A Comparative Evaluation of Surface Properties of Cention N and TiO2-Enriched Cention N After Brushing Simulation and Erosive Challenge: An In Vitro Study.

Background This study aimed to evaluate and compare the abrasive and erosive wear resistance of Cention N and titanium dioxide (TiO2) nanoparticle-enriched Cention N after three years of brushing simulation. Methodology A total of 48 freshly extracted mandibular molars were mounted in acrylic blocks and divided into two groups of 24 molars based on the type of restorative material used to restore them. Cavities of a standardized size were prepared. Group A was restored with Cention N, and group B was restored with 5% TiO2-enriched Cention N. Each group was further divided into three subgroups of eight. Subgroup 1 was the control subgroup. Subgroup 2 was the abrasive subgroup, subjected to the abrasive challenge in a brushing stimulator with 30,000 cycles to 10,000 cycles in the linear X-axis and Y-axis each and another 10,000 cycles divided into 5,000 cycles clockwise and 5,000 cycles anticlockwise. The total number of brushing cycles was equal to three years of brushing with a duration of eight to nine hours. Subgroup 3 was the erosive and abrasive subgroup, subjected to an erosive pH cycle consisting of exposure to Coca­Cola for five minutes thrice a day for seven days, and then subjected to brushing simulation as above. After the surface treatment, specimens were subjected to the Vickers microhardness test using a diamond indenter and the surface roughness test using an optical profilometer. The resulting values were subjected to statistical analysis. Results There was a significant decrease in mean surface roughness in group B, where TiO2 nanoparticles were added after erosive challenge and brushing simulation, than in group A. There was an increase in mean microhardness in group B which was not significant. Conclusions With the addition of 5% TiO2 to Cention N, there was a significant reduction in surface roughness. The surface microhardness of Cention N containing 5% TiO2 increased non-significantly compared to the control group.

Antibiotic Prescription Patterns for Endodontic Procedures in India: A Knowledge, Attitude, and Practices (KAP) Survey.

Objective The purpose of this study is to evaluate the antibiotic prescription patterns of endodontists, general dentists, and other dental specialists for endodontic procedures in India by using the knowledge, attitude, and practices (KAP) survey method. Methods This cross-sectional study was carried out from February 2022 to May 2022 and involved dentists across India. A self-made questionnaire survey was created to judge the knowledge of various dental practitioners, which includes general dentists, endodontists, other dental specialists, and post-graduates with regard to antibiotic usage guidelines for endodontic purposes. A total of about 310 dental practitioners were surveyed across India. The questionnaire was circulated via social platforms such as WhatsApp, Instagram, and Facebook Messenger. Statistical analysis Data for KAP regarding antibiotic prescription patterns among general dentists, endodontists, other dental specialists, and postgraduates were entered into Microsoft Excel and analyzed using IBM SPSS Statistics for Windows, Version 20 (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp.). Descriptive statistics of the study population were examined. The level of statistical significance was determined at p<0.05. Results For the percentage of patients who were prescribed systemic antibiotics every day for endodontic reasons, about 38.6% (119) responded 0-10% and 27.3% (84) responded 10-30%. For the order of antibiotics that they prefer from most to least, about 85.4% (263) responded amoxicillin > metronidazole > doxycycline > azithromycin > clindamycin > ciprofloxacin. For the question of whether they use local antibiotics, about 35% answered yes of which 25% were endodontists, 2% were general dentists, 5% were other dental specialists, and 3% were post-graduates. About 77.3% of the total participants were unaware of the antimicrobial stewardship concept and AwaRe classification from WHO. About 53.2% (164) attended CDE programs with regard to antibiotic usage. Conclusion It is evident from the results of the present study that there is over-prescription of antibiotics by practitioners especially by general dentists without following proper guidelines for endodontic treatments. More emphasis should be made on the proper prescription pattern of antibiotics, proper understanding of endodontic diagnosis, and the need for antibiotics at the undergraduate level. In addition, proper awareness, as well as proper prescription of antibiotics, should be made for existing dental professionals.

Comparative Evaluation of Retention of Fiber Posts in Different Dentin Regions Using Various Bonding Techniques: An In Vitro Study.

Aim This study aims to evaluate the retention of fiber posts in the coronal, middle, and apical dentin regions with various bonding techniques by using fifth, sixth, and eighth-generation bonding agents and self-etch adhesive cement. Materials and methods For this study, 96 freshly extracted human incisors with straight roots were selected. Endodontic treatment of the specimens was performed. The post spaces were created immediately after obturation and the posts were luted with three different bonding agents and self-adhesive resin cement and the specimens were divided into four groups. Approximately 3 mm thick sections were made from different dentin regions of the post space and were tested for three subgroups: Subgroup I: Coronal, Subgroup II: Middle, Subgroup III: Apical. The specimens were tested on a universal testing machine. Results Statistical analysis was done using one-way analysis of variance (ANOVA) and Tukey's post hoc test using SPSS software version 17.0 (SPSS Inc., Chicago ). The intra-group comparison showed that the bond strength was more in the fifth-generation bonding agent (Cervical- 8.2574± 1.49034, Middle- 11.4800± 2.59938, Apical- 14.7108±1.82931), followed by the sixth (Cervical- 9.102± 2.76119, Middle-9.3152±2.11585, Apical- 12.9478±4.69404) and eighth-generation bonding systems (Cervical- 9.0938±2.77537, Middle- 7.1585±1.97601, Apical- 9.3726±0.73720) and the self-etch adhesive dental resin cement (Cervical- 5.1004±2.17389, Middle- 4.1574±1.28664, Apical-7.8884±1.90078). The inter-group comparison showed that the bond strength was higher in the fifth-generation bonding agent followed by sixth-generation, eighth-generation, and self-adhesive resin cement. Conclusion The present study reveals that the highest push-out bond strengths were obtained in apical sections followed by the middle and cervical areas. The bond strength was higher when using the fifth-generation bonding agent followed by the sixth, eighth, and self-adhesive resin cement. Despite many advancements, the fifth-generation bonding agent still showed superior retention in different dentin regions among various other bonding techniques.

Comparative Evaluation of Outcome of Natural Antioxidants on Shear Bond Strength of Composite Bonded to Bleached Enamel: An In vitro Study.

Background: The depletion of bond strength after the bleaching procedure has resulted in the usage of several antioxidants to get rid of discharging oxygen from residual peroxides before any adhesive restorations. Aim: The in vitro study aimed to compare and evaluate the shear bond strength of composite after application of three over-the-counter natural antioxidants on bleached enamel. Materials and Methods: Thirty-six extracted human anterior teeth were decoronated at the level of cementoenamel junction and implanted into self-cure acrylic resin exposing the labial surface alone. The embedded specimens were categorized into six groups of six teeth each, and the groups were as follows: Group I: unbleached + composite bonding, Group II: bleaching + delayed composite bonding, Groups III, IV, and V: bleaching + antioxidants - olive oil/Vitamin E oil/propolis + immediate composite bonding, and Group VI: bleaching + immediate composite bonding. The shear bond strength analysis was performed with the help of the universal testing machine, and the values obtained were statistically analyzed using IBM SPSS for Windows, v. 21.0. Results: The results obtained from the study reveal that all the three experimental groups showed an increase in the shear bond strength in comparison to Group VI (positive control) and the difference in the bond strength between the experimental groups and positive control is also statistically significant. Conclusion: Within the limitations of this study, although the bond strength of composite resin after application of the three natural over-the-counter antioxidants falls very closely, the usage of oil-based antioxidants had been found to perform less effectively in improving the shear bond strength.

Comparative Evaluation of Smear Layer Removal in Apical Third Using Four Different Irrigants With Ultrasonic Agitation: An In Vitro Scanning Electron Microscopy (SEM) Analysis.

Aim This study aims to compare and evaluate the efficacy of four different irrigating solutions like sodium hypochlorite, ethylenediaminetetraacetic (EDTA), Oxum, and ozonated water with ultrasonic agitation in removing the smear layer in the apical third of root canals using Scanning Electron Microscopy (SEM). Materials and methods For the study, 50 freshly extracted human mandibular premolars with single well-developed roots without any curvatures were taken. The teeth taken were decoronated to obtain a uniform working length of 15 mm, and the samples were instrumented using a ProTaper Gold rotary file system (Dentsply Maillefer, Ballaigues, Switzerland) up to F2 size, along with irrigation of 1 ml of 3% sodium hypochlorite (NaOCl) in between instrumentation. The samples were randomly divided into five groups with 10 samples each, according to the final irrigant used. Group I-EDTA 17%, Group II-NaOCl 5%, Group III-Oxum, Group IV-ozonated water, and Group V-normal saline. In all groups, ultrasonic agitation of the irrigating solution was performed using a size 20 file, held passively inside the root canal. Then the samples were flushed with distilled water, dried with paper points, split into two halves, and subjected to SEM analysis. SEM images of the apical third region of root samples were taken at 5000X resolution and scored on a scale of 1 to 4. Results Statistical analysis was done using one-way ANOVA followed by Tukey's post hoc test using software version SPSS software version 17.0 (SPSS Inc., Chicago). The results showed that the 17% EDTA group showed the least smear layer scores when compared to other groups with statistical significance. This was followed by the Oxum group and 5% NaOCl group, whereas the ozone water group and saline control group showed the highest smear layer scores. Conclusion The present study reveals that the EDTA is the superior irrigant in the elimination of smear layer in root canal treatment. Newer irrigants, such as Oxum, can be used as an alternative to EDTA for smear layer removal while remaining biocompatible with dentin. Whereas ozone can be combined with other irrigants for synergistic action of enhanced antimicrobial property and smear layer elimination in the future.

Finishing and Polishing of Composite Restoration: Assessment of Knowledge, Attitude and Practice Among Various Dental Professionals in India.

Aim The key to the success of a composite restoration lies in the important final step of finishing and polishing. This survey aims to assess the knowledge, attitude, and practice about finishing and polishing in composite restoration among various dental professionals in India. Materials and methods A cross-sectional questionnaire survey was conducted among various dental professionals in India. The participation of dentists was voluntary. A total of 350 responses were received, and the data were converted to Microsoft Excel 2019 program and descriptive statistics were analyzed using SPSS Version 21.0 software. Results Almost 99% of respondents know the importance of finishing and polishing procedures of composite restoration. Overall, 71% of respondents felt it is necessary to remove the surface layer to improve the surface characteristics of the composite restoration, 59.8% of professionals follow the sequential order of abrasives for finishing and polishing of composites, 74.2% use interproximal strips to finish interproximal areas of restoration, and 55.8% of professionals use polishing paste for the final polishing of composite restoration. Only 44.2% are aware of liquid polish/composite glaze, among which 12.4% of practitioners use liquid polish often. Conclusion Most of the respondents were aware of the benefits of proper finishing and polishing of composite restorations. However, still they need to follow proper sequential series of burs, abrasive points, disks, strips, and polishing pastes. The usage of surface sealants should be emphasized for enhanced results.

An Immature Traumatic Teeth Management With Apical Pathology Using the Novel Biodentine™ Obturation: A Case Report.

Pulpal and periapical pathosis in an immature anterior tooth following traumatic injury is a frequent occurrence, and management of open apices in such cases poses a constant challenge to endodontists. This is due to the absence of apical constriction that would result in poor three-dimensional seal/adaptation of the obturated material within the canal system. Treatment of immature pulpless teeth with long-term calcium hydroxide may consequently weaken the dentin and increase the fracture susceptibility. Obturating the root canals completely with bioactive agents like Biodentine/mineral trioxide aggregate (MTA) has benefits like increased fracture resistance when compared to apexification. When used for obturation, Biodentine™, a new calcium silicate-based cement, performs superior to other Portland cement derivatives. This case report demonstrates a six-month follow-up result of an open apex and a periapical lesion involving maxillary right central incisor #11 with the Biodentine obturation that was previously subjected to triple antibiotic paste as an intra-canal medicament for three weeks. The satisfactory healing rate of tooth 11 with the reduction in the size of periapical radiolucency at the end of the six-month follow-up in this current article is highly considerable.

Comparative evaluation of pulp tissue dissolution ability of sodium hypochlorite by various activation techniques: An in vitro study.

BACKGROUND: The success in endodontic therapy is dependent largely on the absolute elimination of pulp tissue remnants and the maximum reduction of pathologic microbial load present within the root canal system. AIM: The aim of this in vitro study was to compare and evaluate the ability of pulp tissue dissolution with and without activation of 5.25% sodium hypochlorite (NaOCl). MATERIALS AND METHODS: Pulp tissue samples collected from intact, noncarious extracted third molars were standardized to 8 mg in each group. These samples were placed in conical Eppendorf tubes of 15 ml with 10 ml 5.25% NaOCl for 4 min and were activated suitably according to the group specifications. All the procedures in this study were carried out at room temperature. The preweighed pulp tissue samples were further weighed again after the dissolution phase, and residual weight loss in each group along with its percentage was obtained. The results were then statistically analyzed using one-way analysis of variance and Tukey post hoc test. RESULTS: The maximum amount of pulp tissue dissolution was found in the laser-assisted irrigation group, i.e., NaOCl with Er, Cr: YSGG (P < 0.05) and showed a statistically significant result in comparison with other groups. CONCLUSION: Within the limitations of the study, laser-assisted irrigation with a radial firing tip (NaOCl activated by Er, Cr: YSGG) was the most effective in dissolving the pulp tissue in comparison with other groups. The ultrasonic activation also showed a considerable amount of pulp tissue dissolution comparable to laser-activated irrigation in this study.