Dentinal Microcracks after Root Canal Preparation in Primary Root: An In Vitro Evaluation of ProTaper Gold and Kedo-S Rotary File Systems.

Context: There is a possibility of dentinal crack formation in primary teeth after root canal preparation using rotary files. Aims: To evaluate and compare the effect of ProTaper-Gold and Kedo-S rotary files on crack formation after root canal preparation in primary molars. Settings and design: A total of 120 freshly extracted mandibular primary molars (6-9 years) were randomly divided into three groups of 40 each: ProTaper-Gold, Kedo-S, and Hand H-files, respectively. Materials and methods: The roots were covered with a snuggly fitting surgical glove and stabilized in the teeth slot of a silicone mold of mandibular mixed dentition. Dental casts were obtained in a mixture of plaster of paris and sawdust. A screw system was incorporated in the cast for stabilization of the cast into the phantom head. All the root canals were instrumented in a standard operating position till 1 mm short of the radiographic apex. All roots were then stained and sectioned perpendicular to the long axis at the furcation level and 2 mm below the furcation to obtain one section per tooth. Sections were examined under a stereomicroscope at 25× magnification for any crack formations and recorded. Data were analyzed using Wilcoxon signed-rank and Kruskal-Wallis tests (p = 0.05). Results: The total number of cracks in terms of percentage following the use of ProTaper Gold, Kedo-S, and H-files were 35, 10, and 0%, respectively, on the upper surface and 15, 5, and 0% on the lower surface. Within the group, there was a statistically significant difference in ProTaper-Gold (p = 0.001). Conclusion: The use of ProTaper-Gold resulted in a greater number of dentinal cracks compared to Kedo-S and H-files. How to cite this article: Patil MB, Mandroli PS, Jalannavar P, et al. Dentinal Microcracks after Root Canal Preparation in Primary Root: An In Vitro Evaluation of ProTaper Gold and Kedo-S Rotary File Systems. Int J Clin Pediatr Dent 2023;16(5):692-697.

In vitro evaluation of cytotoxicity of Emblica officinalis (amla) on cultured human primary dental pulp fibroblasts.

CONTEXT: The dental pulp tissue is capable of healing after surgical amputation of infected/inflamed tissue during vital pulp therapy, when in contact with a suitable medicament. Emblica officinalis (amla), a traditional medicine, is one such medicament which has never been evaluated for its healing potential in pulp therapy. AIMS: The aim of the study was to evaluate the cytotoxicity of E. officinalis (amla) against human primary dental pulp fibroblasts. SETTINGS AND DESIGN: This was in vitro study. SUBJECTS AND METHODS: Human dental pulp fibroblasts were obtained from dental pulp tissue of extracted over-retained primary incisors. The primary cells were cultured using the Dulbecco's Modified Eagle's Medium and used for the study after the fourth passage. The test medicament was E. officinalis with mineral trioxide aggregate (MTA) (100%) and untreated cells as positive and negative controls, respectively. Methyl-thiazol-diphenyl-tetrazolium (MTT) cytotoxicity assay was performed, and the cell survival was observed and analyzed at intervals of 24, 48, and 72 h. STATISTICAL ANALYSIS USED: Cell survival within groups was compared with Wilcoxon matched-paired t-test and in between groups at each point interval was analyzed with the Kruskal-Wallis ANOVA test. The level of significance was set at 0.05. RESULTS: Within the groups, across the time periods of evaluation, there was a decline in cell survival in both the groups but was statistically significant in the MTA group. On interval-wise comparison, the decline in cell survival was statistically significant between the three groups at 72 h (P = 0.001). CONCLUSIONS: E. officinalis preserved the vitality of the human primary dental pulp fibroblasts and has the potential to be developed into vital pulp therapy medicament.

Modified micro-marsupialization as an alternative treatment for the management of ranulas in children.

The anatomical location of ranulas is challenging to the dental surgeon in terms of their management. The regional complexities of the area call for a skilled approach because of a number of vital structures within. Although complete excision with removal of the sublingual gland continues to be the gold standard of treatment, recent literature highlights successful outcomes by simple modification of the conventional ranular marsupialization technique. This micro-marsupialization option is minimally invasive and advantageous in children due to shorter procedural time, minimal discomfort, and no postoperative complications. The following case report highlights the successful management of a case using a modified micro-marsupialization technique.

Pulpotomy with curcumin: Histological comparison with mineral trioxide aggregate in rats.

CONTEXT: It is important to develop new therapeutic materials that have requisite clinical actions, are safe and economical. AIMS: This study aims to histologically evaluate curcumin, an extract of turmeric (Curcuma longa) as a pulpotomy agent in rat molars and to compare it to mineral trioxide aggregate (MTA). SETTINGS AND DESIGN: Animal study. SUBJECTS AND METHODS: Twelve Wistar-Albino rats were randomly divided into two groups of 6 each. Pulpotomies were performed on caries free maxillary first and second molars on both sides of the arch, with MTA and curcumin (24 teeth each), respectively. Access cavities were sealed with resin-modified glass ionomer cement. Postoperative histological evaluation of pulpotomized teeth in both groups was done at 7, 14, and 30 days under a light microscope (×10). STATISTICAL ANALYSIS USED: Data were evaluated with Freidman's test and Mann-Whitney test at 0.05 level. RESULTS: (a) There was a gradual reduction in inflammatory cell response in both groups across time periods tested (MTA P = 0.074, curcumin P = 0.039). (b) The overall architecture of pulp was maintained better in the curcumin group across all time periods tested (P = 0.368). (c) Dentinal bridge formation was consistently seen across time periods tested in MTA group (P = 0.9094) and was feeble in curcumin group (P = 0.9094) across time periods tested. CONCLUSIONS: Curcumin has been shown to have wound healing properties. It has the potential to be developed into a predictable and cost-effective vital pulp therapy medicament.

An in vitro evaluation of cytotoxicity of curcumin against human periodontal ligament fibroblasts.

INTRODUCTION: Curcumin, a component of turmeric (Curcuma longa L.), is a molecule of multitude of medicinal properties. Although curcumin has found a place in the treatment of gingival and periodontal diseases, there are no reported cytotoxicity studies on the cells of clinical significance (i.e., periodontal ligament [PDL] fibroblasts). AIMS: The objective of this research was to assess the in vitro cytotoxicity of curcumin against human PDL fibroblasts. MATERIALS AND METHODS: Human PDL fibroblasts from premolar teeth were cultured and used for cytotoxicity tests from healthy children presented for orthodontic extractions. Test concentrations of curcumin (100%, 50%, and 25%) were prepared by diluting 95% curcumin with di­methyl­sulfoxide and added to 96­well microtiter plate (in triplicate) containing the fibroblast culture (approximately 2 × 104 cells/well). Fibroblast cells without treatment (without curcumin) acted as a control group. The viability of cells after 48 h of incubation at 37°C in a humidified atmosphere of 5% CO2 and 95% air was ascertained by the 3­(4, 5­dimethyl­thiazol­2­yl)­2, 5­diphenyl­tetrazolium bromide (MTT) assay. The viability of PDL fibroblast cells of experimental wells was expressed relative to that of control, in terms of change in the color intensity. Absorbencies were recorded at 450 nm on a microplate reader with background subtraction at 620 nm. The cell viability at various concentrations of curcumin against the PDL fibroblasts was calculated as mean absorbance (optical density) and percentage values. RESULTS: Cell viability of PDL fibroblasts to 100%, 50%, and 25% curcumin concentration was 111.75%, 112.50%, and 114.40%, respectively. CONCLUSIONS: No in vitro cytotoxicity was detected for curcumin against human PDL fibroblasts, at any of the concentrations used (100%, 50%, and 25%) by MTT assay at the end of 48 h.

An Assessment of Curve of Spee in Healthy Human Permanent Dentitions: A Cross Sectional Analytical Study in a Group of Young Indian Population.

INTRODUCTION: An awareness of the standard value of the maxillary and the mandibular curves of Spee may aid the clinician in developing occlusion in the sagittal plane and would be useful when providing prosthetic rehabilitation for patients with occlusal derangement. AIM: To assess and compare the radius and depth of curve of Spee in maxillary and mandibular arches in men and women, in a group of young Indian population. MATERIALS AND METHODS: The study cohort consisted of 25 men and 25 women between 19 to 24 years. Impression of maxillary and mandibular arches were made with alginate. Casts were poured in die stone. Standardized digital pictures of the right side of maxillary and mandibular dental casts were made with a digital camera and transferred to a computer. Tips of the distal cusps of molars, premolars and canines of the maxilla and mandible were located. The radius and the depth of the curve of Spee were measured from the digital photographs of dental casts, with the help of 'dimension tool' in the computer software (Corel DRAW X5). Mann-Whitney test was used to analyze the difference in the curve of Spee between men and women and the difference between maxillary and mandibular arches. RESULTS: The mean values were as follows: a) Men: Radii of curve of Spee in the maxillary and mandibular arch were 140.22±65.98 and 109.67±46.80 respectively; depths of curve of Spee in maxillary and mandibular arch were 1.65±0.67 and 1.49±0.74 respectively; b) Women: Radii of curve of Spee in the maxillary and mandibular arch were 120.58±63.91 and 98.31±63.59 respectively; depths of curve of Spee in maxillary and mandibular arch were 1.45±0.54 and 1.40±0.61 respectively. In the mandibular arch, the difference in the radii (p=0.0467) was statistically significant between men and women. In women, the difference in radii (p=0.0467) between maxillary and mandibular arches was statistically significant. CONCLUSION: The radii and depths of curve of Spee were larger in maxillary than mandibular arches in both men and women. Also, the difference in the radii of mandibular arch was statistically significant between men and women.

Single- versus two-visit pulpectomy treatment in primary teeth with apical periodontitis: A double-blind, parallel group, randomized controlled trial.

CONTEXT: Reduction of the bacterial populations to levels compatible with periradicular tissue healing is the primary microbiological goal of the endodontic treatment of teeth with apical periodontitis. The number of visits required to treat teeth with apical periodontitis represents one of the most debatable issues in endodontics. OBJECTIVES: The objective of this study was to compare and evaluate the clinical and radiographic outcome of single- versus two-visit pulpectomy treatment in primary teeth with apical periodontitis at the end of 6-month healing period. SETTINGS AND DESIGN: A parallel group, double-blind, randomized controlled trial was carried out in 64 children aged 4-8 years. Nonvital primary teeth with apical periodontitis with enough coronal structure were selected. Sixty-four children were assigned randomly into two groups (32 children each) by block randomization, and allocation concealment was done with closed envelop method. METHODS AND MATERIALS: Group I underwent single-visit pulpectomy followed by obturation with zinc oxide eugenol (ZOE). Group II underwent conventional two-visit pulpectomy with intracanal calcium hydroxide, followed by obturation with ZOE. Postoperative clinical and radiographic evaluation was carried out at 1, 3, and 6 months after the end of the treatment. STATISTICAL ANALYSIS USED: The data were analyzed by Wilcoxon's signed rank test, Mann-Whitney U-test, and Friedman test. RESULTS: There was no statistically significant difference in clinical and radiographic outcomes in both the groups at the end of 6-month healing period. CONCLUSION: Single-visit pulpectomy can be considered as a viable option for the treatment of primary teeth with apical periodontitis.

An in-vitro evaluation of antibacterial effect of Amalgomer CR and Fuji VII against bacteria causing severe early childhood caries.

OBJECTIVE: To evaluate the antibacterial action of Amalgomer CR and Fuji VII against bacteria causing S-early childhood caries. MATERIALS AND METHODS: Antibacterial activity of Amalgomer CR and Fuji VII was assessed using the agar diffusion test in triplicate. The powder and liquid of each test material was mixed and inserted in the punched wells (6 mm × 2 mm). A composition of 0.2% chlorhexidine digluconate acted as control. The agar plates were incubated at 37°C for 24 h for Streptococcus mutans, S. salivarius, S. parasanguinis and Actinomyces viscosus, whereas Lactobacillus casei was incubated for 48 h. Sizes of the inhibition zones were calculated by subtracting the diameter of the specimen (6 mm) from the average of the three measurements of the halo. For each test material against each bacteria, 9 measurements were made (3 measurements × 3 times). Kruskal-Wallis test was done to compare the zones of inhibition of test materials against individual bacteria. Pair-wise comparison was done by Mann-Whitney U-test. RESULTS: Amalgomer CR had the most antibacterial against S. mutans (31.0 mm), followed by A. viscosus (21.87 mm), S. salivarius (13.87 mm), S. parasanguinis (10.80 mm), and L. casei (9.69 mm). Fuji VII had the most antibacterial action against S. salivarius (10.65 mm), followed by A. viscosus (9.10 mm). However, it did not inhibit the growth of S. mutans (0 mm), S. parasanguinis (0 mm), and L. casei (0 mm). CONCLUSION: Amalgomer CR and Fuji VII showed wide variation in antibacterial action against all test organisms.

Evaluation of remineralizing potential of commercially available child formula dentifrices: an in vitro study.

AIM: The aim of this in vitro study is to evaluate the remineralizing potential of commercially available low fluoride child formula dentifrice on primary teeth. MATERIALS AND METHODS: Total 30 primary teeth were placed in demineralizing solution for 96 hours to produce artificial carious lesions of approximately 100 µm depth, and then cut longitudinally into 30 sections of 100-150 µm thickness and randomly assigned to three groups. Sections were treated with dentifrices containing Colgate ® (anti tooth decay) 500 ppm NaF, Cheerio gel ® 458 ppm MFP and Vicco ® non-fluoridated dentifrice. Lesions were evaluated using polarized light microscopy. RESULTS: Colgate ® (anti tooth decay) 500 ppm NaF sections exhibited a statistically significant decrease in lesion depth (P < 0.05, paired t-test), whereas those in Cheerio gel ® 458 ppm MFP showed a decrease in lesion depth but was not statistically significant. Vicco ® non-fluoridated dentifrice showed increase in lesion depth. STATISTICS: A paired t-test is used to evaluate pre- and post-treatment lesion depth measurements, and Newman-Keuls multiple post hoc procedures was carried out to compare pair-wise difference of pre- and post-treatment lesion depth. CONCLUSION: The Colgate ® (anti tooth decay) 500 ppm NaF dentifrice and Cheerio gel ® 458 ppm MFP demonstrated remineralization of carious lesions by virtue of decrease in lesion depth, whereas Vicco ® non-fluoridated dentifrice showed increase in lesion depth.