Effect of Dentin Disinfection with 2% Chlorhexidine Gluconate and 0.3% Iodine on Dentin Bond Strength: An in vitro Study.

OBJECTIVE: Cavity preparation is a surgical procedure that attempts to remove all infected dentin.1 Bacteria left beneath the filling material is greatest threat to the pulp. To reduce the potential for residual caries development and sensitivity, an antibacterial solution with the ability to disinfect the prepared tooth surface would be of help.2 So this study was conducted to evaluate and compare the effect of dentin disinfection with 2% chlorhexidine gluconate (Consepsis) and 0.3% iodine (Ora5) on shear bond strength (SBS) of self-etch adhesives to dentin. MATERIALS AND METHODS: Buccal surfaces of 36 caries-free permanent third molars were ground to expose dentin. All specimens were mounted on acrylic block, divided randomly into three groups, namely group I (control), group II (Con-sepsis), and group III (Ora5). After the application of cavity disinfectant and bonding procedures as per manufacturer's instructions, composite cylinders were built. Then SBS was measured using universal testing machine. RESULTS: Statistical analysis of the measurements were made using one-way analysis of variance (ANOVA), which showed that when cavity disinfectants (Consepsis and Ora5) were used there was significant reduction in SBS of composite to dentin when compared with that of control group. INTERPRETATION AND CONCLUSION: The results indicate that the use of commercially available cavity disinfectants, Consepsis containing 2% chlorhexidine gluconate and Ora5 containing 0.3% iodine and 0.15% potassium iodide with self-etch adhesive (Adper Prompt), would significantly lower SBS of composite to dentin. HOW TO CITE THIS ARTICLE: Suma NK, Shashibhushan KK, Reddy VVS. Effect of Dentin Disinfection with 2% Chlorhexidine Gluconate and 0.3% Iodine on Dentin Bond Strength: An in vitro Study. Int J Clin Pediatr Dent 2017;10(3):223-228.

Comparative evaluation of secondary caries formation around light-cured fluoride-releasing restorative materials.

AIM: The aim of this study was to compare and evaluate secondary caries formation around light-cured fluoride-releasing restorative materials. METHODOLOGY: Standard Class V cavities were prepared on the buccal and lingual surfaces of forty extracted healthy premolars. The teeth were randomly divided into four groups of ten teeth each and labeled as Group I, II, III, and IV and restored with one of the following materials, namely, Fuji II LC (Group I), Vitremer (Group II), F-2000 (Group III), and Z-100 (Group IV; Control). The teeth were thermocycled and immersed in jars containing an acid gel for caries-like lesion formation. After 15 weeks, the samples were removed, washed, and sectioned buccolingually through the restoration. The sections were then grounded to a thickness of 80-100 µm. After imbibition in water, the sections were mounted on slides and lesions were examined, measured, and photographed with Leica DMRB Research Microscope. The observation recorded was subjected to (a) analysis of variance, (b) Studentized range test (Newman-Keuls), (c) Snedecor's F-test. RESULTS: The depth of the outer lesion in teeth restored with Z-100 (Group IV; Control) was significantly higher than the teeth restored with F-2000 (Group III), Vitremer (Group II), and Fuji II LC (Group I) (P < 0.01). The depth of the outer lesion in teeth restored with F-2000 (Group III) was also significantly higher than the teeth restored with Vitremer (Group II) and Fuji II LC (Group I) (P < 0.01). However, there was no significant difference in depth of the outer lesions among the teeth restored with Vitremer (Group II) and Fuji II LC (Group I). No wall lesion (WL) was evident in teeth restored with Vitremer (Group II) and Fuji II LC (Group I). The WL length and body depth in teeth restored with Z-100 (Group IV; Control) were significantly higher than the teeth restored with F-2000 (Group III) (P < 0.01). CONCLUSION: It was concluded that Fuji II LC and Vitremer had a inhibitory effect on the development of WL and OL depth. Even though F- 2000 was not fully effective in preventing the development of WL, there was significant reduction in WL and depth when compared to Z-100.

Comparative evaluation of microleakage of conventional and modifications of glass ionomer cement in primary teeth: An in vitro study.

AIMS: The aim of the present study was to evaluate the microleakage among conventional, resin modified glass ionomer cements (GIC), and compomer cements in primary teeth. MATERIALS AND METHODS: Forty-five over retained non carious primary molars beyond exfoliation time were collected and randomly divided into three groups (n = 15). Group A: GC Fuji II; Group B: Vitremer; Group C: Compoglass F. A standard Class V cavity was prepared on the buccal surface of each tooth with no mechanical retention and restored accordingly. Then all the samples were subjected to thermocycling for 250 cycles at different temperatures and covered with nail varnish. Later, samples were immersed in 0.5% methylene blue dye for 24 h. Teeth were sectioned buccolingually through the center of the restoration and studied under a stereomicroscope for dye penetration. Data obtained were analyzed using Kruskal-Wallis ANOVA and Mann-Whitney U-test. RESULTS: Samples restored with vitremer showed comparatively higher microleakage than the samples in other groups. However, overall there were no significant difference between the microleakage scores of the samples in all three groups (P > 0.05). CONCLUSION: It can be concluded that none of the three GICs was free from microleakage. Hence, further research is required to compare microleakage of the newer material.

Comparison of relative efficacy of two techniques of enamel stain removal on fluorosed teeth. An in vivo study.

OBJECTIVE: The present study was conducted to compare and evaluate the relative efficacy of enamel microabrasion (using 18% HCl) and bleaching with McInnes solution in the esthetic improvement of fluorosed teeth and to check postoperative sensitivity. STUDY DESIGN: 30 children aged between 9-14yrs with a mild or moderate grade of fluorosis as classified according to Dean's fluorosis index and who complained of objectionable esthetics were selected. Split mouth study design was selected in our study. Each subject had one of their maxillary central incisor randomly selected for Enamel microabrasion and the contra lateral maxillary central incisor for McInnes bleaching. Esthetic improvement was assessed by comparing the pre and postoperative digital photographs. During the evaluation session, the pre and postoperative photographs of 30 subjects were incorporated into a power point presentation and were projected side by side in a darkened room. Four calibrated and blinded examiners, including a layman rated the photographs under standardized viewing conditions. Esthetic improvement was assessed for both short and long term improvement. The postoperative sensitivity was recorded for both the procedures immediately after treatment and at one, three and six months interval. RESULTS: The results proved that both immediate and long term (6 month) esthetic improvement achieved by McInnes bleaching were superior to enamel microabrasion. There is a reduction in aesthetics of teeth in both the procedures after six months, which was very minimal in McInnes procedure and significant in enamel micro abrasion. Postoperative sensitivity in both techniques were negligible. The sensitivity observed were transient and subsided within an one-month post operatively. None of the subjects reported sensitivity at one, three and six months intervals. CONCLUSION: McInnes bleaching is a better procedure compared to enamel microabrasion in improving the appearance of fluorosed teeth. Both techniques are conservative and safe.

Self etching adhesive on intact enamel.

BACKGROUND AND OBJECTIVE: to analyze the poor performance of self-etch adhesives on intact enamel. MATERIALS AND METHODS: labial surfaces of 20 caries free permanent upper central and lateral incisors were cleaned, sectioned of their roots. All specimens were mounted on acrylic block and divided randomly into two groups. In one group the application of self-etch adhesive was carried as per manufacturer's instructions, composite cylinders were built, whereas in the other group, 37% phosphoric acid was applied before the application of self-etching adhesives. Then the resin tags were analyzed using the scanning electron microscope. RESULTS: showed that when phosphoric acid was used, there was significant increase in the depth of penetration of resin tags. CONCLUSION: the results indicate that out of both treatment groups, pre-etching the intact enamel with 37% phosphoric acid resulted in the formation of longer resin tags and higher depth of penetration of resin tags of the Clearfil SE bond, which might have resulted in attaining higher bond strength of the Clearfil SE bond to intact enamel.

Effect of casein phosphopeptide-amorphous calcium phosphate containing chewing gum on salivary concentration of calcium and phosphorus: an in-vivo study.

AIM: Caries clinical trials of sugar-free chewing gum have shown that the gum is noncariogenic and in fact has anticariogenic effect through the stimulation of saliva. Sugar-free gums, therefore, may be an excellent delivery vehicle for safe and effective additive, capable of promoting enamel remineralization. Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) nanocomplexes incorporated into sugar-free chewing gum have shown to remineralize enamel subsurface lesions in situ. So this study was conducted to evaluate the effect of CPP-ACP containing sugar-free chewing gum on salivary concentration of calcium and phosphorous. MATERIALS AND METHODS: Unstimulated saliva from each 24 selected subjects was collected. Then each subject was given two pellets of chewing gum containing CPP-ACP and asked to chew for a period of 20 min, after which saliva samples were collected from each individual. Once all the samples were collected they were assessed for calcium and phosphorous concentration using affiliated reagent kits and photometer. STATISTICAL ANALYSIS USED: Data obtained were analyzed using student's paired t test. RESULTS: Significant difference was found in the calcium and phosphorus concentration of saliva before and after chewing CPP-ACP containing chewing gum. CONCLUSIONS: Chewing of CPP-ACP containing chewing gum showed a significant increase in the salivary concentration of calcium for a prolonged period of time hence it may help in the remineralization of tooth surfaces.

Allotransplantation of tooth: a case report.

Tooth transplantation has attracted great interests since ancient times. A successful case of tooth allotransplantation is presented. A mandibular first premolar from the donor was implanted into the socket of maxillary central incisor Follow up after 12 months indicated good periapical healing with no resorption. Clinically, the transplantation site was free of symptoms and there was no evidence of periodontal disease or tooth mobility. This article suggests tooth transplantation as an alternative to other restorative options.

Self-etching adhesive on intact enamel, with and without pre-etching.

OBJECTIVE: Bond strengths of composite resin to enamel using self-etch adhesive (SEA) Clearfil SE bond system on intact enamel and enamel pre-etched with phosphoric acid were compared. The objective was to determine if the pre-etching would increase the bond strengths of the SEA systems to intact enamel and to evaluate the effect of pre-etching on bond formation of self-etch adhesives on intact enamel. MATERIALS AND METHOD: Labial surfaces of 40 caries free permanent upper central and lateral incisors were cleaned, sectioned of their roots. All specimens were mounted on acrylic block and divided randomly into four groups. In two groups the application of self-etch adhesive, Clearfil SE bond was carried as per manufacturer's instructions, composite cylinders were built, whereas in the other two groups, 37% phosphoric acid etching was done before the application of self-etching adhesives. Then the resin tags were analyzed using scanning electron microscope and shear bond strength was measured using Instron universal testing machine. RESULTS: When phosphoric acid was used, there was significant increase in the depth of penetration of resin tags and in the Shear Bond Strength of composite to enamel. CONCLUSION: The results indicate that out of both treatment groups, pre-etching the intact enamel with 37% phosphoric acid resulted in formation of longer resin tags and higher depth of penetration of resin tags of the Clearfil SE bond, and attaining higher bond strength of the Clearfil SE bond to intact enamel.

Dentigerous cyst in an uncommon site: a rare entity.

Trauma to the deciduous teeth may have severe consequences. Pulp necrosis is the commonly observed sequel in traumatized primary teeth and is one of the possible etiologic factors for the development of dentigerous cyst. Dentigerous cyst is more commonly seen in mandibular third molar and maxillary canine region and is rarely associated with other teeth. This article addresses a case of dentigerous cyst associated with the germ of upper permanent central incisor, an uncommon site of occurrence, which was impacted, dislodged from its natural site of eruption after trauma to the predecessor incisor.

In vivo comparison of reduction in bacterial count after caries excavation with 3 different techniques.

PURPOSE: The purpose of this in vivo study was to evaluate and compare the reduction in bacterial count in dentin after caries excavation with a spoon excavator, carbide bur, and polymer bur. METHODS: Forty-five primary molar teeth from 36 children with occlusal dentinal carious lesions without pulpal involvement were chosen and divided into 3 groups: (1) caries was excavated using a brand new round bur with a slow-speed handpiece at 800 rpm from the occlusal aspect; (2) new polymer burs were used with slow-speed handpiece at 800 rpm, according to the lesion's size; (3) caries was excavated using a sterile spoon excavator. RESULTS: The mean difference in colony forming units of Streptococcus mutans and lactobacilli before and after caries excavation was found to be significant (P<.01) in all 3 groups. Further intergroup comparison of percentage reduction in bacterial counts between different groups was statistically significant, except when the percentage reduction in S mutans of group 2 was compared to that of group 3 (P=.26). Reduction in S mutans count was highly significant (P<.001) for group 1 vs group 3. CONCLUSIONS: Caries removal with a carbide bur, polymer bur, and spoon excavator produced significant reduction in viable count of both Streptococcus mutans and lactobacilli. Carbide burs, however, produced greater reduction in the viable count of bacteria followed by polymer bur and spoon excavator.

Short communication: pre- and co-curing effect of adhesives on shear bond strengths of composite resins to primary enamel and dentine: an in vitro study.

AIM: To evaluate and compare shear bond strengths of composite resins to primary enamel and dentine when the adhesives are pre-cured (light cured before the application of the resin) or co-cured (adhesive and the resin light cured together). METHODS: Buccal surfaces of 80 caries-free primary molars were wet ground to create bonding surfaces on enamel and dentine and specimens mounted on acrylic blocks. Two bonding agents (Prime and Bond NT® and Xeno III®) were applied to either enamel or dentine as per manufacturer's instructions. In 40 specimens, the bonding agent was light cured immediately after the application (pre-cured). The other 40 specimens were not light cured until the composite resin application (co-cured). Resin composite cylinders were made incrementally using acrylic moulds over the adhesives and light cured. Specimens were stored in deionised water for 24 hours at room temperature. Shear bond strength was measured using an Instron universal testing machine (in MPa) and was analysed with Student's unpaired t test. RESULTS: Light curing the adhesive separately produced significantly higher bond strengths to primary dentine than co-curing (p<0.001). At the same time light curing the adhesive separately did not produce significantly different bond strengths to primary enamel (p>0.05). CONCLUSION: Curing sequence had no significant effect on shear bond strength of adhesives on the primary enamel. Pre-curing adhesives before curing composite resins produced greater shear bond strength to primary dentine.

A comparative study of pH modulation and trace elements of various fruit juices on enamel erosion: an in vitro study.

Fruit juices are popular worldwide with children of all ages as they are sweet and perceived to be healthful. This in vitro study was sought to measure pH of 10 different fruit juices, to find out possible erosive effects on human dental enamel of 40 extracted sound premolars and also to measure fluoride and trace elements of these juices. The estimation of pH of fruit juices was done by using Systronic upH 362 pH meter. The erosive effects of fruit juices were tested by using polarized light microscope. Orion electrode was used to measure fluoride. The trace elements were estimated by using Atomic Absorption Spectrophotometer No. 6501F. The pH values in different juices were observed at different levels, and pH values of these juices were more acidic than baseline after 24 hours. As the time increased, the erosion effect became more in pineapple; grape and sugarcane juices, and they had more cariogenic trace elements like selenium, iron and manganese. So, these juices were found to be cariogenic. To conclude, orange, mousambi, mango, pomegranate, apple, chikku and watermelon juices had no erosive effect on the human enamel, with the presence of highest amount of trace elements like fluoride and phosphorous which are considered as strongly cariostatic.

Peripheral ossifying fibroma in the maxillary arch.

Many types of localized reactive lesions may occur on the gingiva, including focal fibrous hyperplasia, pyogenic granuloma, peripheral giant cell granuloma and peripheral ossifying fibroma. Peripheral ossifying fibroma is a gingival growth, usually arising from interdental papilla and represents up to 2% of all lesions that are biopsied. Other terms used to describe this lesion include peripheral cementifying fibroma, peripheral fibroma with cementogenesis, peripheral fibroma with osteogenesis, peripheral fibroma with calcification, calcified or ossified fibrous epulis and calcified fibroblastic granuloma. This article reports a case of a 10 year old male child with an unusually large peripheral ossifying fibroma in the left maxillary alveolar ridge which showed recurrence after the surgical treatment.

Microleakage and SEM analysis of flowable resin used as a sealant following three fissure preparation techniques--an in vitro study.

OBJECTIVE: Preventive procedures using pit and fissure sealants are one of the important aspects of pediatric dental practice. The objectives of this in vitro study were to comparatively evaluate microleakage and resin tag penetration of a flowable resin used as a sealant on molars after preparation with Conventional, Enameloplasty and Fissurotomy techniques. METHOD: A total of 48 teeth were divided into 3 groups (n-16). Group A (CST), Group B (EST), and Group C (FT). Following the fissure preparation sealant was applied as per manufacturer's instructions. 8 samples in each group were used for Microleakage and Resin tag analysis. Microleakage analysis was done under Stereomicroscope after Methylene blue dye immersion by using scoring system. The resin tag analysis was done by measuring the length of resin tags on scanning electron microscope (SEM) images consisting of 10 microm scale taken under optical zoom of 2000 X. RESULTS: Significantly lesser microleakage score (P < 0.01) and longer resin tag penetration (P < 0.001) observed in EST (mean score 0.5 +/- 0.53) & (12.19 +/- 1.93 microm) when compared to CST (mean score 1.75 +/- 0.89) & (5.96 +/- 1.84 microm) and FT (mean score 1.5 +/- 0.53) & (6.76 +/- 1.82 microm) which showed more microleakage and short resin tags. No statistical significance between CST and FT was found. CONCLUSION: EST has proven to be an excellent method for preparation of pits and fissures when Flowable composite is used as a sealant because of its lesser microleakage and longer resin tag penetration.

Comparison of antimicrobial substantivity of root canal irrigants in instrumented root canals up to 72 h: an in vitro study.

Disinfection of the root canal system is one of the primary aims of root canal treatment. This can be achieved through the use of various antimicrobial agents in the form of irrigants and medicaments. The antimicrobial substantivity of 2% chlorhexidine gluconate, 1% povidone iodine, 2.5% hydrogen peroxide followed by 2% sodium hypochlorite, and 2% sodium hypochlorite alone as irrigants was assessed in instrumented root canals. 2% chlorhexidine showed antimicrobial substantivity lasting up to 72 h, followed by 1% povidone iodine, and 2% sodium hypochlorite. Thus 2% chlorhexidine should be used as a final rinse irrigant in endodontic treatment protocols.