Novel Management of Hypersensitive Dentin Using Propolis-based Herbal Desensitizing Agents: An In Vitro Scanning Electron Microscopic Study.

AIM: The objective of this in vitro study was to assess the efficacy of novel propolis-based varnish against the two conventional varnishes on quantitative and qualitative assessments of occlusion of dentin tubules and resistance to erosive and abrasive wears employing scanning electron microscope (SEM). METHODS: Thirty human premolars free from caries extracted due to orthodontic reasons were included in the study. Experimental group was done based on treatment received and divided into three groups. Group A: ClinProXT Varnish (n = 10), Group B: MI Varnish (n = 10), and Group C: Propolis Varnish (n = 10) were applied. Teeth were cleaned and decoronation of crown was done with dentin disks. Dentin specimens of dimension 4 × 4 × 2 mm were prepared and subjected to finishing and polishing. The sample specimens were submersed in EDTA solution for a period of five minutes to open up the dentinal tubules. This was followed by treatment with varnishes and subjection to acidic-abrasive challenge. The specimens were analyzed with an image analyzer connected to SEM for the verification of the number of opened dentin tubules. The parameter assessed in SEM includes size, topography and surface characteristics of dentinal tubule were assessed. The obliteration potential of dentinal tubules was assessed with SEM images. Additionally, the dentin surface loss and resistance to acidic and abrasive wear were also evaluated with SEM. Data were analyzed with two-way analysis of variance (ANOVA) with post hoc Tukey's test. RESULTS: MI Varnish caused higher obliteration of dentin tubules followed by ClinproXT Varnish. Propolis Varnish showed the least obliteration of dentinal tubules among tested experimental groups. After acidic-abrasive challenge, Propolis Varnish was found to be more efficient with less material loss among the experimental groups tested. There was an insignificant difference among the MI Varnish and ClinProXT Varnish groups. CONCLUSION: Simulation of hypersensitive lesions mimicking the clinical scenario was a challenging task in this in vitro study. All varnishes tested in the study had good efficacy in the management of dentin hypersensitivity (DH). Propolis-based varnish had good resistance to material loss after subjection to acidic-abrasive challenge among the tested materials. The casein phosphopeptide (CPP)-amorphous calcium phosphate (ACP)-based MI Varnish had good efficacy to obliterate the dentinal tubules among the tested materials. It was prudent to select the varnishes with good long-term efficacy to survive in the clinical scenario which still remains a challenging task for the clinicians. CLINICAL SIGNIFICANCE: The stability of the varnish plays a vital role in maintenance of its long-term efficacy. The chemical nature along with the ability of the material to interact with the substrate plays a major role in management of DH.

Comparative Evaluation of the Antioxidant Effects of Oregano on Bleached Enamel Using Energy-dispersive X-ray Spectroscopy Analysis: An In Vitro Study.

AIM AND OBJECTIVE: The aim of this study was to evaluate the efficacy of novel antioxidant oregano against conventional antioxidants sodium ascorbate and green tea through comparison of the baseline weight percentage (wt%) of minerals prior to bleaching with values after bleaching protocols and antioxidant application by employing energy-dispersive X-ray spectroscopy analysis (EDAX). MATERIALS AND METHODS: Thirty noncarious, freshly extracted human permanent maxillary incisors without any visible defects were selected as samples. They were divided into three groups (n = 10) based on the antioxidant treatment received as follows: group I-10% sodium ascorbate solution, group II-10% green tea solution, and group III-5% oregano solution. 35% hydrogen peroxide was employed for bleaching. The wt% of teeth was calculated at three time intervals. The initial wt% was calculated prior to the bleaching procedure. The second one was calculated after subjecting to bleaching protocols, and final one was calculated after antioxidant treatment using EDAX. RESULTS: There was a statistically significant decrease in the calcium/phosphorus ratio for the bleached samples in comparison with the sound enamel. There was a comparable and significant increase in the calcium/phosphorus ratio values after application of the antioxidant with insignificant difference among the antioxidants evaluated in the study. CONCLUSION: Treatment with antioxidants helped in the reversal of mineral loss, which occurred due to the bleaching procedure while the efficacy of 10% oregano on reversal of the calcium and phosphorus ratio was found to comparable to that of 10% sodium ascorbate and green tea. CLINICAL SIGNIFICANCE: Application of antioxidants after bleaching reduced the time delay in performing the adhesive procedures without compromising their clinical efficacy.

Comparative Evaluation of the Efficacy of Novel Root Canal Irrigation Techniques on Reduction of Enterococcus faecalis Count: An In Vitro Study.

AIM AND OBJECTIVE: To compare the effectiveness of three irrigation systems, namely, Endovac system, Max I probe, and Navitip FX, in reduction of Enterococcus faecalis population from the root canal using agar diffusion method. MATERIALS AND METHODS: Sixty extracted intact human permanent maxillary anterior teeth were selected for this study. In group I, root canals were irrigated using brush covered 30-gauge NaviTipFX. Ultradent in group II root canals was irrigated using brush covered 30-gauge Max-I-Probe Dentsply. In group III, root canals were irrigated using Endoactivator, Dentsply. In group IV, root canal was irrigated by using the Endovac system Sybronendo. The steps followed in the study include preparation of specimen, contamination of the samples followed by conduction of testing procedures with implementation of appropriate irrigation protocols, and sampling procedures. RESULTS: Data were subjected to statistical analysis to interpret the significant differences among various irrigation systems. One-way analysis of variance, Post hoc Tukey tests were used for statistical analysis in the present study. Among the experimental groups, group IV showed statistically significant difference in reduction of E. faecalis. There were no statistical differences between them in reduction of E. faecalis in group I and group II compared and represented in Tables 1 and 2. CONCLUSION: All four irrigation delivery systems have been found to be effective in the reduction of E. faecalis. Endovac showed comparable efficacy in reduction of colony-forming units to that of other delivery systems used in the study. The result has to be validated with in vivo studies and clinical trials of larger sample size. CLINICAL SIGNIFICANCE: Selection of appropriate irrigation system capable of disinfection of canal complexities in apical third with less adverse effects is essential for good clinical success of endodontic treatment.