Evaluating the ability of cultivated odontoblasts to form dentin-like tissue in vitro using fibroblast growth factor and insulin-like growth factor.

Aim: The aim of the study was to evaluate the ability of cultivated odontoblast to form dentin-like tissue using fibroblast growth factor (FGF) and insulin-like growth factor (IGF). Materials and Methods: Dental pulp stem cells (DPSCs) were extracted from 10 human teeth. They were isolated and cultivated in vitro with the use of stem cell markers. The human DPSCs were characterized for trilineage differentiation. They were then differentiated into odontoblasts. The ability of cultivated odontoblasts to form dentin-like tissue was evaluated using FGF and IGF. Results: IGF showed superior ability to form dentin-like tissue as compared to FGF. The addition of FGF showed no significant difference in the formation of dentin-like tissue. A combination of FGF and IGF in odontoblast showed an enhanced ability to form dentin-like tissue. Conclusion: The use of growth factors IGF and FGF with dental stem cells showed a greater potential to form dentin-like tissue. This can profoundly alter the paradigms of conservative vital pulp therapy, which may eventually make it possible to treat dental diseases by regeneration of lost dentine.

Cleaning efficacy and debris extrusion of supplementary file systems XP-endo Finisher and XP-endo Finisher R in endodontic retreatment.

Aim: To evaluate cleaning efficacy and debris extrusion of supplementary file systems XP Endo Finisher (XPEF) and XP Endo Finisher R (XPEFR) in endodontic retreatment. Materials and Methods: Thirty single-rooted teeth with single canals were selected, canal preparation done till file #30 6% and obturation completed using lateral condensation technique with AH Plus sealer. The samples were stored at 37°C in a 100% humidity incubator for 7 days. The samples were distributed across the three groups according to the method of retreatment (n = 10): Group I: Neo Endo retreatment (NER) files, Group II: NER files + XPEF, and Group III: NER files + XPEFR. Removal of gutta percha using each file system according to the distributed groups was performed. The extruded debris was collected in an Eppendorf tube, dried in a hot air oven, and weighed. Teeth were sliced longitudinally using carborundum discs. Coronal, middle, and apical thirds were assessed for cleaning efficacy under a stereomicroscope. Results were tabulated and subjected to the statistical analysis using the Kruskal-Wallis H-test followed by post hoc turkey HSD test. All statistical tests were carried out at significance level P < 0.05. Results: It was seen that Group II (NER files + XPEF) exhibited better cleaning efficacy than Group III (NER files + XPEFR), although the results were not statistically significant. Greater debris extrusion was seen with Group III when compared to Group II. Conclusion: Supplementary files XPEF/XPEFR enhance the cleaning efficacy in endodontic retreatment, but the debris extrusion of XPEFR is more than XPEF.

Comparative evaluation of antifungal efficacy of conventional endodontic irrigants and chitosan nanoparticles.

Aim: The purpose of this study was to evaluate the efficacy of 3% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), and chitosan nanoparticles against Candida albicans using the agar disc-diffusion test. Materials and Methods: Strain of C. albicans was cultivated in Sabouraud Dextrose Agar. Chitosan nanoparticles were synthesized using an ionic gelation method. Four groups were made according to the irrigants used. Group 1: 3% NaOCl, Group 2: 2% CHX, Group 3: chitosan nanoparticles, and Group 4: saline as control. Discs were added with the different irrigants and placed in a dish containing C. albicans. The plates were incubated at 37°C for 24h. The zone of inhibition was measured in millimeter. Results: Statistical analysis was performed using the test of one-way variance (ANOVA) and post hoc Tukey. Group 1 showed significantly higher zone of inhibition compared to Groups 2 and 3 (P < 0.05). There were no significant differences between the zones of inhibition of Groups 2 and 3 (P < 0.05). Conclusion: Chitosan nanoparticles and 2% CHX have similar efficacy against C. albicans, whereas 3% NaOCl was significantly better than both chitosan nanoparticles and CHX.

Bioceramics in endodontics - a review.

Bioceramics are materials which include Alumina, Zirconia, Bioactive glass, Glass ceramics, Hydroxyapatite, resorbable Calcium phosphates, among others. They have been used in dentistry for filling up bony defects, root repair materials, apical fill materials, perforation sealing, as endodontic sealers and as aids in regeneration. They have certain advantages like biocompatibility, non toxicity, dimensional stability and most importantly in endodontic applications, being bio-inert. They have a similarity to Hydroxyapatite, an intrinsic osteo conductive activity and have an ability to induce regenerative responses in the human body. In Endodontics, they can be broadly classified into Calcium Phosphate/ Tricalcium/ Hydroxyapatite based, Calcium Silicate based or mixtures of Calcium Silicate and Phosphates. This review focuses on an overview of Bioceramics, classification and their advantages. It also gives a detailed insight into individual bioceramic materials currently used in the fields of Endodontics along with their properties and applications.

Scaffolds in regenerative endodontics: A review.

Root canal therapy has enabled us to save numerous teeth over the years. The most desired outcome of endodontic treatment would be when diseased or nonvital pulp is replaced with healthy pulp tissue that would revitalize the teeth through regenerative endodontics. 'A search was conducted using the Pubmed and MEDLINE databases for articles with the criteria 'Platelet rich plasma', 'Platelet rich fibrin', 'Stem cells', 'Natural and artificial scaffolds' from 1982-2015'. Tissues are organized as three-dimensional structures, and appropriate scaffolding is necessary to provide a spatially correct position of cell location and regulate differentiation, proliferation, or metabolism of the stem cells. Extracellular matrix molecules control the differentiation of stem cells, and an appropriate scaffold might selectively bind and localize cells, contain growth factors, and undergo biodegradation over time. Different scaffolds facilitate the regeneration of different tissues. To ensure a successful regenerative procedure, it is essential to have a thorough and precise knowledge about the suitable scaffold for the required tissue. This article gives a review on the different scaffolds providing an insight into the new developmental approaches on the horizon.

Comparative evaluation of apically extruded debris with V-Taper, ProTaper Next, and the Self-adjusting File systems.

BACKGROUND: Complete cleaning of the root canal is the goal for ensuring success in endodontics. Removal of debris plays an important role in achieving this goal. In spite of advancements in instrument design, apical extrusion of debris remains a source of inflammation in the periradicular region. AIM: To comparatively evaluate the amount of apically extruded debris with V-Taper, ProTaper Next, and the self-adjusting File (SAF) system. MATERIALS AND METHODS: Sixty-four extracted human mandibular teeth with straight root canals were taken. Access openings were done and working length determined. The samples were randomly divided into three groups: Group I - V-Taper files (n = 20), Group II - ProTaper Next (n = 20), Group III - SAF (n = 20). Biomechanical preparation was completed and the debris collected in vials to be quantitatively determined. The data obtained was statistically analyzed using ANOVA and post hoc Tukey's test. RESULTS: All the specimens showed apical debris extrusion. SAF showed significantly less debris extrusion compared to V-Taper and ProTaper Next (P < 0.001). Among Groups I and II, ProTaper Next showed lesser debris extrusion as compared to V-Taper, but it was not significant (P = 0.124). CONCLUSION: The SAF showed least amount of apical debris extrusion when compared to newer rotary endodontic instruments. This indicates that the incidence of inter-treatment flare-ups due to debris extrusion would be less with the SAF.

Endodontic management of maxillary first molar with type I canal configuration- a rare case report.

Thorough knowledge about the root canal variations is essential for the predictable endodontic treatment outcome. The root and root canal anatomy of maxillary first molar varies greatly. A Pub-med literature search about single rooted single canalled maxillary first molar was done to know its details such as incidence, diagnostic method used, age, sex and ethnic background of patient. This article presented report of a single rooted single canalled maxillary first molar in a 27-year-old healthy Asian female.

Single C-shaped canal in mandibular first molar: A case report.

The variability of root canal system morphology presents a continuous challenge to endodontic diagnosis and therapeutics. There have been reports of teeth with multiple roots and canals as also those with lesser number of root and root canals. Variations of root canal systems need not always be in the form of extra canals. Clinicians should be aware that there is a possibility of existence of fewer numbers of roots and root canals than normal, which presents varied canal anatomy and poses a challenge to the clinician's expertise. This case report deals with the management of an unusual case of C-shaped canal in mandibular molar with two buccally fused roots. Cone-beam computed tomography (CBCT) was employed to confirm the extension of the unusual anatomy. The Self Adjusting File (SAF) system was used to ensure complete cleaning of the canal system. One-year follow-up of the case showed good healing. The clinician should expect to encounter unusual features when performing endodontic treatment. Use of diagnostic aids like CBCT, improved magnification with dental operating microscope, and the use of novel file systems like SAF ensure success.

Antifungal efficacy of Azadirachta indica (neem) - An in vitro study

AIM: To evaluate antimicrobial ability of neem leaf extract, 3% sodium hypochlorite (NaOCl) and 2% chlorhexidine (CHX) against Candida albicans. METHODS: Neem leaf extract was prepared by using absolute ethanol with fresh neem leaves, filtering the extract through muslin cloth, coarse residue and filter paper. Cultures of C. albicans were maintained on Brain Heart Infusion broth and Agar. The antimicrobial efficacy was checked using the Agar Diffusion and the zones of inhibition were measured. The results were statistically analysed using ANOVA test. Inter-group comparison was checked using Kruskal Wallis ANOVA and Mann Whitney tests (a=0.05). RESULTS: There was statistically significant difference between the zones of inhibition seen with 3% NaOCl and Neem extract with 2% CHX (p<0.05). There was no significant difference observed between Neem extract and 3% NaOCl. CONCLUSIONS: Efficacy of Neem extract is comparable to 3% NaOCl against C. albicans and it is significantly better than 2% CHX...

Endodontic management of maxillary first molar with seven root canals diagnosed using Cone Beam Computed Tomography scanning.

The main objective of root canal treatment is thorough cleaning and shaping of the entire pulp space and its complete filling with an inert filling material. A major cause of post-treatment disease is the inability to locate, debride or adequately fill all canals of the root canal system. The form, configuration, and number of root canals in the maxillary first molars have been discussed for more than half a century. Maxillary first molars commonly present with three roots and three canals, with a second mesiobuccal canal (MB2) also present. With the advent of improved magnification there are reports of multiple root canals in the maxillary first molars. Nonsurgical endodontic therapy of a left maxillary first molar with three roots and seven root canals was successfully performed under a dental operating microscope. The diagnosis of multiple root canals was confirmed with the help of Cone Beam Computed Tomography (CBCT) images.