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AIM: The aim of this study was to compare the fracture resistance of simulated immature teeth restored with gutta-percha, glass fiber posts (GFP), experimental dentine posts (DP) or Intracanal composite Resin (ICR). MATERIALS AND METHODS: Fifty maxillary canines were decoronated, standardized and enlarged until, number 5 Peeso reamers were allowed to simulate immature teeth. After placement of 5 mm of MTA, the canals were divided into 5 groups and filled as follows: Group 1: AH Plus + gutta-percha, lateral compaction; Group 2: GFP luted with PARACORE dual cure resin; Group 3: DP luted with PARACORE dual cure resin; Group 4: PARACORE dual cure resin. A standardized core was built in all groups except in Group 5. Each of the specimens was tested for fracture resistance by universal testing machine. RESULTS: The mean fracture resistance were 817 ± 27.753, 1164.6 ± 21.624, 994.4 ± 96.8747, 873.8 ± 105.446 and 493.7 ± 6.945 newtons for Groups 1, 2, 3, 4, and 5 respectively. Independent "t" test revealed statistically significant discrepancies, in the fracture resistance among the 4 groups except Group 1 and Group 4 (P < 0.05). CONCLUSIONS: This study suggests that GFP and DP may be preferred for additional reinforcement of immature teeth.
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Resinas Compostas/uso terapêutico , Restauração Dentária Permanente/métodos , Dentina/cirurgia , Técnica para Retentor Intrarradicular , Dente Canino/cirurgia , Análise do Estresse Dentário , HumanosRESUMO
AIMS: To compare amount of root canal debris and irrigant extruded apically after irrigants agitation using closed and open chambers. METHODS AND MATERIAL: Sixty maxillary central incisors were selected, decoronated, and mounted in preweighed glass vials filled with distilled water. Biomechanical preparation was completed using ProTaper rotary files until number F4 and 1 mL of 3% NaOCl solution after each file use. Samples were randomly divided into closed or open chamber sets which were further subdivided into 6 groups, based on the agitation techniques: no agitation (control), canalBrush, lentulospiral, passive ultrasonic agitation (PUA), EndoActivator, and EndoVac. Canals were irrigated with 1 mL of 17% EDTA and agitated for 30 s and then flushed with 2 mL of distilled water. Apically extruded irrigant was measured and vials were kept in incubator for 5 days at 68 °C for drying for weight calculation. Statistical Analysis. Analysis was done using Student's t-test, one-way ANOVA, and post-hoc. RESULTS: All agitation techniques showed apical extrusion of the debris and irrigant. The closed chamber apparatus showed significantly less extrusion of debris and irrigant than open chamber (P < 0.05). CONCLUSIONS: EndoVac was found to be the safest agitation system among all test groups with regard to apical extrusion of debris and irrigant.
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Instrumentos Odontológicos , Irrigantes do Canal Radicular/administração & dosagem , Irrigação Terapêutica/instrumentação , Cavidade Pulpar/efeitos dos fármacos , Cavidade Pulpar/patologia , HumanosRESUMO
The cases presented here aim to highlight the occurrence of a very rare internal root resorption (IRR) of inflammatory type among mandibular molars (prevalence 0.01%-1%). Patients reported in the outpatient department with a chief complaint of pain in the lower posterior region of the jaws, on thorough clinical and radiological examinations a diagnosis of irreversible pulpitis was made and nonsurgical root canal treatment was planned using thermoplastic obturation technique along with the use of magnification, cone-beam computed tomography, endosonics, and intracanal medicament to attain a successful outcome. Six-month follow-up showed arrest of IRR. This report of two cases with a literature review discusses the etiology, prevalence of IRR, the clinical decision, and the therapeutic management. Early detection of such resorption is the key to successful management and preserves the integrity of the tooth.
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An in-depth understanding of the anatomical variations of maxillary molars is essential for endodontic success. Unlike the maxillary second molars, the presence of a second palatal root is uncommon in the first maxillary molar. This case report describes two cases of non-surgical management of maxillary molars with extra palatal roots. Careful clinical examination, knowledge of the internal anatomy, and the use of advanced radiographic modalities like cone beam computed tomography (CBCT) can reveal the presence of variations in the internal and external anatomy of any tooth. Therefore, for nonsurgical as well as surgical management clinicians should always watch out for any deviations in a tooth and utilize all the available tools to diagnose and manage them successfully.
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Aim: To compare the effectiveness of different intracanal medicaments against polymicrobial biofilm formed by Enterococcus faecalis, Staphylococcus aureus, and Candida albicans. Materials and Methods: Eighty mature human roots with intraradicular polymicrobial biofilm were randomly assigned into four groups (n = 20). Intracanal medicaments 0.2% polyhexamethylene biguanide (PHMB), 2% chlorhexidine (CHX), and calcium hydroxide (CH) were applied into the root canals. Collected dentine samples were tested at 7th, 15th, and 30th day for microbial growth, and the colony-forming units per ml (CFU/ml) were determined. Results: The CFU/ml data were analyzed using unpaired t-test and one-way ANOVA-F comparison test. All medicaments resulted in a significant reduction (P < 0.05) in microbial growth at all time intervals compared to the control group. CHX and PHMB showed a similar reduction in CFU/ml at 7th and 15th day but significantly more than CH at all time intervals. At 30th day, PHMB caused a significantly more reduction in CFU/ml than CHX. Conclusions: All the three tested intracanal medicaments such as CH, CHX, and PHMB Gel were effective in reducing the microbial count. CH has a limited antimicrobial effect against the polymicrobial biofilm found inside the root canal. 2% CHX gel has a time-dependent antimicrobial effect. PHMB has a superior antimicrobial effect in comparison with CHX and CH.
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Objectives: The objective of the study is to evaluate the effect of eugenol-based temporary on microtensile bond strength of self-adhering composite at 1 day and 7-day time intervals. Materials and Methods: Occlusal enamel of 24 human molars was removed. Zinc oxide eugenol (ZnOE) and noneugenol temporary cement (ZnONE) were placed on the dentin surfaces and left for different times (1 day, 7 days). After removal of temporary cement, teeth were randomly divided into eight subgroups: subgroup GE1S (n = 3): ZnOE cement + Self-adhering composite (SAC), subgroup GE1N (n = 3): ZnOE cement + adhesive system (one coat 7 universal) + nanohybrid composite, subgroup GE7S (n = 3): ZnOE cement + SAC, subgroup GE7N (n = 3): ZnOE cement + adhesive system + nanohybrid composite, subgroup GNE1S (n = 3): ZnONE cement + SAC, subgroup GNE1N (n = 3): ZnONE cement + adhesive system + nanohybrid composite, subgroup GNE7S (n = 3): ZnONE cement + SAC, subgroup GNE7N (n = 3): ZnONE cement + adhesive system + nanohybrid composite. Four sticks per tooth were obtained, resulting in 12 sticks per group with a cross-sectional area of 0.5 mm 2. The µTBS test was performed with a crosshead speed of 0.5 mm/min. Statistical Analysis: Kruskal-Wallis and Mann-Whitney U-test were used for analysis. Results: Highest and lowest mean value of microtensile bond strength was observed in GNE7N (12.75MPa) and GE1S (1.42MPa), respectively. Conclusion: The presence of eugenol at early stage, i.e. 1 day, has a negative influence on microtensile bond strength of SAC. At 7 days, the negative effect of eugenol on microtensile bond strength gets nullified. Thus, a waiting period of 1 week is sufficient to overcome negative influence of eugenol-based temporaries on polymerization of SAC.
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AIM: This study aimed to compare the efficiency of continuous and intermittent irrigating methods on the removal of dentin debris from the simulated grooves and to evaluate the dynamics of irrigant using computational fluid dynamics (CFD). METHODOLOGY: Seventy-five extracted human permanent maxillary canines were selected. Access cavities were made, working length was determined, and canals were prepared by crown down technique. The teeth were split longitudinally and standard groove 2.0 mm in length was made in split halves and each groove was filled with dentin debris and the images were taken under a microscope (E200). The halves were re-assembled and divided into five groups based on different irrigation methods. Group 1: ultrasonic Irrigation with continuous flow for 3.0 min; Group 2: ultrasonic irrigation with continuous flow for 1.5 min; Group 3: ultrasonic irrigation with intermittent flow for 3.0 min; Group 4: ultrasonic irrigation with the intermittent flow for 1.5 min; and Group 5: syringe irrigation for 1 min. The root halves were again separated and re-evaluated for debris elimination after the irrigation protocol for all the groups separately. The effect of time and method of passive ultrasonic irrigation were compared. For the computational fluid analysis, a GAMBIT 2.2 (Ansys) software was used for mesh construction. FLUENT 6.2 (Ansys) software was used to set the boundary conditions and reconstruction of the canal; flow patterns and turbulence were graphically constructed. RESULTS: The continuous irrigation methods were better at debris removal than intermittent irrigation flow methods. The CFD showed that the turbulence of flow of irrigant was dependent on the inlet velocity and pressure of the irrigant. CONCLUSION: Debris removal from the simulated grooves was better with continuous irrigation compared with intermittent irrigation. CFD study revealed that the turbulence that was affected by the velocity and pressure of the irrigant introduced and is a variable entity.
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AIM: To compare and evaluate the surface characteristics of different restorative materials used for restoration of cervical defects when subjected to periodontal prophylactic instrumentation techniques. MATERIALS AND METHODOLOGY: Sixty box-shaped cavities were prepared on the labial surface of decoronated permanent maxillary anterior teeth which were randomly divided into two groups (n = 30) based on the instrumentation technique Group I: Manual instrumentation using curettes and Group II: Ultrasonic instrumentation. The samples were further divided into three subgroups based on restorative material subgroups I V and II V-restored with Vitremer, subgroups I F and II F-restored with Filtek Z 250 XT and subgroups I D and II D-restored with Dyract flow, respectively. After finishing and polishing, the samples were subjected to surface profilometry analysis for determining the surface roughness values (Ra). Thereafter, the restored surfaces of all the samples in different subgroups were subjected to prophylactic instrumentation with Gracey's curettes (Group I) and ultrasonic scalers (Group II). Ra values were recorded again after prophylactic instrumentation and after polishing. The data thus obtained were subjected to the statistical analysis using the independent t-test and one-way ANOVA (p<0.05). RESULTS: Ra values were significantly higher for both manual and ultrasonic prophylaxis compared to preprophylaxis and postpolishing in all the three restorative materials. Ultrasonic scaling produced significantly higher Ra for subgroup V as compared to subgroup F and subgroup D, whereas the difference between the materials was not significant for manual scaling. CONCLUSION: Manual prophylaxis resulted in significant reduction in surface roughness of all the three restorative materials while ultrasonic prophylaxis resulted in significant reduction for Vitremer only. Polishing after scaling significantly reduced the effect of both manual and ultrasonic prophylaxis on surface roughness.
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BACKGROUND: Substantivity is one of the desirable characteristics of root canal irrigants. Among conventional endodontic irrigants, only chlorhexidine (CHX) is known to exert significant substantivity on root canal dentin. This study explored the substantivity activity of a polymeric biguanide-poly hexamethylene biguanide (PHMB). AIM: The aim of this study was to determine the substantivity of a polymeric biguanide - 0.2% PHMB and compare it with that of 2% CHX. MATERIALS AND METHODS: To evaluate and compare the substantivity of 0.2% PHMB and 2% CHX on root canal dentin, dentin disks were prepared and substantivity after 1 h, 24 h, 7 days and 21 days was measured using spectrophotometry. STATISTICAL ANALYSIS USED: The data so obtained were analyzed, and the intergroup comparison was made using unpaired t-test. RESULTS: The results of this study indicated that 0.2%. PHMB exerts significantly greater substantivity than 2% CHX on human dentin. CONCLUSION: Within the limitations, this study supports the use of 0.2% polyhexanide as an endodontic irrigant based on its property of substantivity.
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BACKGROUND: Root-end preparation during surgical endodontics may produce dentinal microcrack formation and/or propagation, leading to vertical root fractures. AIM: This study aimed to evaluate and compare the microcrack formation and propagation during ultrasonic root-end cavity preparation, with diamond- and zirconium nitride-coated tips using micro-computed tomography (CT). METHODOLOGY: Twenty-eight extracted, mature, free-of-defect, mandibular premolars were decoronated and micro-CT scanned for the presence of preexisting microcracks. Samples were prepared till F4, were obturated, and were re-scanned to determine an increase in the number of microcracks. After 3 mm of root-end resection, the samples were randomly divided for ultrasonic root-end preparation into Group 1 (n = 12): preparation was done with ProUltra Surg tip, Group 2 (n = 12): preparation was done with KiS tip, and Group 3 (n = 4): no preparation was done. The samples were rescanned, and data collected were analyzed using ANOVA and Student's t-test. The level of significance was set at 5%. RESULTS: Preexisting microcracks were observed in few samples. The mean percentage number increase of microcracks after root-end preparation in ProUltra Surg group was 1.25 and in KiS group, it was 0.5. The difference in mean percentage increase for the number of microcracks after root-end cavity preparation using ProUltra Surg tip and KiS tip was 0.75. However, this difference was not statistically significant (P = 0.34). CONCLUSION: Both diamond- and zirconium nitride-coated ultrasonic tips resulted in more number of dentinal crack formation and propagation when preexisting cracks were present.
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AIM: The aim is to compare and evaluate the different finishing and polishing systems for the change in surface roughness of resin composites and enamel. MATERIALS AND METHODS: To conduct the study, 30 extracted human maxillary central incisors were selected, decoronated, and molded in self-cure acrylic molds. A box-shaped cavity of dimensions 3 mm × 3 mm × 2 mm was prepared in all the teeth. A nanohybrid composite resin (Filtek Z250) was then used to restore the prepared cavities. Thirty samples were divided into two groups, control group (Group A, n = 10) and experimental group (Group B, n = 20). The samples in Group A were cured through the Mylar matrix. The experimental group, i.e., Group B was divided into two subgroups, i.e., Subgroup BX, n = 10 in which Sof-Lex polishing system was used for polishing the tooth surface and Subgroup BF, n = 10 in which Shofu composite polishing system was used. The mean surface roughness (Ra in µm) of the composite restoration as well as for the enamel surface of all the samples before and after polishing was measured with a contact profilometer, and the values were correlated with scanning electron microscopy. RESULTS: The statistical analysis was carried out using paired t-test. The results exhibited a significant decrease in the surface roughness of the resin composite and enamel surface irrespective of the finishing and polishing system used. The mean surface roughness values demonstrated by Mylar matrix was the lowest followed by Sof-Lex polishing system. Shofu polishing system demonstrated the highest surface roughness values. CONCLUSION: Finishing and polishing of composite restoration can achieve a surface roughness similar to that of enamel. Involvement of marginal enamel in finishing and polishing procedures carried out for composite restoration results in smoother enamel surface.
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AIM: This study was conducted to evaluate and compare fluoride ion release by Cention-N (self-cure and light-cure) and conventional glass-ionomer cement (GIC) at different pH and time intervals. METHODOLOGY: Cavities of similar dimensions were prepared in mandibular molars and restored with Cention-N (by self-cure and light-cure techniques) and GIC. Samples were stored in deionized water, and the cumulative fluoride ion release and change in pH were assessed utilizing spectrophotometer and pH meter, respectively, at the end of 7 days, 14 days, and 21 days. The data thus obtained were statistically analyzed. RESULTS: All the tested materials released fluoride ions in both acidic and neutral pH at all time intervals, and the fluoride ion release was significantly higher (<0.05) in acidic pH as compared to neutral pH except in GIC. All the groups showed a statistically significant increase in pH in acidic medium, whereas no significant increase was observed in neutral medium. CONCLUSIONS: Cention-N (self-cure) has the highest fluoride ion release and alkalizing potential in acidic pH as compared to Cention-N (light-cure) and GIC.
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INTRODUCTION: This study evaluated the effect of root canal preparation, obturation, and different techniques of retreatment on the percentage increase in the number of dentinal microcracks using microcomputed tomography (CT) analysis. MATERIALS AND METHODS: Forty-five mandibular premolars after micro-CT scanning were prepared using Protaper universal files up to F4 and obturated. After the second micro-CT scanning again, the samples were randomly divided into three groups (n = 15) for retreatment procedure. In Group 1, retreatment was done with Protaper universal D1, D2, and D3 retreatment files followed by Protaper universal file till F4. In Group 2, retreatment was performed with R-Endo reciprocating motion, Re, R1, R2, R3, and Rs followed by Hero Shaper size #40. In Group 3, retreatment was performed with H-files and xylene till size #40. After gutta percha removal, the samples were again scanned for micro-CT for the evaluation of percentage increase in dentinal microcracks. Data were analyzed using "Kruskal-Wallis test ANOVA" and "student t-test" at 5% level of significance. RESULTS: Few unprepared samples showed preexisting microcracks. There were statistically significant percentage increase dentinal cracks after root canal preparation and obturation as well as after retreatment procedure with statistically significant percentage increase in the number of dentinal microcracks between all three groups. CONCLUSION: Intraradicular procedures such as shaping and cleaning and obturation as well as the use of retreatment file lead to the induction and propagation of dentinal microcracks. In the present study, the maximum microcracks were produced with Protaper universal retreatment file system followed by R-Endo system. H-files produced minimum cracks during retreatment procedures.
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AIM: The purpose of this study was evaluation and comparison of the contact angle of new root canal sealers - Hybrid Root Seal, mineral trioxide aggregate (MTA) Plus, and the conventional AH Plus sealer with dentin and gutta-percha. MATERIALS AND METHODS: Two groups (Group D - dentin and Group G - gutta-percha) of 18 samples each were further randomly divided into 3 subgroups based on the type of sealer used, that is, AH Plus, Hybrid Root Seal, and MTA Plus. Contact angle measurement device (Phoenix 300) was used to measure the contact angle of the sealers on both dentin and gutta-percha. The results thus obtained were analyzed using one-way analysis of variance and Student's t-test. RESULTS: MTA Plus recorded significantly higher values of contact angle on both the substrates, that is, dentin and gutta-percha when compared to AH Plus and Hybrid root canal sealer. The lowest value of contact angle in gutta-percha and dentin was shown by Hybrid root canal sealer and AH Plus, respectively. CONCLUSION: Both AH Plus and Hybrid Root Seal exhibited lower contact angle values, and hence, better wettability on both dentin and gutta-percha as compared to MTA Plus.
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INTRODUCTION: This study evaluated and compared techniques of postspace preparation for induction of dentinal microcracks utilizing microcomputed tomography (CT). MATERIALS AND METHODS: A total of 45 extracted micro-CT scanned mandibular premolars were prepared and obturated. After the second micro-CT, samples were divided into three groups (n = 15). In Group 1, postspace preparation was done using hand K files up to the size of #110. In Group 2, postspace preparation was done using Peeso reamer up to the number of #3. In Group 3, postspace preparation was done using ParaPost XT Drills with the tip diameter of 1.1 mm. Thereafter, the third micro-CT scan was performed for microcracks evaluation, and statistical analysis was performed. RESULTS: Few unprepared samples showed the presence of microcracks (1.54%). There was statistically significant (P < 0.05) percentage increase in the number of microcracks after root canal preparation and obturation (5.44%) and after postspace preparation (8.35%). The percentage increase in microcracks observed for Group 1, 2, and 3 from obturation to postspace preparation was 0.19%, 4.21%, and 6.86%. There was a significant difference among the three techniques of postspace preparation (P < 0.05). CONCLUSION: Microcracks may exist preoperatively. Postspace preparation increased the number of microcracks irrespective of the technique utilized. ParaPost XT Drills produces maximum microcracks in the root dentin followed by Peeso reamers and K files.
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AIM: The aim of this study is to evaluate the marginal sealing ability of self-adhesive flowable composite resin when used as a liner in Class II composite restoration with and without aging. MATERIALS AND METHODS: A total of 120 standardized Class II tooth preparations with gingival margins 1 mm coronal and apical to cementenamel junction (CEJ) were prepared on 60 extracted permanent mandibular molars and were randomly divided into eight equal Groups: Group 1: cavities coronal to CEJ and restored with Dyad flow liner + Herculite ultra, Group 2: same as Group 1 but cavities margins apical to CEJ, Group 5: cavities coronal to CEJ and restored with only Herculite ultra, and Group 6: same as Group 5 but cavities apical to CEJ. Groups 3,4,7,8 were similar to Groups 1,2,5,6, respectively, but were aged for 6 months. After thermocycling, microleakage testing was done using 0.5% basic fuchsin dye. RESULT: At cervical level, Group 5 exhibited statistically lower (P = 0.006) microleakage than Group 6, and Group 1 showed lesser microleakage than Group 5 (P = 0.162). Group 2 exhibited significantly less microleakage than Group 6 (P = 0.002). Increased microleakage was observed in aging Groups; however, the difference with nonaging Groups was not statistically significant (P > 0.005). CONCLUSION: Margins of the cavity in cementum can be better sealed by placing self-adhesive liner and is not affected by aging.
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Presence of diastema between anterior teeth is often considered an onerous esthetic problem. Various treatment modalities are available for diastema closure. However, not all diastemas can be treated the same in terms of modality or timing. The extent and the etiology of the diastema must be properly evaluated. Proper case selection is of paramount importance for a successful treatment. In this case report, diastema closure was performed with direct composite restorations. One bottle etch-and-rinse adhesive was used and a single shade was used to close the diastemas. Contoured sectional posterior matrix was used to achieve anatomic contouring of the proximal surfaces of the teeth. This was followed by finishing and polishing using polishing discs. Patient was kept on recall every 6 months. Conclusion. Diastema closure with correct anatomic contouring is easy to perform using the contoured sectional matrices. At 14-month recall, no clinical signs of failure like discoloration or fracture were evident. Also, patient did not complain of any sensitivity. Thus, direct composite restorations serve as durable and highly esthetic restorations leading to complete patient satisfaction.
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Several procedures have been recommended to induce the root end barrier formation in teeth with open apices. Conventional treatment for such cases will require many appointments with an average duration of 12.9 months. During this period, the root canal is susceptible to reinfection from around the provisional restoration, which may promote apical periodontitis and arrest of apical repair. Mineral trioxide aggregate (MTA) has been successfully used for one visit apexification wherein the root canal can be obturated within 24 hours after placement of MTA. Using a matrix prior to the placement of MTA avoids its extrusion, reduces leakage in the sealing material, and allows favorable response of the periapical tissues. This report presents a case of apexification where an absorbable suture was used as an apical matrix. Use of an absorbable suture circumvents all the problems associated with other conventional materials. Conclusion. Placement of the matrix made from the suture material is predictable and is easily positioned at the apex and the length can be adjusted as required. 10-month follow-up of the case shows resorbed matrix and bone healing in the periapical region. The patient was asymptomatic during the whole follow-up period and tooth exhibited mobility within physiologic limits and was functioning normally.
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AIM: The purpose of the study was to evaluate and compare the sealing ability of mineral trioxide aggregate (MTA) with three different methods. MATERIALS AND METHODS: Forty single canal teeth were decoronated, and root canals were enlarged to simulate immature apex. The samples were randomly divided into Group MD = MTA-angelus mixed with distilled water and Group MC = MTA-angelus mixed with 2% chlorhexidine, and apical seal was recorded with glucose penetration method, fluid filtration method, and dye penetration methods and compared. RESULTS: The three methods of evaluation resulted differently. The glucose penetration method showed that MD sealed better than MC, but difference was statistically insignificant (P > 0.05). The fluid filtration method resulted that Group MC was statistically insignificant superior to Group MD (P > 0.05). The dye penetration method showed that Group MC sealed statistically better than Group MD. CONCLUSION: No correlation was found among the results obtained with the three methods of evaluation. Addition of chlorhexidine enhanced the sealing ability of MTA according to the fluid filtration test and dye leakage while according to the glucose penetration test, chlorhexidine did not enhance the sealing ability of MTA. This study showed that relying on the results of apical sealing by only method can be misleading.
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Traditional configuration of maxillary second premolars has been described to have two cusps, one root and one or two root canals. The endodontic literature reports considerable anatomic aberrations in the root canal morphology of maxillary second premolar but the literature available on the variation in cuspal anatomy and its relationship to the root canal anatomy is sparse. The purpose of this clinical report was to describe the root and root canal configuration of a maxillary second premolar with four cusps.