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Background: Rotary and ultrasonic instruments are not appreciable in the complete removal of Biodentine from root canals. Therefore, organic solvents can be used as an adjunct for its retrieval. Aim: The aim of this study was to compare the efficacy of 10% citric acid, 2% acetic acid, and 20% tartaric acid on the microhardness of Biodentine and radicular dentin. Materials and Methods: Forty single-rooted extracted teeth were decoronated at the cementoenamel junction and root canals were prepared with peeso reamers. Two-millimeter sections were obtained and restored with Biodentine. All samples were subjected to Vicker's microhardness test to record the microhardness of Biodentine and radicular dentin. Samples were randomly divided into four experimental groups and treated with (n = 20) - distilled water, 10% citric acid, 2% acetic acid, and 20% tartaric acid groups for 10 min, after which specimens were again subjected to the same microhardness test. Statistical Analysis: The data were subjected to Kruskal-Wallis ANOVA test, followed by Wilcoxon signed-rank test with a level of significance set at P ≤ 0.05. Results: 10% citric acid followed by 2% acetic acid exhibited the lowest mean microhardness values after immersing in respective solutions, whereas 20% tartaric acid exhibited the highest mean microhardness values on Biodentine and radicular dentin. Conclusion: 10% citric acid can be used for retrieving Biodentine from root canals for a limited time without adversely affecting the physical and chemical composition of radicular dentin.
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Aim: The aim of this study was to assess the impact of nonthermal atmospheric plasma (NTAP) on the bond strength of composite resin following plasma application at different steps of dentin bonding in total-etch and self-etch adhesive systems. Materials and Methods: Ninety extracted third molars were taken, and the occlusal surfaces were removed until the exposure of the dentin. Samples were distributed into two main groups: Group T: total-etch adhesive system and Group S: self-etch adhesive system. Groups are further subdivided (n = 10) based on plasma application at different steps of dentin bonding. T1: surface etching with 37% phosphoric acid and bonding agent application. T2: plasma application and bonding agent application. T3: plasma application, etching, and bonding agent application. T4: etching, plasma application, and bonding agent application. T5: etching, plasma application, bonding agent application, and again plasma application. S1: self-etch bonding agent application. S2: plasma application and bonding agent application. S3: Bonding agent application and plasma application. S4: plasma application, bonding agent application, and again plasma application. For all the samples, composite resin buildup was done, and shear bond strength (SBS) was measured. The contact angle was measured at different steps of dental adhesive systems. Statistical Analysis: Two-way analysis of variance and the post hoc Tukey's test were used for analysis, regarding P < 0.05 as statistically significant. Results: Among all groups of total-etch and self-etch adhesives, Group T4 (48.81 Mpa) and Group S2 (36.59 Mpa), respectively, have demonstrated significantly greater bond strength values than the corresponding control groups. Conclusion: NTAP enhanced the composite resin's SBS when plasma treatment was done before bonding agent application and significantly reduced the contact angles of the distilled water.
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Aim: Using confocal laser scanning microscopy (CLSM), the current study assessed the impact of nonthermal atmospheric plasma (NTAP) on the dentinal tubule penetration of bioceramic and epoxy resin-based root canal sealers (CLSM). Materials and Methods: Forty human mandibular premolar teeth with a single root that had just undergone extraction were chosen and biomechanical preparation of root canals was done with ProTaper Gold rotary Nickel-titanium instruments. Samples were divided into four groups (n = 10). Group 1: Bioceramic sealer (BioRoot RCS); Group 2: Epoxy resin-based sealer (AH Plus) without application of NTAP; Group 3: Bioceramic sealer (BioRoot RCS); and Group 4: Epoxy resin-based sealer (AH Plus) with the application of NTAP for 30 s. In Groups 3 and 4, all of the samples underwent obturation with the appropriate sealers following NTAP application. For determination of the sealer's dentinal tubule penetration values, slices with a thickness of 2 mm were taken from the middle third of sample's root and examined using CLSM. The acquired data were statistically analyzed with one-way analysis of variance and the Post hoc Tukey's test. The cutoff for statistical significance was P < 0.05. Results: In comparison to other groups, the maximum sealer penetration values into dentinal tubules were significantly higher in Group 3 for Bioceramic sealer with NTAP application and Group 4 for Epoxy resin-based sealer with NTAP application. Conclusion: NTAP application increased the dentinal tubule penetration of bioceramic and epoxy resin-based sealers in comparison to groups without NTAP application.
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INTRODUCTION: Candida albicans is the most commonly isolated fungi from the oral cavity. It is the most infective to various intracanal medicaments and is considered as invasive yeast. Sodium dichloroisocyanurate (NaDCC) which is used as a disinfectant and as a biocide in treating potable water has similar action to that of sodium hypochlorite against microbes. The aim of the present study is to compare the effectiveness of calcium hydroxide and NaDCC against Candida albicans. MATERIALS AND METHODS: After obtaining the stock cultures of Candida, the isolates were divided into six groups which were exposed to different concentrations of NaDCC and calcium hydroxide Ca(OH)2. Group 1 consisted of the isolates which were subdivided into three groups, subjected to three different concentrations of NaDCC. Group 2 also consisted of three subgroups exposed to three different concentrations of Ca(OH)2. Group three consisted of three subgroups which were exposed to three different concentrations of combinations of both NaDCC and Ca(OH)2. RESULTS: The results of the present study show that calcium hydroxide was totally ineffective at all concentrations and NaDCC was effective and also the combination of both was shown to be effective. CONCLUSION: NaDCC alone was effective at all concentrations and the combination with Ca(OH)2 was found to be less effective. Ca(OH)2 was totally ineffective.
Assuntos
Antifúngicos/farmacologia , Hidróxido de Cálcio/farmacologia , Candida albicans/efeitos dos fármacos , Higienizadores de Dentadura/farmacologia , Triazinas/farmacologia , Antifúngicos/administração & dosagem , Hidróxido de Cálcio/administração & dosagem , Contagem de Colônia Microbiana , Combinação de Medicamentos , Humanos , Teste de Materiais , Testes de Sensibilidade Microbiana , Viabilidade Microbiana/efeitos dos fármacos , Triazinas/administração & dosagemRESUMO
Background: Tooth whitening procedures such as bleaching and microabrasion alters the enamel surface and thus reduce the composites' bond strength. Hence, various surface treatments were introduced to overcome this problem. Aim: To assess the effect of nonthermal atmospheric plasma (NTAP), grape seed extract (GSE) and bromelain on the shear bond strength (SBS) of the composite after bleaching and microabrasion. Materials and Methods: Eighty extracted maxillary anterior teeth were distributed into two groups. Group 1: bleaching and Group 2: Microabrasion and further subdivided into four subgroups (n = 10) based on the form of surface treatment employed. Group A: no surface treatment, Group B: bromelain, Group C: GSE, Group D: NTAP. Composite resin was bonded to the labial surface and placed in artificial saliva for 24 h. SBS testing was done for all the samples. Statistical Analysis: Analysis was performed using two-way analysis of variance and post hoc Tukey's test with P < 0.05 considered statistically significant. Results: Group 1D revealed the highest bond strength (35.4 Mpa) and Group 1A showed the least bond strength values (15.7 Mpa). Among the bleaching groups, significant difference was observed between all the subgroups except Group 1A and 1B (P = 0.972). In microabrasion group, significant difference was observed between Group 2A and 2D (P = 0.0001), Group 2B and 2D (P = 0.0010), and Group 2C and 2D (P = 0.0001). Conclusions: Following bleaching, NTAP application and GSE significantly improved the SBS of composite resin. Application of NTAP to microabraded surfaces increased the bond strength of composite resin.
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Aim: To evaluate the effect of natural antioxidants as final irrigants on the push-out bond strength of epoxy resin-based sealer to the hypochlorite treated dentin. Methods: Eighty single-rooted human mandibular incisors were prepared using ProTaper Gold (Dentsply, TN, USA) and an irrigation protocol including 3% NaOCl, followed by ethylenediaminetetraacetic acid (EDTA), and 3% NaOCl. The groups (n =20) were divided according to the final irrigant used: Group 1: None (Control); Group 2: 5% sodium ascorbate, Group 3: 5% grape seed extract (GSE); and Group 4: 5% pine bark extract. The obturation of root canals was performed using gutta-percha and AH Plus (Dentsply DeTrey, Germany). Bond strength was evaluated using the push-out test under the universal testing machine at a crosshead speed of 0.5 mm/min, and statistical analyses were performed using one-way ANOVA. The p-value significance was evaluated by Tukey's post hoc test (p<0.01). Results: Mean push-out bond strength values were compared in all the groups, and there was a statistically significant improvement in the experimental final irrigating groups. 5% pine bark extract had improved bond strength than the other groups, and the least bond strength was observed in the control group. Conclusion: The irrigation protocols and naturally derived antioxidants affected the resin-based sealer's bond strength to root dentin. It was observed that the use of antioxidants effectively reversed the compromised bond strength of resin-based sealers to root dentin. 5% pine bark extract application showed better bond strength.
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Background: Various instrument kinematics used in single-visit endodontics influence the occurrence of pain after endodontic therapy. This study aimed to evaluate the occurrence of pain after mechanical instrumentation with Hyflex EDM (HEDM) and WaveOne Gold (WOG) during single-visit endodontic therapy. Methods: Sixty patients diagnosed with asymptomatic irreversible pulpitis and normal apical tissues in mandibular premolar teeth were included in the study for single-visit root canal therapy. The patients were divided into two groups (n = 30) according to the rotary instrument used during root canal preparation (group A [HEDM] and group B [WOG]). Pain was evaluated after endodontic therapy at 8, 24, and 48 h intervals using the visual analog scale (VAS). Data obtained were analyzed using the chi-square test, independent t-test, MannWhitney U test, and Wilcoxon matched-pairs test. Results: Statistically significant differences were observed between the two groups (P < 0.001) at 8, 24, and 48 h, with WOG exhibiting less pain than HEDM files. Conclusion: Postoperative pain was lower in the WOG file system than in the HEDM file system after single-visit root canal therapy at 8, 24, and 48 h.
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Aim: The aim of the study is to determine the effect of autoclaving on the cyclic fatigue resistance (CFR) in respect to three different rotary nickel-titanium (NiTi) systems. Methods: Three rotary NiTi files with different manufacturing process were selected and arranged into three groups. Group 1: Neolix Neoniti files (n = 15), Group 2: Edge Files (n = 15), Group 3: NeoendoFlex files (n = 15). Each group was then subdivided into three subgroups containing 5 samples each based on the number of cycles of autoclaving (0, 1, 5 cycles). The instruments were subjected to autoclave without usage. The files of size 25, taper 6%, and 25 mm length were taken. After the autoclaving cycles, the files were rotated in cyclic fatigue testing device with simulated canal curvature of 60° until file separation. Time taken for the instrument separation (in minutes) was multiplied by the number of rotations per minute to attain the mean number of cycles to failure for every file. The obtained results were subjected to statistical analysis using two-way ANOVA and Newman-Keuls multiple post hoc procedures. Results: Neolix Neoniti files exhibited the maximum CFR (98.80) than EdgeFiles (80.47) and Neoendo Flex files (41.80) (P = 0.0001). Reduction in CFR was observed with increase in the number of cycles of autoclaving (i.e., 0, 1, 5 cycles). Conclusion: Autoclaving has a negative influence on the CFR of the rotary NiTi files used. Neolix Neoniti files exhibited greater CFR than EdgeFiles and Neoendo Flex files.
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AIM: The aim of this study was to evaluate the number of intracanal bacteria extruded apically after instrumentation with three different nickel-titanium rotary instruments. MATERIALS AND METHODOLOGY: Forty freshly extracted mandibular premolars were selected, access cavities were prepared, and the teeth were mounted in the bacterial collection apparatus. Root canals were contaminated with a suspension of Enterococcus faecalis and incubated for 24 h at 37°C. The contaminated teeth were divided into four groups of 10 teeth each according to the rotary system used for instrumentation: Group 1: ProTaper universal files, Group 2: MTwo files, Group 3: ProTaper Next files, and Group 4: Control group (no instrumentation). Bacteria extruded after preparations were collected into vials. The number of colony-forming units (CFUs) was determined for each sample. STATISTICAL ANALYSIS: The data obtained were analyzed using the one-way analysis of variance followed by post hoc Tukey's test with a P = 0.05 as the level for statistical significance. RESULTS: The results suggested a statistically significant difference in the number of CFUs between four experimental groups (P < 0.001). CONCLUSION: Least amount of bacterial extrusion was seen in ProTaper Next Group while more bacterial extrusion was seen in MTwo Group.
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The success of nonsurgical endodontic management depends on the complete elimination of infection that compromises the tooth function. Thorough knowledge about the root canal anatomy is one of the principal factors in achieving a successful outcome. The morphology of root canals is not always typical. Maxillary molars, known for varied morphology, require advanced imaging modalities such as cone-beam computed tomography. This case report describes a series of four maxillary molars with different forms, numbers, and configurations of root canals and with unusual morphology, including a case of a third mesiobuccal canal, a case of a second mesiobuccal canal with two palatal canals (mesiopalatal and distopalatal), a case of three mesiobuccal canals, three distobuccal canals, and two palatal canals (mesiopalatal and distopalatal), and a case of taurodontism, where different access cavity modifications, diagnostic methods, and magnifications were considered.
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Clinicians proceed the canal exploration according to the literature so far reported. At times, there are apparent variations in the teeth. These discrepancies should be thoroughly surveyed and piled up to date. One such rare complexity of canal morphology was discussed in the present case. A 48-year-old female patient referred to the endodontic clinic for full-mouth rehabilitation. On intraoral hard-tissue examination, decay was noted in multiple teeth which were confirmed by an orthopantomogram and endodontic treatment plan was suggested. The patient was prepared for the access opening of right mandibular first premolar (tooth #44) before which endodontic treatment of first and second quadrants was completed. The cone-beam computed tomography (CBCT) images revealed that tooth # 44 had two separate roots and four distinct root canals (mesiobuccal, mesiolingual, distobuccal, and distolingual). Root canal treatment was completed in two visits. Postoperative CBCT was advised to confirm the obturation of all the canals.
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Dens Invaginatus is a developmental disturbance resulting from abnormal morpho differentiation. It is characterized by an invagination of the enamel and dentin, creating a lumen inside the affected tooth, which may extend as deep as the apical foramen. In the present scenario, calcified Oehler's type IIIb dens invaginatus in left maxillary lateral incisor in 23-year-old male patient was seen. As the two-dimensional imaging lacks accuracy in such complicated cases, cone beam computed tomography was used to assess the calcification three dimensionally. Endodontic treatment was performed in two visits, using thermoplastized gutta percha obturation technique.
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Knowledge and understanding the anatomical configuration of individual tooth play a significant role in success of endodontic treatment, in addition to through debridement and obturation of the canals. The canal anatomy of maxillary second premolar has been studied extensively, and the presence of a significant variety of multirooted canals is relatively rare in it. A 27-year-old female reported with a chief complaint of pain in her upper right posterior region for 10 days. On intraoral hard tissue examination, ill-defined access preparation was seen in maxillary right second premolar with exposed pulp. An intraoral periapical radiograph reveals radiolucency involving the pulp space and varied morphology in the same tooth. The occurrence of three roots with four canals in the maxillary second premolar is rare and not documented in the literature so far. This case report describes the nonsurgical endodontic management of such varied anatomical configuration using cone beam computed tomography as an evaluating diagnostic tool.
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AIM: The purpose of this study was to evaluate the effectiveness of three desensitizing agents on dentinal tubule obliteration and their durability in use on the dentinal tubules. MATERIALS AND METHODS: Sixty specimens were obtained from 30 extracted sound human maxillary first premolars. Each tooth was mesiodistally sectioned to obtain 30 buccal and 30 lingual surfaces, and enamel was removed in order to simulate hypersensitive dentin. Specimens were divided into four groups with 15 specimens each. Group 1 samples were immersed in artificial saliva, Group 2 samples were coated with Vivasens, Group 3 samples were coated with VOCO Admira Protect, and Group 4 samples were coated with Neo Active Apatite suspension. These specimens were examined under scanning electron microscope (SEM) to find out the occluding ability of the respective products. The specimens were brushed to find out their durability for 1 week and 1 month and were examined under SEM. STATISTICAL ANALYSIS: The results were statistically analyzed by analysis of variance (ANOVA) and Tukey's test. RESULTS: Group 1 differed significantly from the Vivasens, Admira, and Neo Active Apatite groups at 5% level of significance (P < 0.05). The Vivasens group differed significantly from the Admira and Neo Active Apatite groups at 5% level of significance (P < 0.05). CONCLUSION: The Ormocer-based Admira Protect showed the best results.
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AIM: The aim of this in vitro study is to compare the smear layer removal efficacy of different irrigating solutions at the apical third of the root canal. MATERIALS AND METHODS: Forty human single-rooted mandibular premolar teeth were taken and decoronated to standardize the canal length to 14 mm. They were prepared by ProTaper rotary system to an apical preparation of file size F3. Prepared teeth were randomly divided into four groups (n = 10); saline (Group 1; negative control), ethylenediaminetetraacetic acid (Group 2), BioPure MTAD (Group 3), and QMix 2 in 1 (Group 4). After final irrigation with tested irrigants, the teeth were split into two halves longitudinally and observed under a scanning electron microscope (SEM) for the removal of smear layer. The SEM images were then analyzed for the amount of smear layer present using a three score system. STATISTICAL ANALYSIS: Data are analyzed using the Kruskal-Wallis test and Mann-Whitney U-test. RESULTS: Intergroup comparison of groups showed statistically significant difference in the smear layer removal efficacy of irrigants tested. QMix 2 in 1 is most effective in removal of smear layer when compared to other tested irrigants. CONCLUSION: QMix 2 in 1 is the most effective final irrigating solution for smear layer removal.
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AIM: This in vitro study evaluated and compared the marginal adaptation of three newer root canal sealers to root dentin. MATERIALS AND METHODS: Thirty freshly extracted human single-rooted teeth with completely formed apices were taken. Teeth were decoronated, and root canals were instrumented. The specimens were randomly divided into three groups (n = 10) based upon the sealer used. Group 1 - teeth were obturated with epoxy resin sealer (MM-Seal). Group 2 - teeth were obturated with mineral trioxide aggregate (MTA) based sealer (MTA Fillapex), Group 3 - teeth were obturated with bioceramic sealer (EndoSequence BC sealer). Later samples were vertically sectioned using hard tissue microtome and marginal adaptation of sealers to root dentin was evaluated under coronal and apical halves using scanning electron microscopy (SEM) and marginal gap values were recorded. RESULTS: The data were statistically analyzed by two-way ANOVA and Tukey's multiple post hoc test. The highest marginal gap was seen in Group 2 (apical-16680.00 nm, coronal-10796 nm) and the lowest marginal gap was observed in Group 1 (apical-599.42 nm, coronal-522.72 nm). Coronal halves showed superior adaptation compared to apical halves in all the groups under SEM. CONCLUSION: Within the limitations of this study epoxy resin-based MM-Seal showed good marginal adaptation than other materials tested.
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AIM: The aim of this study is to evaluate the response of human pulp tissue to mineral trioxide aggregate (MTA), Emdogain (EMD), and combination of MTA/EMD. MATERIALS AND METHODS: This study was performed on sixty intact first and second premolars of human maxillary and mandibular teeth. A standard pulpal exposure was done on all the teeth and was divided into three groups of twenty teeth each and was capped with MTA, EMD, and MTA/EMD combination. The final restoration was done with resin-modified glass ionomer cement. The teeth were then extracted on the 15th or 45th day and histological evaluation done. RESULTS: Differences in inflammatory response and thickness of dentin bridge formation of the exposed pulp to the three different groups were statistically evaluated using Chi-square and Mann-Whitney tests and were found to be significant. No significant difference was found between MTA/EMD and MTA in terms of calcified bridge formation and pulp inflammatory response to the capping materials. CONCLUSIONS: MTA and MTA/EMD combination produced a better quality hard tissue response compared with the use of EMD.
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AIM: To compare the bond strength of four different endodontic sealers to root dentin through push-out test design. MATERIALS AND METHODS: Forty single-rooted teeth with completely formed apices were selected. Teeth were decoronated, and working length was determined. Instrumentation and irrigation were performed. The teeth were divided into four groups based upon the sealer used. Group 1: Bioceramic sealer (Endosequence), Group 2: Mineral trioxide aggregate (MTA) based sealer (MTA Fill apex), Group 3: Epoxy resin based sealer (MM-Seal), and Group 4: Dual cure resin-based sealer (Hybrid Root Seal). Manipulation and application of the sealer was done as per the manufacturer instructions. All the teeth were obturated using 6% gutta-percha. After obturation, each tooth was prepared for push-out test with root slices of 2 mm thickness using universal testing machine. RESULTS: The highest bond strength was found in Group 1 (Endosequence) (P < 0.05) compared to other groups. The lowest bond strength was found in Group 2 (MTA Fill apex). Statistical analysis is done by two-way ANOVA and Newman-Keuls multiple post hoc. CONCLUSION: The push-out bond strength of Bioceramic sealer was highest followed by resin-based sealer and lowest bond strength was observed in MTA-based sealer.
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INTRODUCTION: Marginal integrity of adhesive restorative materials provides better sealing ability for enamel and dentin and plays an important role in success of restoration in Class V cavities. Restorative material with good marginal adaptation improves the longevity of restorations. AIM: Aim of this study was to evaluate microleakage in Class V cavities which were restored with Resin Modified Glass Ionomer Cement (RMGIC), Giomer and Nano-Ionomer. MATERIALS AND METHODS: This in-vitro study was performed on 60 human maxillary and mandibular premolars which were extracted for orthodontic reasons. A standard wedge shaped defect was prepared on the buccal surfaces of teeth with the gingival margin placed near Cemento Enamel Junction (CEJ). Teeth were divided into three groups of 20 each and restored with RMGIC, Giomer and Nano-Ionomer and were subjected to thermocycling. Teeth were then immersed in 0.5% Rhodamine B dye for 48 hours. They were sectioned longitudinally from the middle of cavity into mesial and distal parts. The sections were observed under Confocal Laser Scanning Microscope (CLSM) to evaluate microleakage. Depth of dye penetration was measured in millimeters. STATISTICAL ANALYSIS: The data was analysed using the Kruskal Wallis test. Pair wise comparison was done with Mann Whitney U Test. A p-value<0.05 is taken as statistically significant. RESULTS: Nano-Ionomer showed less microleakage which was statistically significant when compared to Giomer (p=0.0050). Statistically no significant difference was found between Nano Ionomer and RMGIC (p=0.3550). There was statistically significant difference between RMGIC and Giomer (p=0.0450). CONCLUSION: Nano-Ionomer and RMGIC showed significantly less leakage and better adaptation than Giomer and there was no statistically significant difference between Nano-Ionomer and RMGIC.