Stereomicroscopic Dye Leakage Measurement of Six Different Root Canal Sealers.

INTRODUCTION: Hermetic sealing of the root canal is the most desirable outcome of any root canal treatment, but almost always the filling of the root canal is defective, which is a multifactorial outcome. One such factor majorly influencing the obturation is the root canal sealer used. AIM: The present study was done for evaluating microleakage in different root canal sealers. MATERIALS AND METHODS: Sixty extracted human single rooted teeeth were used in this in-vitro study. Sealers tested for microleakage in this study were zinc oxide eugenol based sealer, Sealapex, AH Plus, MTA Plus, EndoRez, Endosequence BC. All the specimens were examined under stereomicroscope for microleakage and the obtained data were statistically analysed using One-way ANOVA test and Tukey's multiple comparision tests using the software GraphPad Prism 7.02. RESULTS: The Endosequence BC group showed the least dye leakage and the highest leakage was seen in Zinc oxide Eugenol based sealer. CONCLUSION: Bio ceramic salers being hydrophilic show better sealing ability compared to resin based and eugenol based sealers.

Effect of ultrasonic activation of photosensitizer dye temoporfin (Foscan) on antimicrobial photodynamic therapy: An ex vivo study.

AIM: The aim of this study is to evaluate the effectiveness of ultrasonic activation of photosensitizer (PS) drug Foscan in the elimination of endodontic pathogen from root canal system. MATERIALS AND METHODS: The minimal bactericidal concentration of "Foscan" was determined using disc diffusion and broth dilution method. Forty-eight extracted single-rooted premolars with periapical pathology were used for the study. After access opening, the first microbial sample was taken. The teeth were then randomly divided into four groups: Group 1: Chemomechanical debridement (CMD), Group 2: CMD and passive ultrasonic irrigation (CMD + PUI), Group 3: CMD and antimicrobial photodynamic therapy (aPDT), and Group 4: CMD and aPDT with activation by ultrasonics. After antimicrobial protocols, the second microbiological sample was collected. The samples were analyzed by multiplex polymerase chain reaction for the effectiveness of four antimicrobial protocols on Fusobacterium nucleatum, Prevotella intermedia, Porphyromonas gingivalis, and Treponema denticola. STATISTICAL ANALYSIS USED: Wilcoxon signed-rank test and Mann-Whitney U-test with the significant level P < 0.05, using IBM SPSS statistics 20 version software. RESULTS: Foscan at concentration of 3.125 µg/ml was chosen for antimicrobial analysis. The prevalence of T. denticola, F. nucleatum, P. gingivalis, and P. intermedia was 79.17%, 70.84%, 70.83%, and 58.33%, respectively. Group 4 showed highest bacterial reduction of 99.51%, followed by Group 1 which showed bacterial reduction of 97.35%. CONCLUSIONS: Foscan can be used as an effective PS dye at low concentration with minimal tendency for tooth discoloration. Ultrasonic activation of PS dye facilitated better diffusion into dentinal tubules and biofilm obtaining greater bacterial reduction.

Histological evaluation of mineral trioxide aggregate and enamel matrix derivative combination in direct pulp capping: An in vivo study.

AIM: The aim of this study is to evaluate the response of human pulp tissue to mineral trioxide aggregate (MTA), Emdogain (EMD), and combination of MTA/EMD. MATERIALS AND METHODS: This study was performed on sixty intact first and second premolars of human maxillary and mandibular teeth. A standard pulpal exposure was done on all the teeth and was divided into three groups of twenty teeth each and was capped with MTA, EMD, and MTA/EMD combination. The final restoration was done with resin-modified glass ionomer cement. The teeth were then extracted on the 15th or 45th day and histological evaluation done. RESULTS: Differences in inflammatory response and thickness of dentin bridge formation of the exposed pulp to the three different groups were statistically evaluated using Chi-square and Mann-Whitney tests and were found to be significant. No significant difference was found between MTA/EMD and MTA in terms of calcified bridge formation and pulp inflammatory response to the capping materials. CONCLUSIONS: MTA and MTA/EMD combination produced a better quality hard tissue response compared with the use of EMD.

Comparative Evaluation of Microleakage Between Nano-Ionomer, Giomer and Resin Modified Glass Ionomer Cement in Class V Cavities- CLSM Study.

INTRODUCTION: Marginal integrity of adhesive restorative materials provides better sealing ability for enamel and dentin and plays an important role in success of restoration in Class V cavities. Restorative material with good marginal adaptation improves the longevity of restorations. AIM: Aim of this study was to evaluate microleakage in Class V cavities which were restored with Resin Modified Glass Ionomer Cement (RMGIC), Giomer and Nano-Ionomer. MATERIALS AND METHODS: This in-vitro study was performed on 60 human maxillary and mandibular premolars which were extracted for orthodontic reasons. A standard wedge shaped defect was prepared on the buccal surfaces of teeth with the gingival margin placed near Cemento Enamel Junction (CEJ). Teeth were divided into three groups of 20 each and restored with RMGIC, Giomer and Nano-Ionomer and were subjected to thermocycling. Teeth were then immersed in 0.5% Rhodamine B dye for 48 hours. They were sectioned longitudinally from the middle of cavity into mesial and distal parts. The sections were observed under Confocal Laser Scanning Microscope (CLSM) to evaluate microleakage. Depth of dye penetration was measured in millimeters. STATISTICAL ANALYSIS: The data was analysed using the Kruskal Wallis test. Pair wise comparison was done with Mann Whitney U Test. A p-value<0.05 is taken as statistically significant. RESULTS: Nano-Ionomer showed less microleakage which was statistically significant when compared to Giomer (p=0.0050). Statistically no significant difference was found between Nano Ionomer and RMGIC (p=0.3550). There was statistically significant difference between RMGIC and Giomer (p=0.0450). CONCLUSION: Nano-Ionomer and RMGIC showed significantly less leakage and better adaptation than Giomer and there was no statistically significant difference between Nano-Ionomer and RMGIC.

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.

Microleakage evaluation around retrograde filling materials prepared using conventional and ultrasonic techniques.

INTRODUCTION: The importance of the retrograde cavity preparation and the material used to restore is of utmost importance to achieve successful surgical endodontics. AIM: The aim of the present study is to evaluate the apical micro-leakage of root end cavities filled with Mineral trioxide aggregate, Biodentine and light cure GIC using two different cavity preparation techniques that is conventional bur preparation and ultrasonic tip preparation. MATERIALS AND METHODS: Eighty extracted single rooted human teeth (except mandibular incisors) with one canal, fully developed apices and without any major carious lesion are collected for the study. The teeth were sectioned at CEJ to standardize the length. Roots are instrumented upto master apical file 40 K size and obturated with gutta percha and AH plus sealer in lateral condensation technique. The teeth were then resected apically at 90° angle axis to the long axis of the root removing 3 mm of the apex. The teeth were divided in to four groups of 20 each- • Group I- samples restored with MTA. • Group II- samples restored with Biodentine. • Group III- (Positive control group)- samples restored with Light activated GIC. • Group IV - (negative control group)- no filling material. Each group is divided into two subgroups (a, b) of ten teeth each 1. Retropreparation done with ultrasonic retrotip. 2. Retropreparation done with conventional bur. The teeth were then immersed in 0.5% Rhodamine B dye for 48 h. The teeth were split longitudinally and the interface between the restored material and the canal wall is observed under Confocal laser scanning microscope. Depth of dye penetration was examined under stereomicroscope. RESULTS: The statistical analysis was performed by One way ANOVA, t test. Pair wise comparision was done by Newman - Keuls multiple post hoc test. The mean values of Dye penetration for Group Ia (321.23), Group Ib (490.11), Group IIa (1065.14), Group IIb (1170.96), Group IIIa (1888.90), Group IIIb (2025.35). The samples prepared with ultrasonic retrotip showed less microleakage but it is statistically not significant. CONCLUSION: MTA showed significantly less microleakage when compared to Biodentine and light cure GIC and there is no statistical difference between the ultrasonic retrotip preparation and conventional bur preparation.

Re - treatment of a Two-rooted Maxillary Central Incisor - A Case Report.

This case report is on endodontic retreatment of a maxillary central incisor with two roots. A twenty-year-old male patient presented with pain in maxillary left central incisor. Radiographic examination showed an incompletely filled canal and an additional palatal root with periapical radiolucent lesion. Conventional cleaning and shaping of both the roots, i.e., buccal and additional palatal root canals was performed and obturation was done. After one year recall examination, the tooth was asymptomatic and periapical lesion had healed.