An Insight into the Role of Marine Biopolymer Alginate in Endodontics: A Review.

Alginate is a natural marine biopolymer that has been widely used in biomedical applications, but research on its use as an endodontic material is still sparse in the literature. This pioneer review aims to summarize the emerging roles of alginate and to outline its prospective applications as a core biomaterial in endodontics. Ten electronic databases and five textbooks were used to perform a search of English-language literature on the use of alginate in endodontics published between January 1980 and June 2022. The risk of bias (RoB) of each included study was assessed using the Office of Health Assessment and Translation (OHAT) tool. Subsequently, studies were categorized into three tiers to represent the overall risk. Qualitative analysis was performed, and the articles were sorted into different thematic categories. An initial search yielded a total of 1491 articles, but only 13 articles were chosen. For most domains, all the studies were rated with 'probably low' or 'definitely low' RoB, except for domains 2 and 6. All included studies fall in the Tier 1 category and were either in vitro, in vivo, or ex vivo. Four thematic categories were identified: endodontic regeneration, intracanal medicament, filing material, and chelating agent. Based on the available evidence, alginate has emerged as a cell carrier and scaffold in regenerative endodontics, a microcapsule delivery system for intracanal medicaments, a chelating agent reinforcing material, and a root canal sealer. More well-designed experiments and clinical trials are needed to warrant the promising advent of this hydrogel-based biomaterial.

Acceptability of atraumatic restorative treatment and Hall Technique among children, parents, and general dental practitioners: a systematic review and meta-analysis.

OBJECTIVE: This systematic review aimed to evaluate the acceptance level of atraumatic restorative treatment (ART) and Hall Technique (HT) among children, parents, and general dental practitioners. METHOD AND MATERIALS: The study was registered in the PROSPERO database. Articles published between January 1960 and January 2021 were searched in 11 online databases and six textbooks according to PRISMA guidelines. Fifteen studies were chosen for qualitative and quantitative analyses. Among them, five studies focused on ART, seven studies on HT, and the remaining three studies compared both ART and HT. The children, parents, and general dental practitioners' acceptance were estimated using the DerSimonian-Laird random--effects method based on both single-arm and two-arm approaches. The risks of bias were evaluated using Cochrane RoB 2, ROBINS-1, NOS, and JBI assessment tools, while evidence levels were determined using OCEBM. Subgroup analysis and meta-regression were conducted to assess the effect of different evaluation methods on the acceptance rates of ART and HT among children and parents. RESULTS: The acceptance rates of ART among children, parents and general dental practitioners were 90.1%, 95.7%, and 67.7%, respectively, whilst the acceptance rates of HT were 88.3%, 85.7%, and 81.8%, respectively. Two-arm meta-analysis revealed no significant difference (P > .05) between the acceptance of HT and ART among children and parents, respectively. Subgroup analysis showed that using questionnaire-based evaluation had a higher (P < .05) acceptance value than using face scale-based evaluation. CONCLUSION: Both ART and HT are considered well--accepted among children, parents, and general dental practitioners, although general dental practitioners showed a slightly lower level of acceptance. A standardized evaluation tool for assessing acceptance level should be established for better comparison among published articles. Future well-designed studies are warranted to verify the validity of the present review.

Novel dental composite resin derived from rice husk natural biowaste: A systematic review and recommendation for future advancement.

OBJECTIVES: This review aimed to summarize contemporary evidence related to dental composite resin derived from rice husk biowaste and its potential future advancement. This review paper included the techniques for synthesis, characterization, and preparation of rice husk composite resin. Focus was also given to the flexural strength and modulus, compressive strength, wear rate, hardness, surface roughness, color stability, polymerization shrinkage, degree of conversion, and their application onto root canal treated teeth. MATERIAL AND METHODS: A search of English peer-reviewed literature (January 1960-February 2021) was conducted from electronic databases (PubMed Central, Cochrane, LILACS, Science Direct, Web of Science, SIGLE, EMBASE, EBSCO, Medline, and Google Scholar). RESULTS: 11 articles and a book section were finally selected for qualitative analysis. Studies concluded that the physicomechanical properties and the color stability of rice husk dental composites showed comparable results to conventional dental composites. Incorporation of zirconia nanopowder into rice husk dental composite increased the compressive strength and hardness values, associated with lower shrinkage, a high degree of conversion, and improved fracture strength when applied on root canal treated teeth. CONCLUSIONS: Due to its low cost, eco-friendliness, and acceptable clinical performances, rice husk dental composite resin can be considered as an alternative to conventional composites. CLINICAL SIGNIFICANCE: Dental composite resin derived from rice husk silica demonstrated excellent performance, which could potentially substitute currently available composite resins. This review will give new insight to clinicians and researchers on the usage of natural biowaste mass in the field of dental restorative materials.

Success rates of coronal and partial pulpotomies in mature permanent molars: a systematic review and single-arm meta-analysis.

Objectives: This systematic review aimed to evaluate the clinical and radiographic outcomes of coronal and partial pulpotomies in mature permanent molars with cariously exposed vital pulp. Method and materials: The protocol of the current review was registered in the PROSPERO database (CRD 42020190785). Articles published between January 1980 and June 2020 were searched in eight different online databases and six textbooks according to PRISMA guidelines. Eleven studies were included in the analysis of 1-year success rates, whereas five studies were included in the analyses of 2-year and > 2-year success rates for coronal pulpotomy. Two studies were included in the analyses of the 1-year and 2-year success rates for partial pulpotomy. The clinical and radiographic success rates were estimated using the DerSimonian-Laird random effect method. The risks of bias were evaluated using Cochrane RoB 2, ROBINS-I, and Newcastle-Ottawa scale assessment tools. Evidence levels were determined using the Oxford Centre for Evidence-Based Medicine (OCEBM) recommendation tool. The success rates using different pulp capping medicaments and restorative materials were analyzed using meta-regression analysis. Results: The clinical and radiographic success rates of coronal pulpotomy ranged between 92.2% and 99.4%, whilst for partial pulpotomy, the success rates ranged between 78.2% and 80.6%. Different pulp capping medicaments and restorative materials showed no significant effect on the success rates of coronal pulpotomy, but the former significantly (P < .05) affected the success rates of partial pulpotomy. Conclusion: Coronal and partial pulpotomies demonstrated a high success rate in treating cariously exposed vital pulp of mature permanent molars. Further well-designed studies with longer follow-up periods are required to validate these findings.