Evaluating the fracture resistance of fiber reinforced composite restorations - An in vitro analysis.

BACKGROUND: Laboratory reports show that fiber-reinforced composites have improved fracture resistance over traditional composites. However, limitations in the biomechanics of tests to evaluate the fracture resistance of fiber-reinforced composites need to be considered for accurate clinical applications. AIM: To assess the fracture resistance of particulate filler composites, glass fiber-reinforced composites, and polyethylene-fiber reinforced composites by analyzing the different fracture types and failure patterns. MATERIALS AND METHODS: A standardized incisal (Group I) and mesioincisal fractures (Group II) were prepared on human maxillary central incisors. The test samples were further subdivided according to the restorative material used; particulate filler composites (Filtek Z 250), glass fiber-reinforced composites (fibre splint), and polyethylene-reinforced composites (Ribbond). The type of fractures was evaluated under the stereomicroscope and the failure patterns were analyzed using the graphical output from Universal Testing Machine. STATISTICAL ANALYSIS: The Chi-square test of association was used to test the association between fiber-reinforced composites and fracture resistance of tooth restoration complex. RESULTS: No statistical association was observed between fiber-reinforced composites to the type of fractures in both incisal (P = 0.29) and mesioincisal restoration (P = 0.27). A significant association was observed between the fiber-reinforced composites to the failure patterns in both the incisal (P = 0.005) and mesioincisal restoration (P = 0.007). CONCLUSION: The glass and polyethylene fiber-reinforced composites showed improved fracture resistance properties than the traditional particulate filler composites in both incisal and mesioincisal restorations.

Comparative evaluation of biodentine, 2% chlorhexidine with RMGIC and calcium hydroxide as indirect pulp capping materials in primary molars: An in vivo study.

BACKGROUND: Indirect pulp therapy (IPT) is conventional treatment of deep dentinal carious lesions without risk of pulp exposure. Development of new biomaterials with biocompatibility and seal has changed the attitudes toward IPT. AIM/OBJECTIVES: This study was conducted to evaluate and compare the clinical and radiographic success of biodentine, 2% chlorhexidine gluconate with resin-modified glass ionomer cement (RMGIC), and calcium hydroxide as indirect pulp-capping materials in primary molars over an observation period of 12 months. MATERIALS AND METHODS: A total of 54 primary molars within the age group of 3-9 years, which were indicated for IPT were randomized into three groups of 18 samples each; Group I: biodentine, Group II: 2% chlorhexidine gluconate followed by RMGIC, Group III: calcium hydroxide (Dycal). These cases were followed up for evaluation clinically and radiographically at 3, 6, and 12 months. The recorded data were subjected to statistical analysis using Chi-square test. RESULTS: After 12 months, the clinical and radiographic success of biodentine group was 100% (18/18), with 2% chlorhexidine gluconate disinfecting solution followed by RMGIC was 94.4% (17/18) and calcium hydroxide (Dycal) was 94.4% (17/18), failures included one at 3 months with RMGIC and another at 12 months with calcium hydroxide group; but there was no statistically significant difference observed between them with P = 0.361 at 3 months and P = 0.371 at 12 months interval. CONCLUSION: Biodentine can be effectively used as indirect pulp-capping medicament in primary teeth which has similar clinical and radiographic success as 2% chlorhexidine gluconate in conjunction with RMGIC and calcium hydroxide.

Zinc oxide eugenol and Endoflas pulpectomy in primary molars: 24-month clinical and radiographic evaluation.

CONTEXT: Despite modern advancement in material and technical aspect, management of infected primary molars is of prime concern in pediatric endodontics. An effective root canal material plays the major role in achieving the fluid impervious seal by defending against variant microflora and maintaining the tooth in function for longer duration. AIMS: This study aims to evaluate and compare the success of endoflas as root canal filling material in infected primary molars with zinc oxide eugenol (ZOE). MATERIALS AND METHODS: Primary molars with necrotic pulp in healthy, cooperative children were selected. Ethical clearance and informed consent was obtained. Standardized pulpectomy procedure was done and root canals were filled with either ZOE or endoflas. Further follow-up with clinical and radiographic evaluation was carried at 0, 3, 6, 12, and 24 months. The findings obtained were statistically analyzed using Chi-square test. RESULTS: Endoflas showed acceptable results as root canal filling material in primary molars even at 2-year follow-up, though overfilling of root canals led to low success rate compared to teeth with combined optimal and under fillings. There was no significant difference between the two materials (P > 0.05). CONCLUSIONS: Endoflas could be a potential alternative to ZOE for preserving infected primary molars.

Evaluating the Marginal Integrity of Bulk Fill Fibre Reinforced Composites in Bio-mimetically Restored Tooth.

INTRODUCTION: Over the past years, composites in aesthetic dentistry are showing a considerable progress, but mechanical strength and polymerization shrinkage are the two main drawbacks, which limit their use in high stress bearing areas. AIM: To evaluate the marginal integrity of short glass fibre reinforced composite restorations, fibre reinforced composites with composite superficial layer, and fibre reinforced composites with underlying flowable composite layer. MATERIALS AND METHODS: This study was done on twenty eight sound premolar teeth with standardized class V cavities restored under four groups as Group I: Particulate filler composite (Filtek Z 250 XT, 3M ESPE); Group II: Short glass fibre reinforced composite (everX Posterior, GC); Group III: Short glass fibre reinforced composite with an overlying layer of particulate filler composite; Group IV: Short glass fibre reinforced composite with an underlying layer of flowable composite (Filtek Z 250 XT, 3M ESPE). Test samples were immersed in a 2% methylene blue dye for 24 hours at 37°C and each tooth was sectioned bucco-lingually. Staining along the tooth restoration interface was recorded and results were analysed statistically using Independent sample t-test and Tukey's post-hoc one-way ANOVA. RESULTS: The results showed significant difference in the dye penetration between the restorative materials in the occlusal and gingival margins (p=0.02). Short fibre reinforced composites showed a statistically significant difference in the microleakage scores when compared with the particulate filler composites (p=0.01). CONCLUSION: Short glass fibre reinforced composite restorations showed an improved marginal integrity when compared to the traditional particulate filler composite restorations.

A comparative assessment of different techniques for obturation with endoflas in primary molars: An In vivo Study.

PURPOSE: The rationale of this in vivo study was to evaluate and compare different obturation techniques for the intracanal conveyance of Endoflas in the primary molars using conventional radiography. MATERIALS AND METHODS: Thirty-eight children (4-9 years old) with total of 45 pulpally infected primary mandibular molars indicated for pulpectomy were categorized into three groups (i) endodontic pluggers, (ii) lentulospirals, and (iii) NaviTips, respectively, for obturation with Endoflas. The level of obturation and the presence of voids were evaluated radiographically, and the obtained data were statistically analyzed using Chi-square test. RESULTS: The results showed no significant difference between the three techniques to deliver Endoflas. Motor-driven lentulospirals showed better results (64.4% optimal fillings) compared to the pluggers (62.2%), but NaviTips showed poor results (48.9%) for the level of obturation (P > 0.05). Voids were observed in all the techniques used. Pluggers and lentulospirals showed similar results with greater void-free canals, whereas NaviTip system showed more voids which was statistically not significant (P > 0.05). CONCLUSION: Motor-driven lentulospiral and pluggers were almost equally efficient to fill Endoflas to an optimal level, devoid of voids, and both were considered better compared to NaviTip system.

Variation in levels of anxiety to dental treatment among nonorphan and orphan children living under different systems.

BACKGROUND: It is essential to understand the factors influencing the level of anxiety to dental treatment among different children as it can influence seeking dental care. Here, we assessed the impact of parental loss on dental anxiety among 6-13-year-old children. MATERIALS AND METHODS: A total of 444 children within the age group 6-13 years were selected. Group 1 consisted of orphan children living in government-run orphanages, Group 2 consisted of orphan children taken care by a person with a motherly relationship, Group 3 consisted of abandoned children living in private organization and Group 4 consisted of children living with their parents. Dental anxiety was measured using children's fear survey schedule-dental subscale and modified faces version of modified child dental anxiety scale. RESULTS: The highest number of anxious children were observed in Group 4 and the difference in the anxiety levels among the four groups was found to be highly statistically significant. Children living in government-run orphanages had least dental anxiety. CONCLUSION: All the orphans may not have the same anxiety levels and the environment of upbringing the orphans plays a significant role in the development of the anxiety.