Comparative evaluation of clinical performance of ceramic and resin inlays, onlays, and overlays: A systematic review and meta analysis.

Background: Advances in adhesive technologies and escalation in esthetic demands have increased indications for tooth-colored, partial coverage restorations. Recently, material knowledge has evolved, new materials have been developed, and no systematic review has answered the question posed by practitioners: Is the clinical efficacy of resin or ceramic better, for inlay, onlay, and overlay in the long run? Aim: The aim of this systematic review and meta-analysis was to evaluate the clinical performance of ceramic and resin inlays, onlays, and overlays and to identify the complication types associated with the main clinical outcomes. Materials and Methods: Two reviewers (VN and AJ) searched PubMed, Embase, and Cochrane Central registry of controlled trials for published articles between 1983 and 2020 conforming to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines for systematic reviews. Only clinical studies which met the following criteria were included (1) studies regarding ceramic and resin inlays, onlays, and overlays were included; (2) randomized controlled trials, retrospective or prospective studies conducted in humans; (3) studies with a dropout rate <50% 4) studies with a follow-up higher than 5 years. Results: Of 1718 articles, 21 articles were selected. At 5 years, the estimated survival rates for resin (n = 129) was 86%, feldspathic porcelain (n = 1048) was 90%, and glass ceramic (n = 2218) was 92%; at 10 years, the survival of resin was 75% (n = 115), feldspathic porcelain was 91% (n = 1829), and glass ceramic was 89% (n = 1075). Conclusion: The meta-regression indicated that ceramic partial coverage restorations (feldspathic porcelain and glass-ceramic) outperformed resin partial coverage restorations both at 5-year and 10-year follow-up. When compared between ceramic types, glass ceramics outperformed feldspathic porcelain at 5 years' follow-up and feldspathic porcelain outperformed glass ceramics at 10 years' follow-up. The failures were mostly due to fractures (6.2%), endodontic problems (3%), secondary caries (1.7%), and debonding which was 0.9%.

Comparative evaluation of antimicrobial and antifungal efficacy of bioactive root-end filling materials: An in vitro study.

CONTEXT: Microorganisms are the main cause of failure of endodontic treatment. When retreatment fails periapical surgery followed by retrograde filling is done to seal the apex. A root-end filling material should have antimicrobial property as well as bioactive properties necessary for healing, repair, and regeneration of the apex. AIMS: The aim of this study was to evaluate the antibacterial and antifungal efficacy of three bioactive root-end filling materials: mineral trioxide aggregate (MTA) Plus, Biodentine, Endosequence root repair material (ERRM) against Enterococcus faecalis and Candida albicans. SUBJECTS AND METHODS: E. faecalis and C. albicans standard bacterial strains were used. 100 µl was taken from liquid cultures of E. faecalis and planted in Mueller-Hinton agar and the same amount of C. albicans was planted in Sabouraud dextrose agar by lawn culture. MTA Plus, Biodentine, and ERRM were aseptically filled into the opened pits. Following this, the media were kept in the drying oven at 37°C for 24, 48, and 72 h and the diameters of the inhibition zones were measured. STATISTICAL ANALYSIS USED: Statistical analysis was carried out by Kruskal-Wallis, Post hoc (Mann-Whitney), Friedman, and Post hoc (Wilcoxon-sign) test. RESULTS: Among the three groups, the antimicrobial activity of Biodentine against E. faecalis was statistically higher than MTA Plus and ERRM (P < 0.05). Antifungal activity of MTA Plus against C. albicans was statistically higher than Biodentine and ERRM (P < 0.05). ERRM showed the smallest inhibition zone against E. faecalis and C. albicans among the three groups (P < 0.05). CONCLUSIONS: Biodentine exhibited the greatest antimicrobial activity and MTA Plus exhibited the greatest antifungal activity among the three groups. ERRM exhibited the least antibacterial and antifungal activity among the three groups.

"Evaluation of the antibacterial efficacy of EZLASE diode LASER on the infected root canal system:" An in vivo study.

AIMS AND OBJECTIVES: The aim of this in vivo study was to evaluate the antibacterial efficacy of a diode LASER on the infected root canal system. METHODOLOGY: A total of forty patients with infected root canals were selected. The root canals were prepared mechanically, and irrigation was done with 3% sodium hypochlorite (NaOCl). Microbiological samples were collected before LASER treatment with the help of the master apical file (MAF) to full working length for subsequent microbiological examination. The procedure was followed by laser treatment with an EZLASE diode LASER (940 nm), at different output powers. Following irradiation, samples were collected for microbiological examination. The samples were transferred to an agar plate and incubated for 48 h at 37°C. The colonies formed were then counted, and the total number of bacteria per ml before and after LASER application was assessed. Colony-forming unit (CFU/ml) was counted for Enterococcus faecalis and other bacterial flora from pretreatment and posttreatment samples that were then analyzed using the Kruskal-Wallis test and Mann-Whitney U-test. RESULTS: The highest power of laser used (1.95 W) had resulted in maximum reduction of bacterial flora and E. faecalis counts. CONCLUSIONS: Combination therapy consisting of irrigation using NaOCl and LASER irradiation, especially at high output power was an effective treatment option for a reduction in E. faecalis as well as other bacterial flora from the root canal system.

Evaluation of three different agents for in-office treatment of dentinal hypersensitivity: a controlled clinical study.

CONTEXT: Dentin desensitizers are used for in-office treatment of dentinal hypersensitivity. They block the open tubules and bring about a reduction in hypersensitivity. AIM: The aim was to evaluate and compare the clinical effectiveness of a dentin desensitizer, a combination of a dentin desensitizer + adhesive and one-bottle self-etching adhesive for in-office treatment of dentin hypersensitivity. SETTINGS AND DESIGN: Institutional, prospective double-blind parallel clinical design. SUBJECTS AND METHODS: A total of 54 teeth in 20 patients were randomly allocated to one of the three study groups, with 18 teeth in each group as follows: Group A-Gluma Desensitizer (GD), Group B-Gluma Comfort Bond + Desensitizer (GCBD), Group C-Single Bond Universal (SBU). The patients' dentinal hypersensitivity scores for tactile (hand-held scratch device), thermal (cold), and evaporative (dental unit air syringe) stimuli were recorded on a visual analog scale. The parameters were recorded at baseline, immediately after application of the agent, 3- and 6-week posttreatment. STATISTICAL ANALYSIS USED: The data were analyzed with Friedman's test, Wilcoxon signed ranks test, Kruskal-Wallis test, and Mann-Whitney-U-test (P < 0.05). RESULTS: All three groups showed a significant reduction in dentinal hypersensitivity (P < 0.05) compared to baseline at all time intervals. Statistically, significant differences were noted between GD and SBU; between GCBD and SBU in all testing parameters. Between GD and GCBD no significant difference was noted. CONCLUSIONS: GD and GCBD showed a greater reduction in dentin hypersensitivity than SBU.

Evaluation of minimal inhibitory concentration of two new materials using tube dilution method: An in vitro study.

AIM: The aim of the study is to evaluate and compare the antimicrobial efficacy of two new materials MTA Plus and Biodentine with ProRoot MTA using tube dilution method. MATERIALS AND METHODS: The materials used were ProRoot MTA (Dentsply), MTA Plus (compounded by Prevest Denpro, Jammu, India for Avalon Biomed Inc, USA) and a calcium silicate based material Biodentine (Septodont, Saint-Maur-des-Fosses, France). Doubling dilutions of the material were prepared in Sabouraud's dextrose broth (SDB) and Brain Heart Infusion (BHI) broth for Candida albicans and Enterococcus faecalis, respectively. The minimal concentration at which inhibition of microorganism occurred was measured and noted as minimal inhibitory concentration (MIC) of the material. RESULTS: There was no statistically significant difference between the materials against C. albicans. Biodentine was statistically significant than MTA Plus against E. faecalis (P-value-0.022). ProRoot MTA was statistically significant at different time intervals against E. faecalis (P-value-0.001). CONCLUSION: ProRoot MTA and Biodentine proved to have antimicrobial property. MTA Plusproved as a good antifungal agent.