Comparative assessment of the outcome of complete pulpotomy using mineral trioxide aggregate and Biodentine in mature permanent mandibular molars with symptomatic irreversible pulpitis: A randomized clinical trial with 18 months of follow-up.

Background: Mature permanent teeth with irreversible pulpitis have traditionally been managed with pulpectomy. With advancements in pulp biology and dental materials, many clinicians are using vital pulp therapies like pulpotomy to manage such teeth. The current study was conducted to help clinicians in making decisions about case selection and choice of material for such cases. Aim: This randomized clinical trial evaluated the outcome of complete pulpotomy, using mineral trioxide aggregate (MTA) and Biodentine, in permanent mandibular molars with symptomatic irreversible pulpitis (SIP). Materials and Methods: Fifty patients with moderate-to-severe pain in mandibular molars with SIP were included in this prospective, parallel, single-blind clinical trial. Coronal pulp was completely removed and hemostasis was achieved with a cotton pellet moistened with 2.5% sodium hypochlorite. Subsequently, the radicular orifices were randomly covered with MTA or Biodentine. All teeth were permanently restored with composite restoration at the same appointment. Clinical evaluation was performed at 1 week, 3 months, 6 months, 12 months, and 18 months and radiographic evaluation was done after 6 months, 12 months, and 18 months. Mann-Whitney U and Chi-square tests were utilized for statistical analysis. Results: Success rates of MTA and Biodentine pulpotomy were 63.6% and 69.6%, respectively, with no significant difference between the two groups at any follow-up period (P > 0.05). Conclusion: There were no significant differences in complete pulpotomy success rates between MTA and Biodentine over 18 months in mandibular molars with SIP.

Effect of different irrigating solutions with surfactants on the microhardness and smear layer removal of root canal dentin: An in vitro study.

AIM: The present in vitro study was undertaken to check the effect of the different irrigating solutions with surfactants, i.e., sodium hypochlorite-(Naocl)-Extra, chlorhexidine (CHX)-Ultra, ethylenediaminetetraacetic acid (EDTA), QMix, and BioPure MTAD on the microhardness and smear layer removal of root canal dentin. MATERIALS AND METHODS: A total of 120 straight rooted lower premolars were collected and were randomly divided into 2 equal groups of 60 each (n = 60). The microhardness of the samples was evaluated by Vickers hardness tester and the removal of smear layer by scanning electron microscope after irrigation of the samples with the tested solutions. RESULTS: CHX-Ultra showed the least microhardness reduction, and EDTA showed the maximum microhardness reduction in all the tested groups. BioPure MTAD showed the maximum removal of smear layer in the apical third, and CHX-Ultra showed the minimal smear layer removal in the apical third. CONCLUSION: During smear layer removal, irrigating solutions cause alterations in the chemical composition of dentin, which may decrease the microhardness of the root dentin causing erosion and affecting the clinical performance of the endodontically treated teeth. Irrigating solution with maximum smear layer removal with minimum changes in microhardness should be used.

An in vitro comparison of the antimicrobial efficacy of positive pressure and negative pressure irrigation techniques in root canals infected with Enterococcus faecalis.

AIM: The aim of this in vitro study was to compare the efficacy of irrigation with the negative pressure and the traditional positive pressure in eradicating Enterococcus faecalis from the root canal. MATERIALS AND METHODS: A total of 40 extracted mandibular premolars were sterilized and divided into four groups with 10 samples each. Then, they were prepared to apical size #35 (Group 1, 3) and 45 (Group 2, 4) and inoculated with E. faecalis for 7 days and then irrigated with 3% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. The positive pressure irrigation was performed in Group 1 and Group 2 while the negative pressure irrigation (NPI) using the Endovac in Group 3 and Group 4. Samples taken after the root canal irrigation procedures were cultured and the colony-forming units were counted. Data were statistically analyzed using the Fisher's exact test. RESULTS: Results were statistically significant when comparing apical negative-pressure irrigation size 45 (Group 4) to positive-pressure irrigation size 35 (Group 1). CONCLUSION: The results of this in vitro study showed that the apical NPI method (Endovac) was more effective in removing E. faecalis from the root canal at the larger apical preparation size.

MTA versus Biodentine: Review of Literature with a Comparative Analysis.

An ideal dental repair material should possess certain exclusive properties such as adequate adhesive ability, insolubility, dimensional stability, biocompatibility, bioactivity etc. New materials claiming better performance are continuously being introduced in the market to optimize the care of dental patients. Biodentine has been recently introduced as the "the first all-in-one, bioactive and biocompatible material for damaged dentin replacement". Manufacturers claim that Biodentine has noticeably shorter setting time in contrast to other silicate cements such as Mineral Trioxide Aggregate (MTA) and also has better mechanical and handling properties. This article is aimed to compare the properties of MTA and Biodentine analyzing the research work done in this field so far by various researchers all across the globe.

Healing of a large periapical lesion using triple antibiotic paste and intracanal aspiration in nonsurgical endodontic retreatment.

A patient with a large periapical lesion in relation to the maxillary right central and lateral incisors is presented here. During the conservative root canal treatment, aspiration of the fluid was done through the root canal, followed by placement of triple antibiotic paste for two weeks. Complete periapical healing was observed at the 24-month recall. This report confirms that for treatment of a large periapical lesion it is not always necessary to do surgical treatment and even cyst-like periapical lesions heal following conservative endodontic therapy.