A Comparative Evaluation of the Effects of Three Remineralizing Agents on Bleached Enamel: A Scanning Electron Microscopy (SEM) Analysis.

With the emerging concern of patients on esthetics, bleaching has become quite popular to get that "Shining White Smile." However, bleaching chemicals used on enamel's surface have been a clinical issue due to the fact that they might cause a variety of side effects, including sensitivity, gingival irritation, dentinal sensitivity, demineralization, and changes in the enamel's surface morphology. As a result, it is important to investigate different remineralizing agents that help to reduce the adverse effects. The researchers in this in-vitro study used a scanning electron microscope (quanta 200 SEM, California, USA) and a universal testing machine to assess the effects of three remineralizing products such as Tooth Mousse Plus (GC Corporation, India), Tooth Min (Abbott, India), and Elsenz (Group Pharmaceuticals Ltd, India) on bleached enamel. Based on the data available, we determined that bleaching greatly reduces the enamel microhardness of permanent human premolars; however, this loss could be recovered with a remineralizing agent. Tooth Mousse Plus is the most effective remineralizing agent among the three, followed by Elsenz and, finally, Tooth Min.

Comparative Evaluation of Dentinal Crack After Root Canal Preparation Using TruNatomy, Neoendo Flex, and Neoendo Neohybrid Files: An In Vitro Study.

AIM: The objective of the study was to assess and compare the dentinal microcracks produced by TruNatomy, Neoendo Flex, and Neoendo Neohybrid files during root canal preparation. MATERIAL AND METHODS: In this in vitro investigation, four groups of 25 samples each were assembled from 100 mandibular premolar teeth. Using TruNatomy, Neoendo Flex, and Neoendo Neohybrid files, or leaving the teeth unprepared (control), the teeth underwent root canal preparation. Horizontal sections were taken at different distances from the apex to analyze dentinal cracks. A stereomicroscope was used to assess the existence or lack of cracks, and chi-square tests were performed on the data. RESULTS: In the control group, there were no cracks. TruNatomy files created fewer cracks compared to Neoendo Flex and Neoendo Neohybrid files. CONCLUSIONS: This in vitro investigation demonstrates that the root surface might acquire dentinal cracks as a result of nickel-titanium instruments. Compared to Neoendo Flex and Neoendo Neohybrid files, TruNatomy showed a decreased incidence of cracks. However, it is important to note that these conclusions are limited to the scope of this study.

Data on the push-out bond strength of three different root canal treatment sealers.

It is of interest to document data on the push - out bond strength of three different root canal treatment sealers such as MTA Fillapex (MTA based), AH plus (Epoxy Resin based) and Apexit plus (Calcium hydroxide based). Forty-five freshly extracted human maxillary central incisors with closed apices were selected randomly. All the teeth were sectioned at cement-enamel junction using a diamond disc before starting the root canal preparation to obtain root length of 12 mm. All teeth were instrumented using ProTaper rotary instruments. 5.25% sodium hypochlorite was used for irrigation between instrumentation followed by 17% EDTA, and final rinse by saline. Obturation procedures were done using the gutta-percha single cone technique. 45 roots were randomly assigned to 3 groups of 15 for obturation with gutta-percha cones and 1 of the 3 sealers (n=15). Group 1 = MTA Fillapex sealer + gutta-percha: Group 2 = AH plus sealer + gutta-percha:Group 3 = Apexit plus sealer + gutta-percha. The roots were sectioned horizontally to its canal into 3 sections: Coronal, Mid-root and Apical-thirds using a precision cutting machine, with a thickness of 3 mm. The specimens were subjected to push-out test using a universal testing machine that carried a plunger. The loading speed was 1mm/min until the dislodgment of the material occurred. The independent t- test was used to compare the mean scores among the study groups. The level of significance was set at 5% for all tests. After the push-out bond strength test, each sample was evaluated under stereomicroscope (40x) to determine the mode of failure and recorded as one of the following categories: adhesive, cohesive or mixed. The observations thus obtained were subjected to statistical analysis using Student - t test. AH Plus showed significantly higher values than MTA Fillapex and Apexit plus (p < 0.05). Amongst the push-out bond strength AH Plus sealer showed significant difference from MTA Fillapex and Apexit plus groups. There was no significant difference between MTA Fillapex and Apexit plus however (p>0.05). Microscopic analysis displayed that the majority of the modes were cohesive failures for AH Plus, adhesive failures for MTA Fillapex and mixed failures for Apexit Plus. . Thus, AH Plus had the highest bond strength and MTA Fillapex had the lowest bond strength to root dentin. Mean push-out bond strength values were ranked as follows; AH Plus >Apexit Plus > MTA Fillapex. Microscopic analysis displayed that the majority of the modes were cohesive failures of AH Plus, adhesive failures for MTA Fillapex and mixed failures for Apexit Plus.

Self-disinfecting Alginate vs Conventional Alginate: Effect on Surface Hardness of Gypsum Cast-An in vitro Study.

INTRODUCTION: For the construction of any dental prosthesis, accurate impressions are necessary. Hence, we undertook the present study to evaluate and compare the surface hardness of gypsum casts poured from impressions made using conventional alginate and self-disinfecting alginate. MATERIALS AND METHODS: A total of 30 impressions of stainless steel die were made, out of which 15 impressions were made with conventional alginate and 15 were made with self-disinfecting alginate and poured using Type III dental stone. Thirty stone specimens were subjected for hardness testing. Data were analyzed using independent samples t-test to compare the mean surface hardness. RESULTS: Difference in surface hardness was statistically insignificant (p > 0.05). CONCLUSION: Surface hardness of gypsum casts poured using impressions made from self-disinfecting alginate and conventional alginates were comparable. CLINICAL SIGNIFICANCE: Self-disinfecting alginates may be employed in clinical practice as safe and effective materials to overcome the infection control issues without compromising on the properties of the material.

Assessment of Coronal Leakage of Temporary Restorations in Root Canal-treated Teeth: An in vitro Study.

INTRODUCTION: Coronal leakage is one of the constant concerns in routine dental practice. It is one of the factors responsible for the failure of root canal therapy. Permanent restorations should be given as soon as possible after the completion of root canal therapy. If unavoidable, provisional restoration should be given in such a way that it maximally reduced the leakage of microorganisms and fluids from the external environment into the canal space. Hence, we evaluated the effect of saliva on the coronal leakage of temporary restorations. MATERIALS AND METHODS: Biomechanical preparation of the root canals of 204 fresh mandibular first premolar teeth was done using endodontic files with intermittent irrigation of sodium hypochlorite solution and ethylenediaminetetraacetic acid. Alternate irrigation with normal saline was done periodically. After preparation, drying of the canals was done using paper points followed by sealing of the apical foramen. For the assessment of the microleakage, Siqueira et al apparatus and method was used. All the specimens were divided into four groups based on the provisional restorative material used. All the groups were further divided into three subgroups based on the presence and absence of intracanal medicaments. Verissimo et al's criteria were used to check the turbidity at 1-, 2-, 3-, and 4-week interval respectively. All the results were analyzed by Statistical Package for the Social Sciences (SPSS) software. Chi-square test was used to measure the level of significance, and p < 0.05 was considered to be significant. RESULTS: In group I, all the subgroups' specimens showed significant difference at 1 week's time. Only the subgroup with no intracanal medicaments in Cavit-containing provisional restoration showed nonsignificant alterations. Statistically significant alterations were seen at 1, 2, and 3 weeks' interval in all the subgroups except for one with intracanal medicaments. CONCLUSION: All the temporary restorative materials were not able to prevent microleakage after 1 week's time, with worst bacterial resistance shown by Ketac Molar and ionomer restorative material. Future studies are advocated for better prognosis of root canal therapy.

Comparison of Time Required by D-RaCe, R-Endo and Mtwo Instruments for Retreatment: An in vitro Study.

INTRODUCTION: To evaluate and compare the amount of time required by three rotary NiTi instruments in removing gutta-percha from root canal during retreatment with hand file as control. MATERIALS AND METHODS: Eighty human mandibular premolars with single straight root canals were prepared and obturated by cold lateral condensation with gutta-percha and AH Plus sealer. After two weeks, the 80 teeth were divided into one control group and 3 retreatment groups (n = 20 each). Gutta-percha was removed using H-files, the D-RaCe, or the Mtwo or the R-Endo retreatment systems. Retreatment time was calculated using stopwatch. RESULTS: D-RaCe and Mtwo required significantly less time than R-Endo and hand file. Hand file took maximum time, which was significantly slower than all groups. However, D-RaCe and Mtwo retreatment time was statistically insignificant. CONCLUSION: D-RaCe and Mtwo remove gutta-percha faster than R-Endo and Hand files.

Comparison of root canal sealer distribution in obturated root canal: An in-vitro study.

BACKGROUND AND OBJECTIVES: Endodontic sealer is currently regarded with such importance in the root canal treatment that it is often considered to be more important than the core obturating material itself. Sealer with the least film thickness is favorable for minimizing microleakage. The aim of the study is to compare sealer distribution in root canal using three different sealers with three different obturation techniques. MATERIALS AND METHODS: AH plus, Fuji-1, Tubliseal Extended Working Time (EWT) was placed into the prepared root canals of 90 maxillary central incisors using a lentulospiral. Thereafter, the canals were obturated using three different gutta-percha root filling techniques (single cone, lateral condensation, vertical condensation). Horizontal sectioning was carried out at 3 mm and 6 mm from the apex with a diamond disk. The two specimens thus obtained were examined for sealer distribution using a stereomicroscope and the percentage of sealer coating the perimeter (PSCP) was calculated using a digital imaging system. RESULTS: A significant difference existed in the mean PSCP values of three different sealers (P < 0.000), where Tubliseal (EWT) had the highest PSCP values followed by the AH plus and Fuji-1. Also, between techniques, differences were observed (P < 0.00), where a single cone technique had the highest mean values followed by lateral condensation and vertical condensation. Between the 3 mm and 6 mm sections a non-significant difference was observed (P < 0.945). CONCLUSION: Tubliseal EWT showed highest PSCP value and Single cone technique showed the higher PSCP value then lateral and vertical condensation technique at 3 mm and 6 mm sections.

Non-syndromic bilateral supplemental maxillary lateral incisors: a rare case.

Supernumerary teeth or hyperdontia are defined as the teeth that exceeds the normal dental formula, regardless of their location and morphology. A supernumerary tooth is a developmental anomaly and it has been argued to arise from multiple aetiologies. Supernumerary teeth with orthodox shapes and sizes, that resemble the normal dentition are called 'supplemental teeth'. The supplemental teeth are often overlooked because of their normal shapes and sizes. Supplemental lateral incisors are rare and bilateral cases are even rarer, with only two cases being reported in the literature till date. Therefore, we are describing a rare case of non-syndromic, bilateral, supplemental, maxillary, lateral incisors and we have discussed the management of supernumerary teeth.

Can accidental local application of a drug cause discolouration of permanent teeth?

Thorough knowledge on the aetiology of tooth staining is of importance to dental surgeons, in order to enable a correct diagnosis to be made when examining a discoloured dentition and it allows the dental practitioner to explain to the patient the exact nature of the condition. Tetracyclines are a group of drugs which can discolour teeth permanently. One such case of discolouration of adult teeth caused by administration of tetracycline(oxytetracycline) has been reported here and it has been discussed in detail.

A comparative evaluation of the vertical root fracture resistance of endodontically treated teeth using different root canal sealers: an in vitro study.

OBJECTIVE: The objective of this study is to evaluate the vertical root fracture resistance of endodontically treated teeth obturated with - Tubli-Seal EWT/Gutta-percha, AH Plus/Gutta-percha, Epiphany SE sealer/Epiphany point. STUDY DESIGN: Sixty-five single rooted premolars were decoronated and root length was 14 mm for each specimen. Fifty five teeth were enlarged up to ISO size 40 master apical file with stainless steel K-files using standardized preparation and remaining ten teeth were served as negative control. Then teeth were randomly assigned into different groups depending on sealer used for obturation as follows: Group 1: Negative control-no instrumentation was performed. Group 2: Positive control-gutta-percha with out the use of any sealer. Group 3: Experimental group-gutta-percha and Tubli-Seal EWT root canal sealer. Group 4: Experimental group-gutta-percha and AH Plus. Group 5: Experimental group-epiphany SE sealer and epiphany points. After 72 hours, the specimens were embedded in autopolymerizing resin leaving 7 mm of each root exposed and were subjected to fracture testing under universal testing machine at a crosshead speed of 1.0 mm per minute until the root fractured. Results were statistically analyzed using one-way ANOVA and independent t-test. RESULTS: Showed that Epiphany SE sealer/Epiphany points showed highest mean fracture resistance and Tubli-Seal EWT group showed the least fracture resistance of all the materials tested. There was no statistically significant difference among experimental groups. CONCLUSION: Epiphany SE sealer/Epiphany points demonstrated highest fracture resistance values than the other materials tested and intact tooth had highest resistance against vertical root fracture. CLINICAL SIGNIFICANCE: Epiphany SE sealer/Epiphany points may be one of the materials of choice in the endodontic treatment of teeth.