasonics with chitosan: An in vitro study.

AIM: The aim of this study was to compare the effect of diode laser, endoActivator, and passive ultrasonics for smear layer removal at the apical third from root canals with 0.2% chitosan. MATERIALS AND METHODS: A total of 40 mandibular premolars were decoronated to establish a working length of 12 mm and shaped with ProTaper rotary files up to size F3. In Group A, canals were irrigated with 1 ml of 0.2% chitosan. In Group B, canals were initially irrigated with 0.8 ml of 0.2% chitosan and the remaining 0.2 ml was activated with diode laser. In Group C, canals were irrigated with 1 ml of 0.2% chitosan which was activated with endoActivator. In Group D, canals were irrigated with 0.2% chitosan and activated with passive ultrasonics. All samples were finally flushed with 3 ml of distilled water. The percentage of smear layer removal was analyzed with a scanning electron microscope examination at ×1000 and ×3000. Data were analyzed using Statistical Package for the Social Sciences version 16.0 (SPSS Inc., Chicago, IL, USA) at a significance level of P < 0.05. RESULTS: The mean value for Group B when compared to Group C for the removal of smear layer was higher, but there was no statistically significant difference between the two groups (P < 0.068 and P < 0.295). Both Group B and Group C showed a statistically significant difference (P < 0.001) when compared to Group A and Group D for the removal of smear layer. CONCLUSION: Diode laser and endoActivator with 0.2% chitosan proved better in the removal of the smear layer when compared to passive ultrasonic irrigation.

A comparative evaluation of shear bond strength of composite resin to pulp chamber dentin treated with sodium thiosulfate and proanthocyanidin: An in vitro study.

AIM: Based on the importance of coronal sealing right after endodontic treatment, this in vitro study aimed to evaluate the difference of shear bond strength to pulp chamber dentin treated with sodium thiosulfate and proanthocyanidin (PA). MATERIALS AND METHODS: Fifteen extracted mandibular molar teeth were decoronated at the level of cementoenamel junction horizontally. The individual teeth were then sectioned mesiodistally to expose the pulp chamber dentin using a diamond disc. The specimens were randomly divided into three groups (n = 10). Group A: control group, treated with 5.25% sodium hypochlorite (NaOCl) for 30 min followed by a final rinse with 17% ethylenediaminetetraacetic acid (EDTA) solution for 3 min; Group B: after pretreatment with NaOCl and EDTA, it is further treated with 5% sodium thiosulfate (Na2S2O3) for 10 min; and Group C: after pretreatment with NaOCl and EDTA, it is further treated with 6.5% PA for 10 min. After drying the specimens, a bonding agent namely One Coat Bond SL (SwissTEC, Coltene) was applied to the pulp chamber dentin followed by a composite restoration (SwissTEC, Coltene). Each specimen was then tested under a universal testing machine at the dentin/resin interface to determine the shear bond strength. RESULTS: Both the groups in which 5% Na2S2O3 and 6.5% PA were used for 10 min showed bond strength that was found to be statistically higher than the positive control (P < 0.05). CONCLUSION: The use of Na2S2O3 and PA can significantly increase the bond strength of composite resin to NaOCl/EDTA-treated dentin, allowing adhesive restorations to be immediately applied after endodontic treatment.

The Contribution of Indian Endodontists in Rotary Endodontics to Pubmed Database, from 2000-2017.

AIM: This study aimed at assessing the trends of publications of Indian Endodontists in the field of rotary Endodontics in the PubMed database from 2000-2017. METHODS: The date of publication was set from 1st January 2000 to 31st December 2017, wherein keywords entered in the advanced search were "Indian" AND "Dental" AND "Rotary Endodontics". From the collected articles the following criteria were noted: year of publication, the name of the journal, status of the journal, name of the first author, state of origin and the rotary Endodontic file system used. RESULTS: All data was subjected for statistical analysis by SPSS software version 16. The data were subjected to chi-square test, and a statistically significant difference (p < 0.001) was obtained in the inter-6 yearly interval starting from 2000-2017; in the status of the journal; the state of origin and in the generation of rotary files which were published during the study period. CONCLUSION: The plethora of publications by Indian Conservative Dentists and Endodontists is on the rise, and with the advent of better technology a greater interest in the mechanics and properties of these rotary file systems has invoked greater research work.

Scanning Electron Microscopic Evaluation of Efficacy of 17% Ethylenediaminetetraacetic Acid and Chitosan for Smear Layer Removal with Ultrasonics: An In vitro Study.

INTRODUCTION: The main aim of root canal treatment is cleaning, shaping and then obturating three dimensionally to prevent reinfection. This includes chemicomechanical cleansing by instrumentation and the use of irrigating solutions. Therefore, the purpose of this study was to compare the smear layer removal from root canal dentine subjected to two root canal irrigants, 17% EDTA and 0.2% Chitosan, a new irrigant using Scanning Electron Microscope. METHODOLOGY: 40 single rooted premolars were decoronated followed by instrumentation with I Race files and intermediate irrigation with 3% sodium hypochlorite and activation with ultrasonics. Then the samples were longitudinally sectioned and place in the respective test solutions and their controls for 5 minutes. Scanning Electron Microscopic evaluation was further carried out. RESULTS: The results of the present study indicates that the Chitosan which was proved effective in removing smear layer. CONCLUSION: A moderate concentration of 0.2% chitosan removes the smear layer with greater efficiency.

In vitro Evaluation of the Efficacy of 2% Carbonic Acid and 2% Acetic Acid on Retrieval of Mineral Trioxide Aggregate and their Effect on Microhardness of Dentin.

INTRODUCTION: In this in vitro study, the efficacy of 2% carbonic acid and 2% acetic acid on the surface, microhardness of white mineral trioxide aggregate (MTA) and dentin after 1 day of setting and 21 days of setting of MTA is measured. MATERIALS AND METHODS: Tooth molds were made using 60 single-rooted premolars by slicing them to 4 mm in the mid-root region. White MTA (Angelus) was mixed and packed in the molds. Three experimental groups were formed and exposed to 2% carbonic acid, 2% acetic acid, and saline for 10 minutes on 1 and 21 days of setting respectively. Vickers hardness test of white MTA and dentin was done before and after exposure. Data were subjected to analysis of variance (ANOVA) and post hoc tests. RESULTS: The results show that 2% acetic acid was significantly effective in reducing the microhardness of white MTA compared to 2% carbonic acid and saline on exposure for 10 minutes. CONCLUSION: The results of the present study indicate that 2% acetic acid has maximum efficacy in reducing the surface microhardness of partial and completely set MTA, followed by 2% carbonic acid. CLINICAL SIGNIFICANCE: The following study will help find an adjunct for retrieval of MTA, which was found difficult with the existing methods.

Karyotype, Pedigree and cone-beam computerized tomography analysis of a case of nonsyndromic pandental anomalies.

This case report presented a karyotype and pedigree analysis of a case with unusual combination of dental anomalies: Generalized short roots, talon cusps, dens invagination, low alveolar bone heights, very prominent cusp of carabelli and protostylid on first permanent molars, taurodontism of second permanent molars, rotated, missing and impacted teeth. None of the anomalies alone are rare. However, until date, nonsyndromic pandental anomalies that are affecting entire dentition with detailed karyotype, pedigree and cone-beam computerized tomography analysis have not been reported. The occurrence of these anomalies is probably incidental as the conditions are etiologically unrelated.

Comparison of canal transportation and centering ability of rotary protaper, one shape system and wave one system using cone beam computed tomography: An in vitro study.

AIM: The aim of the present study was to compare the canal transportation and centering ability of Rotary ProTaper, One Shape and Wave One systems using cone beam computed tomography (CBCT) in curved root canals to find better instrumentation technique for maintaining root canal geometry. MATERIALS AND METHODS: Total 30 freshly extracted premolars having curved root canals with at least 10 degrees of curvature were divided into three groups of 10 teeth each. All teeth were scanned by CBCT to determine the root canal shape before instrumentation. In Group 1, the canals were prepared with Rotary ProTaper files, in Group 2 the canals were prepared with One Shape files and in Group 3 canals were prepared with Wave One files. After preparation, post-instrumentation scan was performed. Pre-instrumentation and post-instrumentation images were obtained at three levels, 3 mm apical, 3 mm coronal and 8 mm apical above the apical foramen were compared using CBCT software. Amount of transportation and centering ability were assessed. The three groups were statistically compared with analysis of variance and Tukey honestly significant. RESULTS: All instruments maintained the original canal curvature with significant differences between the different files. Data suggested that Wave One files presented the best outcomes for both the variables evaluated. Wave One files caused lesser transportation and remained better centered in the canal than One Shape and Rotary ProTaper files. CONCLUSION: The canal preparation with Wave One files showed lesser transportation and better centering ability than One Shape and ProTaper.

'Split posterior tooth': conservative clinical re-attachment.

Trauma is the prime causative factor for fracture of teeth/dentition. Many procedural management options are followed successfully in relation to the anterior teeth. However, most posterior cases where the tooth is fractured have only limited options to pursue to save the tooth. Fractured teeth, whether they are vital/non-vital, are predominantly managed with surgical options. This paper discusses a conservative approach to reattaching a split posterior tooth. A split tooth situation is mostly an absolute indication for extraction, but the clinician may go in for extensive surgical procedures if he/she wishes to save it. The reattachment of the tooth can be successfully done and it can be put to function. This paper discusses how a split posterior tooth can be treated successfully, although depending on multiple factors. A full crown cemented after successful reattachment and root canal therapy would provide sufficient support in order for the tooth to heal.

A Clinical and Radiographic Evaluation of Periodontal Regenerative Potential of PerioGlas®: A Synthetic, Resorbable Material in Treating Periodontal Infrabony Defects.

BACKGROUND: Study of the clinical application of bioactive glass in treating periodontal defects has been gaining momentum. Studies in the past have hypothesized that bioactive glass resulted in an improvement of bony lesion when compared with open flap debridement. Considering that there were very few studies in the Indian dental literature involving the analysis of PerioGlas®- A particulate Bioglass in intrabony defects, the present clinical trial aimed to clinically and radiographically evaluate the efficacy of PerioGlas® and compare it to open debridement as control in the treatment of human periodontal osseous (three and two wall) defects in South Indian population. MATERIALS AND METHODS: Ten patients with chronic periodontitis within the age group of 30-45 years having at least two pockets with depth of ≥6 mm exhibiting vertical osseous defects were selected for the study. A total of 20 defect sites were randomly assigned to one of the two treatment modalities such that 10 sites (experimental) received PerioGlas® material after open flap debridement and 10 sites with open flap debridement (controls). Plaque index and gingival index (GI) were recorded at baseline, 6 weeks, 3 months, 6 months and 9 months, whereas probing pocket depth (PPD), clinical attachment level and gingival recession (GR) were recorded at baseline, 6 and 9 months postoperatively. Linear radiographic measurements were carried out at baseline, 6 and 9 months to evaluate the defect fill, defect resolution and change in the alveolar crest height (ACH). RESULTS: Both experimental and control site showed a significant reduction in plaque and GI, and a slight increase in GR. The mean reduction in PPD for experimental and control site was 4.4 ± 0.34 mm and 3.2 ± 0.1 mm, respectively. Gain in clinical attachment at experimental and control site was 4.4 ± 0.21 and 3.4 ± 0.11, respectively which on comparison was statistically non-significant for both sites. The radiographic mean defect fill for experimental site was 1.73 mm. The mean defect resolution was 46.5% and 15.3% for the experimental group and control group, respectively, with a slight increase in the ACH at the experimental site. CONCLUSION: Comparison of experimental and control sites revealed a statistically significant improvement in both clinical and radiographic parameters, but experimental sites showed better results when compared with control. How to cite the article: Chacko NL, Abraham S, Rao HN, Sridhar N, Moon N, Barde DH. A clinical and radiographic evaluation of periodontal regenerative potential of PerioGlas®: A synthetic, resorbable material in treating periodontal infrabony defects. J Int Oral Health 2014;6(3):20-6.

Conservative management of persistent facial cutaneous sinus tract with a dental origin.

Facial and cervical area sinus tracts can be odontogenic or non-odontogenic, and so clinicians should be aware that lesions with a dental origin can be confused with dermatological lesions. We describe three cases of cutaneous lesions of dental origin that were initially misdiagnosed as being dermatological in origin. Multiple unsuccessful treatments were attempted but the lesions failed to heal. However, conservative endodontic intervention resulted in complete resolution of the causative periapical lesions within a short period, making surgery unnecessary. Dental aetiology, as part of a differential diagnosis, must be considered in such oro-facial lesions.

Effect of grape seed extracts on bond strength of bleached enamel using fifth and seventh generation bonding agents.

BACKGROUND: The objective of this in-vitro study was to evaluate the effect of grape seed extract (oligomericproanthocyanidin complexes [OPCs]) on the bond strength of composite resin to bleached enamel using 5th and 7th generations of bonding agents. MATERIALS & METHODS: Eighty maxillary central incisors were randomly assigned to four groups as follows: Group I (n=20): no bleaching (control); Group II (n=20): bleaching with 38% hydrogen peroxide gel, without the use of an antioxidant; Group III (n=20): bleaching followed by the use of 10% sodium ascorbate; Group IV (n=20) : bleaching followed by the use of 5% proanthocyanidin solution. All the four groups were further subdivided into two groups of ten teeth each depending on the adhesive system used in order to bond the resin composite to enamel surfaces. Subgroup A: 5th generation bonding agent and subgroup B : 7th generation bonding agent. Shear bond strength of the specimens was tested under universal testing machine. RESULTS: The shear bond strength values were observed to be significantly higher in teeth treated with 10% sodium ascorbate and 5% proanthocyanidin as compared to the group in which no antioxidant was used. Also, bonding with 5th generation bonding agent resulted in significantly higher shear bond strength when compared to the 7th generation bonding agent. CONCLUSION: The use of grape seed extract as an antioxidant after bleaching significantly improves the bond strength of composite resin to bleached enamel. 5th generation bonding agents have higher shear bond strength of composite resin to enamel. How to cite this article: Abraham S, Ghonmode WN, Saujanya KP, Jaju N, Tambe VH, Yawalikar PP. Effect of grape seed extract on bond strength of bleached enamel using fifth and seventh generation bonding agents. J Int Oral Health 2013; 5(6):101-7 .

The effect of fiber reinforcement on the dimensional changes of poly methyl methacrylate resin after processing and after immersion in water: an in vitro study.

AIMS AND OBJECTIVES: To evaluate and compare the effect of fiber reinforcement on the dimensional changes of heat-cured poly (methyl methacrylate) resin after processing and immersion in water. MATERIALS AND METHODS: Three different heat-cure resins were selected for the present study: (1) Nonreinforced heat-cure methyl methacrylate resin, (2) High Impact heat-cured methyl methacrylate resin and (3) Fiberglass reinforced methyl methacrylate resin. Ninety samples were prepared using three different resins and denture bases obtained for the same. The amount of space between the tissue surface and the cast in the anterior, middle and posterior regions is measured after processing and immersion in water for 17 days using a traveling microscope having a least count of 0.001 cm. RESULTS: Mean and standard deviation were calculated for the dimensional changes and were subjected to statistical analysis (Student t-test, unpaired). Among the three groups of resins, fiber reinforced heat-cured methyl methacrylate resin was found to be statistically highly significant in terms of dimensional changes when compared with the nonreinforced and high impact heat-cured resins. CONCLUSION: Dimensional changes were evident in all the planes in the three groups studied and were in the following decreasing order-fiberglass reinforced heat-cured poly (methyl methacrylate) resin, high impact heat-cured poly (methyl methacrylate) resin and nonreinforced heat-cured poly (methyl methacrylate) resin. CLINICAL SIGNIFICANCE: The fibers are added in order to increase the strength of acrylic resin. Considering only the strength may in turn affect the dimensional accuracy of the acrylic resin resulting in loss of retention and stability, affecting the fit of the denture.

Comparative evaluation of pain, tenderness and swelling followed by radiographic evaluation of periapical changes at various intervals of time following single and multiple visit endodontic therapy: an in vivo study.

AIM: This clinical study was undertaken to evaluate the postoperative sequelae following single-visit versus multiplevisit endodontic therapy at various interval of time in vital as well as nonvital teeth. MATERIALS AND METHODS: Thirty-two cases were randomly assigned to the following four groups, group I, group II, group III and group IV. After gaining the access to the pulp chamber, establishing the working length , thorough cleaning and shaping was done for all the cases. Obturation was done by protaper (variable taper) gutta-percha and AH-PLUS sealer using lateral and vertical condensation technique. All the cases were recalled after 48 hours, 1 week, 4 weeks and 6 weeks following obturation and were evaluated for postoperative pain, tenderness and swelling. RESULTS: There was no statistically significant difference amongst all the four groups in the incidence and severity of postoperative pain, tenderness and swelling at the end of one week. However, within 48 hours groups I, II and IV showed more pain when compared to group III. And groups I, II and III showed more tenderness compared with groups IV. Postoperative swelling was not reported. Radiographic investigation at the end of 6 weeks showed significant change in the appearance of the periapical region in group II and group IV cases. CONCLUSION: On strict adherence to biological principles and proper case selection, no significant difference in the success, postoperative pain and tenderness exist when treated with either single-visit or multiple-visit therapy. CLINICAL SIGNIFICANCE: No significant difference in the success rate or postoperative pain, tenderness, and swelling exists when treated with either single-visit or multiple-visit endodontic therapy. Hence, one can readily integrate one-visit endodontic therapy into the routine clinical practice of dentistry.

A comparative study of impression procedures for distal extension removable partial dentures.

AIM: This study was carried out with the purpose of comparing three impression methods as to which of them placed tissues most favorably. METHODS: The methods used were Hindels method, selective tissue placement method and functional reline method. The measurements obtained were analyzed to determine which of the three impression methods placed the mucosal tissues maximally. To compare and measure tissue placements, autopolymerizing acrylic resin platforms were constructed to the height of the occlusal surfaces of the remaining teeth. 15 orthodontic buccal tubes were placed on each side of the platform. They were arranged in three sets of five and attached to the platform over selected reference regions by means of autopolymerizing resin. The selected reference areas were in anterior, middle and posterior areas of the ridge on either side. RESULTS: No significant difference was seen in tissue placement in the anterior middle and posterior regions in each of the three methods when each method was assessed separately. Selective tissue placement method placed the tissues maximally (7.547 mm) followed by Hindels method (7.2110 mm) and the least placement was by functional reline method (5.856 mm). Tissue placement was significantly higher in Hindels method as compared to functional reline method (p < 0.001). CONCLUSION: Tissue placement was maximum in the posterior region, followed by the middle region and least in the anterior region of the mandibular ridge for all three methods. Selective tissue placement method showed the maximum overall tissue placement followed by the Hindels method and minimum placement was by functional reline method. CLINICAL SIGNIFICANCE: Selective tissue placement method provided maximum overall tissue placement and can be a preferred technique for impression making for bilateral distal extension removable partial denture fabrication.