A Comparative Evaluation of Smear Layer Removal by Using Four Different Irrigation Solutions like Root Canal Irrigants: An In Vitro SEM Study.

BACKGROUND: The present study aimed to evaluate and compare the efficacy of 17% ethylenediaminetetraacetic acid (EDTA), 18% etidronic acid, 10% citric acid, and 7% maleic acid in the removal of smear layer at the apical third of the root canals. MATERIALS AND METHODS: Sixty single-rooted teeth were equally divided into four study groups (n = 15), according to the type of irrigant used (17% EDTA, 18% etidronic acid, 10% citric acid, and 7% maleic acid) to remove the smear layer effectively from apical third of root canal. In each group, respective irrigant was used with 5.25% of sodium hypochlorite during instrumentation. Each study sample was then sectioned longitudinally and removal of smear layer was observed using a scanning electron microscope (SEM) at 2000×. RESULTS: A 7% maleic acid revealed better smear layer removal than all other three groups at apical third. A 10% citric acid was found to be more efficient than EDTA and etidronic acid. The intergroup comparison was performed using Mann-Whitney U test, and there was no significant difference between all the study groups, except maleic acid. CONCLUSION: The present study compared the effect of various irrigants as an adjunct with 5.25% of sodium hypochlorite for root canal irrigation during and after instrumentation. The use of irrigants aids in the removal of the smear layer from the root canals, thereby increasing the success rate of endodontic therapy. CLINICAL SIGNIFICANCE: This study supports the hypothesis that a thorough use of root canal irrigants can efficiently remove the smear layer which is the key for successful root canal treatment. The present study helps in choosing an appropriate irrigant that can ensure complete root canal debridement from all thirds, especially from the apical third of the root canal. How to cite this article: Mankeliya S, Singhal RK, Gupta A, et al. A Comparative Evaluation of Smear Layer Removal by Using Four Different Irrigation Solutions like Root Canal Irrigants: An In Vitro SEM Study. J Contemp Dent Pract 2021;22(5):527-531.

sTNF-R Levels: Apical Periodontitis Linked to Coronary Heart Disease.

BACKGROUND: Different studies have implicated the exposure to systemic conditions in the aetiology of cardiovascular diseases like chronic inflammation including chronic periodontitis. AIM: The present study has been conducted to examine whether biomarker sTNF-R was elevated in apical periodontitis as sTNF-R is a systemic marker of inflammation and has been identified as risk factors for cardiovascular diseases. MATERIAL AND METHODS: sTNF-R levels were measured in 52 patients with apical periodontitis (M:F::25:27), aged 20-45 years and in 20 control patients without periodontitis (M:F::10:10, aged 20-48 years). Measurement of sTNF-R1 and sTNF-R2 was carried out in duplicate with standardised, commercially available enzyme immunoassays (R&D Systems Europe, Abingdon, UK). RESULTS: The mean sTNF-R1 and sTNF-R2 levels in periodontitis were 820 (240) pg/ml (413 - 1620 pg/ml) and 1309 (403) pg/ml (540 - 2430 pg/ml), while in normal sTNF-R1 and sTNF - R2 levels were 740 (340) pg/ml (407-1240 pg/ml) and 1283 (414) pg (480 - 2340 pg/ml) respectively. Results indicated a positive high relationship between cardiovascular markers such as sTNF-R1 and sTNF - R2 and apical periodontitis. CONCLUSION: Elevated levels of sTNF-R1 and sTNF - R2 in apical periodontitis patients indicate an increased independent risk of coronary heart disease.

Remineralization Potential of Three Tooth Pastes on Enamel Caries.

BACKGROUND: Different formulations of dentifrices exist in the market. Usually, single toothpaste is used by all family members including children. There is a big concern of fluoride ingestion with the toothpaste containing high fluoride content in children. Recently, new toothpaste (including toothpaste) with remineralization potential without fluoride content has been formulated. AIM: There is an urgent need to compare remineralization potential of this new formulation with the exiting dentifrices. Therefore, the present study has been undertaken to assess and compare the remineralization potential of three dentifrices with different compositions on artificially induced carious lesions in vitro by using scanning electron microscopy and polarised light microscopy. MATERIALS AND METHODS: The present in vitro study was conducted on 21 healthy extracted primary central incisor teeth surfaces, which were divided into three groups and were treated by three different dentifrices. Artificial demineralization was followed by remineralization using dentifrice slurry as per the group distribution. All the samples were studied for remineralization by using scanning electron microscopy and polarised light microscopy. Data were analysed using SPSS version 11 software. RESULTS: A significant difference was found between the remineralization potential of incudent toothpaste and other toothpaste groups based on the analysis of polarised light microscopy and stereomicroscope. The remineralizing ability of incudent toothpaste for artificial enamel lesions was found to be significantly higher than that of Colgate® and Crest toothpaste. CONCLUSIONS: The limitations of this study include, being a short term study, low sample size and in vitro experiment. incudent toothpaste has exhibited a higher remineralizing potential as compared to fluoride based toothpaste in our study.