Proximal contact tightness of direct Class II composite resin restorations with various matrix systems: A systematic review.

Background: Restoring an ideal proximal contact in direct Class II composite resin restorations is challenging due to polymerization shrinkage, absence of condensability of composite materials, thickness of matrix bands, and the use of various separation techniques, retainers, and bands. Aims: The aim of this study was to evaluate the proximal contact tightness that is achieved by various matrix systems used to restore a direct Class II cavity with composite resin restoration. Methods: A systematic review was carried out according to the PRISMA 2020 statement guidelines. The online search for the articles was done in electronic databases of MEDLINE/PubMed, Cochrane, and Google Scholar. The articles comparing different matrix systems for restoration were selected. Out of 146 articles, a total of 6 articles met the selection criteria and were included. The QUIN risk-of-bias (RoB) tool was used for assessing the study quality. The data extracted from full text articles selected for inclusion, using a standardized software (Office Excel 2013 Software, Microsoft Corporation, Redmond, WA, USA). Results and Conclusion: Combination of sectional matrices and separation rings resulted in tighter proximal contact compared to other matrix systems.

Assessing Fear and Anxiety of Corona Virus Among Dental Practitioners.

OBJECTIVE: Originating in China in December 2019, coronavirus disease 2019 (COVID-19) rapidly spread to more than 216 countries in the world by May 2020. Because dentists are at a higher risk of contracting the disease, the present study assessed the fear and anxiety among dental practitioners of becoming infected with COVID-19. METHODS: An online cross-sectional questionnaire survey comprising of 9 questions was conducted among dental practitioners of Telangana. Age, gender, qualification, type of practice, years of practice, and place of residence were the demographic variables recorded. The response to each question was recorded in a YES or NO format, and mean fear score was calculated to categorize answers into low and high levels of fear. Comparison of mean fear score was done using t-test for 2 variables and analysis of variance for 3 or more than 3 variables. Multiple logistic regression analysis of the levels of fear with demographic variables was done. P < 0.05 was considered statistically significant. RESULTS: The mean fear and anxiety score of this study population reported was high 6.57 ± 2.07, with 58.31% of the population presenting with a low level of fear and anxiety. Only qualification (P = 0.045) and gender (P = 0.035) revealed a significant difference in fear to Q7and Q8, respectively. Irrespective of the age, gender, qualification, type of practice, and years in practice, the levels of fear reported in the present study were very similar. Respondents between 41 and 60 y of age (6.70 ± 2.01 y) and those with individual practices (6.70 ± 2.06 y) exhibited high fear scores. CONCLUSIONS: The present study demonstrates cross-sectional data of fear and anxiety among dental practitioners during the COVID-19 outbreak. Heightened levels of fear observed in this study call for a nationwide analysis of fear among dentists and deliberate management strategies for the same.

A three-dimensional finite element analysis of stress distribution in maxillary central incisor with a horizontal mid root fracture after various management protocols.

Context: The incidence of root fractures is about 1.2%-7% in permanent teeth and horizontal mid root fractures are most common in maxillary anteriors. Aims: This study aims to evaluate the stress distribution in a maxillary central incisor with mid root fracture after various management protocols using three-dimensional finite element (FE) analysis. Materials and Methods: Four three dimensional FE models were constructed: Model 1-Normal tooth, Model 2-tooth with horizontal mid root fracture, Model 3-tooth with horizontal mid root fracture, coronal fragment filled with Biodentine, and access cavity sealed with composite resin cement and apical fragment left untreated and Model 4-tooth with horizontal mid root fracture restored with intraradicular fiber post as a splint and access cavity sealed with composite resin cement. The properties of materials were assigned and a force of 100 N was applied at 45° angle to the longitudinal axis of the tooth onto the palatal surface incisal to the cingulum. Statistical Analysis: Von-Mises stress along the length of the root analyzed and compared. Results: The maximum stress distribution was observed at the palatal end of the coronal radicular fragment in both without treatment and with biodentine treatment. The stress distribution was concentrated more at the junction of the splinted area in the intraradicular fiber post splinted model. Conclusions: The model with intraradicular fiber post as a splint exhibited more stress concentration at the splinted area due to bending forces. These stresses may adversely affect the healing around the fracture site and affect the longevity.

Comparative evaluation of apical bacterial extrusion following root canal instrumentation using different endodontic file systems: An in vitro study.

AIM: This study aims to evaluate the amount of apical extrusion of bacteria during root canal instrumentation using K3XF, Protaper Gold, Edge taper platinum, and Hyflex CM Rotary systems. MATERIALS AND METHODS: Sixty freshly extracted maxillary incisors teeth collected in saline. Access cavity prepared and canals were made free of bacterial and pulp. The teeth were mounted on the bacteria collecting apparatus. Root canals were contaminated with the Fusobacterium Nucleatum (ATCC25586) and dried at 37°C for 24 h. In Group 1 (Control group): No instrumentation was done and biomechanical preparation done in all other groups with Group 2: Hand K-files, Group 3: Protaper gold, Group 4: K3XF, Group 5: Edge taper platinum, and Group 6: Hyflex CM rotary file systems. Then, the extrude was collected, and it is incubated in Mueller-Hinton agar for 24 h and the number of colony forming units were counted and statistical comparison was done using Kruskal-Wallis test and Mann-Whitney U test. RESULTS: Hand K-files extruded more bacteria when compared to other four rotary systems, K3XF file system extruded least number of bacteria. CONCLUSION: All instrumentation techniques extruded intracanal bacteria apically. However, engine-driven nickel-titanium instruments extruded less bacteria than the manual technique. The K3XF rotary file system comparatively extruded less bacteria than other rotary file systems.

Antiplaque Efficacy of Tooth and Gums Tonic, Hiora-GA Gel, and Spirogyl Gum Paint in Comparison with Chlorhexidine M Gel: A Double-blind Randomized Control Trial.

OBJECTIVE: To compare the efficacy of three different herbal products (Tooth and Gums Tonic, Hiora-GA gel, and Spirogyl Gum paint) in reducing plaque, gingival inflammation and bacterial count in comparison with chlorhexidine M gel among participants with moderate to severe periodontitis. MATERIALS AND METHODS: A total of eighty participants with moderate to severe periodontitis were initially recruited after obtaining their informed consent. All participants were offered scaling and polishing on the first visit to remove visible calculus. Then, these participants were randomly divided into four groups of twenty participants each using block randomization method. Participants in Group 1, 2, 3, and 4 were given chlorhexidine M gel, Hiora-GA gel, Spirogyl Gum paint, and Tooth and Gums Tonic, respectively. All participants were instructed to brush their teeth twice day with a soft bristled toothbrush and their regular fluoridated toothpaste. They were instructed to apply the respective gels twice a day according to the manufacturer's guidelines. The posttreatment follow-up examinations for gingival and plaque changes were assessed after 30, 60, and 90 days by three trained and calibrated investigators using gingival and plaque index. The investigators and statistician were blind about group allocation. The supragingival plaque samples were collected before and 90 days after treatment from the buccal surfaces of maxillary right first permanent molar of each participant for microbial analysis. RESULTS: The mean plaque, gingival scores significantly decreased at different intervals following intervention in all groups. The bacterial counts also significantly reduced postintervention with no significant difference in the efficacy of these products compared to chlorhexidine. CONCLUSION: All three herbal products were found to be effective when used along with oral prophylaxis. Hence, they can all be used as alternates to chlorhexidine in the management of periodontal diseases.

Revascularization of immature mandibular premolar with pulpal necrosis - a case report.

This case report describes the Revascularization of a Permanent Immature Mandibular Premolar with Pulp Necrosis and apical periodontitis. Access opening was done & the canal was disinfected with copious irrigation using 2.5% NaOCl and triple antibiotic paste (Ciprofloxacin, Metronidazole, and Minocycline) as intracanal medicament. After the disinfection protocol is complete, it is followed by revascularization procedure. The apex was mechanically irritated to initiate bleeding into the canal to produce a blood clot to the level just below the level of cementoenamel junction. Mineral trioxide aggregate was placed over the blood clot followed by bonded resin restoration above it. After one year follow up; the patient was asymptomatic, no sinus tract was evident. Apical periodontitis was resolved, and there was radiographic evidence of continuing thickness of dentinal walls.

Sarjeev's supernumerary tooth notation system: a universally compatible add-on to the Two-Digit system.

AIM: To give notation for quadrants, tooth position, and the type of supernumerary teeth for both permanent and deciduous dentition. Tooth numbering provides dentists with an essential shortcut in clinical record keeping. MATERIALS AND METHODS: Three systems are favored worldwide: the Zsigmondy/Palmer system, the Universal system, and the Federation Dentaire Internationale (FDI) Two-Digit system. Histories of all tooth-numbering methods were traced and the strengths and deficiencies of each system were reviewed. The FDI Two-Digit system is widely used throughout the world, except USA, and is the only method that makes the visual sense, cognitive sense, and computer sense. CONCLUSION: On review it was noticed that all tooth notation systems in vogue have a drawback as they do not provide any information or notations for supernumerary teeth such as paramolar, distomolar, mesiodens, and fused teeth.