Comparative assessment of titanium-prepared platelet-rich fibrin, EndoSequence root repair material, and calcium hydroxide as pulpotomy agents in permanent teeth with irreversible pulpitis: A randomized controlled trial.

Context: Pulpotomy is a procedure in which part of an exposed vital pulp is removed, usually as a means of preserving the vitality and function of the remaining part. Aim: The aim is to compare the effectiveness of Dycal (CH), EndoSequence, and Titanium-prepared platelet-rich fibrin with EndoSequence (T-PRF) as pulpotomy agents in mature permanent molars with irreversible pulpitis. Settings and Design: Sixty permanent mandibular molars with carious exposure and symptoms of irreversible pulpitis were randomly allocated to three groups. Subjects and Methods: Full pulpotomy was performed using Dycal, EndoSequence, and T-PRF with EndoSequence as pulpotomy agents. Pain intensity was analyzed using a Numeric Rating Scale score at baseline 24 h, 7 days, 6 months, and 1 year. The clinical and radiographic evaluations were done at 6 months and 1 year. Statistical Analysis: Nonparametric tests (Kruskal-Wallis, Chi-square) were applied to analyze the data as the normality test does not follow a normal distribution. Results: T-PRF and EndoSequence showed effective results when compared clinically, and there was no significant difference between radiographic success rates among the three groups at (P = 0.325 at 6 months, 0.466 at 12 months) follow-up. Conclusion: T-PRF and EndoSequence showed higher success rates among Dycal, EndoSequence as pulpotomy agents in teeth with irreversible pulpitis.

Synchrotron radiation-based micro-computed tomographic analysis of dentinal microcracks using rotary and reciprocating file systems: An in vitro study.

BACKGROUND: Advances in both X-ray sources and X-ray optics have dramatically improved the feasibility of these techniques in various fields. AIMS: We aimed to evaluate the frequency of dentinal microcracks observed after root canal preparation with ProTaper Gold (PTG), Hyflex electrodischarge machining (HEDM), Reciproc (RPC), and WaveOne Gold (WOG) using synchrotron radiation-based micro-computed tomographic (SR-µCT) analysis. SUBJECTS AND METHODS: Forty mandibular molars were assigned to 4 experimental groups (n = 10) according to the file system used for the root canal preparation: Group 1: PTG (25/0.08), Group 2: HEDM (25/0.08), Group 3: RPC (25/0.08), and Group 4: WOG (25/0.07). The specimens were scanned on SR-µCT system before and after root canal preparation. The pre- and postoperative cross-sectional images (N = 183,200) of the mesial roots were screened to identify the presence of dentinal microcracks. The number of microcracks was determined as a percentage for each group. STATISTICAL ANALYSIS: There was no necessity of statistical analysis in the present study. The number of microcracks was determined as a percentage for each group. RESULTS: Among the four file systems tested, HEDM (0.9%) has shown a fewer number of new dentinal microcracks. CONCLUSIONS: SR-µCT can be used as a reliable diagnostic tool for further implications.

Effect of Preetching on Microleakage with All-In-One Adhesives Using Calcium-Based Desensitizers: An In vitro Study.

OBJECTIVES: The aim of this study was to evaluate the effect of calcium-based desensitizers on the microleakage with and without preetching enamel in Class V cavities restored with all-in-one adhesives. MATERIALS AND METHODS: Class V cavities were prepared on the buccal surfaces of 100 extracted human premolars. A total of 100 box-shaped cavities were divided into five groups (n = 20). Group 1 - no desensitizer was applied and Groups 2 and 4 - desensitizer (CCP-ACP and Novamin) was applied, respectively, followed by the application of G-Bond and restored with composite restoration. Groups 3 and 5 are same as Group 2 and 4, but preetching of enamel was done for 3 s after desensitizers application. The teeth were thermocycled and the specimens were examined for microleakage using methylene blue as a marker. The teeth were sectioned buccolingually and evaluated for microleakage under stereomicroscope and the scores obtained were analyzed with Kruskal-Wallis and Mann-Whitney tests. RESULTS: Statistically significant difference existed between Groups 2 and 3 (P < 0.05). There was also statistically significant difference between Groups 4 and 5 (P < 0.05). Groups 3 and 5 showed significantly less microleakage (P < 0.05). No statistically significant difference in microleakage values was observed between the two desensitizers CCP-ACP and Novamin. CONCLUSION: The application of calcium-containing desensitizers with selective etch enamel technique in all-in-one adhesives could be considered an advisable procedure to minimize microleakage.

Comparison of the Antimicrobial Efficacy of Two Antibiotics Sparfloxacin and Augmentin as Experimental Root Canal Irrigating Solutions against Enterococcus faecalis - An Invitro Study.

INTRODUCTION: One of the main goals of endodontic treatment is root canal disinfection and to prevent subsequent chances of reinfection. Adjuvant to instrumentation, root canal irrigants are required to eliminate the bacteria found on the root canal walls and lateral canals within the dentinal tubules. AIM: To measure and compare the antibacterial efficacy of two antibiotics as experimental root canal irrigating solutions against Enterococcus faecalis (E. faecalis). MATERIALS AND METHODS: Fifteen Brain Heart Infusion agar plates were inoculated with Enterococcus faecalis-American Type Culture Collection (ATCC) 29212. 5 micrograms (mcg) Sparfloxacin discs, 30mcg Augmentin discs, and sterile paper test discs saturated with 2% Chlorhexidine (CHX), 3% Sodium Hypochlorite (NaOCl) and 5% NaOCl solutions were placed on agar plates. Sodium Chloride 0.9% (NaCl) paper discs were used as controls. Fifteen plates were incubated aerobically at 37°C. Results were expressed as per the terms of the diameter of the inhibition zone. RESULTS: Results suggested a statistically significant difference in the zones of inhibition between five irrigating solutions (p < 0.001). CONCLUSION: Although, zones of inhibition were found in all the groups, 5mcg Sparfloxacin and 30mcg Augmentin showed maximum antimicrobial activity against E.faecalis.

Comparative evaluation of apically extruded debris during root canal preparation using ProTaper™, Hyflex™ and Waveone™ rotary systems.

BACKGROUND AND AIMS: Extrusion of any debris during endodontic treatment may potentially cause post-operative complications such as flare-ups. The purpose of this in vitro study was to assess the amount of apically extruded debris during the root canal preparation using rotary and reciprocating nickel-titanium instrumentation systems. MATERIALS AND METHODS: In this study, 60 human mandibular first premolars were randomly assigned to 3 groups (n = 20 teeth/group). The root canals were instrumented according to the manufacturers' instructions using the Reciprocating single-file system WaveOne™ (Dentsply Maillefer, Ballaigues, Switzerland) and full-sequence rotary Hyflex CM™ (Coltene Whaledent, Allstetten, Switzerland) and ProTaper™ (Dentsply Maillefer, Ballaigues, Switzerland) instruments. The canals were then irrigated using bidistilled water. The debris that was extruded apically was collected in preweighed eppendorf tubes and assessed with an electronic balance and compared. STATISTICAL ANALYSIS USED: The debris extrusion was compared and statistically analyzed using analysis of variance and the post hoc Student-Newman-Keuls test. RESULTS: The WaveOne™ and ProTaper™ rotary instruments produced significantly more debris compared with Hyflex CM™ rotary instruments (P < 0.05). CONCLUSIONS: Under the conditions of this study, all systems that were used resulted in extrusion of apical debris. Full-sequence rotary instrumentation was associated with less debris extrusion compared with the use of reciprocating single-file systems.