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ABSTRACT: Enterococcus faecalis has long been implicated in persistent root canal infections and therapy-resistant endodontic infections. It has also been associated with bacteremia, that is, infective endocarditis arising from certain invasive dental procedures. E. faecalis endocarditis antigen (efaA) has been identified as one of the principal virulence factors associated with infective endocarditis.
To detect the presence of putative E. faecalis virulence factor, efaA in root canals of therapy-resistant endodontic infections using polymerase chain reaction (PCR) amplification.
Samples were obtained from 32 patients (20-70 years) undergoing endodontic retreatment, which were incubated in prereduced thioglycollate broth and subcultured onto ethyl violet azide broth (EVA; selective medium for E. faecalis). Deoxyribonucleic acid (DNA) was extracted from the samples and analyzed for the endocarditis virulence factor efaA using PCR.
Among the positive E. faecalis samples, efaA gene was identified in 11 out of 15 samples.
Our findings indicate that efaA, a potent E. faecalis virulence gene can be found in E. faecalis strains detected in root canals of therapy-resistant endodontic infections similar to reports for 'medical' strains.
Journal of Conservative Dentistry 10/2012; 15(4):319-22.
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ABSTRACT: The purpose of the study was to compare the canal centring ability of K3, Liberator and EZ Fill Safesiders by using spiral computed tomography (SCT). Forty curved mandibular premolars were selected. Before and after instrumentation teeth were scanned by spiral computed tomography and nine cross-sectional views of each tooth were obtained at 1.5 mm intervals from the apex. Canal centring ratio was calculated. Mean values were compared between different study groups by using one-way ANOVA followed by Tukey - HSD procedure. At 1st, 2nd and 3rd levels, there was no statistical difference between groups. From 4th to 9th levels Safesider showed higher centring ratio, followed by Liberator and K3. Safesider showed better canal centring ability followed by Liberator and K3.
Australian Endodontic Journal 08/2012; 38(2):55-9. · 0.96 Impact Factor
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ABSTRACT: Evaluation of microhardness of root dentin provides indirect information on the change in mineral content of root dentin thereby providing useful information on the bonding quality of resin-based root canal sealers.
This study evaluated the effect of 17% EDTA, MTAD, and 18% HEBP solutions on the microhardness of human root canal dentin using the Vickers microhardness test.
Forty human single-rooted teeth were decoronated at the cementoenamel junction and sectioned longitudinally into buccal and lingual segments. Eighty specimens were divided into four groups (n=20). Group I was treated with distilled water (control), groups II, III, and IV were treated with 1.3% NaOCl as a working solution for 20 minutes followed by 17% EDTA, MTAD, and 18% HEBP respectively. The surface hardness of the root dentin was determined in each specimen with a Vicker's hardness tester. The values were statistically analyzed using the one-way ANOVA and post hoc Tukey multiple comparison tests.
There was a statistical significant difference among all the groups (one-way ANOVA; P<0.001). Among the experimental groups, HEBP showed the highest dentin microhardness (53.74 MPa, P<0.001). Least microhardness was found with MTAD (42.85 MPa, P<0.001).
HEBP as a final rinse appears to be a promising irrigation protocol with less impact on the mineral content of root dentin.
Journal of Conservative Dentistry 04/2012; 15(2):170-3.
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ABSTRACT: The aim of this study is to evaluate the bactericidal effect of 908 nm diode laser in conjunction with various irrigation regimes in disinfection of apical third of root dentin.
Sixty prepared teeth with single canals were contaminated with Enterococcus faecalis. The specimens were divided into 6 groups (n = 10): Group 1 and 3 and 5 were subjected to chemo-mechanical preparation using 5.25% sodium hypochlorite (NaOCl), 17% Ethylenediaminetetraacetic acid (EDTA); 1.3% NaOCl, MTAD (mixture of doxycycline, citric acid and a detergent (Tween 80); and, 8.5% saline, respectively followed by 908 nm diode laser irradiation; Group 2 and 4, followed the same procedure as Group1 and 3, however without laser irradiation; and, Group 6, rinsed with saline solution (control). Dentin shavings from apical third were analyzed for the presence of E. faecalis using culture method and Polymerase Chain reaction (PCR).
One-way Analysis of variance showed statistically significant differences between the laser irradiated groups, non irradiated groups and the control group.
908 nm diode used in conjunction with conventional chemomechanical techniques demonstrated a significant elimination of E. faecalis in the apical third of root dentin.
Journal of Conservative Dentistry 01/2012; 15(1):46-50.
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ABSTRACT: To evaluate the bonding ability of composite to unset glass-ionomer cement (GIC) using different self-etching bonding systems.
One hundred samples of composite bonded to unset GIC were prepared and were divided into four groups. In Group A, composite was bonded to unset GIC employing a strong (pH 1) self-etch primer was used. In Group B, intermediary strong (pH 1.4) self-etch primer was employed. In Group C and D, mild (pH 2) and (pH 2.2) self-etch primer was employed. Shear bond strength analysis was performed at a cross-head speed of 0.5 mm/min.
Statistical analysis performed with one way analysis of variance and Tukey's test showed that the bond strength of composite to unset GIC was significantly higher for the mild self-etch primer group. In addition, energy dispersive x-ray (EDX) analysis was used to determine the composition of various structural phases identified by FE-SEM along the GIC-bonding agent interfaces.
Hence this present study concludes that clinically the use of mild self-etching bonding agent over unset GIC has improved bond strength compared to the use of strong and intermediate self-etching bonding agent.
Journal of Conservative Dentistry 01/2012; 15(1):27-31.
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ABSTRACT: The present review provides an insight into various potential areas of dentistry that are being invaded by nanotechnology based drugs and drug delivery systems. Current treatments for diseases of dental and oral structures rely on the use of classical pharmacological agents which, in some cases are limited by low efficacy and lack of selectivity to target cells. However, various nanostructures in drug delivery and their challenges in the field of dentistry have not been reviewed so far in the literature. The different treatment opportunities of importance include caries control restorations, tooth remineralisation, management of dentinal hypersensitivity, dental caries vaccine, management of oral biofilm, root canal disinfection, local anaesthesia and periodontal infection. The authors have also identified few dental applications demanding extensive research to emerge as a promising therapeutic strategy. We conclude by claiming that dentistry should follow the trend of probing matter at nanoscale to achieve a predictable treatment outcome.
Current Drug Delivery 06/2011; 8(5):586-94.
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ABSTRACT: Invasive cervical resorption (ICR) may occur as a consequence of trauma, orthodontic treatment, intracoronal bleaching, and surgical procedures and may lead to the progressive and destructive loss of tooth structure. The restoration of these resorptive defects is a challenging task because no single restorative material possesses good sealing ability, reinforcement of remaining tooth structure, and biocompatibility simultaneously.
This case presented with invasive cervical resorption class 2 (Heithersay) and apical inflammatory resorption caused by trauma in tooth #9. The surgical management of ICR was performed, and, finally, the roots were externally reinforced by filling the resorptive defect with a combination of composite and resin-modified glass ionomer cement, proposed as reverse sandwich restoration (RSR).
This novel RSR was well tolerated by the periodontal tissues. A follow-up x-ray showed no pathological changes and no recurrence of resorption.
This case report presents a treatment strategy for root reinforcement that might improve the healing outcomes for patients with invasive cervical resorption.
Journal of endodontics 05/2011; 37(5):706-10. · 2.95 Impact Factor
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ABSTRACT: To evaluate the disinfection of dentinal tubules using calcium hydroxide with propylene glycol and calcium hydroxide with iodoform in silicone oil, as compared to 2% chlorhexidine gel.
The antimicrobial efficacy of the medicaments against E.faecalis and C.albicans were assessed in vitro, using a dentinal tubule model at depths of 200 μm and 400 μm in extracted single rooted teeth. Saline was taken as the negative control (Group I) RESULTS: All three medicaments used in this study exerted antibacterial and antifungal activity. Group II (calcium hydroxide with propylene glycol) and Group IV (2% chlorhexidine gel) had the highest antimicrobial activity and the differences between their antibacterial activities were not statistically significant. Group III (calcium hydroxide with iodoform in silicone oil) and Group IV had the highest antifungal activity and the differences between their antifungal activities were not statistically significant. The inhibition of growth at 200 μm and 400 μm was uniform, with no statistical difference.
Two percent chlorhexidine gel was effective against both E.faecalis and C.albicans. Calcium hydroxide with propylene glycol was the most effective intracanal medicament along with 2% chlorhexidine against E.faecalis, whereas, calcium hydroxide with iodoform in silicone oil was the most effective intracanal medicament along with 2% chlorhexidine against C.albicans.
Journal of Conservative Dentistry 04/2011; 14(2):182-6.
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ABSTRACT: The purpose of the study was to evaluate the effect of MTAD in comparison with EDTA as a final rinse on the shear bond strength of Kerr, Apexit and AH plus. Dentine surfaces of 135 extracted human non-carious maxillary premolars were divided into three groups (n = 45). Groups I and II were conditioned with 1.3% NaOCl for 20 min, followed by a final rinse of 17% EDTA for 1 min and MTAD for 5 min respectively. Group III was treated with distilled water. Each group was further divided into three subgroups (n = 15). Subgroup 1: Kerr, Subgroup 2: Apexit and Subgroup 3: AH plus. Three-millimetre-long sections of polyethylene tubes were filled with freshly mixed sealer and placed on the dentine surfaces. The bonding between the sealer and dentine surface was evaluated using shear bond testing. The values were statistically evaluated using one way anova followed by Tukey's test. Significant difference was found among the bond strength of the sealers and irrigating regimes. AH plus showed superior bond strength among the tested sealers, when EDTA was employed as the final rinse (P < 0.05). MTAD as a final rinse affected the bond strength of AH plus and Apexit, which were significantly lower than the control group.
Australian Endodontic Journal 04/2011; 37(1):12-7. · 0.96 Impact Factor
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ABSTRACT: This case report explains about an innovative treatment strategy for the management of damaged anterior teeth with reduced incisal clearance by means of a single-unit all-ceramic post-core-crown zirconia ceramic restoration fabricated by Computer-aided designing and computer-aided manufacturing (CAD/CAM) technology. The reinforced zirconia ceramics allow fabrication of durable esthetic restorations in cases with high functional loading and the unification of the post, core, and crown in a single unit decreases the frequency of failure by creating a monobloc effect. In addition, the use of CAD/CAM technology for designing and fabricating ceramic restorations offers the option of expeditiously preparing these high-strength all-ceramic restorations.
Journal of Conservative Dentistry 01/2011; 14(1):86-9.
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ABSTRACT: This study has been designed to evaluate the effect of strong (MTAD) or soft (1- hydroxyethylidene - 1, 1-bisphosphonate (HEBP) final irrigating solution on the shear bond strength of AH plus sealer to coronal dentin. 17% EDTA was used as the reference.
Forty freshly extracted human maxillary first premolars were prepared using different irrigation protocols (n=10). All the test groups had 1.3% NaOCl as initial rinse and followed by specific final rinse for each group: G1 - distilled water(control), G2 - 17% EDTA, G3- 18% HEBP and G4 - MTAD. Sections of polyethylene tubes that are 3mm long were filled with freshly mixed sealer and placed on the dentin surfaces. The bonding between the sealer and dentine surface was evaluated using shear bond testing. The values were statistically evaluated using one-way ANOVA followed by Tukey's test.
Significant difference was found among the irrigating regimes. EDTA showed highest bond strength followed by HEBP and MTAD.
Journal of Conservative Dentistry 01/2011; 14(1):40-2.
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ABSTRACT: Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal. Of these three essential steps of root canal therapy, irrigation of the root canal is the most important determinant in the healing of the periapical tissues. The primary endodontic treatment goal must thus be to optimize root canal disinfection and to prevent reinfection. In this review of the literature, various irrigants and the interactions between irrigants are discussed. We performed a Medline search for English-language papers published untill July 2010. The keywords used were 'root canal irrigants' and 'endodontic irrigants.' The reference lists of each article were manually checked for additional articles of relevance.
Journal of Conservative Dentistry 10/2010; 13(4):256-64.
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ABSTRACT: To compare the laterally condensed gutta-percha, vertically compacted thermoplastized gutta-percha (E and Q Plus system) and cold free-flow gutta-percha (GuttaFlow). This is a volumetric analysis using spiral CT, an in vitro study.
Access cavities were prepared in 60 single rooted anterior teeth; cleaning and shaping was done and obturated with three of the different techniques: group A: cold lateral; group B: vertically compacted thermoplasticized and group C: cold free-flow obturation techniques. Volume analysis was done using spiral computed tomography (CT). The percentage difference was calculated and statistically analyzed using one-way ANOVA and post hoc multiple comparison Tukey HSD tests.
There were statistical significant differences between group A (0.183cm(3)) and group B (0.136cm(3)); group A (0.183cm(3)) and group C (0.128cm(3)). But there was no statistical significance between group B (0.136cm(3)) and group C (0.128cm(3)).
Within the limitations of this in vitro study it can be concluded that cold free-flow obturation technique showed the highest volume of obturation, followed by the vertically condensed thermoplasticized technique. The least volume of obturation was observed in cold lateral condensation technique.
Journal of Conservative Dentistry 10/2009; 12(4):145-9.
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ABSTRACT: The development of methods to amplify nucleic acids has provided a way of identifying and quantifying infectious pathogens in infected pulp and periapical region. Recent studies have detected human herpes virus in periapical pathosis and periodontitis. The aim of this study is to detect the presence or absence of herpes simplex virus, human cytomegalovirus and Epstein Barr virus in an infected pulp. Ten pulp tissue samples from teeth with irreversible pulpitis and eight control samples were subjected to polymerase chain reaction(Perkin - Elmer Gene Amplification System) for detection of human herpesvirus. The results of this study did not reveal any human herpes virus in both the control and infected pulp tissue samples. According to this study, human herpes virus may not have an entry through the infected pulp to reach the periapical region and may not be a causative organism in the pulp.
Australian Endodontic Journal 05/2009; 35(1):9-12. · 0.96 Impact Factor
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ABSTRACT: Trauma to anterior teeth results in crown root fracture in 5% of cases. Calcific healing of a complicated oblique crown root fracture is rarely reported in literature. This article highlights the calcific healing of a traumatized maxillary central incisor with crown root fracture. This unique observation of healing following trauma was confirmed with the use of spiral computed tomography and Hounsfield units.
Dental Traumatology 01/2009; 24(6):e96-100. · 1.20 Impact Factor
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ABSTRACT: Aim/Objective: To compare the laterally condensed gutta-percha, vertically compacted thermoplastized gutta-percha (E and Q Plus system) and cold free-flow gutta-percha (GuttaFlow). This is a volumetric analysis using spiral CT, an in vitro study. Materials and Methods: Access cavities were prepared in 60 single rooted anterior teeth; cleaning and shaping was done and obturated with three of the different techniques: group A: cold lateral; group B: vertically compacted thermoplasticized and group C: cold free-flow obturation techniques. Volume analysis was done using spiral computed tomography (CT). The percentage difference was calculated and statistically analyzed using one-way ANOVA and post hoc multiple comparison Tukey HSD tests. Results: There were statistical significant differences between group A (0.183cm<sup> 3</sup> ) and group B (0.136cm<sup> 3</sup> ); group A (0.183cm<sup> 3</sup> ) and group C (0.128cm<sup> 3</sup> ). But there was no statistical significance between group B (0.136cm<sup> 3</sup> ) and group C (0.128cm<sup> 3</sup> ). Conclusion: Within the limitations of this in vitro study it can be concluded that cold free-flow obturation technique showed the highest volume of obturation, followed by the vertically condensed thermoplasticized technique. The least volume of obturation was observed in cold lateral condensation technique.
Journal of Conservative Dentistry. 01/2009;
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ABSTRACT: During instrumentation of the root canal, it is important to develop a continuously tapered form and to maintain the original shape and position of the apical foramen. However, the presence of curvatures may cause difficulty in root canal instrumentation. The ability to keep the instruments centered is essential to provide a correct enlargement, without excessive weakening of the root structure. Several studies have shown that Ni-Ti instruments remain significantly more centered and demonstrated less canal transportation than stainless steel files. Considerable research has been undertaken to understand the several factors related to an instrument's canal-centering ability. In this article, we have discussed the influence of various parameters such as alloys used in the manufacture of instruments, instrument cross-section, taper, and have given tips on canal-centering ability.
Journal of Conservative Dentistry 01/2009; 12(1):3-9.
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ABSTRACT: Coconut water is biologically pure and sterile, with a rich presence of amino acids, proteins, vitamins, and minerals. The purpose of this study was to use a collagenase-dispase assay to investigate the potential of a new storage medium, coconut water, in comparison with propolis, Hank's balanced salt solution (HBSS), and milk in maintaining viable periodontal ligament (PDL) cells on simulated avulsed teeth. Seventy freshly extracted human teeth were divided into 4 experimental groups and 2 control groups. The positive and negative controls corresponded to 0-minute and 8-hour dry times, respectively. The experimental teeth were stored dry for 30 minutes and then immersed in 1 of the 4 media (coconut water, propolis, HBSS, and milk). The teeth were then treated with dispase grade II and collagenase for 30 minutes. The number of viable PDL cells was counted with a hemocytometer and analyzed. Statistical analysis showed that coconut water kept significantly more PDL cells viable compared with propolis, HBSS, or milk. Coconut water can be used as a superior transport medium for avulsed teeth.
Journal of endodontics 06/2008; 34(5):587-9. · 2.95 Impact Factor
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ABSTRACT: The purpose of this paper is to suggest an easier, non-metallic radiographic grid system for measuring the working length and radiographic size of pathologic areas during endodontic diagnosis and prognosis determination.
Australian Endodontic Journal 05/2008; 34(1):36-8. · 0.96 Impact Factor
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ABSTRACT: The aim of our study was to assess the setting time and surface crazing of glass ionomer cement when layered over partially set mineral trioxide aggregate (MTA). To assess setting time, 40 hollow, cylindrical stainless steel molds were taken and equally divided into 4 groups. In groups I, II, and III glass ionomer cement was layered over partially setting MTA at 45 minutes, 4 hours, and 3 days, respectively. Group IV was used as a control. An additional 50 specimens were prepared for assessment of surface crazing. Twenty specimens (groups I and II) were prepared to study normal and desiccated patterns of conventional glass ionomer cement, respectively. Thirty specimens (groups III, IV, and V) were prepared by layering glass ionomer cement over partially set MTA at various time intervals. All the specimens were stained with red ink and analyzed for craze lines by light microscopy. From our study, it was observed that there was no statistical difference in setting time of glass ionomer cement when layered over partially set MTA in comparison to that of the control group. No craze lines were observed in those specimens (groups III, IV, and V) when viewed under staining and light microscopy. It could be concluded that conventional glass ionomer cement might be layered over partially set MTA after 45 minutes and could be used for single visit procedures.
Journal of Endodontics 05/2008; 34(4):478-80. · 2.88 Impact Factor
