Comparative evaluation of the marginal fit of computer-aided design-computer aided manufacturing fabricated crowns from direct and indirect digital impression - A systematic review.

The accuracy of the digital impression method is responsible for fabricating crowns with adequate marginal fit which in turn determines the postendodontic prognosis. This systematic review was undertaken to identify the influence of the two digital impression techniques in producing full coverage crowns with better marginal fit. This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. A detailed search was done in electronic databases (PubMed, EBSCOhost, LILACS, Cochrane) along with hand searches of reference articles. In vivo crossover studies comparing the marginal fit of the computer-aided design-computer-aided manufacturing (CAD-CAM) fabricated crowns from direct and indirect digital impressions published from inception till July 2023 were included in this review. The quality assessment of the included articles was done based on a modified Cochrane collaboration tool for crossover studies. A total of 280 articles were identified, after duplicate removal, title and abstract screening, and full-text evaluation, 7 articles were included in this systematic review. The overall quality of evidence is moderate. The CAD-CAM crowns fabricated from direct digital impressions exhibited a better marginal fit than those crowns fabricated by indirect digital impressions. The overall quality of evidence is moderate. Further clinical studies has to be conducted for evaluating the latest technologies towards achieving the misfit of zero.

Reinforced Immediate Dentin Sealing vs Conventional Immediate Dentin Sealing on Adhesive Behavior of Indirect Restorations: A Systematic Review.

AIM: The aim of this systematic review is to compare the bonding performance of indirect restoration with the reinforced immediate dentin sealing (IDS) method as opposed to the conventional IDS method. MATERIALS AND METHODS: A literature search was conducted in PubMed, Cochrane, and EBSCOHost up to January 31st 2022, accompanied by a hand search in Google Scholar. Inclusion criteria involved studies comparing conventional IDS and reinforced IDS protocol and evaluating various parameters influencing the bonding performance, such as type of indirect restoration, etching protocol, cavity design, tooth surface preparation, method of oral cavity simulation, and processing after luting. The quality of six included studies was appraised using CRIS guidelines. RESULTS: A total of 29 publications was identified, and 6 of them fulfilled the inclusion criteria. All of the included studies were in vitro studies. The predetermined data were independently extracted and evaluated by four reviewers. It was observed that most of the studies showed an improvement in bond strength with reinforced IDS when compared with conventional IDS. Also, etch-and-rinse and 2-step self-etch adhesive protocols have shown better bonding performance than universal adhesive systems. CONCLUSION: Reinforced IDS has similar or better bond strength to that of conventional IDS strategies. The need for prospective studies is highlighted. The future clinical studies for immediate dentin sealing ought to be reported in a uniform and methodological way. CLINICAL SIGNIFICANCE: Application of an additional layer of low-viscosity resin composite provides a thicker adhesive layer, prevents re-exposure of dentin during the final restoration, and allows a smoother preparation in lesser clinical chair time and eliminates any possible undercuts. Thus, reinforced IDS has shown to result in better preservation of the dentinal seal than IDS technique.

Comparative Evaluation of the Anti-bacterial Efficacy of Herbal Medicaments and Synthetic Medicaments Against Enterococcus faecalis using Real-time Polymerase Chain Reaction.

Periradicular bacterial infections are the proven cause of the failure of endodontic treatment. When the pulp canal gets infected or becomes necrotic, bacterial growth takes place in the form of biofilms and aggregates. During the endodontic procedure, bacterial colonies are disrupted, and the microbial load is reduced by biomechanical preparation, cleaning with anti-microbial solutions, and placing anti-bacterial medicaments in the root canal. These anti-microbial substances are synthetic, having a cytotoxicity effect. In recent times, herbal medicines are an alternative medicine being used increasingly as an intra-canal medicament to fight or prevent common endodontic infections. Aim The objective of this study is to compare the anti-bacterial efficacy of herbal medicaments and synthetic medicaments against Enterococcus faecalis (E. faecalis). Materials and methods This was an in-vitro study in which a total of 60 teeth specimens (n=60) were inoculated with E. faecalis for 21 days. Specimens were divided into six groups (Group 1: Piper nigrum (Piperaceae); Group 2: Piper longum (Piperaceae); Group 3: Zingiber officinale Roscoe (Zingiberaceae); Group 4: Calcium hydroxide; Group 5: 2% chlorhexidine gel (CHX); and Group 6: saline (negative control). The intra-canal medicaments were packed inside the tooth. After five days, the remaining microbial load was determined by using real-time PCR. Results The threshold cycle (Ct) values of Piper nigrum, Piper longum, dried ginger extract, 2% CHX, calcium hydroxide, and saline were found to be 21.36, 20.55, 22.14, 22.51, 23.62, and 17.81, respectively. The obtained mean bacterial load of these products was 8.64, 12.52, 7.23, 0.82, 0.14, and 149.49, respectively. Conclusion Two percent CHX showed high antibacterial activity against E. faecalis followed by calcium hydroxide, Zingiber officinale Roscoe, Piper nigrum, Piper longum, and saline.

Vertical tooth fracture: reunion with a miniature lag screw.

The treatment and prognosis of teeth with crown root fracture are dictated solely by the extent of the fracture line. Vertical tooth fracture, a variant of crown root fracture, presents serious complications in management because of the extent of the fracture line to the full vertical length of the tooth. It is invariably followed by extraction of the entire or a segment of the tooth. Literature recommends various treatment possibilities for vertical tooth fracture, yet no predictable protocol with a long-term prognosis has been described. This case report details a multidisciplinary approach towards reunion of the fractured fragments of maxillary I premolar by providing interfragmentary compression with the use of a miniaturized lag screw.