- [Show abstract] [Hide abstract] ABSTRACT: To promote the remineralization by ionic exchange mechanism instead of invasive techniques many remineralizing agents can be used. To evaluate the remineralization effects of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on white spot lesions (WSLs) and its inhibitory effect on Streptococcus mutans colonization. The study group consisted of 60 subjects exhibiting at least 1-WSL. Subjects were randomly divided into 2 groups: A test group using CPP-ACP cream (GC-Tooth Mousse, Leuven, Belgium) and a control group using only fluoride containing toothpaste for a period of 3-month. Baseline WSLs were scored using DIAGNOdent device (KaVo Germany) and the saliva samples were collected to measure S. mutans counts. After the 3-month period the WSLs were again recorded and the saliva collection was repeated. DIAGNOdent measurements were increased by time (P = 0.002) in the control group and no statistically significant difference (P = 0.217) was found in the test group by the 3-month period. In both groups, the mutans counts were decreased in the 3-month experimental period. These clinical and laboratory results suggested that CPP-ACP containing cream had a slight remineralization effect on the WSL in the 3-month evaluation period however, longer observation is recommended to confirm whether the greater change in WSLs is maintained.
- [Show abstract] [Hide abstract] ABSTRACT: The aim of this in vitro study was to evaluate the depth of penetration of 4 different endodontic resin sealers into the radicular dentinal tubules with the aid of confocal microscopy. Eighty single-rooted teeth were instrumented and divided into 4 groups composed of 20 teeth each. The samples were obturated with AH Plus, RealSeal, EndoRez, and RoekoSeal resin sealers, respectively. The core material in all the groups was Resilon. The teeth were sectioned at the coronal, middle, and apical thirds and viewed under confocal microscope to determine the depth of penetration of the sealer into the dentinal tubules. The results showed that the maximum penetration was exhibited by RealSeal resin sealer, followed by AH Plus, RoekoSeal, and EndoRez. The coronal third showed the maximum penetration, followed by middle third and least at the apical third. Under the parameter of this study, RealSeal resin sealer exhibited the maximum penetration.
- [Show abstract] [Hide abstract] ABSTRACT: Successful root canal treatment depends primarily on the removal of micro-organisms through chemo-mechanical instrumentation of the root canal system. This encompasses shaping by mechanical removal of the dentine and cleaning by chemical disinfection of microorganisms and dissolution of organic tissues from the root canal. While root canal shaping can be predictably and efficiently attained with advanced instrumentation technology, effective cleaning of the entire root canal system remains a challenge. Rotary nickel titanium instruments are known for their efficient preparation of root canal. This is mainly because of the super elasticity of the nickel titanium alloy which gives an increased flexibility and allows the instrument to efficiently follow the original path of root canal. The purpose of this study is to compare the cleaning efficiency and shaping ability of M two, K3, Race ni-ti rotary instruments during the preparation of curved canals in extracted molars. Thirty teeth with 18 mm as their working length were selected and divided into three groups of 10 teeth each Angle of curvature, Radius of curvature, was determined using computerized tomography. A Pre and Post-operative measurement of canal width and volume was recorded and compared using CT. The teeth was then sectioned into two halves and subjected to scanning electron microscope. Images were taken at the level of apical third, middle third and coronal third for debris and smear layer. Scoring was done separately for both debris and smear layer. Results were tabulated and statistically analyzed to evaluate the shaping ability and cleaning efficiency. Instruments were examined for any deformation or fracture during canal preparation. M two showed greater enlargements in all the three levels, when compared its width and volume, with other two instruments. K3 was better than Race when compared among them. In the scanning electron microscope study for debris and smear layer M Two performed better followed by K3 and Race.
- [Show abstract] [Hide abstract] ABSTRACT: The aim of this ex vivo study was to evaluate the effect of in-office bleaching agents,-35% and 38% hydrogen peroxide containing bleaching agents, on the phosphate concentration of the enamel evaluated by Raman spectroscopy. Forty noncarious, craze-free human maxillary incisors, extracted for periodontal reasons, were used in this study. Baseline Raman spectra from each specimen were obtained before the application of the bleaching agent to assess the phosphate content present in the teeth. The teeth were divided into two groups: Group A - bleached with pola office bleach (35% hydrogen peroxide, potassium nitrate) (light activated). Group B - bleached with opalescence Xtra bleach (38% hydrogen peroxide potassium nitrate and fluoride) (chemical activated). After the bleaching procedure, the treated specimens were taken to obtain Raman spectra to assess the phosphate loss after bleaching treatment. The results showed that the chemically activated bleaching agent showed less phosphate loss when compared with the light activated bleaching agent. Within the limitations of this study, it can be concluded that the chemically activated bleaching agent showed minimal phosphate loss when compared to light activated bleaching agent. The chemically activated bleaching agent was better than the light activated bleaching agent when values were evaluated statistically.
- [Show abstract] [Hide abstract] ABSTRACT: Mandibular molars demonstrate considerable variations with respect to number of roots and root canals. The possibility of additional root canals should be considered even in teeth with a low frequency of abnormal root canal anatomy. This paper discusses the endodontic management of the rare anatomical complexity middle mesial canals in mandibular first molar and also serves to remind the clinicians that such anatomical variations should be taken into account during the endodontic treatment of the mandibular molars.
- [Show abstract] [Hide abstract] ABSTRACT: A clear understanding of the root morphology and canal anatomy is an essential prerequisite to achieve clean, disinfected and 3-dimensionally obturated root canal systems. Undetected extra roots or root canals can directly affect the outcome of endodontic therapy. The purpose of this article was to present a clinical case of a maxillary first molar with two palatal canals in a single palatal root. This report serves in reminding clinicians that such anatomical variations should be taken into account during the endodontic treatment of the maxillary molars.
- [Show abstract] [Hide abstract] ABSTRACT: The study was designed as a randomized double-blind trial to evaluate the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine in inferior alveolar nerve block (IANB) and infiltration anesthetic techniques to anesthetize mandibular molars with irreversible pulpitis. The study was composed of 2 test arms and 1 control arm. Subjects in the test arms received either a standard IANB or a buccal infiltration (B Infil) of 4% articaine with 1:100,000 epinephrine, whereas the subjects in the control arm received a standard IANB of 2% lidocaine with 1:100,000 epinephrine. Subject's self-reported pain response was recorded on Heft Parker Visual Analogue Scale after local anesthetic administration during access preparation and pulp extirpation. For statistical analysis Pearson χ(2), Student's paired t test, 1-way analysis of variance, and Friedman tests showed no significant difference in success rates among the 3 arms of the trial. Although B Infil and IANB of 4% articaine were equally effective, B Infil can be considered a viable alterative in IANB for pulpal anesthesia in mandibular molars with irreversible pulpitis.
- [Show abstract] [Hide abstract] ABSTRACT: Dental amalgam is the primary direct posterior restorative material used worldwide, but it have certain shortcomings due to the lack of adhesiveness to the cavity. The introduction of the concept of bonded amalgam helped improve the use of amalgam as a restorative material. Evaluation of the comparative push-out shear bond strength of four types of conventional glass ionomers used to bond amalgam to tooth in simulated class I situations. FOUR CHEMICAL CURE GLASS IONOMERS ARE USED: GC Fuji I, GC Fuji II, GC Fuji III and GC Fuji VII, and are compared with unbonded amalgam. The push-out bond strength was tested using the Instron Universal Testing Machine at a crosshead speed of 0.5 mm/min. One-way ANOVA and post hoc Bonferroni tests were used to analyze the data. The results showed that the use of glass ionomer to bond amalgam resulted in an increase in the bond strength of amalgam. The Type VII glass ionomer showed the highest bond strength in comparison with the other glass ionomers. Conventional glass ionomer bonds to amalgam and shows a beneficial increase in the bond strength of the restoration in comparison with unbonded amalgam.
- [Show abstract] [Hide abstract] ABSTRACT: The aim of this in vitro study was to compare the shear bond strengths of two different dentin bonding agents with two different desensitizers. Eighty molars were taken which were ground to expose the dentin. The teeth were divided into two major groups. Each major group was subdivided into four subgroups of 10 samples each. Groups Ia and IIa were treated as dry bonding groups, groups Ib and IIb were treated as a moist bonding groups, groups Ic and IIc were rewetted with Gluma desensitizer, and groups Id and IId were rewetted with vivasens desensitizer. Major group I was treated with Gluma comfort bond and Charisma. Major group II was treated Prime and Bond NT and TPH. The samples were thermo cycled and shear bond test was performed using an Instron machine. The data were analyzed using one-way analysis of variance and Tukey's Honestly significant different test. The results revealed that the specimens rewetted with Gluma desensitizer showed the highest shear bond strength compared to all other groups, irrespective of the bonding agent or composite resin used. It can be concluded that rewetting with desensitizer provided better bond strength than the other groups.
- [Show abstract] [Hide abstract] ABSTRACT: Anatomical racial variations are an acknowledged characteristic in permanent molars. Generally, mandibular first molars have 2 roots; however, the presence of a third root, radix entomolaris (RE), is a major anatomic variant among many population groups. This study evaluated the prevalence of permanent mandibular first molars featuring a distolingual root in a South Indian population. Five hundred patients of South Indian origin possessing bilateral mandibular first molars were selected. The radiographs of these patients were evaluated under optimal conditions. A total of 1000 mandibular first molars were screened and the incidence of 3-rooted mandibular first molars and the correlation between left and right side occurrence and between either gender was recorded. The prevalence of 3-rooted mandibular first molars was 18.6% of the patients examined and 13.3% of the teeth examined. There was no statistically significant difference between genders or side of occurrence (P > .05). The bilateral incidence of a symmetric distribution was 43.01%. RE is considered an Asiatic trait. The occurrence of this macrostructure in the South Indian population was 13.3%, which was lower than that of other patients of Mongoloid origin. The clinician must thoroughly examine the radiograph before initiation of endodontic therapy.
- [Show abstract] [Hide abstract] ABSTRACT: 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. 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. 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. 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.
- [Show abstract] [Hide abstract] ABSTRACT: This study aimed at qualitatively evaluating the remineralization potential of casein phosphopeptide amorphous calcium phosphate on artificial early enamel lesions in an ex-vivo scenario by observing the treated tooth surface using a scanning electron microscope (SEM). This randomized study was conducted on 10 subjects undergoing orthodontic treatment with premolar extraction as part of their treatment. Artificial white lesions were created with the application of 37% phosphoric acid for 20 mins. Teeth were then divided into two groups: one experimental and the other control. Customised orthodontic band with a window was luted with intermediate restorative material in the experimental group whereas in the control group, band without a window was luted. The casein phosphopeptide amorphous calcium phosphate (GC TOOTH MOUSSE) paste was then applied on the window region of the experimental group for 3 mins thrice daily after meals for 14 days, whereas no paste was applied in the control group. After 14 days, teeth were extracted and viewed under an SEM. The study groups showed remineralization of the lesions as compared with the control group in most of the samples. Casein phophopeptide could significantly remineralize the artificial enamel lesions in vivo.
- [Show abstract] [Hide abstract] ABSTRACT: The study assessed quantitatively the calcium and phosphorous loss from the enamel surface following bleaching with 35% hydrogen peroxide and reversal with 10% sodium ascorbate using energy-dispersive X-ray analysis (EDAX). Eight non-carious, freshly extracted human permanent maxillary central incisors without any visible defects were used. Each specimen was bleached with 35% hydrogen peroxide activated by light and reversed with sodium ascorbate antioxidant gel. The calcium and phosphorous content in weight percent of sound, bleached and reversed enamel was acquired using EDAX. The Ca/P ratio was calculated from the obtained data. One-way ANOVA followed by Post Hoc Tukey test was used for comparing the Ca/P ratio of sound, bleached and reversed enamel. All the samples subjected to bleaching using 35% hydrogen peroxide showed a statistically significant decrease in the Ca/P ratio as compared with samples in which no bleaching procedure was performed (P-value < 0.01). The striking finding was that there was a significant increase in the Ca/P ratio on application of sodium ascorbate antioxidant gel when compared with the bleached enamel (P-value < 0.01). The authors concluded that 35% hydrogen peroxide causes a significant decrease in the Ca/P ratio. This decrease in the Ca/P ratio can be restored by the application of 10% sodium ascorbate antioxidant gel.
- [Show abstract] [Hide abstract] ABSTRACT: This in vitro study was designed to measure and compare the temperature rise in the pulp chamber with different light curing units. The study was done in two settings-in-vitro and in-vivo simulation. In in-vitro setting, 3mm and 6mm acrylic spacers with 4mm tip diameter thermocouple was used and six groups were formed according to the light curing source- 3 Quartz-Tungsten-Halogen (QTH) units and 3 Light-Emitting-Diode (LED) units. For the LED units, three modes of curing like pulse-cure mode, fast mode and ramp mode were used. For in-vivo simulation, 12 caries free human third molar tooth with fused root were used. K-type thermocouple with 1 mm tip diameter was used. Occlusal cavity was prepared, etched, rinsed with water and blot dried; bonding agent was applied and incremental curing of composite was done. Thermal emission for each light curing agent was noted. Temperature rise was very minimal in LED light cure units than in QTH light cure units in both the settings. Temperature rise was minimal at 6mm distance when compared to 3 mm distance. Among the various modes, fast mode produces the less temperature rise. Temperature rise in all the light curing units was well within the normal range of pulpal physiology. Temperature rise caused due to light curing units does not result in irreversible pulpal damage.
- [Show abstract] [Hide abstract] ABSTRACT: This case report presents the endodontic management of an anatomically variant palatal root with 2 canals (Vertucci type II) in a maxillary first molar, which was confirmed with the help of spiral computed tomography (SCT). This serves to remind clinicians that such anatomic variations should be taken into account during the endodontic treatment of maxillary molars and highlights the invaluable aid of the SCT in accurate diagnosis and in negotiating the complex morphologic variations in root canals, thus enabling successful endodontic management.
- [Show abstract] [Hide abstract] ABSTRACT: To evaluate the effect of surface moisture on dentinal tensile bond strength. Forty freshly extracted caries free, unrestored human mandibular molars were selected. The occlusal surfaces of each tooth were ground to prepare flat dentin surfaces at a depth of 1.5 mm. Following acid etching with 37% phosphoric acid for 15 sec, they were randomly grouped, with ten specimens in each: Group I - Over wet, Group II - Blot dry, Group III- One second dry, Group IV- Over dry. Each group was treated with a single bond adhesive system (3M ESPE) as per manufacturer's instructions. Blocks or cylinders of composite resin were built up using Teflon mould and cured. Tensile bond strengths were tested using Instron universal testing machine. The results were statistically analyzed. The mean tensile bond strength values of group II, Blot dry was highest and statistically significant (P<0.001). After acid etching and rinsing blot drying provided consistently better bond strength.
- [Show abstract] [Hide abstract] ABSTRACT: This case report presents a relatively uncommon clinical case of a mandibular premolar with two roots and three canals. The possibility of additional root canals should be considered even in teeth with a low frequency of abnormal root canal anatomy. Sound knowledge of root canal anatomy, appropriate assessment of the pulp chamber floor, critical interpretation of radiographs and high-magnification examinations are highly desirable to achieve the best possible outcome in complicated root canal therapy.
- [Show abstract] [Hide abstract] ABSTRACT: The aim of this in vitro study was to evaluate the efficacy of 5.25% sodium hypochlorite (NaOCl), 2% chlorhexidine gluconate (CHX), and 17% EDTA as a final irrigant with and without the inclusion of an antifungal agent (1% clotrimazole) on Candida albicans. Sixty-five single-rooted instrumented and inoculated with a suspension of C. albicans. The experimental specimens were divided into two groups. The irrigant group was divided into three subgroups and irrigated with 5.25% NaOCl, 2% CHX, and 17% EDTA, respectively. The irrigant with antifungal group was divided into three subgroups and irrigated with 5.25% NaOCl, 2% CHX, and 17% EDTA respectively followed by 1% clotrimazole. Aliquots from the experimental teeth were plated on 4% Sabouraud agar (Tital Biotech, Delhi, India), and the colony-forming units (CFUs) were evaluated under light microscopy (400x). NaOCl, 5.25%, exhibited superior antifungal efficacy compared with 2% CHX and 17% EDTA (p < 0.001). On inclusion of 1% clotrimazole, there was a significant decrease in the CFU (p < 0.001); 5.25% NaOCl and 2% CHX with clotrimazole showed significantly greater antifungal properties than 17% EDTA with clotrimazole (p < 0.001). One percent of clotrimazole proved to be effective against C. albicans when used along with root canal irrigants as a final rinse.
- [Show abstract] [Hide abstract] ABSTRACT: Identification and treatment of extra canals is the cornerstone to successful endodontic practice. Over the years, many diagnostic aids have evolved to facilitate the clinician in detection of hidden canals and to familiarize with the internal radicular anatomy. This case report highlights the rare incidence of 3 canals in the distal root of a permanent mandibular first molar. A spiral computerized tomography scan was used as a noninvasive diagnostic tool to confirm the diagnosis.
- [Show abstract] [Hide abstract] ABSTRACT: To evaluate the bacterial microleakage across remaining Gutta-percha in teeth prepared for post space with and without the use of an intracanal glass ionomer barrier. Forty freshly extracted intact human mandibular premolars with single canal were instrumented, obturated with Gutta-percha and AH plus sealer and post spaces were created. Teeth were assigned into experimental groups as follows: Group I - 3 mm of Gutta-percha, Group II - 4 mm of Gutta-percha, Group III - 3 mm of Gutta-percha with 1 mm of Vitrebond as barrier, Group IV - 4 mm of Gutta-percha with 1mm of Vitrebond as barrier. The roots were suspended in Rogosa SL broth and 50 mul of lyophilized Lactobacilli Casei was inoculated as the microbial marker. The mean days taken for the broth to turn turbid were tabulated. The values were statistically analyzed using one way ANOVA and Tukey's HSD test. At the end of 64 days, the mean and standard deviation of the number of days for the broth to turn turbid was: Group I - 20.50, (SD - 3.96). Group II - 25.43, (SD - 4.83), Group III - 38.63, (SD - 9.36), and Group IV - 53.50, (SD - 11.15) Vitrebond could be used as an intracanal barrier to provide a superior coronal seal in teeth requiring post and core.
Ragas Dental CollegeChennai, Tamil Nādu, India