The use of aesthetic paediatric full coverage restorations among paediatric dental practitioners: an international survey.

Despite the recent growing evidence in support of prefabricated zirconia crown use as a successful option in managing grossly carious anterior and posterior primary teeth, the use of such crowns remains controversial within the paediatric dental profession. This study aims to assess the use of aesthetic full coverage paediatric restorations among paediatric dentists worldwide, with emphasis on aesthetic prefabricated zirconia crowns. This was an online cross-sectional survey questionnaire study comprising of 38 multiple-choice questions disseminated worldwide through the contact lists of national, regional and international paediatric dental organisations and social media platforms. The survey was completed by 556 respondents thus achieving power, with 391 (70.3%) females and 165 (29.7%) males. The respondents were from 55 different countries spread across six continents. The use of aesthetic full coverage restorations was reported by 80% (n = 444) of the respondents. For restoring anterior teeth, participants mainly used either composite strip crowns (94.4%, n = 419) or zirconia crowns (73.6%, n = 327), while those who used aesthetic crowns for restoring posterior teeth mainly used zirconia crowns (68.2%, n = 303). Within the limitations of this study, the results have shown a wide use of full coverage aesthetic restorations, including the use of zirconia crowns, of primary teeth within this international sample of practicing dentists.

Assessment of dental age estimation using dentinal translucency in ground sections of single rooted teeth: a digital image analysis.

Human dentition is unique to individuals and helps in identification of individuals in forensic odontology. This study proposes to study the manually ground sections of single rooted teeth using digital methods for dental age estimation. To assess the dentinal translucency from the scanned digital images of manually ground section of teeth using commercially available image edition software. Corroborating the root dentinal translucency length and region of interest (ROI) of translucency zone in pixels (as a marker of dental age) with the chronological age of the subject, as stratified by different age groups. Twenty single-rooted extracted teeth from 20 patients each from 6 groups divided as per age. Manual sectioning of the teeth followed by scanning the sections was done. Root area in pixels and ROI of translucency zone were measured. From the observed values, translucency length percentage (TLP) and percentage of ROI in pixels (TPP) was calculated and tabulated. Pearson's correlation coefficients were obtained for age with TLP and TPP. Positive correlation existed between age and TLP and also between age and TPP. With the obtained data, multilinear regression equations for specific age groups based on 10-year intervals were derived. By a step-down analysis method, age was estimated with an average error of around ±7.9 years. This study gives a novel method for age-estimation that can be applied in real-time forensic sciences.

Physico-chemical and biological characterization of synthetic and eggshell derived nanohydroxyapatite/carboxymethyl chitosan composites for pulp-dentin tissue engineering.

Hybrid nanohydroxyapatite/carboxymethyl chitosan (nHAp-CMC) scaffolds have garnered significant attention in the field of regenerative engineering. The current study comparatively analyzed the physicochemical and biological properties of synthetic nanohydroxyapatite (SnHA)- and eggshell-sourced nanohydroxyapatite (EnHA)- based CMC biocomposites for pulp-dentin regeneration. EnHA and CMC were synthesized through a chemical process, whereas SnHA was commercially obtained. Composite scaffolds of SnHA-CMC and EnHA-CMC (1:5 w/w) were prepared using freeze-drying method. All biomaterials were characterized by FTIR, micro-Raman, XRD, HRSEM-EDX, and TEM analyses, and their in vitro bioactivity was assessed by immersing them in simulated body fluid for 21 days. The biological properties of the composite scaffolds were evaluated by assessing cytocompatibility using MTT assay and biomineralization potential by analyzing the odontogenic gene expressions (ALP, DSPP, DMP-1 and VEGF) in human dental pulp stem cells (DPSCs) using RT-qPCR method. Characterization studies revealed that EnHA displayed higher crystallinity and superior surface morphology compared to SnHA. The composite scaffolds showed a highly interconnected porous microstructure with pore sizes ranging between 60 and 220 µm, ideal for cell seeding. All tested materials, SnHA, EnHA, and their respective composites, displayed high cytocompatibility, increased ALP activity and degree of mineralization with significant upregulation of odontogenic-related genes on DPSCs (p < 0.05). Nevertheless, the odontogenic differentiation potential of EnHA-CMC on DPSCs was significantly higher when compared to SnHA-CMC. The findings from this study highlight the potential of EnHA-CMC as a promising candidate for pulp-dentin engineering.

Efficacy of Platelet Rich Plasma and Platelet Rich Fibrin for Direct Pulp Capping in Adult Patients with Carious Pulp Exposure- A Randomised Controlled Trial.

OBJECTIVE: This study evaluated the effectiveness of Platelet Rich Plasma (PRP), Platelet Rich Fibrin (PRF) and Mineral Trioxide Aggregate (MTA) as direct pulp capping materials in patients with carious pulp exposure using cone beam computed tomography. METHODS: This parallel, triple blinded, randomised trial was done on 30 permanent posterior teeth chosen as candidates for direct pulp capping based on stringent inclusion and exclusion criteria. The samples were allocated based on sequentially numbered opaque sealed envelope method into three groups: MTA, PRP and PRF for direct pulp capping. The treated teeth were restored with Glass Ionomer cement liner and light-cured resin composite. Patients were followed up for a period of 12 months. Statistical analyses were performed with statistical software SPSS version 25. Data were analysed for normality using Shapiro Wilk's test. Dentine bridge volume analysis across the groups were done using Kruskal Wallis test with the significance level at P=0.05. As the test revealed a significant difference, post hoc analysis was done with Dunn test. RESULTS: CBCT analysis revealed that the volume of dentine bridge formed by PRP and PRF was significantly higher than the volume of dentine bridge formed by MTA (P<0.001; CI: 90%). There was no significant difference in the efficacy between the three direct pulp capping agents based on clinical assessment. A total of 27 teeth (90%) showed positive response to pulp sensibility testing and evidence of dentine bridge formation in radiograph at 12 months. No adverse events were encountered.

Clinical Outcome of Nonsurgical Root Canal Treatment Using a Matched Single-Cone Obturation Technique with a Calcium Hydroxide-based Sealer: A Retrospective Analysis.

INTRODUCTION: The aim of this retrospective study was to estimate the outcome of nonsurgical root canal treatment using matched single-cones with a calcium hydroxide-based sealer and to identify the various prognostic factors influencing the outcome. METHODS: This was a retrospective study that enrolled 272 patients who underwent routine endodontic therapy and were obturated with matched single-cones and Sealapex as sealer. This study involved 223 patients with 261 teeth meeting the selection criteria and recalled between 24 and 84 months. The outcome was categorized as success (healed/healing clinically and radiographically) or failure (not healed clinically and/or radiographically). Two calibrated examiners assessed the treatment outcomes. A binomial logistic regression model was performed to identify the effect of various prognostic factors. The χ2 test was used to find the association between sealer extrusion and the initial periapical index scores. RESULTS: The overall success rate was found to be 89.7% for a mean recall period of 39.18 (±11.05) months. An increase in age was associated with increased odds of success, whereas the success rates were reduced by an increase in the number of roots and negative pulp sensibility status. Initial periapical index scores, presence of preoperative sinus tract, number of visits, and sealer extrusion did not affect the outcome significantly (P > .05). CONCLUSION: Within the limitations of this study, it was found that teeth obturated with matched single-cone and Sealapex achieved substantial success rates. Sealer extrusion did not have any significant effect on the treatment outcome.

Microshear bond strength evaluation of surface pretreated zirconia ceramics bonded to dentin.

OBJECTIVES: To comparatively assess the micro shear bond strength (MSBS) of dentin bonded surface pre-treated zirconia ceramics. MATERIALS AND METHODS: Zirconia blocks were sectioned into 50 cubical blocks. The blocks were further categorized into five groups (n = 10 each). Group I: No treatment was performed on zirconia samples; Group II: The zirconia samples were sand-blasted; Group III: Group II + etched with 9.8% of hydrofluoric (HF) acid for 60 s; Group IV: The sandblasted zirconia samples were selectively infiltrated with low fusing porcelain; and Group V: Group IV + etched using 9.8% HF acid gel. The zirconia specimens were then bonded to dentin samples, and the samples were tested for MSBS evaluation using universal testing machine. RESULTS: The MSBS of all the four experimental groups shows greater value than group I. Among the experimental groups, group V and group IV do not show any statistical significant difference, whereas the mean MSBS of groups IV and V were statistically greater than group III and group II. However, groups I, II, and III do not show any statistical significant difference in mean MSBS values between them. CONCLUSION: Selective infiltration etching of zirconia ceramics provides the highest bond strength with resin cement.

Comparative evaluation of propolis and triantibiotic mixture as an intracanal medicament against Enterococcus faecalis.

INTRODUCTION: The aim of this study was to evaluate and compare the antimicrobial activity of calcium hydroxide, triantibiotic mixture (TAM), and an ethanol extract of propolis as intracanal medicaments on Enterococcus faecalis-infected root canals. METHODS: One hundred twenty extracted intact human permanent incisors were decoronated, and chemomechanical preparation of the root canal was performed. After sterilization of the samples, they were inoculated with pure culture of E. faecalis and incubated. After incubation, colony-forming units were recorded before medication. Then, samples were divided randomly into five groups (n = 24). Each group was then exposed to various intracanal medicaments, namely calcium hydroxide (group 1), TAM (group 2), propolis (group 3), ethanol (group 4), and saline as the control group (group V). The antibacterial effectiveness of the different intracanal medicament was recorded by determining the percentage reduction in colony counts (%RCC) at the end of days 1, 2, and 7. The data were statistically analyzed using one-way analysis of variance and Tukey Honestly Significant Difference (HSD) post hoc test. RESULTS: The %RCC was highest for propolis showing 100% reduction on day 2 followed by TAM showing 82.5%, 92.2%, and 98.4% of reduction on days 1, 2, and 3, respectively. Calcium hydroxide showed a gradual increase in antibacterial activity with a maximum of 59.4% on day 7. CONCLUSIONS: Propolis was more effective than TAM against E. faecalis at a 2-day time period, and both were equally effective at 7 days.

Biocomposites containing natural polymers and hydroxyapatite for bone tissue engineering.

Bone tissue engineering is an alternative strategy to generate bone utilizing a combination of biomaterials and cells. Biomaterials that mimic the structure and composition of bone tissues at nanoscale are important for the development of bone tissue engineering applications. Natural or biopolymer-based composites containing chitin, chitosan, or collagen have advantages such as biocompatibility, biodegradability that are essential for bone tissue engineering. The inclusion of nanoparticles of hydroxyapatite (one of the most widely used bioceramic materials) into the biopolymer matrix improves the mechanical properties and incorporates the nanotopographic features that mimic the nanostructure of bone. This review summarizes the recent work on the development of biocomposites containing natural polymers with hydroxyapatite particles suitable for use in bone defects/bone regeneration.

Polymeric composites containing carbon nanotubes for bone tissue engineering.

Several natural and synthetic polymers are now available for bone tissue engineering applications but they may lack mechanical integrity. In recent years, there are reports emphasizing the importance of carbon nanotubes (CNTs) in supporting bone growth. CNTs possess exceptional mechanical, thermal, and electrical properties, facilitating their use as reinforcements or additives in various materials to improve the properties of the materials. Biomaterials containing polymers often are placed adjacent to bone. The use of CNTs is anticipated in these biomaterials applied to bone mainly to improve their overall mechanical properties and expected to act as scaffolds to promote and guide bone tissue regeneration. This review paper provides a current state of knowledge available examining the use of the polymeric composites containing CNTs for promoting bone growth.

Comparison of anesthetic efficacy of 4% articaine and 2% lidocaine for maxillary buccal infiltration in patients with irreversible pulpitis.

OBJECTIVE: The purpose of this prospective, randomized, double-blind study was to compare the anesthetic efficacy of 4% articaine and 2% lidocaine (both with 1:100,000 epinephrine) for buccal infiltration in patients experiencing irreversible pulpitis in maxillary posterior teeth. STUDY DESIGN: Forty patients with irreversible pulpitis in first premolar or first molar were divided into 4 study groups and received buccal infiltration of either 4% articaine or 2% lidocaine in a double-blind manner. Endodontic access was begun 5 minutes after solution deposition. Success was defined as no or mild discomfort (VAS recordings) during the endodontic procedure. RESULTS: The success rate for maxillary buccal infiltration to produce pulpal anesthesia using articaine was 100% in first premolar and first molar, and for the lidocaine solution, success rate was 80% in first premolar and 30% in first molar. There was high significant difference between the articaine and lidocaine solutions (ANOVA; P < .001). CONCLUSION: The efficacy of 4% articaine was superior to 2% lidocaine for maxillary buccal infiltration in posterior teeth.