Minimally Invasive Esthetic Reinforcement of a Fractured Anterior Tooth Using Dentapreg PINPost: A Case Report.

The reason to use post is to retain the core that holds the definitive prosthesis. The maxillary central incisor always poses a challenge during reconstruction using the post and core system. Dentapreg PINPost, a pre-cured flexible post made of fiber-reinforced composite (FRC), has many advantages over metallic posts and fiber posts. The purpose of this case report is to present an innovative technique to place both FRC posts and FRC sheets as a single assembly into the canal which gives a monoblock effect. This technique is feasible and may eradicate some of the problems associated with the failure of the post and core.

Comparative evaluation of the antibacterial efficacy of two experimental calcium silicate-based intracanal medicaments: An in-vitro study.

Introduction: Success of endodontic treatment relies on minimizing microbial load by chemo-mechanical preparation and intra-canal medication(ICM). Calcium hydroxide based ICMs have known disadvantages. Calcium silicate-based cements(CSC) exhibit antibacterial activity, thus promoting researchers to experiment with their formulations to use them as ICMs. Aim: Evaluation and comparison of the antimicrobial efficacy of two experimental CSC (MTA & Biodentine + 2%chlorhexidine) and Bio-C Temp against E.faecalis. Methods and Material: Test materials were divided into four groups namely Group1-Bio-C Temp, Group2-UltraCAL XS, Group3-Biodentine+2%CHX and Group4-MTA+2%CHX. Direct contact test was done by placing a standardized suspension of E.faecalis on test materials and bacterial growth was assessed spectrophotometrically using ELISA at one, three and seven days. Statistical Analysis: Data was analysed using one-way ANOVA, Tukey's multiple post hoc test and paired-t test. Results: Intragroup comparison revealed decreased mean optical density(OD) in groups 1, 2, and 4; no significant difference in group 3. Intergroup comparison showed statistical differences in mean OD values between groups (3 and 4); groups (1 and 2) at days one(p-0.018) and three(p-0.035), but no difference individually. Group 4 showed the highest antimicrobial efficacy on day seven. Conclusion: MTA+2%CHX & Biodentine+2%CHX showed better antimicrobial efficacy and hence could be used as potential ICMs.

Comparative evaluation of antibacterial efficacy of nonsteroidal anti-inflammatory medications and proton-pump inhibitor against Enterococcus faecalis: An in vitro study.

Aim: The present in vitro experimental study was undertaken to evaluate and compare the antimicrobial activity of triple antibiotic paste (TAP), diclofenac, and proton-pump inhibitor (PPI) against the microorganism Enterococcus faecalis. Materials and Methods: Three medicaments were selected for the study, TAP, diclofenac, and PPI. The experimental groups for the test were as follows: Part 1 - Group 1: TAP, Group 2: diclofenac, and Group 3: PPI; Part 2 - Group 1: TAP + PPI and Group 2: diclofenac + PPI. An agar well diffusion test was used to determine the efficacy of the experimental medicaments against E. faecalis (ATCC 29212). The diameter of inhibition zones was measured in millimeters using an inhibition zone measuring scale and the results were recorded. Statistical Analysis: The statistical analysis was done using an analysis of variance and an unpaired t-test. P value was set at < 0.05. Results: There was a significant difference in the diameter of growth inhibition zones, with the greatest diameter noted for TAP + PPI followed by diclofenac sodium (DS) + PPI, TAP, DS, and PPI. Conclusions: The antimicrobial effectiveness of TAP + PPI was found to be superior to all other medicaments (DS + PPI, TAP, DS, and PPI).

Comparative Evaluation of the Mechanical Properties of a Bioactive Material Enhanced by Phytosynthesized Nanoparticles: An In vitro Study.

Aims: The aim was the study was to evaluate and compare the mechanical properties of ACTIVA Bioactive Base/Liner (ABBL) enhanced with phytosynthesized titanium dioxide nanoparticles (nTiO2) and nano-curcumin (nCur). Methodology: Thirty samples each of ABBL (Group 1), ABBL + nTiO2 (Group 2), and ABBL + nCur (Group 3) were prepared for testing the compressive strength (CS) and flexural strength (FS). Forty-five cylinders (15 per group) (6 mm × 4 mm) were fabricated for CS and 45 for three-point bending FS measurements (22 mm × 2 mm × 2 mm). They were tested in a universal testing machine at a crosshead speed of 0.5 mm/min for CS and 0.5 mm/min with 20 mm space between the two supports for FS measurements. Statistical Analysis: Intergroup comparison of CS and FS was assessed using one-way ANOVA. The level of significance was set at 0.05. Results: Intergroup comparison showed an overall significant difference (P = 0.016 for CS) and (P = 0.001 for FS), where Group 1 had the highest and Gr 3 the least strength. No significant difference was observed between Group 1 and Group 2, while Group 3 showed significantly low strength when compared to Group 1. Conclusions: ABBL + 3% nTiO2 showed nonsignificant decrease while ABBL + 7% nCur showed significant decrease in mechanical properties.

Does Cavity Disinfectant Affect Sealing Ability of Universal Self-etch Adhesive?

AIM: The purpose of this study was to evaluate 2% chlorhexidine disinfectant (CHX), chitosan, and octenidine dihydrochloride (as cavity disinfectants) on microleakage in cavities restored with universal self-etch adhesive. MATERIALS AND METHODS: Eighty extracted human permanent premolars were selected. Class V cavities were prepared on the facial surface of each tooth. The teeth were then divided into four groups of 20 teeth each. For the control group after cavity preparation, no disinfectant was applied. The other 3 groups were treated with 0.1% chitosan, 2% CHX, and 0.1% octenidine dihydrochloride (OCT). All the groups were restored with universal adhesive followed by composite resin. The teeth were then immersed in 1% methylene blue dye and were sectioned buccolingually. Microleakage was checked under a stereomicroscope on both occlusal and gingival margins. RESULT: Among all the groups chitosan-treated cavities showed the least microleakage. Chlorhexidine treated cavities showed less leakage as compared to control, OCT group at both the margins. CONCLUSION: Chitosan as a cavity disinfectant improves the sealing ability of the self-etch adhesive. Furthermore, in vivo studies need to be conducted to examine the interaction and long-term effect of chitosan with the other self-etch adhesive systems. CLINICAL SIGNIFICANCE: Chitosan a natural polysaccharide can be used as a cavity disinfectant as it improves the sealing ability of self-etch adhesive.

Radiological Appraisal of Biodentine and Pulpotec Individually or in Combination with Photo-activated Disinfection as Pulp-capping Cements in Mature Teeth.

AIM AND OBJECTIVE: The aim of the study was to evaluate and compare radiographically, Pulpotec cement and Biodentine as direct pulp-capping agents in mature teeth, individually and in combination with photo-activated disinfection (PAD). MATERIAL AND METHODS: In the present study, 80 mature teeth with deep occlusal caries were selected for direct pulp-capping procedure and randomly assigned to one of the four groups [Pulpotec (I), Biodentine (II), Pulpotec + PAD (III), and Biodentine + PAD (IV)] allocating 20 teeth to each group. Direct pulp capping and cavity disinfection were performed based on the group allotted followed by permanent restoration with composite. The teeth were evaluated radiographically (densitometric analysis) at intervals of 3, 6, and 12 months. The radiographic gray values obtained at follow-up periods for each group were subjected to two-way analysis of variance (ANOVA) with repeated measures. RESULTS: There was a significant improvement (p <0.0001) in the scores of all the groups at follow-ups as compared to the baseline. There was a significant difference between group I/group II with groups III and IV (p = 0.000) with group IV scoring highest at all follow-ups. However, the difference between groups I/II and groups III/IV was nonsignificant. CONCLUSION: Both, Biodentine and Pulpotec can be used for direct pulp capping of mature teeth. Furthermore, PAD prior to material application significantly improved the radiographical success of Biodentine and Pulpotec, with Biodentine showing better results than Pulpotec. CLINICAL SIGNIFICANCE: Biodentine and Pulpotec demonstrated comparable success as a pulp-capping agent and PAD application exhibited a synergistic effect when used in conjunction with these materials.

Effect of Different Intracanal Medicaments on Apical Sealing Ability of BioRoot RCS.

AIMS AND OBJECTIVES: The aim of the present study was to determine the effect of different intracanal medicaments on the apical seal of BioRoot root canal sealer (RCS). MATERIALS AND METHODS: One hundred permanent single-rooted teeth were used in this study. All the samples were decoronated at the cementoenamel junction and instrumented in a sequential order from 15 to 50 number k-file. The specimens were randomly divided into five groups containing 20 teeth each. Intracanal medicaments used in this study were Metapex, triple antibiotic paste, Metrogyl DG gel forte (metronidazole gel 1.5% w/w), and curenext gel. For control group following instrumentation, the roots were obturated with laterally compacted gutta-percha with BioRoot RCS. In medicament groups after the period of 14 days, the medicaments were removed. All the four groups were obturated with BioRoot RCS and gutta-percha cones using lateral compaction technique. All the specimens were coated with nail varnish and immersed in 2% methylene blue. Then the specimens were demineralized and diphanized. The cleared teeth were analyzed by means of a stereomicroscope under 10× magnification. All the data were analyzed in SPSS version 18 software (IBM, Chicago, IL, USA). RESULT: Among all the intracanal medicaments, triple antibiotic paste showed the highest microleakage. When Metpaex and Metrogyl DG gel forte were compared with Curcuma longa, differences were not statistically significant. CONCLUSION: Among all the intracanal medicaments, triple antibiotic paste showed the highest microleakage and least was Metapex. CLINICAL SIGNIFICANCE: Incomplete removal of medicaments prevents the penetration of sealer into the dentinal tubules and interferes with the normal setting reaction, thus affecting the seal of obturating material leading to microleakage and subsequent treatment failure. Hence, while placing an intracanal medicament, it is important to consider its effect on leakage of the root canal system.

A Scanning Electron Microscope Analysis of Sealing Potential and Marginal Adaptation of Different Root Canal Sealers to Dentin: An In Vitro study.

AIM: The present study aimed to evaluate the sealing potential and marginal adaptation of different root canal sealers to dentin. MATERIALS AND METHODS: A total of sixty human lower premolars of the permanent dentition that were extracted were used for this study. The visible debris and calculus were removed from the extracted teeth ultrasonically and were kept for 2 hours in 2.5% sodium hypochlorite and stored in normal saline till next use. A low-speed diamond disc was used to section all the teeth samples at the cementoenamel junction. Later, cleaning and shaping of the canals was done. Based on the sealer used, the samples (each group consisting of 20 samples) were divided randomly into three groups: group I-bioceramic sealer, group II-resin-based sealer, group III-MTA-based sealer. All split samples were visualized under scanning electron microscope (SEM) at apical and coronal thirds of root canal, the marginal gap at root dentin and sealer interface were assessed. RESULTS: The highest marginal adaptation (5.60 ± 0.12) was demonstrated by EndoSequence BC sealer, followed immediately by ProRoot MTA sealer (4.48 ± 0.12) and EndoREZ sealer (2.10 ± 0.54). A statistically significant difference (p = 0.001) was seen between the EndoSequence BC and ProRoot MTA sealer for apical and coronal marginal adaptation. Also, a statistically significant difference (p < 0.05) was found between EndoSequence BC sealer vs EndoREZ sealer at coronal and EndoSequence BC sealer vs EndoREZ sealer and EndoREZ sealer vs ProRoot MTA sealer at apical third. CONCLUSION: The present study concluded that significant and better sealing ability and marginal adaptation was demonstrated by EndoSequence BC (bioceramic sealer) when compared to ProRoot MTA sealer (MTA-based sealer) and EndoREZ sealer (resin-based sealer). CLINICAL SIGNIFICANCE: Numerous endodontic sealers enter the market with various factors to attain acceptable seal. According to current study bioceramic sealer, is the appropriate sealer that hermetically seals all the margins.

Effect of temperature and activation techniques of irrigating solutions on push-out bond strength of fiber post.

AIM: This study evaluated the effect of preheated irrigants (EDTA, QMix), then use of various activation techniques such as ultrasonic system and laser on push-out bond strength (POBS) of fiber posts to root dentin. METHODOLOGY: One hundred and twenty extracted human teeth were decoronated below the cementoenamel junction. All the root canals were instrumented, irrigated using sodium hypochlorite and normal saline, dried with paper points, and filled with gutta-percha and AH Plus sealer. Post spaces were prepared. The irrigating solutions QMix and EDTA were heated to 60°C. Normal QMix and EDTA served as control. The irrigants were activated with Laser and Ultrasonic system. Then, the fiber posts were cemented, roots were sliced to thickness of 2 mm and mounted for measurement of POBS. RESULTS: Preheated irrigants group showed maximum POBS as compared to Normal irrigants. QMix group showed better results as compared to EDTA. Irrigants when activated with laser and ultrasonics showed comparable results. CONCLUSION: Within the limitations of the study, it can be concluded that preheated irrigants(QMix, EDTA) increase the POBS of fiber post to root dentin. Both laser and ultrasonic are equally effective for increasing the POBS.

Role of Herbal Agents - Tea Tree Oil and Aloe vera as Cavity Disinfectant Adjuncts in Minimally Invasive Dentistry-An In vivo Comparative Study.

INTRODUCTION: The prevention and control of caries necessitates the elimination of cariogenic bacteria and cavity disinfectants have proved to play a major role in achieving the goal. The use of phytotherapy is trending and many natural products have shown anti-microbial properties which can be used as cavity disinfectant in the field of dentistry. AIM: The aim of this study was to compare the efficacy of herbal antibacterial agents (Tea Tree Oil (TTO) and Aloe vera) with commercially available 2% chlorhexidine (CHX) as cavity disinfectant for use in minimally invasive dentistry. MATERIALS AND METHODS: The study included three test groups, Group I (2% chlorhexidine), Group II (tea tree oil), Group III (Aloe vera gel) with a control group (distilled water). Ten patients with atleast one tooth with an occlusal or occluso-proximal lesion suitable for Atraumatic Restorative Treatment (ART) were selected for each group, dentinal samples were collected using sterile spoon excavators at three stages from each tooth viz., pre-excavation, post-excavation and post-disinfection of the cavities. These dentinal samples were subjected to microbiological analysis for Total Viable Count (TVC). The data collected were statistically analysed using ANOVA and Bonferroni post-hoc test. RESULTS: The results of present study showed that there was a statistically significant reduction in TVC when compared between pre and post excavation in all the groups (p<0.05) and post- excavation and post-disinfection in all the test groups (p<0.05) (except control group). Post-disinfection, 2% chlorhexidine showed highest reduction in TVC followed by 1% tea tree oil and aloe vera gel. CONCLUSION: Natural antibacterial agents like tea tree oil and aloe vera could be effectively used as cavity disinfectants which will help in minimizing secondary caries and rendering a long term restorative success.

Fabrication and Appraisal of Poly (Lactic-Co-Glycolic Acid) - Moxifloxacin Nanoparticles using Vitamin E-TPGS: A Potential Intracanal Drug Delivery Agent.

INTRODUCTION: Nanotechnology is gaining momentum in the search for ideal biomaterials by dental researchers. The expansible nature of Endodontology deems exploration, learning and scrutinizing newer avenues which have the potential to be applied and investigated. The popularity of polymers as drug delivery vehicles has opened avenues for their application in the root canal system. This study utilized application of biodegradable polymers as potential drug delivery vehicles against Enterococcus faecalis, one of the main reasons for post treatment disease. AIM: This study aimed at fabricating Poly (Lactic-co-Glycolic Acid) (PLGA)-moxifloxacin nanoparticles and assessing its sustained antimicrobial efficacy with calcium hydroxide and chitosan-moxifloxacin hydrogel against Enterococcus faecalis. MATERIALS AND METHODS: PLGA (50:50) in a quantity of 100 mg was dissolved in 1 ml ethyl acetate and 45 ml of 0.3% w/v Vitamin-E Polyethylene Glycol 1000 Succinate (vitamin E-TPGS) was kept for magnetic stirring in separate beaker. Moxifloxacin (50 µl) was added to polymer PLGA following which vitamin E-TPGS was added to the polymer. Nanoparticles were fabricated using ultrasonication and collected by centrifugation. Surface characterization was assessed using scanning electron microscope. Results were obtained in the form of zone of inhibition by the nanoparticles against Enterococcus faecalis and comparisons were made with chitosan-moxifloxacin hydrogel and calcium hydroxide using Analysis of Variance (ANOVA) followed by Student t-test. RESULTS: Upon statistical analysis, the zone of inhibition against E. faecalis remained constant with PLGA-moxifloxacin nanoparticles for 14 days while it decreased with chitosan-moxifloxacin hydrogel and remained nil for calcium hydroxide (p<0.01). CONCLUSION: The study posits that PLGA encapsulated moxifloxacin nanoparticles showcased sustained antibacterial effect in low doses against the test pathogen. Its sustained and programmed release makes them unique contenders for further evaluation in Endodontics as potential intracanal medicaments.

Anti bacterial Effectiveness of Electro- Chemically Activated (ECA) Water as a Root Canal Irrigant- An In-vitro Comparative Study.

INTRODUCTION: Sodium hypochlorite, is the irrigant of choice for many clinicians, but its strong toxic and damaging effects on vital periapical tissues is always a matter of concern. So, the search for a root canal irrigant with a broad antimicrobial spectrum yet with a limited toxicity on vital tissues is always desirable. AIM: The study evaluated antimicrobial efficacy of Electro-Chemically Activated (ECA) water as a root canal irrigant against E. faecalis. MATERIALS AND METHODS: Forty eight single rooted human teeth were decoronated to a length of 15mm. All teeth were divided into four test groups (group A - ECA anolyte, group B - 1% sodium hypochlorite, group C - 3% sodium hypochlorite, group D - distilled water) of 12 each. Only 1ml of Ringer's solution and calibrated suspensio of E. faecalis was injected into each canal, aspirated and placed on agar plates and incubated aerobically at 37°C for two days. The suspension was aspirated and spread onto the blood agar plate and incubated. All samples were irrigated with four test solutions and Brain Heart Infusion (BHI) solution was injected into each canal then aspirated and spread onto blood agar and incubated. After inoculations Colony Forming Unit (CFU) and optical density was measured under a microscope and spectrophotometer. The data obtained were statistically analysed by one way ANOVA and Dunkan's multiple range test. RESULTS: CFU reduction was not statistically significant between the test groups. The optical density showed statistically significant difference between the test groups (p≤0.001). CONCLUSION: The antimicrobial efficacy of ECA was found to be comparable to sodium hypochlorite solutions.

Spectrophotometric Evaluation of the Pulpal Peroxide Levels in Intact and Restored Teeth - An Invitro Study.

INTRODUCTION: Hydrogen peroxide (30%) is a commonly used "in office" bleaching agent. Deleterious effects of hydrogen peroxide on the pulp have been observed. AIM: The present study was conducted with the aim to evaluate the penetration of 30% hydrogen peroxide into the pulp chamber through intact teeth and through the surface of teeth, restored with either hybrid composite or Resin Modified Glass Ionomer Cement (RMGIC). MATERIALS AND METHODS: Sixty extracted human maxillary central incisors were selected and divided into six groups. Two groups were restored with hybrid composite resin and two with RMGIC, while two groups were left intact. The teeth with acetate buffer solution in their pulp cavity were then immersed in either 30% hydrogen peroxide or distilled water depending upon the group, for 60 minutes at 37°C. Then horseradish peroxidase and leucocrystal violet were added to the acetate buffer solution present in the pulp chamber after it was transferred to a test tube and the optical density of the resultant blue solution obtained was measured spectrophotometrically. STATISTICAL ANALYSIS: The data obtained were analyzed using one way ANOVA and Student's t-test. RESULTS: The data obtained established that hydrogen peroxide penetrated into the pulp from the bleaching agent used. Hydrogen peroxide (30%) showed the highest pulpal peroxide level in teeth restored with RMGIC followed by teeth restored with hybrid composite resin and the least amount of penetration was observed in intact teeth. CONCLUSION: The amount of peroxide penetration into the tooth is more through restored tooth than intact tooth and is also dependant on the type of restorative materials used.

An in vitro spectrophotometric analysis of the penetration of bleaching agent into the pulp chamber of intact and restored teeth.

AIM: To investigate the pulp chamber penetration of bleaching agent in intact teeth and teeth following restorative procedure. METHODOLOGY: Sixty extracted human incisors were selected and divided into 6 Groups. Four Groups were restored with hybrid composite resin and resin modified glass ionomer cement respectively, while 2 Groups were left intact. The Groups were then immersed in the treatment agents for 60 mins at 37°C. The optical density of the resultant blue solution obtained by adding leucocrystal violet and horseradish peroxidise to the acetate buffer solution present in the pulp chamber was measured spectrophotometrically and the data thus obtained was statistically analysed using ANOVA and paired t-test. RESULTS: The amount of pulpal peroxide penetration in restored teeth was significantly higher than intact teeth (p< 0.001). the control Group showed no peroxide penetration. Groups restored with resin modified glass ionomer cement showed higher pulpal peroxide levels than Groups restored with hybrid composites, though the difference was not statistically significant (p = 0.52). CONCLUSION: Peroxide readily penetrates into the pulp through intact and restored teeth, with restored teeth showing higher pulpal peroxide levels than intact teeth. Teeth restored with resin modified glass ionomer cement showed higher pulpal peroxide level than teeth restored with composite resins.