Dawn of a New Age Fissure Sealant? A Study Evaluating the Clinical Performance of Embrace WetBond and ART Sealants: Results from a Randomized Controlled Clinical Trial.

OBJECTIVES: The main purpose of this article is to evaluate the clinical performance of atraumatic restorative treatment (ART) sealant versus Embrace WetBond sealant in terms of retention and fissure caries prevention among a section of school children in the southern Indian state of Karnataka (ClinicalTrials.gov NCT02716558). MATERIALS AND METHODS: After obtaining consent from the parents and screening the children against the inclusion cum exclusion criteria, 90 school children whose mandibular first molars were caries free and with a well-defined pit and fissure system were recruited for this spilt mouth trial. The respective molars were allocated either to the ART sealant or the embrace group after the randomization process. The sealants were applied according to the manufacturer's instructions and followed up at the end of 3rd, 6th, and 12th month, respectively. The outcome measures assessed were the retention and the caries preventive effects of the materials. RESULTS: At the end of the 6th month, about one-fourth of the sealants in either group remained totally intact, without evidence of caries. No significant differences were seen between the sealants either in terms of retention or caries preventive benefits at the end of 12 months. STATISTICAL ANALYSIS: The chi-squared test was used to check differences in proportions. The significance value was set at <0.05. Kappa test was performed to assess the intraexaminer reproducibility with respect to retention and caries status. CONCLUSION: The moisture-tolerant resin sealant could not replicate the physical properties usually associated with conventional resin sealants. The usage of ART sealants was deemed to be less cumbersome in an outreach setting as observed in this trial.

An in Vitro Evaluation of Antimicrobial Efficacy of 2% Chlorhexidine Gel, Propolis and Calcium Hydroxide Against Enterococcus faecalis in Human Root Dentin.

AIM: To evaluate in vitro the antimicrobial efficacy of 2% Chlorhexidine gel, Propolis and Calcium hydroxide against Enterococcus faecalis in human root dentin. METHODOLOGY: One hundred and twenty human extracted anterior teeth were decoronated below CEJ and the apical part of root was removed to obtain 6mm of middle of the root. GG no 3 was used to standardize the internal diameter of root canal. Dentin blocks were infected with E faecalis for 21 d. They were assigned into four groups (n = 30).Group 1, Saline (negative control); Group 2, Propolis; Group 3, 2% CHX; Group 4, Calcium hydroxide, At the end of 1, 3, and 5 days an assessment of microbial cells was carried out at a depth of 400 µm and colony counts were calculated.The data were analysed statistically with one-way analysis of variance followed by Scheffe multiple comparison test (p < 0.05). RESULTS: The number of colony-forming units was significantly lower in all experimental groups compared to the control group - Saline. 2% Chlorhexidinegluconate produced better antimicrobial efficacy (100%) on day 1, 3 and 5. Propolis (66.37%) had greater antimicrobial activity than Calcium hydroxide (50.89%) on day 1 but there was no significant difference in their antimicrobial activities on day 3 and day 5. CONCLUSION: 2% Chlorhexidine gel showed the maximum antimicrobial activity against E faecalis and Calcium hydroxide the least. Propolis can be used as an effective alternative intracanal medicament.

Role of mineral trioxide aggregate in management of external root resorption.

External root resorption (ERR) is a lytic process occurring in the cementum or cementum and dentin of the roots of teeth. Here we report a case of inflammatory ERR in a mandibular right molar in a 22-year-old male patient with history of incomplete root canal treatment with the same. Considering the biological properties of mineral trioxide aggregate cement, especially its alkalinity and sustained calcium hydroxide release, this material was used for the treatment of ERR, followed by permanent prosthesis. The clinical and radiographic follow-up for 24 months revealed that treated teeth were functional, the progression of the ERR had ceased, the resorptive area were replaced with newly formed bone and periapical radiolucencies was healed.

To evaluate and compare the efficacy, cleaning ability of hand and two rotary systems in root canal retreatment.

AIM: To evaluate and compare the efficacy, cleaning ability of hand and two rotary systems in root canal retreatment. METHODOLOGY: Sixty extracted premolars were retreated with following systems: Group -ProTaper Universal retreatment files, Group 2-ProFile system, Group 3-H-file. Specimens were split longitudinally and amount of remaining gutta-percha on the canal walls was assessed using direct visual scoring with the aid of stereomicroscope. Results were statistically analyzed using ANOVA test. RESULTS: Completely clean root canal walls were not achieved with any of the techniques investigated. However, all three systems proved to be effective for gutta-percha removal. Significant difference was found between ProTaper universal retreatment file and H-file, and also between ProFile and H-file. CONCLUSION: Under the conditions of the present study, ProTaper Universal retreatment files left significantly less guttapercha and sealer than ProFile and H-file. CLINICAL SIGNIFICANCE: Rotary systems in combination with gutta-percha solvents can perform superiorly as compared to the time tested traditional hand instrumentation in root canal retreatment.

Effect of endodontic irrigating solutions on the microhardness and roughness of root canal dentin: an in vitro study.

CONTEXT: To evaluate the effect of widely used endodontic irrigating solutions on root dentin microhardness and surface roughness. MATERIALS AND METHODS: One hundred twenty, non-carious extracted human permanent incisor teeth were selected. The crowns of the teeth were sectioned and the roots were separated longitudinally to get 240 specimens. These specimens were then divided into six groups according to the irrigating solutions used. The solutions used were 5% and 2.5% NaOCl solutions, 3% H2 O2 , 17% EDTA solution, 0.2% chlorhexidine gluconate, and distilled water. Then, the specimens were subjected to microhardness and roughness testing. The data were analyzed using ANOVA and Tukey's multiple comparison tests. RESULTS: The results of this study indicated that all irrigation solutions, except 0.2% chlorhexidine gluconate, decreased the microhardness of root dentin, and 3% H2 O2 and 0.2% chlorhexidine gluconate had no effect on surface roughness. CONCLUSIONS: Within the limitation of this study, it is concluded that 0.2% chlorhexidine gluconate seems to be an appropriate irrigation solution, because of its harmless effect on the microhardness and surface roughness of root canal dentin.