Effect of nonthermal atmospheric plasma on bond strength of composite resin using total-etch and self-etch adhesive systems.

Aim: The aim of this study was to assess the impact of nonthermal atmospheric plasma (NTAP) on the bond strength of composite resin following plasma application at different steps of dentin bonding in total-etch and self-etch adhesive systems. Materials and Methods: Ninety extracted third molars were taken, and the occlusal surfaces were removed until the exposure of the dentin. Samples were distributed into two main groups: Group T: total-etch adhesive system and Group S: self-etch adhesive system. Groups are further subdivided (n = 10) based on plasma application at different steps of dentin bonding. T1: surface etching with 37% phosphoric acid and bonding agent application. T2: plasma application and bonding agent application. T3: plasma application, etching, and bonding agent application. T4: etching, plasma application, and bonding agent application. T5: etching, plasma application, bonding agent application, and again plasma application. S1: self-etch bonding agent application. S2: plasma application and bonding agent application. S3: Bonding agent application and plasma application. S4: plasma application, bonding agent application, and again plasma application. For all the samples, composite resin buildup was done, and shear bond strength (SBS) was measured. The contact angle was measured at different steps of dental adhesive systems. Statistical Analysis: Two-way analysis of variance and the post hoc Tukey's test were used for analysis, regarding P < 0.05 as statistically significant. Results: Among all groups of total-etch and self-etch adhesives, Group T4 (48.81 Mpa) and Group S2 (36.59 Mpa), respectively, have demonstrated significantly greater bond strength values than the corresponding control groups. Conclusion: NTAP enhanced the composite resin's SBS when plasma treatment was done before bonding agent application and significantly reduced the contact angles of the distilled water.

A confocal laser scanning microscopic evaluation of nonthermal atmospheric plasma on the dentinal tubule penetration of bioceramic and epoxy resin-based root canal sealers.

Aim: Using confocal laser scanning microscopy (CLSM), the current study assessed the impact of nonthermal atmospheric plasma (NTAP) on the dentinal tubule penetration of bioceramic and epoxy resin-based root canal sealers (CLSM). Materials and Methods: Forty human mandibular premolar teeth with a single root that had just undergone extraction were chosen and biomechanical preparation of root canals was done with ProTaper Gold rotary Nickel-titanium instruments. Samples were divided into four groups (n = 10). Group 1: Bioceramic sealer (BioRoot RCS); Group 2: Epoxy resin-based sealer (AH Plus) without application of NTAP; Group 3: Bioceramic sealer (BioRoot RCS); and Group 4: Epoxy resin-based sealer (AH Plus) with the application of NTAP for 30 s. In Groups 3 and 4, all of the samples underwent obturation with the appropriate sealers following NTAP application. For determination of the sealer's dentinal tubule penetration values, slices with a thickness of 2 mm were taken from the middle third of sample's root and examined using CLSM. The acquired data were statistically analyzed with one-way analysis of variance and the Post hoc Tukey's test. The cutoff for statistical significance was P < 0.05. Results: In comparison to other groups, the maximum sealer penetration values into dentinal tubules were significantly higher in Group 3 for Bioceramic sealer with NTAP application and Group 4 for Epoxy resin-based sealer with NTAP application. Conclusion: NTAP application increased the dentinal tubule penetration of bioceramic and epoxy resin-based sealers in comparison to groups without NTAP application.

To compare the efficacy of various organic solvents on retrievability of Biodentine and their effect on microhardness of Biodentine and radicular dentin: An in vitro study.

Background: Rotary and ultrasonic instruments are not appreciable in the complete removal of Biodentine from root canals. Therefore, organic solvents can be used as an adjunct for its retrieval. Aim: The aim of this study was to compare the efficacy of 10% citric acid, 2% acetic acid, and 20% tartaric acid on the microhardness of Biodentine and radicular dentin. Materials and Methods: Forty single-rooted extracted teeth were decoronated at the cementoenamel junction and root canals were prepared with peeso reamers. Two-millimeter sections were obtained and restored with Biodentine. All samples were subjected to Vicker's microhardness test to record the microhardness of Biodentine and radicular dentin. Samples were randomly divided into four experimental groups and treated with (n = 20) - distilled water, 10% citric acid, 2% acetic acid, and 20% tartaric acid groups for 10 min, after which specimens were again subjected to the same microhardness test. Statistical Analysis: The data were subjected to Kruskal-Wallis ANOVA test, followed by Wilcoxon signed-rank test with a level of significance set at P ≤ 0.05. Results: 10% citric acid followed by 2% acetic acid exhibited the lowest mean microhardness values after immersing in respective solutions, whereas 20% tartaric acid exhibited the highest mean microhardness values on Biodentine and radicular dentin. Conclusion: 10% citric acid can be used for retrieving Biodentine from root canals for a limited time without adversely affecting the physical and chemical composition of radicular dentin.

Evidence of improved bond strength of resin-based sealer with the use of natural antioxidants on hypochlorite treated dentin: an in vitro study.

Aim: To evaluate the effect of natural antioxidants as final irrigants on the push-out bond strength of epoxy resin-based sealer to the hypochlorite treated dentin. Methods: Eighty single-rooted human mandibular incisors were prepared using ProTaper Gold (Dentsply, TN, USA) and an irrigation protocol including 3% NaOCl, followed by ethylenediaminetetraacetic acid (EDTA), and 3% NaOCl. The groups (n =20) were divided according to the final irrigant used: Group 1: None (Control); Group 2: 5% sodium ascorbate, Group 3: 5% grape seed extract (GSE); and Group 4: 5% pine bark extract. The obturation of root canals was performed using gutta-percha and AH Plus (Dentsply DeTrey, Germany). Bond strength was evaluated using the push-out test under the universal testing machine at a crosshead speed of 0.5 mm/min, and statistical analyses were performed using one-way ANOVA. The p-value significance was evaluated by Tukey's post hoc test (p<0.01). Results: Mean push-out bond strength values were compared in all the groups, and there was a statistically significant improvement in the experimental final irrigating groups. 5% pine bark extract had improved bond strength than the other groups, and the least bond strength was observed in the control group. Conclusion: The irrigation protocols and naturally derived antioxidants affected the resin-based sealer's bond strength to root dentin. It was observed that the use of antioxidants effectively reversed the compromised bond strength of resin-based sealers to root dentin. 5% pine bark extract application showed better bond strength.

Effect of nonthermal atmospheric plasma on the push-out bond strength of epoxy resin-based and bioceramic root canal sealers: An in vitro study.

AIM: The aim of this study was to evaluate the effect of nonthermal atmospheric plasma (NTAP) on the bond strength of epoxy resin-based and bioceramic root canal sealers. MATERIALS AND METHODS: Freshly extracted forty (n = 40) single-rooted mandibular premolar teeth were divided into four groups (n = 10) based on the sealer used and NTAP application - Group 1: Epoxy resin-based sealer (AH Plus) without NTAP application, Group 2: Epoxy resin-based sealer (AH Plus) with NTAP application for 30 s, Group 3: Bioceramic sealer (BioRoot RCS) without NTAP application, and Group 4: Bioceramic sealer (BioRoot RCS) with NTAP application for 30 s. After NTAP application in Groups 2 and 4, all the samples were obturated using sealers according to their grouping protocols. Two-millimeter slices were obtained from each sample using hard tissue microtome, which were subjected to push-out bond strength (PBS) under the universal testing machine. Data were subjected to statistical analysis using one-way analysis of variance followed by the Post hoc tukey test. The level of statistical significance was set at P < 0.05. RESULTS: The PBS values were observed to be significantly higher in bioceramic sealer with NTAP application (Group 4) followed by epoxy resin-based sealer with NTAP application (Group 2). CONCLUSION: NTAP application enhanced the PBS of bioceramic (BioRoot RCS) and epoxy resin-based (AH Plus) sealers compared to their control groups.

Effect of indirect ultrasonic activation of modified bioceramic materials on the bond strength and tubular penetration in root canals.

BACKGROUND: To maintain the integrity of the interface between root canal filling and radicular dentin an ideal endodontic biomaterial should have good adhesion. This study was aimed to evaluate the bond strength and tubular penetration of modified bioceramic materials by indirect ultrasonic activation. MATERIALS AND METHODS: In the present in vitro experimental study, 120 coronal root slices of 2 mm were prepared from mandibular premolars and randomly divided into six groups (n = 20) in accordance to placement techniques: Group I: Nano Biodentine-manual, Group II: CaCl2 modified ProRootMTA-manual (MM), Group III: Biodentine-manual, Group IV: Nano Biodentine: Ultrasonic, Group V: CaCl2 modified ProRootMTA-ultrasonic, and Group VI: Biodentine-ultrasonic (BDU). The samples were kept in humidifier for 4 days at 37°C and push out bond strength, sealer penetration were evaluated using an universal testing machine and confocal laser scanning microscope respectively. Data were subjected to statistical analysis using SPSS software by using One-way ANOVA for overall significance and Tukey's multiple post hoc test for intergroup comparison (P < 0.05). RESULTS: Highest push out bond strength and greater tubular penetration were observed with Group VI (BDU), while the lowest bond strength and tubular penetration were associated with Group II (MM). CONCLUSION: Within the limitations of current study it was observed that Biodentine with indirect ultrasonic activation has resulted in highest pushout bond strength among all the study groups.

Effect of 17% ethylenediaminetetraacetic acid and 0.2% chitosan on pushout bond strength of biodentine and ProRoot mineral trioxide aggregate: An in vitro study.

AIM: The purpose of this study was to evaluate the effect of 17% ethylenediaminetetraacetic acid (EDTA) and 0.2% chitosan on pushout bond strength of biodentine and ProRoot mineral trioxide aggregate (MTA). MATERIALS AND METHODS: Midroot dentin of single-rooted human canine teeth were sectioned into 2-mm-thick slices horizontally (n = 60). The canal space of each dentin slice was enlarged with a 1.3-mm-diameter diamond bur. The samples were divided into two groups (n = 30) based on the type of perforation repair material placed, i.e., Biodentine and ProRoot MTA. The samples were wrapped in wet gauge for 10 min, and based on the type of chelating agent used for removal of smear layer, each group is further divided into three subgroups (n = 10), to be immersed into saline (control), 17% EDTA and 0.2% chitosan for 30 min, and a wet cotton pellet was placed over each test material. After 48 h of incubation, the dislodgement resistance of the samples was measured using a universal testing machine. STATISTICAL ANALYSIS: Data were analyzed using one-way analysis of variance and post hoc Tukey tests. The level of statistical significance was set at 0.05. RESULTS: Biodentine showed significantly higher pushout bond strength than ProRoot MTA. Biodentine and ProRoot MTA lost strength when exposed to 0.2% chitosan. CONCLUSION: Biodentine showed considerable performance as a perforation repair material than ProRoot MTA even after being exposed to various endodontic chelating agents.

Effect of NaOCl and EDTA Solutions on Topography of ESX, TruShape and ProTaper Gold NiTi Rotary Instruments - An Atomic Force Microscopic Study.

AIM: The study was aimed to evaluate the effect of 5.25% NaOCl and 17% ethylenediaminetetraacetic acid (EDTA) Solutions on Surface Topography of ESX, TruShape, and ProTaper Gold nickel-titanium (NiTi) Rotary Instruments using Atomic Force Microscope (AFM). MATERIALS AND METHODOLOGY: A total of 27 each of three commercially available brands of endodontic NiTi instruments were analyzed, which were divided into three groups as follows: Group I: ESX (Brasseler, USA) Group II: Tru shape (Dentsply Tulsa, USA) Group III: Pro Taper Gold (Dentsply Tulsa, USA). These files were further divided into three subgroups containing nine files each, no immersion, immersion in 5.25% NaOCl for 5 min, and immersion in 17% EDTA for 5 min. Surface areas along 3 mm sections at the tip of the files (perfect squares of 10 µm × 10 µm) were analyzed using AFM operating in contact mode under ambient conditions. STATISTICAL ANALYSIS: Data were analyzed using two-way ANOVA and pairwise comparison of three main groups with respect to Ra and RMS by Tukey's multiple posthoc procedures. RESULTS: Three-dimensional AFM images of the surface of all the rotary NiTi instruments, including new and those immersed in 5.25% NaOCl and 17% EDTA solutions, revealed topographic irregularities at the nanometric scale. Ra and RMS values of instruments treated with 5.25% NaOCl and 17% EDTA solutions were statistically higher than that of the new ones (P < 0.05). CONCLUSION: Using AFM for analysis indicated that short-term contact between 5.25% NaOCl and 17% EDTA solutions and NiTi instruments caused alterations in the topography of instruments.

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.

Comparison of the Antibacterial Efficacy of Manuka Honey Against E.faecalis and E.coli - An In vitro Study.

AIM: To compare the antibacterial efficacy of Manuka honey against E.faecalis and E.coli. MATERIALS AND METHODS: Escherichia coli (ATCC-25922) and Enterococcus faecalis (ATCC-29212) were separately inoculated in the nutrient broth and incubated at 37(o)C for 24-48 hrs. Bacterial samples were kept in contact with each disinfectant solution for varying intervals of time. Once the test time had elapsed 10µL of the bacterial dilutions were plated on Mueller-Hinton agar and incubated for 24-48 hrs at 37°C to estimate the density. Study of the disinfection process with respect to time and Modeling was done. RESULTS: The mean value of the antimicrobial activity of Manuka honey against E.coli and E.faecalis are 1.55 and 0.36 respectively and are relatively higher. It shows that there is a significant difference among the various root canal disinfectant groups against E. coli and E. feacalis. (p<0.001) CONCLUSION: Manuka honey is shown to be a potential root canal disinfectant against gram positive and gram negative bacterial pathogens.

Surgical management of mandibular central incisors with dumbbell shaped periapical lesion: a case report.

Dental traumatic injuries may affect the teeth and alveolar bone directly or indirectly. Pulpal necrosis and chronic and apical periodontitis with cystic changes are the most common sequelae of the dental traumatic injuries, if the teeth are not treated immediately. This case report focuses on the conventional and surgical management of mandibular central incisors. A twenty-four-year-old male patient presented with pain in the mandibular central incisors. Radiographic examination revealed mandibular central incisors with dumbbell shaped periapical lesion. After root canal treatment, parendodontic surgery was performed for mandibular central incisors. After one-year recall examination, the teeth were asymptomatic and periapical lesion had healed.

Comparative evaluation of antimicrobial efficacy of triple antibiotic paste and calcium hydroxide using chitosan as carrier against Candida albicans and Enterococcus faecalis: An in vitro study.

AIM: To analyze the sustained release of intracanal medicaments with or without a carrier and testing their antimicrobial efficacy in root canal against Candida albicans and Enterococcus faecalis. MATERIALS AND METHODS: A total of 80 single-rooted anterior teeth were selected, root canal preparation was done, and teeth were divided into two halves and contaminated with C. albicans and E. faecalis, which were further divided into four test groups each according to intracanal medicaments used. Chitosan was used as vehicle for triple antibiotic paste (TAP) and calcium hydroxide and antimicrobial assessment was performed on second and seventh day. Dentine samples were collected after each. RESULTS: All four medicaments used in this study showed antifungal and antibacterial activity. Group II (TAP + chitosan) and Group III (Ca(OH)2 + chitosan) had the higher antifungal and antibacterial activity compared with two other groups. CONCLUSION: Combination of TAP + chitosan and Ca(OH)2 + chitosan produced better results compared with the combination of medicaments with saline.

Comparative Evaluation of the Effect of EDTA, EDTAC, NaOCl and MTAD on Microhardness of Human Dentin - An In-vitro Study.

AIM: The aim of this study was to evaluate the microhardness of human dentin by using four irrigating solutions. Materials and Methodos: A total of 40 extracted mandibular premolars were selected and sectioned horizontally in the middle third of the root. Forty specimens of 4 mm thickness were embedded in acrylic resin and polished. Four test groups, each group containing ten specimens were immersed in respective irrigating solution and subjected to vicker's microhardness test at T0, T2 and T5min. STATISTICAL ANALYSIS: The data obtained were analyzed using the one way ANOVA followed by Tukey HSD method with ap=0.05 as the level for statistical significance. RESULTS: Suggested that there was no statistically significant difference in mean values between four experimental irrigating solutions. CONCLUSION: Mixture of Tetracycline isomer i.e. Doxycycline, Citric acid and a Detergent (Tween 80) MTAD not altered the microhardness of root canal dentin significantly and seems to be an appropriate irrigating solution, because of its harmless effect on the microhardness of the root canal dentin.

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.

Quantitative evaluation of apical extrusion of intracanal bacteria using K3, Mtwo, RaCe and protaper rotary systems: An in vitro study.

AIM: This aim of this study was to evaluate the number of bacteria extruded apically during root canal preparation using Four Rotary instrumentation techniques. MATERIALS AND METHODS: A total of 50 extracted mandibular premolars were selected, access cavities prepared and inserted in to rubber stoppers of 10 mL glass vial. Root canals were contaminated with a suspension of Enterococcus faecalis (E. faecalis) American Type Culture Collection (ATCC) 29212 and incubated for 24 h at 37°C. Debris extruded from the apical foramen during instrumentation was collected into vials. The numbers of Colony-forming units were determined for each sample. STATISTICAL ANALYSIS: The data obtained were analyzed using the one-way ANOVA followed by post-hoc tukey's test with a P = 0.05 as the level for statistical significance. RESULTS: Results suggested a statistically significant difference in the number of colony forming units between four experimental rotary Nickel-Titanium instrumentation groups (P < 0.001). CONCLUSION: Although, extrusion of bacteria was found in all the experimental groups. There was less bacterial extrusion in K3 Group while more bacterial extrusion was seen in Mtwo Group.