Evaluation of Marginal Adaptation of Composite Restorations Reinforced with Novel Enamel Inserts (Biofillers) in Class V Cavities.

AIM AND OBJECTIVE: To evaluate the marginal adaptation at the tooth-restoration interface at enamel and cementum margins using composite restoration reinforced with novel enamel inserts/biofillers. MATERIALS AND METHODS: Standardized class V box-shaped cavities were prepared in 40 extracted maxillary first premolar teeth which were divided randomly into four experimental groups consisting of 10 samples each. Group I: Bulk placement. Groups II: Horizontal incremental technique. Group III: Restoration with precured composite balls (megafillers). Group IV: Restoration with biofillers. All the cavities were restored with visible light-activated direct restorative nanocomposite. The specimens were thermocycled for 24 hours. After thermocycling, the samples were immersed in a 1% methylene blue for 4 hours and subsequently evaluated for microleakage. Microleakage scores (0-4) were obtained from gingival margins of class V restorations and analyzed by statistical analysis. Evaluation of the data was performed by Kruskal-Wallis one-way analysis of variance (ANOVA), and Mann-Whitney U tests. RESULTS: Microleakage scores have indicated restorations with biofillers showed best results followed by megafillers, incremental horizontal build-up, and bulk filling. CONCLUSION: Biofillers provide a novel approach in improving microleakage and marginal adaptability of composite resin restorations. CLINICAL SIGNIFICANCE: Incorporation of inserts, which are capable of adequate bonding to resin and tooth, may provide improved marginal adaptability and reduce microleakage around restorative margins.

Nonsurgical management of large periapical lesion in mature and immature teeth using different calcium hydroxide formulations: case series.

This case series evaluates the effectiveness of different calcium hydroxide formulations with various vehicles in management of large periapical lesion in mature and immature teeth. This will help clinicians to make informed judgments about which formulations of calcium hydroxide should be used for specific endodontic procedures.

Comparative evaluation of self-etching primers and phosphoric acid effectiveness on composite to enamel bond: an in vitro study.

AIM: The aim of the present study was to investigate the effectiveness of the one total-etch self-priming adhesive, one two-step self-etching primer adhesive, and one 'all-in-one' self-etching adhesive system on the adhesion of a resin composite to enamel. MATERIALS AND METHODS: Thirty-six freshly extracted human mandibular molars were selected for this study. A fat area about 5 mm in diameter was created on the exposed mesial surface of enamel of each tooth by moist grinding with 320, 420 and 600 grit silicon carbide paper. Twelve teeth were randomly assigned into three groups. In group 1, Adper Easy One (3M ESPE), a one step self-etching primer adhesive was applied and light curing unit for 10 seconds. In group 2, Adper SE Plus, a two-step self-etching primer with bottle A containing the aqueous primer and bottle B containing the acidic adhesive was applied and light cured for 10 seconds. Group 3 (control)-etchant 37% phosphoric acid is applied to the surface for 15 seconds and rinsed with water and air dried and adhesive (single bond 2) is applied to the surface and tube is placed and light cured for 20 seconds. Composite material (Z350) was placed in the tube and light cured for 40 seconds in all the groups. Bond strength testing was done using universal testing machine at the enamel-composite interface. The debonded enamel surface was evaluated in stereomicroscope to assess the cohesive, adhesive or mixed fracture. Data was statistically analyzed by one way analysis of variance (ANOVA). RESULTS: Group 1 performed least among all groups with a mean score of 19.46 MPa. Group 2 had a mean score of 25.67 MPa. Group 3 had a mean score of 27.16 MPa. CONCLUSION: Under the conditions of this in vitro study, the bond strength values of the two-step self-etching primer systems tested were similar to the total-etch. And, one step self-etching primers have lower bond strength compared to the total-etch.

Endodontic treatment of mandibular canine with two roots and two canals.

In majority of cases, mandibular canines have one root and one root canal, although 15% may have two canals. Literature report shows incidence of two-rooted canine as low as 1.7%. This article reports a clinical case of endodontic treatment of mandibular canine with two roots and two canals.