Evaluation of Sealing Ability of Biodentine to Root-End Cavities Irrigated either with Maleic Acid or Irritrol Using Glucose Filtration Model

ABSTRACT Objective: To compare the effect of Maleic acid and Irritrol (combination of Chlorhexidine & Ethylenediaminetetraacetic acid) irrigation on the sealing ability of Biodentine when used as root-end filling material. Material and Methods: Thirty single-rooted human premolars were subjected to standardized root canal instrumentation and were irrigated with 2.5% Sodium Hypochlorite (NaOCl) after each instrument change. Apical root resections were done by removing 3 mm of the apex at a 90° angle to the long axis of the root with a diamond bur. The root end cavity preparation was done using ultrasonic tips at a low power setting under water coolant. They were randomly divided into 3 groups (n=10). Group 1 was irrigated with 7% Maleic acid, Group 2 was irrigated with Irritrol, and Group 3 was irrigated with 0.9% Saline (Control). Then, the root end cavities of all the samples were restored with Biodentine and were subjected to leakage analysis using a glucose filtration test. The mean values for each group were calculated and the obtained data was statistically analysed using ANOVA with post-hoc Tukey's test, ANOVA with post-hoc Games-Howell test and repeated measures ANOVA with post-hoc Bonferroni test. Results: The specimens irrigated with Irritrol showed least microleakage as compared to 7% Maleic acid and 0.9% Saline. Conclusion: A regimen involving irrigation of the root-end cavity with Irritrol followed by root-end filling with Biodentine can improve the apical seal.

Anomalies and Clinical Significance of Mylohyoid Nerve: A Review.

BACKGROUND: The mylohyoid nerve is a branch of the inferior alveolar nerve (IAN), which is a branch of the posterior division of the mandibular nerve (MN). It is the source of motor nerve supply to the mylohyoid and anterior belly of the digastric muscle. At times, it provides sensory innervation to the mandibular teeth and skin below the chin. Since the location, anatomical variation and communications of the mylohyoid nerve are varied, it becomes clinically important to have an in-depth knowledge when treating patients for dental and maxillofacial procedures. Such anatomical variations of the mylohyoid nerve innervations may account for failure of the nerve blocks and hence, knowledge is very important for the practitioner. MATERIALS AND METHODS: A thorough literature search was done using the key words mandibular nerve, communications of the mylohyoid nerve, inferior alveolar nerve, lingual nerve, failure of dental anaesthesia, mylohyoid nerve and dental implants "from the Databases - PubMed, Scopus Embase and Web of Science (years 1952-2020)". RESULTS: The mylohyoid nerve may contain motor and sensory fibres, it may pass through the mylohyoid groove or canal and communicate with other nerves, which is clinically significant. Such anatomical variations may be one of the reasons for the failure of the inferior alveolar nerve block. CONCLUSION: Awareness of these variations is very significant in planning treatment and avoiding any unnecessary steps. The most frequently encountered anatomic variation of the mylohyoid nerve was innervation of the submental skin and the anterior teeth.

Comparative in vitro evaluation of efficacy of mouthrinses against Streptococcus mutans, Lactobacilli and Candida albicans.

PURPOSE: The present study was undertaken to compare the relative antimicrobial efficacy of two commercially available mouthrinses, Hexidine (0.12% chlorhexidine mouthrinse) and S-Flo (0.2% sodium fluoride), and a laboratory-manufactured propolis mouthrinse (10%) tincture with a dilution of 1:5 with water and their combinations against Streptococcus mutans, lactobacilli and Candida albicans. MATERIALS AND METHODS: Unstimulated saliva samples were obtained from the patients using the spitting method and the isolates of Streptococcus mutans, Lactobacillus and Candida albicans were obtained. The agar diffusion method was used to evaluate the antimicrobial activity of these test solutions and their combinations. RESULTS: Hexidine (0.12% chlorhexidine gluconate mouthrinse) showed the best antimicrobial efficacy against all the tested microorganisms. The laboratory manufactured propolis mouthrinse showed an effective antimicrobial action only against Streptococcus mutans. The antimicrobial efficacy of propolis (P) against Streptococcus mutans was similar to that of chlorhexidine (CHX) and the combination of propolis with chlorhexidine (CHX+P). S-Flo mouthrinse (0.2% sodium fluoride) showed the least efficacy against Streptococcus mutans among all tested solutions, but had better efficacy than propolis against lactobacilli and Candida albicans. The antimicrobial efficacy of the combination of chlorhexidine and fluoride mouthrinse and the combination of chlorhexidine and propolis mouthrinse was less than chlorhexidine mouthwash alone. Among all the tested combinations, the combination of fluoride and propolis showed the least efficacy against all the tested microorganisms. CONCLUSION: The results of the study indicate that 0.12% chlorhexidine gluconate mouthrinse (Hexidine) has the best anti-microbial efficacy against all the tested microorganisms, with laboratory-manufactured propolis mouthrinse showing an equivalent efficacy against Streptococcus mutans only. No added advantage of using the tested mouthrinse combinations was observed.

Effect of three indigenous food stains on resin-based, microhybrid-, and nanocomposites.

PURPOSE: This study investigated the effects of three indigenous food stains (tea, tobacco, turmeric) on a nanocomposite (Ceram-X-Mono, Dentsply DeTery, Konstanz, Germany), a microhybrid posterior (P60, 3M ESPE, St. Paul, MN, USA), and a universal microhybrid (Z100, 3M ESPE) resin-based composite (RBC). MATERIALS AND METHODS: Thirty-six disk-shaped specimens were fabricated (10 × 2 mm) for each type of RBC material, using a polytetraflouroethylene (PTFE) sheet. Specimens from each group were randomly distributed into three subgroups for each of the used stains. The baseline color values were measured using a spectrophotometer. The specimens were immersed in the staining solutions for a period of 3 hours per day for 15 days (3 hours/day × 15 days). Following this, the color change value (ΔE) was calculated. RESULTS AND CONCLUSION: All the tested groups showed a clinically perceptible color change (ΔE values = 3.3 or >3.3), except for tea-stained P60 (ΔE = 3.15) and Z100 (ΔE = 1.63) groups. Turmeric caused the most significant color change for all the tested RBCs. The least amount of color change was observed with the Z100 (tea, ΔE = 1.63; tobacco, ΔE = 13.59; turmeric, ΔE = 38.77) group that was statistically significant from P60 (tea, ΔE = 3.15; tobacco, ΔE = 18.83; turmeric, ΔE = 57.72), and Ceram-X-Mono (tea, ΔE = 3.32; tobacco, ΔE = 18.83; turmeric, ΔE = 53.95) groups.

Resin-based composite as a direct esthetic restorative material.

The search for an ideal esthetic material for tooth restoration has resulted in significant improvements in both materials and the techniques for using them. Various resin-based composite (RBC) materials have recently been introduced into the market that offer improved esthetic and physical properties. This article reviews RBCs, including their compositions, advantages, and disadvantages, that are contemporary to today's clinical practice as well as those that are under research consideration and/ or in clinical trial phase.

Comparison of the efficacy of maleic acid and ethylenediaminetetraacetic acid in smear layer removal from instrumented human root canal: a scanning electron microscopic study.

INTRODUCTION: The aim of this study was to assess, by scanning electron microscopic (SEM) analysis, the ability of 17% EDTA and 7% maleic acid in the removal of the smear layer from the human root canal system. METHODS: Eighty single-rooted human anterior teeth were subjected to standardized root canal instrumentation (step-back technique) and were irrigated with 2.5% NaOCl after each instrument. Based on the final irrigating solution used, samples were divided randomly into three groups: (1) the EDTA group: 17% EDTA+ 2.5% NaOCl (n = 30), (2) the maleic acid group: 7% maleic acid + 2.5% NaOCl (n = 30), and (3) the control group: 0.9% saline (n = 20). After final irrigation, teeth were prepared for SEM analysis to evaluate the cleaning of the coronal, middle, and apical thirds of radicular dentin by determining the presence or absence of smear layer. The data was statistically analyzed using the Kruskall-Wallis test. RESULTS: At the coronal and middle thirds, there was no significant difference between EDTA and maleic acid. Both were equally efficient in the removal of smear layer. In the apical third, maleic acid showed significantly better smear layer removing ability than EDTA. CONCLUSION: Final irrigation with 7% maleic acid is more efficient than 17%EDTA in the removal of smear layer from the apical third of the root canal system, which is a crucial area for disinfection.

Current strategies and applications of tissue engineering in dentistry--a review part 1.

UNLABELLED: A new direction in the field of vital pulp therapy is given by the introduction of tissue engineering as an emerging science. It aims to regenerate a functional tooth-tissue structure by the interplay of three basic key elements: stem cells, morphogens and scaffolds. It is a multidisciplinary approach that combines the principles of biology, medicine, and engineering to repair and/or regenerate a damaged tissue and/or organ. This two part article reviews and discusses the basic concept and strategies so far studied and researched for the engineering of basic dental tissues, to restore a functional tooth anatomy. This first part focuses on a detailed description of key elements used in tissue engineering and their applied clinical applications in dentistry. The second part will deal with the strategies that are being used and/or developed to regenerate the tooth tissues with the help of this scientific principle. CLINICAL RELEVANCE: The field of tissue engineering has recently shown promising results and a good prospect in dentistry for the development of the most ideal restorations to replace the lost tooth structure with a functional replacement.

Current strategies and applications of tissue engineering in dentistry--a review Part 2.

UNLABELLED: The three main key elements used in tissue engineering are the stem cells, morphogens and the scaffolds that, under a conductive external influence (environment) combine in the engineering of tissues. Part 1 of this two-part review article described in detail the various stem cells, morphogens and scaffolds that can be used in tissue engineering. This second article describes the various ways in which these three key elements can be used to engineer biological tissues. A number of strategies and technologies (Figure 1) such as, stem cell therapy, gene therapy, guided tissue regeneration, self-assembling systems, etc have been proposed. CLINICAL RELEVANCE: The field of tissue engineering has recently shown promising results and good future prospects in dentistry for the development of restorations to replace lost tooth structure with a functional replacement.

Esthetic management of fused carious teeth: a case report.

UNLABELLED: A rare case of a carious supernumerary tooth fused to the labial surface of a maxillary right central incisor is reported. Root canal therapy on the maxillary right central incisor was performed owing to the pulpal communication between the supernumerary tooth and the maxillary right central incisor after removing the carious supernumerary tooth structure. The defect was then restored with anterior resin composite and the esthetics reestablished. CLINICAL SIGNIFICANCE: Clinical significance lies in identifying a rare case of fusion of supernumerary tooth to a permanent tooth and treating the anomaly in the most conservative way.