Comparative Assessment of Qmix as Endodontic Irrigant on Reversal of Bond Strength in Teeth Subjected to Irradiation: An Scanning Electron Microscope Study.

AIM: The aim of this current study was to compare and evaluate the reversal efficacy of Qmix and chitosan-based irrigation materials quantitatively through the assessment of the push-out bond strength of bioceramic sealer employing universal testing machine and to qualitatively analyze the sealer/dentin interface by scanning electron microscope (SEM) in the teeth subjected to fractioned radiation. MATERIALS AND METHODS: Ninety single-rooted straight human maxillary central incisors were randomly divided into six groups (n = 15) where in three groups comprise Chitosan, Qmix, and EDTA/sodium hypochlorite which were not exposed to irradiation while other three groups were challenged with irradiation protocols. Root canals were prepared with ProTaper universal system and all the samples were irrigated according to the final irrigation protocols and obturated with bioceramic sealers. Dentin slices were prepared with 1 mm thickness from each root third for the estimation of bond strength of sealers to dentin. Qualitative assessment of the sealer-dentin interface was done by scanning electron microscopy. Bond strength data were scrutinized by independent t-test and failure modes using the Chi-square test. RESULTS: Significantly lower bond strength (p <0.05) was recorded after irradiation compared with nonirradiated group. To quantify the results irrigation protocols, Qmix had highest bond strength followed by chitosan and EDTA/sodium hypochlorite group irrespective of irradiation status. Bond strength values reduced after irradiation in all root thirds irrespective of the irrigation materials. Scanning electron microscope images revealed traces of repair process for Qmix-based irrigation materials than the chitosan-based materials for both irradiated and nonirradiated specimens. CONCLUSION: All the irrigation materials employed in this study had good bond strength. The specimen irrigated with Qmix had comparatively higher bond strength than the chitosan-based materials. The teeth subjected to irradiation challenge were associated with a decrease in the push-out bond strength of sealers to intraradicular dentin with formation of more gaps and fewer tags at the sealer/dentin interface. CLINICAL SIGNIFICANCE: Selection of ideal irrigation protocols still remains a challenge for the clinical practitioners, and this study explored the utilization of novel materials used for irrigation, especially in the teeth subjected to radiation.

Assessment of Clinical and Radiographic Success Rate of Formocresol-based Pulpotomy versus Collagen-based Pulpotomy: An In Vivo Study.

AIM: The aim of the study is (a) To use collagen as a pulpotomy material in comparison with the gold standard formocresol-based pulpotomy, (b) to assess the clinical and radiographic success rate of formocresol pulpotomy and collagen-based pulpotomy, and (c) to compare the success rate of formocresol-based pulpotomy and collagen-based pulpotomy over a definitive interval of time. MATERIALS AND METHODS: Totally 30 primary first or second molars indicated for pulpotomy after confirming with the operative diagnosis were taken as samples for this study. This split-mouth technique consists of two groups: Group 1-formocresol pulpotomy (n = 15), and group 2-collagen-based pulpotomy (n = 15). Both the procedures were done in the same patient on regular appointments. Pre- and postoperative radiographs were taken. The children were recalled for clinical and radiographic follow-up at 2, 4, and 6 months. The success of the procedure was assessed based on clinical signs (pain, tenderness to percussion, abscess, swelling, fistula, and pathologic mobility) and radiographic findings (radicular radiolucency, internal and external root resorption, periodontal ligament (PDL) space widening, and furcation radiolucency). The Chi-square test was used to compare the differences between the groups. RESULT: The overall success rate for formocresol pulpotomy (n = 15) was 14, 13, and 10 for the second-, fourth-, and sixth-month review period, respectively. For collagen pulpotomy group (n = 15), the overall success rate was 14, 14, and 14 for the second-, fourth-, and sixth-month review period, respectively. The obtained data from the overall success rate were subjected to statistical analysis, and chi-square test was used. The p-value less than 0.1 was considered a statistically significant result. The chi-square value for the fourth- and sixth-month review was 0.37 and 3.33, respectively. CONCLUSION: Statistically significant value was obtained from the sixth-month review period (p <0.1), which describes that the overall success rate was better for the collagen pulpotomy group when compared with the formocresol pulpotomy group. CLINICAL SIGNIFICANCE: Collagen had proven to be a very good alternative for formocresol, its biocompatibility, and regenerative efficiency and is a benchmark for a better clinical success rate in dentistry. However, its implication in pulpotomy should be subjected to further comparative research study on mineral trioxide aggregate (MTA), Biodentine, etc. Keywords: Collagen-based pulpotomy, Formocresol-based pulpotomy.

Estimation of TNF-α Levels in Saliva and Serum of Patients with Periodontal Health and Chronic Periodontitis: A Case-control Study.

AIM: The aim of this case-control study is to estimate the circulatory levels of tumor necrosis factor alpha (TNF-α) in saliva and serum of patients with chronic periodontitis and periodontally healthy subjects. MATERIALS AND METHODS: Forty-four patients were screened, and based on biofilm-gingival interface (BGI) index, they were grouped into group I healthy periodontium [BGI-H (20)] and group II periodontitis [BGI-P3 (24)]. Venous blood and salivary samples were collected and analyzed using solid-phase enzyme-linked immunosorbent assay. Independent sample t test was performed to determine the association. RESULTS: Overall, there were differences in both the saliva and the serum TNF-α levels in healthy and periodontitis subjects. The average serum TNF-α concentration in group I healthy subjects was 23.12 pg/mL and in group II periodontitis was 24.06 pg/mL. In the saliva, the mean TNF-α level in group I healthy subjects was 45.69 pg/mL and in group II diseased subjects was 46.58 pg/mL. However, the values were not statistically significant (p > 0.05). CONCLUSION: Circulatory and salivary TNF-α levels were found in detectable quantities. They showed a marginal increase in chronic periodontitis patients when compared with normal healthy patients in the absence of systemic diseases. Further studies are required in a large scale and with different methodologies to substantiate the role of TNF-α in the progression of periodontal diseases. CLINICAL SIGNIFICANCE: Clinical significance of this study is to analyze the TNF-α levels in saliva and serum, which may be the aggravating factor in causing periodontal disease, thereby helping to treat periodontitis.