Comparative assessment of titanium-prepared platelet-rich fibrin, EndoSequence root repair material, and calcium hydroxide as pulpotomy agents in permanent teeth with irreversible pulpitis: A randomized controlled trial.

Context: Pulpotomy is a procedure in which part of an exposed vital pulp is removed, usually as a means of preserving the vitality and function of the remaining part. Aim: The aim is to compare the effectiveness of Dycal (CH), EndoSequence, and Titanium-prepared platelet-rich fibrin with EndoSequence (T-PRF) as pulpotomy agents in mature permanent molars with irreversible pulpitis. Settings and Design: Sixty permanent mandibular molars with carious exposure and symptoms of irreversible pulpitis were randomly allocated to three groups. Subjects and Methods: Full pulpotomy was performed using Dycal, EndoSequence, and T-PRF with EndoSequence as pulpotomy agents. Pain intensity was analyzed using a Numeric Rating Scale score at baseline 24 h, 7 days, 6 months, and 1 year. The clinical and radiographic evaluations were done at 6 months and 1 year. Statistical Analysis: Nonparametric tests (Kruskal-Wallis, Chi-square) were applied to analyze the data as the normality test does not follow a normal distribution. Results: T-PRF and EndoSequence showed effective results when compared clinically, and there was no significant difference between radiographic success rates among the three groups at (P = 0.325 at 6 months, 0.466 at 12 months) follow-up. Conclusion: T-PRF and EndoSequence showed higher success rates among Dycal, EndoSequence as pulpotomy agents in teeth with irreversible pulpitis.

Synchrotron radiation-based micro-computed tomographic analysis of dentinal microcracks using rotary and reciprocating file systems: An in vitro study.

BACKGROUND: Advances in both X-ray sources and X-ray optics have dramatically improved the feasibility of these techniques in various fields. AIMS: We aimed to evaluate the frequency of dentinal microcracks observed after root canal preparation with ProTaper Gold (PTG), Hyflex electrodischarge machining (HEDM), Reciproc (RPC), and WaveOne Gold (WOG) using synchrotron radiation-based micro-computed tomographic (SR-µCT) analysis. SUBJECTS AND METHODS: Forty mandibular molars were assigned to 4 experimental groups (n = 10) according to the file system used for the root canal preparation: Group 1: PTG (25/0.08), Group 2: HEDM (25/0.08), Group 3: RPC (25/0.08), and Group 4: WOG (25/0.07). The specimens were scanned on SR-µCT system before and after root canal preparation. The pre- and postoperative cross-sectional images (N = 183,200) of the mesial roots were screened to identify the presence of dentinal microcracks. The number of microcracks was determined as a percentage for each group. STATISTICAL ANALYSIS: There was no necessity of statistical analysis in the present study. The number of microcracks was determined as a percentage for each group. RESULTS: Among the four file systems tested, HEDM (0.9%) has shown a fewer number of new dentinal microcracks. CONCLUSIONS: SR-µCT can be used as a reliable diagnostic tool for further implications.

Effect of Preetching on Microleakage with All-In-One Adhesives Using Calcium-Based Desensitizers: An In vitro Study.

OBJECTIVES: The aim of this study was to evaluate the effect of calcium-based desensitizers on the microleakage with and without preetching enamel in Class V cavities restored with all-in-one adhesives. MATERIALS AND METHODS: Class V cavities were prepared on the buccal surfaces of 100 extracted human premolars. A total of 100 box-shaped cavities were divided into five groups (n = 20). Group 1 - no desensitizer was applied and Groups 2 and 4 - desensitizer (CCP-ACP and Novamin) was applied, respectively, followed by the application of G-Bond and restored with composite restoration. Groups 3 and 5 are same as Group 2 and 4, but preetching of enamel was done for 3 s after desensitizers application. The teeth were thermocycled and the specimens were examined for microleakage using methylene blue as a marker. The teeth were sectioned buccolingually and evaluated for microleakage under stereomicroscope and the scores obtained were analyzed with Kruskal-Wallis and Mann-Whitney tests. RESULTS: Statistically significant difference existed between Groups 2 and 3 (P < 0.05). There was also statistically significant difference between Groups 4 and 5 (P < 0.05). Groups 3 and 5 showed significantly less microleakage (P < 0.05). No statistically significant difference in microleakage values was observed between the two desensitizers CCP-ACP and Novamin. CONCLUSION: The application of calcium-containing desensitizers with selective etch enamel technique in all-in-one adhesives could be considered an advisable procedure to minimize microleakage.

Evaluation of threshold response and appropriate electrode placement site for electric pulp testing in fluorosed anterior teeth: An in vivo study.

BACKGROUND: Accurate diagnosis is key to success. Diagnosing the pulpal status in varied clinical situations poses a challenge to the clinician. Electric pulp test (EPT) is one of the valuable attempts in evaluating the sensibility of pulp tissue. The aim of this study was to find out and compare the threshold levels and optimal electrode placement site for EPT in fluorosed and nonfluorosed anterior teeth. MATERIALS AND METHODOLOGY: Eighty volunteers recruited for this study were divided into two groups based on the incidence of dental fluorosis. Electric pulp testing was done on either of the central incisors in fluorosed and nonfluorosed group. Four sites on each crown were tested 4 times with digitest electric pulp tester, and the mean of the threshold responses was recorded. The data were analyzed with SPSS, version 11. Means of variables from each location were compared using one-way ANOVA and Tukey's post-hoc test while the critical level of significance was set at P < 0.05. RESULTS: The mean and standard deviation of threshold levels in fluorosed teeth were greater when compared to that of nonfluorosed teeth at all sites with incisal edge showing the least mean threshold levels for both the groups (P > 0.05). CONCLUSION: Within the limitations of this study, it can be concluded that fluorosed teeth respond to higher threshold levels than the non-fluorosed teeth, and incisal edge was the optimal electrode placement site.

Comparative Evaluation of Antimicrobial Effect of Three Endodontic Sealers with and Without Antibiotics - An In-vitro Study.

INTRODUCTION: Root canal sealers with good sealing ability and antimicrobial activity are desired to entomb the surviving microorganisms. AIM: Aim of the present study is to evaluate the antimicrobial effect of different sealers mixed with antibiotics. MATERIALS AND METHODS: Sixty extracted premolars were taken and were cut coronally & apically such that 7mm of tooth specimen was prepared. They were sterilized by autoclaving, inoculated with E.faecalis and incubated for three weeks. The specimens were divided into six groups of 10 each. Group 1 - ZnOE, Group 2 - ZnOE +TAM, Group 3 - Apexit Plus, Group 4 - Apexit Plus +TAM, Group 5 - AH Plus, Group 6 - AH Plus + TAM. Bacterial growth in the each specimen was calculated before & after sealer application and noted as initial & final colony count. Antimicrobial effect of each sealer was measured by calculating the Percentage Reduction in Colony Count (%RCC). One way analysis of variance and post hoc tests were used for statistical analysis. RESULTS: ZnOE + TAM group showed maximum antibacterial effect among the sealers tested and AH Plus sealer showed least antimicrobial effect. CONCLUSION: When the sealers were mixed with triple antibiotic mixture the antimicrobial effect was increased significantly.

Comparative Evaluation of Marginal Adaptation of Biodentine(TM) and Other Commonly Used Root End Filling Materials-An Invitro Study.

AIM: The purpose of this investigation was to evaluate the marginal adaptation of three root-end filling materials Glass ionomer cement, Mineral trioxide aggregate and Biodentine(TM). METHODOLOGY: Thirty human single-rooted teeth were resected 3 mm from the apex. Root-end cavities were then prepared using an ultrasonic tip and filled with one of the following materials Glass ionomer cement (GIC), Mineral trioxide aggregate (MTA) and a bioactive cement Biodentine(TM). The apical portions of the roots were then sectioned to obtain three 1 mm thick transversal sections. Confocal laser scanning microscopy (CLSM) was used to determine area of gaps and adaptation of the root-end filling materials with the dentin. The Post hoc test, a multiple comparison test was used for statistical data analysis. RESULTS: Statistical analysis showed lowest marginal gaps (11143.42±967.753m2) and good marginal adaptation with Biodentine(TM) followed by MTA (22300.97±3068.883m(2)) and highest marginal gaps with GIC (33388.17±12155.903m(2)) which were statistically significant (p<0.0001). CONCLUSION: A new root end filling material Biodentine(TM) showed better marginal adaptation than commonly used root end filling materials.

Comparative Evaluation of Push-out Bond Strength of Three Endodontic Sealers with and without Amoxicillin-An Invitro Study.

INTRODUCTION: The purpose of this study was to evaluate the sealing ability of three different root canal sealers with and without amoxicillin, using a push-out bond strength test. MATERIAL AND METHODS: Sixty single-rooted extracted human teeth were used for this study. Each tooth was instrumented and irrigated with 5.25% Sodium hypochlorite (NaOCl) and 17% EDTA. The teeth were then divided into six test groups: Gutta percha (GP)/AH Plus (Dentsply, Germany), GP/AH Plus with 10% amoxicillin (TEVA Pharmaceuticals Sellersville, PA), GP/Pulp Canal Sealer EWT (Extended Working Time, SybronEndo Orange, CA), GP/Pulp Canal Sealer EWT with amoxicillin, GP/Apexit Plus, GP/Apexit Plus (Vivadent, Tulsa, US) with amoxicillin. After the sealer was set, the entire root was sectioned into 1 mm thick slices. A push-out bond strength test was performed by using a universal testing machine. The Student's t-test was used to compare the sealer bond strength within the specific sealer test groups and within each sealer at apical, middle and coronal root levels. RESULTS: There was no significant difference between the groups within each sealer (p>0.05) with or without amoxicillin at the same root level. CONCLUSION: This study demonstrated that the addition of 10% by weight of amoxicillin does not significantly (p> 0.05) change the overall push-out bond strength of three endodontic sealers when compared at the apical, middle, and coronal tooth level.