Comparison of the Periodontal Status of Patients Undergoing Labial and Lingual Orthodontic Therapy.

Aim To compare the periodontal status in relation to the lower anteriors of patients between labial and lingual orthodontic therapy. Materials and methods The study includes a total of 20 patients in the age group of 20-30 years. All the included patients were selected with limited lower anterior crowding within 0-8 mm. The subjects were randomly divided into two groups: labial (n=10) and lingual (n=10) fixed orthodontic therapy. The periodontal status was evaluated using three indices, plaque index, calculus index, and gingival index, at two different treatment intervals - the first month and the third month - of orthodontic treatment.  Results The values of all the three indices at both time intervals were tabulated. There was no statistical significance when compared to the values in the first month. In the third month, all three indices were statistically significant for both labial and lingual therapy (p<0.001). The lingual appliance had more plaque and calculus accumulation. Conclusion Therefore, the study proves that the lingual surface of patients undergoing lingual orthodontic treatment exhibits more plaque and calculus deposition, thereby the weakening of the periodontal status.

Esterase like activity of Enterococcus faecalis and Lactobacillus casei on microhardness and weight loss of resin luting cements.

INTRODUCTION: Gap-free/continuous cement margins have been considered important for the longevity of indirect dental restorations. Bacterial species have demonstrated esterase-like activity that can cause biodegradation of resin composites. AIM: The aim of this study was to evaluate the effect of the esterase-like activity of E. faecalis and L. casei on three resin luting cements. SETTINGS AND DESIGN: In-vitro study materials and three resin luting cements tested were: Variolink N, Rely X U200 and Panavia F2.0. E. faecalis and L. casei suspensions and supernatants were assessed for enzymatic activity by bacterial esterase activity assay. Circular samples of resin luting cements were exposed to suspensions of E. faecalis and L. casei for 7 and 28 days followed by testing for solubility, microhardness and bishydroxy propoxy phenyl propane (BisHPPP) release. RESULTS: E. faecalis and L. casei both demonstrated esterase-like activity. Bacterial suspensions had significantly increased enzymatic activity than supernatant solutions (P < 0.05). There was no significant reduction in microhardness or increased weight loss in all three cements after incubation in E. faecalis and L. casei for 7 and 28 days. BisHPPP release signifying resin degradation was seen after 7 and 28 days of incubation in E. faecalis and L. casei. CONCLUSION: Within the limitations of this in vitro study, E. faecalis and L. casei demonstrated esterase-like activity. BisHPPP release was evident in all three cements after 7 and 28 days. However, the bacterial strains did not significantly reduce the microhardness or cause weight loss of the tested resin luting cements (Variolink N, Panavia F2.0 and Rely X U200) after 7 and 28 days of incubation.

Root Canal Preparation Does Not Induce Dentinal Microcracks In Vivo.

INTRODUCTION: This in vivo study aimed to evaluate the development of dentinal microcracks after root canal preparation of contralateral premolars with rotary or hand instruments using micro-computed tomographic technology. METHODS: Sixty contralateral intact maxillary and mandibular premolars in which extraction was indicated for orthodontic purposes were selected and distributed into positive (n = 6, teeth with induced root microcracks) and negative (n = 6, intact teeth) control groups as well as 2 experimental groups (n = 24) according to the instrumentation protocol: ProTaper rotary (PTR) or ProTaper hand (PTH) systems (Dentsply Maillefer, Ballaigues, Switzerland). After root canal preparation, teeth were extracted using an atraumatic technique and scanned at a resolution of 17.18 µm. A total of 43,361 cross-sectional images of the roots were screened for the presence of dentinal microcracks. The results were expressed as the percentage and number of root section images with microcracks for each group. RESULTS: All roots in the positive control group showed microcracks at the apical third, whereas no cracks were observed in the specimens of the negative control group. In the PTR group, 17,114 cross-sectional images were analyzed, and no microcrack was observed. In the PTH group, dentinal microcracks were observed in 116 of 17,408 cross-sectional slices (0.66%) of only 1 specimen. These incomplete microcracks extended from the external root surface into the inner root dentin at the area of reduced dentin thickness. CONCLUSIONS: Root canal instrumentation with PTR and PTH instruments of contralateral maxillary and mandibular premolars did not result in the formation of dentinal microcracks in vivo.

The effect of three desensitizing agents on dentin hypersensitivity: A randomized, split-mouth clinical trial.

OBJECTIVES: This randomized clinical trial tested the effect of three different desensitizing agents on reduction of pain due to hypersensitive cervical dentin lesions. MATERIALS AND METHODS: Twenty-eight individuals with 84 teeth diagnosed with cervical dentin hypersensitivity (DH) in at least one tooth in any three of the four quadrants were selected. Patients exhibiting pain scores of two or more on the visual analog scale (VAS) were included in the study. Each quadrant in an individual was randomly assigned to one of the three treatment groups based on computer-generated random number. The desensitizing agents used were Profluorid Varnish (Voco: Cuxhaven Germany), Admira Protect (Voco: Cuxhaven Germany), and PRG-Barrier Coat (Shofu: japan). One operator recorded the baseline sensitivity scores after evaporative and tactile stimuli by visual analog score system. The second operator who was not aware of the baseline values applied the desensitizing agents and recorded the sensitivity scores. VAS scores for both the stimuli were noted immediately after application, 1 week, and after 1 month. The data were analyzed using repeated measure ANOVA and post hoc Tukey's multiple comparison tests (P < 0.05 was considered statistically significant). RESULTS: There was a significant reduction in VAS scores from baseline in all the three groups at all the time intervals (P < 0.001). Admira Protect showed significant reduction of hypersensitivity scores at 1 month compared to other groups (P < 0.001). CONCLUSION: Admira Protect was proved to be better in reducing pain due to DH than PRG-Barrier Coat and Profluorid Varnish after 1 month of application.

An in vivo assessment of the influence of needle gauges on endodontic irrigation flow rate.

AIM: The aim of this clinical study was to assess the influence of irrigation needle gauge on endodontic irrigation flow rates. SETTINGS AND DESIGN: In vivo assessment. MATERIALS AND METHODS: Five specialist endodontists performed intracanal irrigation procedures on 50 mesiobuccal canal of mandibular first molars using three different irrigation needle gauges. Data of time taken for irrigation was recorded by an irrigation testing system and analyzed using independent sample "T" test and one-way analysis of variance (ANOVA) test. The level of significance was set at P < 0.05. STATISTICAL ANALYSIS USED: The following tests were used for the statistical analysis: Independent sample "T" test, one-way ANOVA test, and post hoc multiple comparison was carried out using Tukey's honest significant difference (HSD) test using Statistical Package for the Social Sciences (SPSS) version 16 for Windows. RESULTS: The average flow rate of 26 gauge was 0.27 mLs(-1), of 27 gauge was 0.19 mLs(-1), and of 30 gauge was 0.09 mls(-1). There was statistical significance among the gauges (P < 0.001). 26 gauge had highest flow rate when compared with other groups followed by 27 gauge and 30 gauge respectively. The operator variability for flow rate of three endodontic irrigation needle gauges (26 gauge, 27 gauge, and 30 gauge) was found to be not significant. CONCLUSIONS: Needle gauge has significant influence on endodontic irrigation flow rate.

Prevalence of periradicular radiolucencies and its association with the quality of root canal procedures and coronal restorations in an adult urban Indian population.

AIMS: The aim of this cross-sectional study was to determine the prevalence of periradicular radiolucencies (PR) from an urban adult Indian population and to investigate the quality of root canal procedures and coronal restorations and their association with prevalence of PR in root-filled teeth. SETTINGS AND DESIGN: Cross-sectional study. MATERIAL AND METHODS: A total of 1,340 subjects (18+ years of age) who reported for non-emergency dental care to 5 different dental care centers had their panoramic radiographs taken during the period from January to December 2013. The periradicular status of 30,098 teeth in these radiographs was evaluated using the Periapical Index Score (PAI). The assessment of the technical quality of the procedure was evaluated based on the criteria of root canal filling length and quality of coronal restoration. STATISTICAL ANALYSIS USED: The data was analyzed statistically by chi-squared test and odds ratio. RESULTS: PR was found in 65% of subjects (n = 865) and 5.8% (n = 1,759) of the 30,098 teeth evaluated (4.30% untreated teeth and 1.53% were root-filled teeth). In all, 4.1% of the teeth (n = 1,234) had some filling material in the root canal(s) and the prevalence of PR in these root-filled teeth was 37.4%, while the remaining 62.6% of root canal-filled teeth showed no evidence of PR. PR occurred significantly more often in teeth where root canal filling was filled more than 2 mm short of radiographic apex or when root filling extruded through the apex. CONCLUSIONS: The prevalence of PR in teeth with untreated root canals in India is 4.30%, which is more than twice the weighted world average, while the prevalence of root-filled teeth (4.1%) is lower than the world average (9.6%). The prevalence of PR in root-filled teeth in India is comparable to that in other populations. Inadequate root canal treatment and poor quality of coronal restoration were associated with increased prevalence of PR.