Comparison of Various Commonly Used Luting Cements on the Success of Composite Inlays Assessed by the Levels of the Microleakage-An In vitro Study.

Introduction: Indirect composite restoration is one of the commonly followed procedures in the posterior teeth. The success of this is dependent on many factors, one being the luting cement. Hence, the current study explores the microleakage of the two luting cements at 2 different times. Materials and Methods: Eighty extracted human teeth were taken, and class II cavities were made that were to receive the composite inlays. They were grouped as supragingival and subgingival, which for further divided as were further subdivided to be observed for marginal leakage at cervical and occlusal margins, at the end of a day and 1 month. Each group had ten specimens. The luting cements that were evaluated were Variolink N and RelyX Unicem. After the composite inlay restoration was done for all the specimens, the sections were put on slides, and a stereomicroscope was used to measure the amount of dye penetration. Leakage was evaluated and compared using Mann-Whitney U test. Results: At the end of 1 day, there was no significant alteration in the microleakage in the occlusal or cervical regions for either region supragingivally or subgingivally between the two luting cements. Significant difference between the two cements at the cervical borders at the end of a month was seen for both the margins. When compared supragingivally and subgingivally at the end of 1 day or at the end of 1 month, there was not a significant difference for any of the cements. Conclusion: Within the constraints of the current investigation, it can be said that there was similar microleakage for both Variolink N and RelyX Unicem at the conclusion of a day's storage time. After a 1-month storage period, RelyX Unicem showed more cervical microleakage than Variolink N.

The Impact of the Gender on the Pulp Vitality Testing for the Various Types of the Conducting Media: An Original Research.

Introduction: To identify gender-based differences in pulpal sensory thresholds in human teeth utilizing various conducting media. Materials and Methods: The study involved 50 participants of both genders equally distributed. The maxillary central incisors were the teeth selected for the intervention. The three conducting media that were put to the test were Colgate Sensitive Pro-Relief Enamel Repair Toothpaste (CS), Himalaya herbals sensitivity toothpaste (HS), and Lignox 2% gel (LG). Subject's sensory threshold readings as well as the Visual analogue scale (VAS) scores were noted at the tiniest sensation they experienced. Following an ANOVA, a post hoc analysis was performed to confirm the significance between the three media. Results: Lox 2% Jelly significantly reduced sensory threshold values compared to the other conducting media (P < 0.001). Comparing the sensory threshold values of the sexes showed that men have greater values. Male and female readings differed significantly in the Lox 2% Jelly group (P = 0.021), whereas Colgate Sensitive Pro-Relief Enamel Repair Toothpaste, Himalaya herbals sensitivity toothpaste (P < 0.001) groups showed highly significant variances. All the three conducting media had a highly significant variance for the VAS scores. (P < 0.001). Conclusion: The conducting material used and gender affect the pulpal sensory thresholds to electric impulses produced by EPT.

Assessment of the Micro-Tensile Strength of the Composites for the Various Antioxidants: An In Vitro Study.

Introduction: The application of the antioxidants after the teeth are bleached has been advocated to fasten the restorative process post-bleaching. The motive of this study was to examine and assess the micro-tensile binding strength of bleached enamel to the resin using a variety of antioxidant solutions. Finding the reason for the tooth fracture was the secondary outcome measured. Materials and Methods: An in vitro study was planned with 100 human extracted teeth, with 20 in each group with one as controls and 4 others tested for the antioxidants sodium ascorbate, epigallocatechin gallate, chitosan, and proanthocyanidin application. The bond strength of bleached enamel to the resin was well as the failure type was assessed after the values were noted and compared using the ANOVA and Tukey's methods keeping P < 0.05 as significant. Results: Epigallocatechin gallate specimens displayed the maximum micro-tensile bond strength under the investigational circumstances, whereas controls displayed the lowest micro-tensile bond strength. There was statistical alteration in micro-tensile bond strengths between all the groups except between epigallocatechin gallate vs chitosan and sodium ascorbate vs proanthocyanidin. High statistical significance was seen between the control and the antioxidant groups as well as between sodium ascorbate and epigallocatechin gallate and chitosan. Conclusion: The antioxidant chemicals significantly augmented the bond strength of bleached enamel to the resin that had been bleached. Also, when compared to the other experimental groups, epigallocatechin gallate and chitosan treatment displayed the greatest mean bond strength values.

In vivo Study to Evaluate the Effect of Instrument Size on the Accuracy of Three Different Apex Locators when Various Irrigation Solutions are used in Vital and Non-Vital Teeth.

Introduction: Root canal success requires working length (WL) optimization. The current study examined how different apex locators on vital and non-vital teeth responded to instrument size. Materials and Methods: Three hundred patients (180 men and 120 women) receiving root canal therapy at the department of Conservative Dentistry and Endodontics were evaluated. Therefore, we determined that 200 of the patients' teeth (100 vital and 100 non-vital teeth from the upper and lower jaws' first molars) qualified for inclusion in our study. The pulp chamber was accessed using a sterile round bur. The coronal region of the root canal was preflared with successive Gates Glidden drills (Mani Inc. Japan) and irrigated with any one of the solutions 3% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), or 17% ethylenediaminetetraacetic acid (EDTA) solution after checking canal patency with a size #10 K file, where (#-number). Later, the working length was established using Ingle's technique and a radiovisiograph (RVG) 0.5 mm short of the radiographic apex. Two endodontists approved this RVG. Results: Overall, the #15 K file and apex locators did not differ from Ingle's method. While the #8 K file differs significantly from all apex locators, the #10 K file showed a significant difference with all apex locators except Root ZX with 2% CHX (P = 0.06). Irrigation didn't influence apex locators' accuracy. Conclusion: Even in the presence of irrigating solutions, electronic apex locator (EAL) can be utilized to calculate the working length with accuracy. The apex locators #15 k files, #10 k files, and #8 k files showed the most promising results.

Assessment of the Apical Transportation and Quantity of Root Canal Dentin Removed Using Different New Rotary File Systems: An Original Study.

Introduction: The rotary systems have found a common application in the clinical practice for the endodontic therapies. Hence, we compared three recent endodontic systems for the comparison of the dentine removal and the apical transportation particularly in the curved canals. Methods: Oneshape, Pro Taper Next, and Edgefile X3 were the three systems that were compared. Thirty maxillary mesio buccal canals of the human permanent teeth were compared due to its curved nature. The volume of dentin removed and apical transportation (mm) were measured using micro-computed tomographic imaging (mm). Both the coronal section and the entire canal length had their dentin removed in accordance with measurements. Total dentine removed, coronal dentine removed, and the canal transportations were compared for the three rotary file systems. The values were compared with appropriate statistical tests for evaluating the significance. Results: There was no statistically significant difference between the three file systems for the dentin removed. The mean canal transportation was 0.33 ± 0.12, 0.21 ± 0.25, and 0.23 ± 0.21 mm, respectively, for Oneshape, Pro Taper Next, and Typhoon CM. In terms of statistics, there were no appreciable variations among the three rotary tools for apical transfer. Conclusions: The three rotary systems were comparable for the apical transportation and the dentine removal. Despite variations in the magnitude of apical enlargements, none of the instrumentation methods detected apical transportation.

A Retrospective Analysis of the Need for the Root Canal Therapy for the Full Crown Restorations: An Original Study.

Introduction: There are numerous chances for pulpal irritation during the placement of a crown on a tooth. This study's goal was to find and examine the variables that influence the prevalence of routine root canal therapy after the teeth were restored with full coverage crowns. Methods: The hospital records were retrospectively evaluated from 2000 to 2010 for a decade. The demographics as well as the various variables that caused for the intervention with the root canal therapy for the teeth with the full crowns were evaluated. The values were compared for the significance. Results: The total number of the teeth that were finalized in the study was 4308. Of the total teeth that were treated with full coverage crowns, 50% were metal ceramic, 42% were full ceramic, and 9% were full metal crowns. After 10 years, possibility that every tooth with a crown would survive was 91%. The most frequent adverse incident was the intervention with the RCT. Metal ceramic crowns had poor survival rates and needed the maximum intervention. Younger age-group had least survival rate than the older age-groups. Conclusions: Endodontic therapy is unlikely to be necessary after crown installation. As the patient's age declines and all-ceramic or PFM crowns are used, this risk rises.

Determination of Antifungal Effect of Natural Oil and Synthetic Gutta Percha Solvents Against Candida Albicans: A Disc Diffusion Assay.

Introduction: The practice of removing root canal fillings with solvent materials is frequently required to help an irrigation solution enter the tubules. The current research was aimed at assessing the antifungal properties specifically the candida albicans of the various solvent materials used for the gutta-percha (GP) material. Materials and Methods: Current research was aimed at as a lab method using the disk diffusion technique where the zone of inhibition (ZOI) was calculated. The materials that were analyzed were: orange oil, xylene, turpentine oil, chloroform, and eucalyptus oil. Candida albicans was the test organism employed in the investigation. The agar plates were covered with approximately 500 µL of the suspension. The sterile and empty disks were impregnated with 10 µL of pure GP solvents. These plates were incubated for one day at room temperature. The ZOI's mean diameters were calculated for all five materials and quantified each solvent's fungicidal activity. For intergroup comparison, ANOVA was utilized. P values < 0.05 were deemed substantial. Results: The maximum inhibition exhibited by the Eucalyptus Oil it was 19.01 ± 1.02 mm. This was followed by Xylene. The other three solvents Chloroform, Orange Oil, and Turpentine Oil exhibited a similar ZOI. When all the solvents were compared there was a significant variance of P < 0.001. However, there were significant variances for the Eucalyptus Oil and the Xylene to all the other solvents P < 0.001. Conclusion: This investigation showed that, in comparison to other solvents, the use of eucalyptus oil considerably reduced the levels of Candida Albicans.

Evaluation of Efficiency of Dyes in Detection of Cancer Cells: An Original Research.

Introduction: The early detection of the cancer will dramatically improve the prognosis. There are many diagnostic aids that can be employed for screening. Hence, in our study, we aim to evaluate the efficiency of dyes in detection of cancer cells. Materials and Methods: We piloted a prospective clinical study among 30 subjects to detect the efficiency of two dyes-Lugol's iodine and toluidine blue. They were grouped equally for potentially malignant and malignant lesions. The areas were analyzed for the diagnostic accuracy of the dyes using the histopathological examination and compared using chi square test deliberating P < 0.05 as significant. Results: We observed that both the dyes showed a diagnostic accuracy of over 90% when used alone or in combination. Both the dyes had greater sensitivity while specificity was 20%. Conclusion: The combination of these two dyes can be used as an efficient screening aid for the identification of the cancer cells.

Retrospective audit for quality assessment of root fillings performed by undergraduate dental students in clinics.

Objectives: To evaluate the technical quality of root canal obturations performed by undergraduate students. Methods: The records of 347 patients who underwent endodontic treatment by undergraduate students of Qassim University between 2018 and 2020 were assessed using standardised criteria based on obturation length, density and taper. All teeth that received primary endodontic treatment and had post-obturation periapical radiographs depicting the entire radicular length and the 2-3-mm periradicular area were included in the study. Results: A total of 653 canals of 397 teeth were evaluated. The maxillary central incisor was the most commonly assessed tooth (15.1%). Overall, 80.2% of the evaluated canals were deemed acceptable based on all three assessment criteria. Maxillary teeth had significantly better obturation quality than the mandibular teeth. The mesio-lingual canal had the lowest quality in all three criteria. Conclusions: The technical quality of root canal obturations performed by undergraduate students in Qassim University was acceptable in the majority of the evaluated cases. Among the evaluated parameters of obturation quality, length control was the most frequently observed deficiency. Additional measures are therefore required to improve the quality of the obturation length.

Enhancement of Odontoblastic Differentiation of Stem Cells from Exfoliated Deciduous Tooth Using N-acetylcysteine-An In Vitro Study.

AIM AND OBJECTIVE: The study was conducted to evaluate the effects of N-acetylcysteine (NAC) on the propagation and differentiation of stem cells from human exfoliated deciduous teeth(SHED). MATERIALS AND METHODS: SHEDs were isolated by explant culture method and characterized for stem cell properties using flow cytometry method. MTT assay and Cell Counting Kit-8 (CCK-8) assay were used to examine the viability and proliferation of the SHEDs. The effects of NAC-induced osteo/odontoblastic differentiation of SHEDs were determined by functional staining for mineralization, and the gene expression of osteo/odontoblastic transcription factors and proteins was evaluated by real-time quantitative reverse transcription-polymerase chain reaction(qRT-PCR) analyses. Protein levels of collagen type 1 (COL1), dentin sialophosphoprotein (DSPP), and dentin matrix acidic phosphoprotein 1(DMP-1) were calculated by the Western blot method to assess the osteo/odontogenic differentiation. RESULTS: SHEDs presented mesenchymal stem cell (MSC)-like characteristics on flow cytometric analysis. The cell viability and metabolic activity of SHEDs were increased with an increase in the concentrations of NAC from 0.5 to 10 nM. However, the concentrations of NAC from 0.5 to 2.5 mM did not affect cell proliferation. NAC incorporated at a concentration of 2.5 mM showed higher mineralization and considerably increased gene expression levels of runt-related transcription factor 2 (RUNX2), COL1A1, DSPP, and DMP-1. It significantly increased the protein expression of odontoblast-related matrix proteins like COL1, DSPP, and DMP-1. CONCLUSION: NAC regulates the healthy propagation of dental stem cells in vitro. Its effects on the differentiation of dental pulp SHEDs remain unidentified. This study explores that NAC can encourage the mineralization of SHEDs and differentiate them into the odontoblastic lineage. CLINICAL SIGNIFICANCE: The results propose that NAC could have a significant pharmacological role in activating and enhancing odontogenic differentiation of dental stem cells and possibly a prospect in regenerative dentistry.

Evaluation of Antibacterial Properties of Organic Gutta-percha Solvents and Synthetic Solvents Against Enterococcus faecalis.

BACKGROUND: The use of solvents is necessary to remove remnants of filling materials within dentinal tubules to allow penetration of irrigating solution within the tubules. AIM AND OBJECTIVES: We aimed at determining the antibacterial effect of various gutta-percha (GP) solvents against Enterococcus faecalis (E. faecalis). MATERIALS AND METHODS: An in vitro study was conducted by measuring the zone of inhibition using the disk diffusion method. The test organism used for the study was E. faecalis, and the solvents were divided into five groups: eucalyptus oil, chloroform, turpentine oil, xylene, and orange oil. About 500 µL of the suspension was spread over the agar plates, and the empty sterilized disks were impregnated with 10 µL of pure essential oils (EOs). The inoculated plates were incubated at 37°C for 18 to 24 h. The antimicrobial activity of each solvent was expressed and measured in terms of the mean diameter of the zone of inhibition (in mm) produced by each solvent at the end of the incubation period. ANOVA was used for intergroup comparison. The P-value of <0.05 was considered significant. RESULTS: The mean zone of inhibition for E. faecalis was 24.00 ± 1.21 for eucalyptus oil, 16.30 ± 0.92 for chloroform, 26.50 ± 1.24 for turpentine oil, 13.70 ± 1.26 for xylene, and 19.80 ± 1.32 for orange oil. The difference between the groups was statistically significant (P < 0.001). CONCLUSION: This study demonstrated that the use of turpentine oil during endodontic retreatment significantly reduced the levels of E. faecalis as compared with other solvents.