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OBJECTIVE: This study aimed to evaluate and compare the efficacies of Papacarie Duo gel, Brix 3000, Selecti-Solve gel, 2.4% sodium hypochlorite gel, and conventional rotary-mechanical method in caries removal and to evaluate the patient comfort. METHODS: It was a single-blinded, randomized, parallel-group, active-controlled trial with five arms. It was conducted at the Department of Restorative Dentistry and Endodontics, Damascus University. Seventy-five specimens were randomly allocated into five groups: chemomechanical caries removal (CMCR) using Selecti-Solve gel (G1), BRIX3000 (G2), Papacarie DUO gel (G3), or 2.4% sodium hypochlorite gel (G4), and caries excavation using conventional rotary-mechanical method (G5) (control group). The trial considered healthy patients aged 18-40. Permanent molars with class I carious lesions extending to the middle third of dentin with no pulpal and/or periodontal pathology were included. The efficacy of caries removal was considered the primary outcome measure, and the secondary outcome measures were treatment time, volumetric measurement of the cavity, and pain assessment. RESULTS: The majority (73.30%) of cases from BRIX3000 and conventional rotary-mechanical method groups showed complete caries removal (p = 0.982). The mean time of caries removal was the highest (17.45 ± 4.42) in the 2.4% sodium hypochlorite gel group (p < 0.05), and the lowest (6.33 ± 1.69) was in the conventional rotary-mechanical method group (p < 0.05). The mean cavity volume was the highest (18.97 ± 9.76) in the Papacarie DUO gel group, and the lowest (14.87 ± 4.76) was in the 2.4% sodium hypochlorite gel group (p = 0.506). The conventional rotary-mechanical group exhibited the highest mean score (5.40 ± 1.72) of pain (p < 0.05). However, the mean score (2.67 ± 1.11) of pain reported reduced in the BRIX3000 group. CONCLUSIONS: CMCR agents could be a potential substitute for conventional rotary instrumentation methods, taking into account the long working time.
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INTRODUCTION: The rate of clinical success in veneers, under esthetics, has achieved a range of 18 months to 20 years. In a plethora of studies, it registers a success rate reaching 75% and even 100%. The most common type of glass ceramics used in ceramics is the vitreous lithium disilicate crystal-reinforced material, e.max®. Recent studies focus on "polycrystalline ceramic use" in manufacturing veneers, as it possesses a stronger structure and different enabling manufacturing schemes. OBJECTIVES: This research aims at comparing e.max and the high-translucent Cubic Zirconia. Such comparison is administered to veneers manufacturing: esthetic (surface and edge, and staining and color matching), functional (crack and fracture, contact point, and patient satisfaction), and biological (posttreatment vitality and hypersensitivity, and periodontal response). MATERIALS AND METHODS: The research sample consisted of 60 veneers, divided into two groups: cubic zirconia and e.max. The sample included 2 males (16.6%) and 10 females (83.3%), with age ranging from 25 to 37 years. Patients were thoroughly diagnosed and treated and included in this study based on certain inclusion-exclusion criteria. Hickel's 2010 criteria were utilized to examine and observe the clinical aspect of veneers during intervals of 1 week, 3 months, 1 year, and 3 years. RESULTS: No significant differences were traced across the groups for all the variables, with a p-value being greater than 0.05. The e.max group revealed better clinical results compared to the cubic zirconia one regarding esthetics and tooth translucency. Nonetheless, the results showed a merely slight increase in hypersensitivity in the e.max group. CONCLUSION: Within the limitation of an extensive follow-up period, we can conclude that there is no difference between cubic zirconia and e.max (p > 0.05), where e.max and cubic zirconia veneers have the same characteristics in terms of the following. The characteristics of the aspects examined were esthetic, functional, and biological.
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Ceramics , Humans , Adult , Materials Testing , Ceramics/chemistryABSTRACT
BACKGROUND: Direct pulp capping can conserve its vitality by placing materials that promote dentin bridge (DB) formation at the exposure site. This study aimed to determine whether TheraCal LC could produce a layer of reparative dentin. It also compared the histological differences between treatment with mineral trioxide aggregate (MTA) and TheraCal LC. MATERIAL AND METHODS: A sample of 20 maxillary and mandibular premolars, which had previously been indicated for extraction in orthodontic therapy, was taken from 10 patients and randomly divided into two halves, a TheraCal LC, and an MTA group. Pulpal exposure was achieved by similar class I preparations, which were restored with a resin-modified glass-ionomer and extracted after ten weeks, noting that these interventions have been performed on live teeth in the oral cavities. The newly formed dentin bridge thickness, the inflammation degree within the pulp tissue, and odontoblast function were thoroughly examined histologically and compared between the two groups using the Mann-Whitney test and an analysis software SPSS (statistical package for the social sciences, v.26, IBM, New York, N, USA), at a significance level of a=0.05. RESULTS: Dentin bridge composition in the TheraCal group had 80% effective tubules and 20% defective tubules, while in the MTA group, the proportions were 90% and 10%, respectively. Dentin bridge thickness in the TheraCal group was greater than 0.25 mm in 60%, and 0.1-0.25 mm in 40% of the sample compared to the MTA group, which had 70% greater than 0.25 mm, and 30% between 0.1 and 0.25 mm in dentin bridge thickness. Statistically, there was no significant difference between both groups (P=0.739). CONCLUSION: Statistically insignificant differences in dentin bridge composition and thickness produced by both TheraCal and MTA materials render them similar in their effectiveness in treating pulp exposures through pulp capping.
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UNLABELLED: An 11-year-old female patient was referred with a chief complaint of pain in the right mandibular second premolar. Clinical and radiographic examinations showed secondary caries under an old composite restoration, a negative response to a pulp test and an immature root with an open apex. After root canal cleaning and shaping, bleeding was invoked in the canal up to 2 mm short of the cemento-enamel junction (CEJ). After 10 min to allow clotting at this level, a plug of Biodentine was placed over the blood clot and the tooth was temporized with glass ionomer cement. At the next visit, the tooth was free of symptoms and a permanent filling was placed. Clinical and radiographic examinations during a two-year follow-up showed complete root maturation and intact supporting soft tissues without sinus tract, pain or swelling. CONCLUSION: The use of Biodentine in a single-visit apexification protocol to treat an immature permanent tooth with necrotic pulp can create a suitable environment for revascularization, resulting in the completion of root maturation.