Antibacterial Efficacy of Mineral Trioxide Aggregate, Bioactive Glass and Epoxy-Resin Based Sealer: An In-Vitro Interventional Study.

Aim: The aim and objective of this in vitro study was to evaluate the antibacterial efficacy of mineral trioxide aggregate, bioactive glass sealer, and epoxy-resin-based sealer. Materials and Methods: In the present study, 22 Mueller Hinton agar (MH agar) plates were employed and equally divided into two groups. Three holes were made by removal of agar at equidistant points and filled with root canal sealers. The strains of the bacteria used in this study were S. aureus (ATCC 6538) and C. albicans (ATCC 10231) and were divided into two groups and root canal sealers were divided into three subgroups: mineral trioxide aggregate (MTA) fillapex Sealer, Nishika Bioactive Glass sealer, and Syntex Epoxy Resin base sealer. For Staphylococcus aureus, peptone water was placed in a 2 mL test tube and bacteria were extracted from blood agar plates using a nichrome wire loop and poured into the peptone water-containing test tube and incubated for 2 hours and for C. albicans, fungi were grown at 37°C for 24 hours in MH Broth and seeded into MH agar to produce turbidity of 0.5 on the McFarland scale, which corresponds to a concentration of 108 CFU/mL. This MH broth was used as a second layer. The seeded agar was then added over the plates immediately after the insertion of sealer cement. After incubation, the diameters of zones of inhibition around the plates were measured. Results: The results of this study showed that the highest inhibition was recorded in Syntex sealer against Staphylococcus aureus followed by MTA fillapex sealer and Nishika sealer, whereas MTA fillapex showed the highest inhibition against C. albicans followed by Syntex sealer and Nishika sealer. Conclusion: Syntex sealer exhibits better antibacterial efficacy against Staphylococcus aureus and MTA fillapex exhibit better antibacterial efficacy against C. albicans.

Repair of a Perforation Defect With Calcium Silicate-Based Cement Using an Internal Matrix.

This case report describes the nonsurgical endodontic management of a distolingual floor perforation in a mandibular first molar using an internal matrix and mineral trioxide aggregate (MTA) cement. The pulp chamber was properly cleaned, and after placement of a synthetic collagen material that served as a barrier at the level of furcation, MTA was used to repair the perforation defect. Root canal treatment was completed and the tooth was restored with a composite restoration followed by a porcelain-fused-to-metal crown.

Location and shape of the apical foramina in posterior teeth: an in-vitro analysis.

PURPOSE: To analyze the morphology of shapes and positions of the apical foramina in permanent maxillary and mandibular posterior teeth. METHODS: Examination of the apical foramina was performed with a stereomicroscope at a magnification of 10×. The anatomic parameters evaluated were the shapes of the peripheral contours of the apical foramina (rounded, oval, asymmetric, and semilunar). The location of the apical foramen was recorded as a center, buccal, lingual, mesial, and distal surface. RESULTS: Results have shown that the frequency of deviation was 68% in all teeth being assessed, while the most frequent location of the apical foramen was in the center, with 32% followed by distal with 18%. The common shape of apical foramina was round shape in all the teeth. CONCLUSIONS: The variation in the location and shapes of apical foramina in teeth. The commonest deviation in location of apical foramina was distal and the frequent shape was of a round shape.

Diagnosis, Evaluation, and Endodontic Management of Rare Four-Rooted Mandibular Second Molar Using CBCT.

When endodontically diagnosing and evaluating the morphology and anatomy of roots and root canals, especially in multirooted teeth, clinicians must exercise extremely keen vision and give careful attention to minute details. Fundamental knowledge of the most common anatomic characteristics and the possible variations of these characteristics is necessary to provide successful endodontic therapy. While all mandibular molars have significant variations in roots and root canal configuration, mandibular second molars perhaps present the biggest challenge. This article highlights the endodontic management of a mandibular second molar with four roots (two mesial and two distal) with one canal in each root and the cone-beam computed tomography (CBCT) evaluation of the tooth, along with orifice location assessment using developmental root fusion lines.

Endodontic Management of Maxillary First Molar With Two Palatal Canals Aided With Cone Beam Computed Tomography: A Case Report.

The success of endodontic therapy is based on having sufficient endodontic access, correct cleaning and shaping, and adequate root canal obturation. However, endodontic treatment is also dependent on having a sound knowledge of the internal anatomy of human teeth, especially when anatomic variations are present. Reporting these alterations is important for improving the understanding and expertise of endodontists. The aim of this case report is to describe a unique case of maxillary first molar with 2 palatal canals within a single root, as confirmed by cone-beam computed tomography (CBCT) scans. This article also reviews recent case reports of extra palatal root canals in the maxillary first molars and the role of CBCT analysis in successfully diagnosing them.

Effect of Various Sugary Beverages on Salivary pH, Flow Rate, and Oral Clearance Rate amongst Adults.

Introduction. Diet is a major aetiological factor for dental caries and enamel erosion. This study was undertaken with the aim of assessing the effect of selected locally available beverages on salivary pH, flow rate, and oral clearance rate amongst adults. Materials and Method. This clinical trial comprised 120 subjects. Test beverages undertaken were pepsi, fruit drink, coffee, and sweetened milk. Statistical analysis was carried out using SPSS version 17. Descriptive statistics, one-way ANOVA, and post hoc Tukey's test were applied in the statistical tests. Results. It was found that salivary pH decreased for all the beverages immediately after consumption and the salivary flow rate increased after their consumption. The oral clearance rate of sweetened milk was found to be the least at 6.5 minutes and that of pepsi was found to be 13 minutes. However, the oral clearance rates of fruit drink and coffee were found to be equal at 15 minutes. Conclusion. Although it was found out that liquids cleared rapidly from the oral cavity, they had a significant cariogenic and erosive potential. Hence, it is always advised to minimise the consumption of beverages, especially amongst children and young adults to maintain a good oral health.

CBCT-Aided Multidisciplinary Approach to Salvaging an Intruded Tooth.

Among the most severe types of traumatic dental injuries is intrusive luxation, which displaces the affected tooth deeper into the alveolus, causing significant damage to the pulp and all of the supporting structures. This article describes a unique case of intrusive luxation of the mature left maxillary central incisor in an 18-year-old male patient. The diagnosis was confirmed using cone-beam computed tomography (CBCT), after which the intruded tooth was successfully repositioned by endodontic and orthodontic management. This was followed by prosthodontic rehabilitation. This case report also discusses the role of CBCT in effectively diagnosing this type of injury.

Screening the Drug Resistance Property Among Aerobic Pathogenic Microorganisms of Dental Caries in North-Western Indian Population: A Preliminary Study.

AIMS AND OBJECTIVES: To evaluate the emerging drug resistance among the caries pathogens isolated from carious dentine microbiologically. MATERIALS AND METHODS: Specimens from dental caries were collected from 75 patients referred to Department of Conservative Dentistry and Endodontics, Vyas Dental College. Microbiological processing of all the samples was done within three hours to isolate the caries pathogens. The samples were inoculated on agar medium (Nutrient agar, Mac-conkey's agar) at 370C for 48 hours aerobically. The identification of strains was done by observing colony morphology and gram's staining. The predominant isolates were subjected to antimicrobial sensitivity test (Kirby Bauer's method). Statistical analysis of the isolates was done using paired t-test. RESULTS: Out of 75 patients more common isolates were Staphylococcus aureus, Klebsiella, Pseudomonas aeruginosa, Yeast. The predominant were Staphylococcus and Pseudomonas species. Newer antibiotics were proved to be effective against these predominant strains after evaluating antibiotic sensitivity tests. CONCLUSION: Although Streptococcus mutans (S.mutans) is the most prevalent microorganism seen in dental caries, the role of other microorganisms like Staphylococcus, Pseudomonas in initiation and progression of caries is evident from this study. Further extensive and large scale studies need to be conducted for better understanding the role of these microorganisms in dental caries.

Antioxidants in Endodontics: A Strategic Review.

Over the past few decades, the free radicals and antioxidants have attracted tremendous importance in the field of dentistry. Depending on the level of free radicals in the body, they can either be harmful or helpful. Antioxidants are the substances that interact with and stabilize free radicals thereby protecting cells from the damage caused by free radicals. The indigenous antioxidants may be useful in preventing the harmful effects of oxidative stress. The present article presents a review on the free radicals formation, their role in disease pathogenesis, antioxidants and their potential role in endodontics.

Non syndromic bilateral microdontia of maxillary second molars: a very rare finding.

Dental anomalies are the formative defects caused by genetic disturbances or environmental factors during tooth morphogenesis. The term microdontia is defined as the condition of having abnormally small teeth. Clinically, microdontia in the permanent dentition, excluding the third molars, is found in 0.8-8.4% of the population. One of the commonest forms of localized microdontia is that which affects the maxillary lateral incisor, a condition called Peg laterals. The next tooth which can be affected is the third molars. Few cases of microdontia in canines have been reported. Localised microdontia of maxillary second molar has never been reported in literature before.

Ultrasonics: a novel approach for retrieval of separated instruments.

An instrument fracture within the root canal interferes and hinders the outcome of the successful root canal treatment. Fracture of endodontic instrument often results from incorrect use or overuse. This article reports a case of retrieval of separated endodontic instrument with help of ultrasonic and discusses the factors influencing the removal of fractured instrument.

Incidence and factors associated with flare-ups in a post graduate programme in the indian population.

OBJECTIVES: The study had twin objectives: to assess the incidence of flare-ups (a severe problem requiring an unscheduled visit and treatment) among patients who received endodontic treatment in the Department of Conservative Dentistry and Endodontics in Vyas Dental college and hospital, Jodhpur during a period of one year, and also to examine the correlation with pre-operative and operative variables. MATERIAL AND METHODS: Data was collected from 1023 teeth from 916 patients who had received endodontic treatment over a 12- month period. Information was obtained for each patient treated, including pulp and peri-radicular diagnosis for the tooth, presence of pre-operatory pain, type of medication being used, type of instrumentation technique used and number of appointments needed to complete the root canal treatment. RESULTS: The results showed an incidence of 2.35% for flare-ups from 1023 endodontically treated teeth. Statistical analysis was done using the chi-square test. CONCLUSIONS: Flare-ups were found to be affected significantly by gender of patient, presence of radiolucent lesions, patients taking pre-operative analgesic or anti-inflammatory drugs and on type of instrumentation technique. In contrast, there was no correlation between flare-ups and age, different arch/tooth groups and single or multiple visit endodontics. Key words:Anti-inflammatory, flare-ups, instrumentation, prospective.

Comparison of anesthetic efficacy of 4% articaine with 1:100,000 epinephrine and 2% lidocaine with 1:80,000 epinephrine for inferior alveolar nerve block in patients with irreversible pulpitis.

OBJECTIVES: This study was done to compare the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine with that of 2% lidocaine with 1:80,000 epinephrine during pulpectomy in patients with irreversible pulpitis for inferior alveolar nerve block in mandibular posterior teeth. MATERIAL AND METHODS: Patients with irreversible pulpitis referred to the Department of Conservative Dentistry and Endodontics, K.D. Dental College, randomly received a conventional inferior alveolar nerve block containing 1.8 mL of either 4% articaine with 1:100,000 epinephrine or 2% lidocaine with 1:80,000 epinephrine. After the patient's subjective assessment of lip anesthesia, the absence/presence of pulpal anesthesia through electric pulp stimulation was recorded and the absence/presence of pain was recorded through visual analogue scale. RESULTS: The pulpal anesthesia success for articaine (76%) was slightly more than with lidocaine (58%) as measured with pulp tester as well as for the pain reported during the procedure the success rate of articaine (88%) was slightly more than that of lidocaine (82%) although the difference between the two solutions was not statistically significant. CONCLUSIONS: Both the local anesthetic solutions had similar effects on patients with irreversible pulpitis when used for inferior alveolar nerve block. Key words:Anesthesia, articaine, lignocaine, pulpitis.

Stem cells-the hidden treasure: A strategic review.

In today's scenario, medical and dental professionals face a mammoth task while treating perplexing medical situations like organ failure or tissue loss. Though, different strategies exist to replace them, but ideal one is the same natural tissue or organ. In this aspect, stem cells have emerged in a promising way to provide an ideal replacement. There are different types of stem cells starting from the embryonic stage referred to as human embryonic stem cells to adult stem cells. Though in dentistry stem cell research is lagging as compared to the medical field but still a lot progress has been achieved in recent years. The stem cells have been isolated from dental pulp, human exfoliated deciduous teeth, and apical papilla and so on. These stem cells have provided exciting results like dentin-pulp regeneration, periodontal regeneration but ambiguity still prevails. As a result, much has to be further researched before its clinical application becomes a reality. Hence, these stem cells opened a new avenue in the field of regenerative dentistry.

Non-syndromic bilateral supplemental maxillary lateral incisors: a rare case.

Supernumerary teeth or hyperdontia are defined as the teeth that exceeds the normal dental formula, regardless of their location and morphology. A supernumerary tooth is a developmental anomaly and it has been argued to arise from multiple aetiologies. Supernumerary teeth with orthodox shapes and sizes, that resemble the normal dentition are called 'supplemental teeth'. The supplemental teeth are often overlooked because of their normal shapes and sizes. Supplemental lateral incisors are rare and bilateral cases are even rarer, with only two cases being reported in the literature till date. Therefore, we are describing a rare case of non-syndromic, bilateral, supplemental, maxillary, lateral incisors and we have discussed the management of supernumerary teeth.

Can accidental local application of a drug cause discolouration of permanent teeth?

Thorough knowledge on the aetiology of tooth staining is of importance to dental surgeons, in order to enable a correct diagnosis to be made when examining a discoloured dentition and it allows the dental practitioner to explain to the patient the exact nature of the condition. Tetracyclines are a group of drugs which can discolour teeth permanently. One such case of discolouration of adult teeth caused by administration of tetracycline(oxytetracycline) has been reported here and it has been discussed in detail.

Bilateral fusion of permanent maxillary incisors.

Dental fusion is a rare developmental anomaly, which is included in the anomalies of tooth morphology or shape. Fusion can occur at the level of enamel or enamel and dentin, which results in the formation of a single tooth with enlarged clinical crown. Fusion is more common in deciduous dentition. Incisors are reported to be fused in primary and permanent dentition, but bilateral fusion is a rare occurrence. The prevalence of bilateral fusion in the permanent dentition is less frequent than unilateral fusion and is reported to be around 0.05%. The authors report a case of a 20-year-old male with bilateral fusion of maxillary central and lateral incisors. Multi-disciplinary treatment approach is essential to get the desired esthetic result. The best way to manage these difficult cases depends on a number of factors including the knowledge and technical skills of the practitioner.