Comparative evaluation of antifungal activity of Sodium Hypochlorite, Calcium Hypochlorite and modified Salt Solution associated with passive ultrasonic irrigation against Candida albicans - An In-Vitro study.

Aim: The study evaluated the antifungal activity of sodium hypochlorite (NaOCl), calcium hypochlorite (Ca(OCl)2), and modified salt solution (MSS) assisted with passive ultrasonic irrigation against Candida albicans. Materials and Methods: One hundred and thirty-six single-rooted premolars were decoronated and enlarged up to a file #45, autoclaved, inoculated with C. albicans, and incubated for 72 h. The samples were randomly distributed into eight groups (n = 17) according to the protocol for decontamination G1: No treatment, G2: Distilled water (DW), G3: 2.5% NaOCl, G4: 2.5% NaOCl + ultrasonic activation (US), G5: 2.5% Ca(OCl)2, G6: 2.5% Ca(OCl)2 + US, G7: MSS, G8: MSS + US. Microbiological testing (Colony forming Unit [CFU] counting) was performed before and after the treatment. Statistical Analysis: Data were subjected to the one-way analysis of variance followed by the Tukey's post hoc test (P < 0.05). Results and Conclusion: Groups 1 and 2 showed the highest mean contamination (5.41 and 4.31 log10 CFU/mL, respectively), which was statistically different from all the other groups (P < 0.001). G4 showed the lowest mean contamination (0.24 log10 CFU/mL) with statistically significant value (P < 0.001). 2.5% NaOCl with ultrasonic activation can aid in significant fungal reduction. Ultrasonic activation of 2.5% NaOCl, 2.5% Ca(OCl)2, and MSS was also found to have improved antifungal activity against C. albicans.

Hemicrania continua secondary to neurogenic paravertebral tumor- a case report.

OBJECTIVES: Hemicrania continua (HC) is one of the trigeminal autonomic cephalalgias (TAC), where sympathetic dysfunction and autonomic dysfunction resulting in parasympathetic over activation with some evidence of sympathetic inhibition have been suggested as probable causes. However, cases of hemicrania continua secondary to sympathetic dysfunction due to neurogenic paravertebral tumor impinging on the sympathetic chain has not been previously reported. In this case, the probability of the sympathetic dysfunction was more likely based on the clinical features and management. CASE PRESENTATION: A 23-year-old female presented with a chief complaint of right unilateral pain in the retro-bulbar, head and facial region for the past three years. An initial MRI of the brain was negative, whereas an MRI of the spine was advised to rule out a cervicogenic origin of the pain. The MRI revealed a well-defined mass lesion within right paravertebral region at T3 indicative of a neurogenic tumor. The patient was diagnosed with probable hemicrania continua secondary to neurogenic tumor impinging on adjacent sympathetic chain. A trial of indomethacin 75 mg/day was advised, which provided complete relief of the headache. The patient was referred to a neurologist for management of the neurogenic tumor. CONCLUSIONS: Headache disorders may be secondary to pathologies and comprehensive evaluation and accurate diagnosis are essential. Knowledge of neuroanatomy is paramount to understand and explain underlying pathophysiological mechanisms. Multidisciplinary management is essential in complex orofacial cases.

Effects of conventional and herbal irrigants on microhardness and flexural strength of root canal dentin: An in vitro study.

AIM: The aim of this in vitro study was to compare the effects of herbal irrigants with conventional irrigants on microhardness and flexural strength of root dentin. MATERIALS AND METHODS: Sixty extracted permanent maxillary canines were selected. Decoronated roots were sectioned longitudinally into buccal and lingual segments to get 120 specimens. These were embedded in auto polymerizing acrylic resin and further grounded with fine emery papers under distilled water. Of these, 100 root segments without any defects were selected, further divided into four test groups and a control group according to the irrigants used (n = 20). Group 1: 2.5% Sodium hypochlorite, Group 2: Miswak stick extract, Group 3: Cashew leaves extract. Group 4: Mango leaves extract and Group 5: Normal saline (control). All specimens were treated with 5 ml of each irrigant for 10 minutes and rinsed immediately. Dentin microhardness was measured with a Vickers indenter, and the flexural strength test was done using a universal testing machine. The data were analyzed using one-way ANOVA and the intergroup comparison by student t-test. RESULTS: The experimental groups showed a significant reduction in microhardness values when compared with the control group. Intragroup comparison among experimental groups, herbal irrigants showed the least reduction in microhardness values at cervical, middle, and apical thirds. When compared to the control group, the flexural strength values decreased significantly with experimental groups. CONCLUSION: Within the limitation of this study, it was concluded that herbal irrigants were least detrimental to root dentin microhardness when compared with conventional irrigant. But the flexural strength was equally reduced by both conventional and herbal irrigants.

Assessment of computer-controlled local anesthetic delivery system for pain control during restorative procedures: A randomized controlled trial.

Background. . Local anesthesia is given to decrease pain perception during dental treatments, but it may itself be a reason for pain and aggravate the dental fear. Computer-controlled local anesthetic delivery system (CCLADS) is one of the alternatives for decreasing the patients' pain during local anesthesia. This study compared the time required for the recovery from anesthesia, pain/discomfort during injection and pain/discomfort 24 hours after administering local anesthesia with CCLADS, a standard self-aspirating syringe and a conventional disposable 2-mL syringe. Methods. The study was conducted on 90 subjects (an age group of 20-40 years), who suffered from sensitivity during cavity preparation. They were randomly divided into three groups of 30 individuals each to receive intraligamentary anesthesia (2% lignocaine with 1:80,000 adrenaline) using either of the three techniques: CCLADS, a standard self-aspirating syringe, or a conventional disposable 2-mL syringe. The onset of anesthesia, time required for recovery from anesthesia (in minutes), pain/discomfort during injection and pain/discomfort 24 hours after administering local anesthesia were recorded. Results. The time required for the onset of anesthesia and recovery from anesthesia was shorter with CCLADS (4.83±2.31 and 34.2±1.895, respectively) as compared to the standard self-aspirating group (10.83±1.90 and 43.5±7.581, respectively) and the conventional group (11.00±2.03 and 43.5±6.453, respectively) (P<0.001). The patients in the CCLADS group experienced no pain during local anesthesia administration as compared to the patients in the self-aspirating and conventional groups. The CCLADS and self-aspirating groups showed lower pain response as compared to the conventional group for pain after 24 hours. Conclusion. CCLADS can be an effective and pain-free alternative to conventional local anesthetic procedures.

Comparing marginal microleakage of three Bulk Fill composites in Class II cavities using confocal microscope: An in vitro study.

AIM: This study aims to evaluate and compare microleakage at the occlusal wall and cervical wall in Class II cavities restored with one SonicFill Bulk Fill composite and two conventional Bulk Fill composites. MATERIALS AND METHODS: Thirty freshly extracted teeth were divided into three groups of 10 teeth each. Standardized Class II cavities were made on the mesial and distal surfaces of each tooth and restored using SonicFill Bulk Fill composite and two conventional Bulk Fill composites, Tetric Evo Ceram, and X-tra fil. After storage, thermocycling and immersion in 0.6% rhodamine dye solution specimens were sectioned and evaluated for microleakage at the occlusal and cervical walls using confocal microscope. STATISTICAL ANALYSIS USED: Kruskal-Wallis test, Wilcoxon Signed-Rank test and Mann-Whitney U-test. RESULTS: The results demonstrated that in the occlusal wall and cervical wall, SonicFill Bulk Fill composite, showed significantly less marginal microleakage than the other groups. CONCLUSION: Based on the results of this study, SonicFill Bulk Fill composite showed less microleakage than the other conventional Bulk Fill composites.

The comparison of the effects of different whitening toothpastes on the micro hardness of a nano hybrid composite resin.

AIM: The aim of this study was to compare the micro hardness of a nanohybrid composite resin after brushing with two herbal and one non-herbal whitening toothpastes. MATERIALS AND METHODS: We divided Eighty disk-shaped specimens of a nanohybrid composite (Tetric N Ceram, Ivoclar Vivadent, Asia) into 4 groups of 20 specimens each: Groups A, B, C, and D. Group A was control, Group B was brushed with Colgate total advanced whitening (Colgate-Palmolive (India) Limited), Group C with Salt and Lemon, Dabur (Dabur International Limited, Dubai, UAE), and Group D with HiOra Shine, Himalaya (The Himalaya Drug Company, India). The specimens were polished using medium, fine, and superfine discs (Sof-lex, 3M, ESPE, USA) and subsequently placed at 37°C in distilled water. They were brushed for 2 minutes twice daily with a soft motorized toothbrush (Colgate 360 sonic power battery-operated tooth brush, Colgate Palmolive, India) for 30 days. The samples were rinsed under running water to remove the toothpaste and stored in distilled water at 37°C until the readout was taken on the Vickers's hardness tester for microhardness. RESULTS: The results revealed that the difference among the groups was statistically significant (P < 0.001). Tukey's test showed that reduction in microhardness for Group B was significantly higher than that for Group C and Group D (P < 0.001). CONCLUSION: Within the limitations of this study, non-herbal whitening toothpaste had a greater impact on the microhardness of nanohybrid resin composite than herbal whitening toothpastes.

In Vitro Evaluation of the Antimicrobial Efficacy of Four Endodontic Biomaterials against Enterococcus faecalis, Candida albicans, and Staphylococcus aureus.

Root canal sealers that possess good antimicrobial property can prevent residual and recurrent infection and contribute to successful endodontic therapy. This study evaluated the antimicrobial activity of four endodontic sealers, AH Plus, Tubliseal EWT, EndoRez, and iRoot SP, against three different microorganisms, E. faecalis, C. albicans, and S. aureus, by direct contact test. 10 µL microbial suspensions were allowed to directly contact the four endodontic sealers for 1 hr at 37°C. Subsequently microbial growth was measured spectrophotometrically every 30 min for 18 hours. The microbial suspensions were simultaneously tested to determine the antimicrobial effect of components which are capable of diffusing into the medium. The results revealed that AH Plus and iRootSP had significantly higher antimicrobial activity against E. faecalis. AH Plus and Tubliseal EWT showed significantly higher antimicrobial activity against C. albicans and S. aureus compared to iRoot SP and EndoRez. EndoRez showed the least antimicrobial activity against all the three microorganisms. Inhibition of microbial growth is related to the direct contact of microorganisms with the sealers. In conclusion AH Plus had significantly higher antimicrobial activity against E. faecalis, C. albicans, and S. aureus.

The Comparative Evaluation of Antibacterial Activity of Methacryloxydodecyl Pyridinium Bromide and Non-methacryloxydodecyl Pyridinium Bromide Dentin Bonding Systems Using Two Different Techniques: An In vitro Study.

BACKGROUND: Adhesive systems have enabled clinicians to preserve more tooth structure by changing cavity designs. However, because of the polymerization shrinkage adhesive systems are not capable of totally prohibiting the gap formation between the cavity and restorative material of composite resin leading to colonization of oral microorganisms from saliva. One possible solution for this serious problem is to use dental materials with antibacterial properties. So the development of such agents has initiated for successful restorations. Hence, the purpose of this study was to compare the antibacterial activities of two dentin bonding systems: Clearfil protect bond (CPB) and prime & bond NT using agar well technique and tooth cavity model. MATERIALS AND METHODS: CPB and prime and bond NT (PBNT) were evaluated in this study using agar well technique and tooth cavity model. In the agar well technique, the materials were filled in the wells of Muller-Hinton agar plates inoculated with Streptococcus mutans NCTC 10449M and the diameter of inhibition zones produced around the materials were measured after 24 h of incubation. For the tooth cavity model test, 3 cavities (of diameter - 1 mm and depth - 2 mm) were prepared in the flat occlusal dentin of human extracted molar. After sterilization, the teeth were left in the culture of broth of S. mutans at 37°C for 72 h for allowing bacteria to invade the cavity for 72 h. The dentin bonding systems were applied separately to each of the two infected cavities, and the third cavity was not applied and used as control. After sealing the occlusal surfaces, the teeth were kept in sterile physiological saline at 37°C for 72 h. The standardized amounts of dentin chips (120 + 5 mg) were obtained from the cavity walls, and the numbers of bacteria recovered were determined. The results were analyzed using one-way ANOVA, Kruskal-Wallis and Mann-Whitney's U-tests. RESULTS: The primer of CPB and PBNT produced similar inhibition zones (P > 0.05), but the bonding resin of CPB did not produce any inhibition. When tested by the tooth cavity model technique, the application of CPB resulted in significantly less bacterial recovery than the PBNT (P < 0.05), demonstrating substantial antibacterial effects. CONCLUSION: The CPB that employs the antibacterial primer containing methacryloxydodecyl pyridinium bromide, was effective in inactivating the bacteria in the cavity compared to little antibacterial activity shown by PBNT. The tooth cavity mode test used in the present study is a reliable method to evaluate the antibacterial effects of dentin bonding agents simulating clinical situations.

Comparison of the efficacy of ethylene diamine tetraacetic acid and maleic acid in the removal of three calcium hydroxide intra-canal dressings: A spiral computerized tomography volumetric analysis.

AIM: To assess the efficacy of 17% ethylene diamine tetra acetic acid and 7% maleic acid in the removal of 3 calcium hydroxide preparations placed as intracanal medicaments. MATERIALS AND METHODS: The root canals of 60 single rooted premolars were prepared with a step back technique and randomly assigned into 3 experimental groups (n= 20). Group A was filled with plain calcium hydroxide mixed with distilled water in which barium sulfate was added for radio opacity, Group B was filled with Apexcal and Group C was filled with Metapex. After 7 days each group was divided into 2 sub groups (n= 10). The medicaments were retrieved with 17% EDTA (first sub group) and 7% maleic acid (second sub group). Along with the above irrigants manual and ultrasonic agitation was used. The pre and post removal volume of medicaments in root canals were measured using spiral computerized tomography. The percentage difference was calculated and statistically analyzed using Kruskal Wallis and Mann Whitney U test. RESULTS: 17% EDTA and 7% maleic acid efficiently removed calcium hydroxide, distilled water mixture (P= 0.218) and Apexcal (P= 0.684), whereas 7% maleic acid showed better retrieval capability of Metapex than 17% EDTA (P= 0.002). CONCLUSION: Calcium hydroxide, distilled water mixture and polyethylene glycol based calcium hydroxide were efficiently removed by 17% EDTA and 7% maleic acid. 7% maleic acid removed silicone oil based calcium hydroxide preparation better than 17% EDTA.

Grape seed extract as a potential remineralizing agent: a comparative in vitro study.

OBJECTIVE: Remineralization is an effective treatment that may stop or reverse early tooth decay. Grape seed extract (GSE) is the potential remineralizing agent under investigation. MATERIALS AND METHODS: Sound human tooth sections were obtained from the cervical portion of the root and stored in demineralizing solution at 37°C for 96 hours to induce artificial root caries lesions. The sections were divided into four treatment groups including 6.5% grape seed extract, sodium monofluorophosphate (220 ppm) with 0.05% calcium glycerophosphate, 0.5% calcium glycerophosphate and control (no treatment). An in vitro pH cycling model was used to cycle the demineralized specimens through treatment solutions, acidic buffer and neutral buffer for 8 days at 6 cycles per day. Subsequently, they were evaluated using confocal laser scanning microscope. Data were analyzed using analysis of variance (p < 0.05). RESULTS: GSE revealed less demineralization and more remineralization compared with other groups. CONCLUSION: GSE promotes remineralization of artificial root caries lesions. CLINICAL SIGNIFICANCE: The search for the perfect remineralizing agent continues to this day. GSE could be a welcome addition to the remineralization armamentarium.

Change of working length in curved molar root canals after preparation with different rotary nickel-titanium instruments.

AIM: The purpose of this study was to investigate change of working length in curved molar root canals after preparation with Profile, ProTaper and K3 Rotary Nickel-Titanium (Ni-Ti) instruments. MATERIALS AND METHODS: One hundred and eighty maxillary and mandibular molars were divided into group I having root curvature angle <300 and group II having root curvature angle >300 comprising 90 teeth in each group based on Schneider's method. Group II and I were further divided into sub group A, B and C having 30 teeth each based on type of instrument used. Profiles, ProTaper and K3 Rotary Ni-Ti files were used to prepare mesial and buccal roots of molars. Radiography platform was made to allow technique for constant object to film distance and object to sensor distance. Conventional access opening was prepared in each tooth. Preoperative and postoperative working length was measured to an accuracy of 0.1 of mm on Dexis 3.0 direct digital radiograph's onscreen measurement device. RESULTS: Mean loss of working length varied from 0.28 to 0.92 mm. Highest working length loss was seen in ProTaper followed by K3 files and Profiles, which is statistically significant.