Comparative Evaluation of the Bonding Efficacy of Multimode Adhesive, Two-Step Self-Etch Adhesive, and a Total-Etch System to Pulpal Floor Dentin - An In vitro Study.

Background: Postendodontic restoration with composite resins has gained popularity due to the development of more reliable adhesives with simplified bonding procedures and less technique sensitivity. Pulpal floor dentin is a complex biological structure and a more challenging bonding substrate. Hence, appropriate selection of the bonding agent for these regions of the tooth is important. Aims: To compare the shear bond strength of a new generation of dental adhesives referred to as multimode adhesives, two-step self-etch adhesive, and a total-etch system to pulpal floor dentin. Materials and Methods: Sixty human mandibular molars were sectioned with a slow speed diamond disc to expose the pulp chamber and divided into four groups of 15 teeth each, based on the bonding agent used. Group A: Single bond universal (self-etch); Group B: Single Bond Universal (etch-and-rinse), Group C: Clearfil SE Bond, Group D: Adper Single Bond 2. Using a split Teflon mold, composite cylinders were built on the prepared dentinal surfaces. The shear bond strength was then evaluated with the universal testing machine. Results: Two step self-etch adhesives recorded higher shear bond strength than total-etch and multimode/universal adhesives applied in both self-etch and etch-and-rinse techniques. Conclusion: The self-etching/priming system bonded more strongly to the pulpal floor dentin than multimode adhesive and total-etch system.

A SEM Evaluation of the Permeability of Different Desensitizing Methods on Occlusion of Dentinal Tubules: An In-vitro Study.

AIM: The purpose of the current research was to assess the permeability of three various desensitizing techniques on dentinal tubule occlusion using a scanning electron microscope (SEM). MATERIALS AND METHODS: For this research, 100 human sound premolar teeth that were extracted for orthodontic purposes were gathered. With the aid of a water-cooled diamond saw, the teeth were divided in a mesiodistal (vertically) orientation. A sectioned sample (5 mm long by 5 mm wide by 3.5 mm deep), including the cervical region, was taken from each buccal side. To fully open the dentinal tubules, these samples were then kept in 17% ethylenediaminetetraacetic acid (EDTA) for 40 minutes. The samples were divided into four groups (n = 25), each receiving the following dentin surface treatments: Group I: Control, Group II: Samples received NaF 5% varnish treatment, Group III: Samples received diode laser treatment, and Group IV: Samples received CPP-ACP treatment. An SEM was used to inspect each specimen at a magnification of about × 3000 and photomicrographs was assessed. RESULTS: The maximum occlusion of dentinal tubules was found in samples were treated with Diode laser (2.96 ± 0.14) followed by samples treated with NaF 5% varnish (3.38 ± 0.10), samples were treated with CPP-ACP (3.42 ± 0.06) and control group (4.26 ± 0.19). There was a statistically significant difference found between the groups. CONCLUSION: In conclusion, all three desensitizing methods used in the present study were successful in the occlusion of dentin tubules. But the application of the Diode laser was effective in the reduction of dentin permeability compared to NaF 5% varnish and CPP-ACP. CLINICAL SIGNIFICANCE: Dentin hypersensitivity (DH) is characterized by a brief period of intense discomfort. One approach to managing DH is to obstruct dentin tubules in order to decrease dentin permeability. There are many substances that can reduce hypersensitivity, but the finest commercially available substance for treating the condition by occluding the tubes should be acknowledged.

The Effects of Various Final Irrigants on the Bond Strength of Root Dentin Exposed to Chloroform: An In vitro Study.

AIM: The aim of the study was to assess the reaction of different final irrigants to the bond strength of root dentin exposed to chloroform. MATERIALS AND METHODS: Fifty extracted maxillary central incisors were selected. Working length was determined, and canal was instrumented with ProTaper rotary system (Dentsply Maillefer) till F4 file. The specimens were then divided into five groups (n = 10). Group 1: not disclosed to any root canal solvent, Group 2: disclosed to chloroform for 5 min, Group 3: chloroform for 5 min followed by absolute alcohol, Group 4: chloroform for 5 min followed by chlorhexidine (CHX), And Group 5 - chloroform for 5 min followed by saline. The canals were obturated with F4 gutta-percha cones with AH Plus sealer. The samples will be sectioned horizontally into 1 ± 0.1 mm thick slices. The push-out bond strength was performed in a universal testing machine. Results were statistically analyzed by one-way analysis of variance. RESULTS: There existed a significant difference between the mean push-out bond strength of different groups. Irrigation with chloroform negatively affected the bonding between root canal sealer and root dentine. Absolute alcohol significantly improved the bond strength values. CONCLUSION: Exposure with chloroform during the retreatment will decrease the bonding between sealer (AH Plus) and root dentine. The use of absolute alcohol as a final irrigant improved the bonding between sealer and dentin. CHX and saline showed no improvement in bond strength.

Evaluation and endodontic management of a patient with 6 single-rooted molars: a case report.

This case report describes a patient with unusual tooth morphology involving the bilateral presence of 6 maxillary and mandibular first and second molars with a single root and a single canal. The article also discusses the endodontic management of a single-rooted maxillary molar and the use of cone beam computed tomography for evaluation and diagnosis of these anatomical variations.

Evaluation of an Indigenously Prepared Herbal Extract (EndoPam) as an Antimicrobial Endodontic Irrigant: An Ex Vivo Study.

BACKGROUNDG: Root canal irrigation plays a pivotal role in endodontics. Constant increase in antibiotic resistance and side effects caused by synthetic irrigants has shifted the research toward developing herbal alternatives. The current study aims to assess the ex vivo effectiveness of an indigenously prepared herbal extract "EndoPam" and compare it with the conventional endodontic irrigants for disinfection of root canals infected with Enterococcus faecalis. MATERIALS AND METHODS: As a preliminary study of the antimicrobial efficacy of the test irrigants, an Agar diffusion study was conducted, and zone of inhibition measured. Forty extracted mandibular premolars with straight root canals were selected and standardized to 12 ± 1 mm in length. Root canals were prepared using rotary ProTaper system until F3 instrument and were infected with the culture of E. faecalis for three weeks. Specimens were divided into four groups (n = 10). Group 1: EndoPam (. INGREDIENTS: Syzigium aromaticum, Eucalyptus globulus, Cinnamomum zeylanicum and Mentha piperita), Group 2: 2% chlorhexidine, Group 3: 5.25% Sodium hypochlorite, Group 4: Normal Saline. Irrigation was performed for each group. Samples were inoculated and incubated for 24 h at 37°C for qualitative analysis qualitative analysis. RESULTS: In the preliminary Agar diffusion study, EndoPam exhibited a zone of inhibition comparable to that of sodium hypochrorite. The diameter of the inhibition zone was in the following order: 2% chlorhexidine gluconate > EndoPam > 5.25% NaOCl > Normal Saline. The qualitative assay done by culturing the bacteria after a period of 3 weeks showed no bacterial growth in any of the tested irrigants, except in normal saline. CONCLUSION: It was found that the experimental product was as effective as conventional irrigants in reducing the microbial count.

Dentine microhardness changes following conventional and alternate irrigation regimens: An in vitro study.

AIM: To compare the changes in microhardness of root dentin caused by two novel irrigation regimens with conventional irrigation. MATERIALS AND METHODS: Forty extracted human permanent incisor teeth were selected. Decoronated roots were separated longitudinally to get 80 specimens that were embedded in autopolymerizing acrylic resin and grounded flat with silicon carbide abrasive papers. Of these, 60 root segments without any cracks or defects were selected and divided into four groups according to the irrigation regimen used (n = 15). Group I: 5% sodium hypochlorite (NaOCl) + 17% ethylenediaminetetraacetic acid (EDTA) + 0.2% chlorhexidine digluconate (CHX) (conventional). Group II: 6% Morinda Citrifolia Juice + 17% EDTA (MCJ). Group III: 5% NaOCl + Q Mix 2 in 1 (QMix). Group IV: Distilled water (control). Irrigation regimens were performed for 5 minutes. Dentin microhardness was measured with a Vickers indenter under a 200-g load and a 20-s dwell time at the midroot level of root dentin. The data were analyzed using Kruskal Wallis test and Dunn's multiple comparison tests. RESULTS: A significant difference was seen in the median values of the four groups. The control group showed the least reduction in microhardness when comparison with the other groups. Except for Group III (Q Mix), the other groups that were tested (MCJ and conventional regimens) showed statistically significant difference from the control group. CONCLUSION: Within the limitation of this study, it was concluded that NaOCl + Q Mix were least detrimental to root dentin microhardness when compared with MCJ and conventional irrigation regimens.

A permanent mandibular second molar with seven root canal systems.

This case report illustrates the nonsurgical endodontic management of a seven-canaled mandibular second molar. The root canal configuration presented as four mesial and three distal canals. Identification of the canal system was made with the aid of magnification, ultrasonics, and multiple angulated radiographs. Postoperative examination at 18 months showed a clinically asymptomatic tooth with resolution of the periapical pathology.