Comparative clinical evaluation of two different formulated in-office newer desensitizing agents (Clinpro XT and Tokuyama Shield Force Plus) in reducing dentin hypersensitivity - A randomized clinical trial.

Aim: The aim of this study was to assess the effectiveness of two various in-office newer desensitizing agents in reducing dentinal hypersensitivity in patients with mild-to-moderate sensitivity for a 1-month follow-up. Materials and Methods: Forty subjects with cervical dentin hypersensitivity (otherwise healthy patients) were included. A split-mouth, randomized clinical trial was conducted. A Visual Analog Scale (VAS) was used to record the initial sensitivity levels at the baseline visit. Each individual has been exposed to thermal (ethyl chloride spray) and evaporative (air blast) stimuli to elicit sensitivity. A single application of two different in-office desensitizing agents, Clinpro XT Varnish (3M ESPE, Minnesota, USA) and Shield Force Plus (Tokuyama Dental, Tokyo, Japan), was done. The sensitivity scores were recorded after the application of the desensitizing agent immediately, after 1 week, and after 1 month using both air and cold stimuli in the same manner as initially. Results: Mean VAS scores represent teeth that were more sensitive to cold stimuli compared to air blasts in both groups. For both stimuli at all-time intervals except baseline, there is a significant difference between CXT and SFP, with low mean VAS scores for CXT. Post hoc analysis revealed that in the CXT group, there is a significant difference in mean VAS score between pre-and postintervention at all-time intervals except between immediate and 1-week time intervals (P < 0.001) but only at immediate and 1-week time intervals in SFP. Conclusion: Clinpro XT Varnish is more efficient compared to Shield Force Plus at all-time points irrespective of the stimuli after a 1-month follow-up.

Detection of second mesiobuccal canals in maxillary first molars of the Indian population - a systematic review and meta-analysis.

Objective The aim of this systematic review and meta-analysis was to integrate the detection of second mesiobuccal (MB2) canals in maxillary first molars reported by different studies and methods on the Indian population.Methods This systematic review was conducted following Meta-analysis Of Observational Studies in Epidemiology (MOOSE) and PRISMA guidelines. A comprehensive search was conducted in PubMed, Medline, LILACS, Science Direct, Clinicaltrials.gov, CTRI and Cochrane databases to identify manuscripts published until 20 May 2021. Two independent reviewers assessed eligibility for inclusion, extracted data and assessed quality using the Newcastle-Ottawa Scale for cross-sectional studies.Results The database search identified 534 citations, including 36 citations through manual search, and communications from authors. After removing duplicates and going through 534 abstracts followed by 26 full-text articles, 16 articles met the inclusion criteria and contributed data for the review. The included studies used CBCT, radiographs, direct vision (DV), dental operating microscope (DOM) or dental operating microscope with ultrasonic instrumentation (DOMI) for MB2 detection. Meta-analysis and forest plot showed a pooled prevalence of 64.76% of MB2 canals in permanent maxillary first molars using CBCT, 26.5% for DV, 60.4% for using magnification in addition to DV and 71.9% for DV and magnification assisted with ultrasonic instrumentation. The prevalence of MB2 was found to be more in men than women.Conclusion The pooled prevalence in this systematic review and meta-analysis for detection of MB2 canals using CBCT was 64.76% compared to the global prevalence of 73.8%. Further well-designed studies are required to establish maxillary first molar MB2 prevalence in the Indian population.

Clinical performance of class I cavities restored with bulk fill composite at a 1-year follow-up using the FDI criteria: a randomized clinical trial.

OBJECTIVES: The present study aimed to evaluate the survival rate and clinical performance of class 1 composite restorations restored with the Filtek Bulk Fill composite material using either the bulk fill technique or the incremental technique at baseline (1 week) and at 3, 6 and 12 months of follow-up. MATERIALS AND METHODS: Forty-two patients with at least 2 carious teeth were selected. Following randomization, one tooth was restored with the Filtek Bulk Fill composite using the incremental fill technique, and the other tooth was restored with the same material using the bulk fill technique. Patients were recalled for follow-up at baseline (1 week) and 3, 6, and 12 months and evaluated using the FDI criteria. RESULTS: The data were analyzed using the McNemar χ2 test. No statistically significant differences were found between the scores of teeth restored with either technique. At baseline and at 3, 6, and 12 months of follow-up; there were no significant difference in the clinical status of both groups of restorations. CONCLUSIONS: Within the limitations of this study, using the bulk fill technique for restorations with the Filtek Bulk Fill material seems to be equally efficient to using the incremental fill technique. TRIAL REGISTRATION: Clinical Trials Registry-India Identifier: CTRI/2017/07/008961.

Accuracy of marginal adaptation of posterior fixed dental prosthesis made from digital impression technique: A systematic review.

AIM: The aim of this systematic review was to investigate the marginal adaptation of three or four unit fixed dental prosthesis (FDP) fabricated with digital impression techniques to those fabricated using any other impression technique. SETTINGS AND DESIGN: Database/electronic searches were conducted till August 2019 in PUBMED-MEDLINE, SCOPUS, and Cochrane library. To identify published articles, multiple keywords were used to develop a search strategy in various combinations. Manual searching of articles was also done. Clinicaltrials.gov.in WHOICTRP and CTRI websites were also searched. Two independent reviewers (TP and VK) assessed eligibility for inclusion, extracted data, and assessed quality using the Cochrane risk of bias tool. RESULTS: Database search identified 497 citations and four citations through manual search. After removing duplicates and going through abstracts, 23 articles were perused for full-text screening. Two articles met the inclusion criteria; characteristics were described qualitatively, with two studies having overall low risk of bias. CONCLUSIONS: Marginal adaptation of FDPs fabricated using the digital and conventional impressions method was within the clinically acceptable limits. However, more robust clinical trials need to be conducted with large sample size to validate the conclusions.

Effect of Preoperative Corticosteroids in Patients with Symptomatic Pulpitis on Postoperative Pain after Single-visit Root Canal Treatment: A Systematic Review and Meta-analysis.

INTRODUCTION: This study addressed the following population, intervention, comparator, outcome, timing, study design and setting question: in patients with preoperative pain who undergo single-visit nonsurgical endodontic treatment, what is the comparative efficacy of corticosteroids compared with other analgesics or placebo in reducing postoperative pain and the incidence of adverse events. METHODS: Database/electronic searches were conducted using the PubMed/MEDLINE, Scopus, and Cochrane databases to identify published articles using included key words in various combinations. Manual searching of articles was performed, and the Clinicaltrials.gov site was also searched. Two independent reviewers assessed eligibility for inclusion, extracted data, and assessed quality using the risk of bias tool. Where applicable, meta-analysis was conducted on the pooled effect size. RESULTS: The database search identified 481 citations and 37 citations through the manual search. After removing duplicates and going through abstracts, 28 full-text articles were perused. Five articles met the inclusion criteria; qualitative analysis revealed 4 studies had unclear risk of bias, and 1 study had low risk of bias. Only 1 study had a sizable sample size; the others had lesser sample sizes. Meta-analysis showed that prednisolone administered preoperatively was able to reduce the incidence of postoperative pain at 6, 12, and 24 hours. The patients in the studies reported no adverse effects. CONCLUSIONS: Corticosteroids may be more effective than placebo for the relief of postoperative endodontic pain in patients with symptomatic pulpitis undergoing single-visit root canal treatment. However, more studies need to be conducted with greater sample sizes to validate the conclusions.

Clinical performance of Class I nanohybrid composite restorations with resin-modified glass-ionomer liner and flowable composite liner: A randomized clinical trial.

BACKGROUND: Liners play a vital role in minimizing polymerization shrinkage stress by elastic bonding concept and increase the longevity and favorable outcome for composite restorations. AIMS: The aim of this study was to evaluate the clinical performance of nanohybrid composite restorations using resin-modified glass-ionomer and flowable composite liners. SETTINGS AND DESIGN: A single-centered, double-blinded randomized clinical trial, with split-mouth design and equal allocation ratio that was conducted in the Department of Conservative Dentistry and Endodontics. MATERIALS AND METHODS: In forty patients, a total of eighty Class I restorations were placed with resin-modified glass-ionomer cement (RMGIC) liner (FUJI II LC, GC America) in one group and flowable composite liner (smart dentin replacement/SDR, Dentsply Caulk, Milford, DE, USA) in another group. All restorations were clinically evaluated by two examiners, immediately (baseline), 3, 6, and 12 months using US Public Health Service modified criteria. STATISTICAL ANALYSIS USED: Statistical analysis was performed using McNemar's test (P < 0.05). RESULTS: There was no significant difference in the color match, marginal discoloration, surface roughness, and marginal adaptation. Restorations with RMGIC liner group show 20% Bravo scores on anatomic form at 12 months but are still clinically acceptable. CONCLUSION: Nanohybrid composite restorations with RMGIC (Fuji II LC) and flowable composite liner (SDR) demonstrated clinically acceptable performance after 12 months.

Effect of addition of lycopene to calcium hydroxide and chlorhexidine as intracanal medicament on fracture resistance of radicular dentin at two different time intervals: An in vitro study.

BACKGROUND: Long-term use of intracanal medicaments such as calcium hydroxide (CH) reduces the fracture resistance of dentin. The present study was undertaken to evaluate the fracture resistance of radicular dentin on long-term use of CH, chlorhexidine (CHX) with lycopene (LP). AIM: To compare the fracture resistance of radicular dentin when intracanal medicaments such as CH, CHX with LP were used for 1-week and 1-month time interval. SETTINGS AND DESIGN: Sixty single-rooted extracted human permanent premolars were collected, and complete instrumentation was done. Samples were divided into three groups based on intracanal medicament used. MATERIALS AND METHODS: Group 1 - no medicament was placed (CON), group 2 - mixture of 1.5 g of CH and 1 ml of 2% CHX (CHCHX), group 3 - mixture of 1.5 g of CH, 1 ml of CHX and 1 ml of 5% LP solution (CHCHXLP). After storage period of each group for 1-week and 1-month, middle 8 mm root cylinder was sectioned and tested for fracture resistance. STATISTICAL ANALYSIS: Results were analyzed using paired t-test. RESULTS: At 1-month time interval, there was a statistically significant difference in fracture resistance between CHCHX and CHCHXLP groups. CONCLUSION: Addition of LP has not decreased the fracture resistance of radicular dentin after 1-month.

Shear bond strength evaluation of adhesive and tooth preparation combinations used in reattachment of fractured teeth: an ex-vivo study.

OBJECTIVES: The objectives of this study were to evaluate the bond strengths of different adhesive materials, different tooth preparation designs and adhesive tooth preparation combinations to reattach fractured incisor fragments. MATERIALS AND METHODS: The study sample comprised 48 intact human maxillary central incisors divided into two groups A and B. The incisal third was sectioned with a diamond disc. The teeth in Group A were reattached with bonding agent and in Group B with resin luting cement. The teeth in each Group were further divided into three sub-groups based on the preparation designs viz., simple attachment, chamfer on labial surface, groove with shoulder on labial surface and restored with nano-composite. Shear Bond Strength was calculated by applying load incisal to the fracture line. T-test and one-way ANOVA were used to evaluate the bond strength between the groups and within the group respectively. RESULTS: Reattachment with resin luting cement showed high bond strength compared to bonding agent (P < 0.05). Within the subgroups 'groove with shoulder' showed better bond strength compared to simple attachment and chamfer and the result was statistically significant (P < 0.05). CONCLUSION: Reattachment of fractured fragments can be considered as a good alternative treatment option when the fragment is available.Reattachment with resin luting cement and the preparation design of "groove with shoulder" showed better results.

A comparative study on the shaping ability of k3, profile and protaper instruments in simulated curved root canals.

INTRODUCTION: The objective of this study was to compare the shaping ability of three rotary filing systems; constant taper K3 instruments, constant taper ProFile instruments and progressive taper ProTaper rotary instruments in clear resin blocks with simulated curved root canals. MATERIALS AND METHODS: Forty five resin blocks were divided into three groups. Group A preparation was conducted with K3, Group B with ProFile and Group C with ProTaper instruments. Pre and post instrumentation images were superimposed and assessment of the canal shape was completed with a computer image analysis program at 14 levels of the root canal system. RESULTS: Group A inner and outer curvature pre and post instrumentation values were significantly different (P<0.05) at levels 3; at level 13 only the outer curvature and levels 6, 7, 8 the inner curvature had significantly different values between pre and post instrumentation. Group C had significant P values (P<0.05) at levels 2, 3, 4, 12, 13 in the outer curvature and at levels 6, 7, 8 of the inner curvature. CONCLUSION: Overall, all three rotary instruments maintained root canal curvatures well. ProTaper instruments significantly removed more resin material from outer canal curvature in the apical third when compared to the other two groups.

Biphasic calcium phosphate in periapical surgery.

Calcium phosphate ceramics like hydroxyapatite and beta -tricalcium phosphate (beta -TCP) possess mineral composition that closely resembles that of the bone. They can be good bone substitutes due to their excellent biocompatibility. Biphasic calcium phosphate is a bone substitute which is a mixture of hydroxyapatite and beta -tricalcium phosphate in fixed ratios. Studies have demonstrated the osteoconductive potential of this composition. This paper highlights the clinical use of biphasic calcium phosphate as a bone substitute in periapical surgery.