A scoping review exploring oral health inequalities in India: a call for action to reform policy, practice and research.

INTRODUCTION: Reduction in health inequalities and providing universal access to health care have been identified as two important global milestones by the World Health Organization for countries to achieve by 2030. Therefore, recognizing the magnitude of oral health inequalities in India has become a pressing priority to improve access to dental care within the country. This scoping review was conducted with the aim of reviewing, collating and analysing the current knowledge base on oral health inequalities in India. METHODOLOGY: The scoping review followed Arksey and O'Malley's approach, and reporting was performed in accordance with the PRISMA-ScR guidelines. A systematic search was conducted on Scopus, PubMed, Web of Science, and EMBASE to identify literature addressing one or more dimensions of oral health inequalities in India, published in English between January 2002 and April 2022. The data were charted, and qualitative analysis was performed to derive themes, highlighting the key concepts emerging from this review. RESULTS: In accordance with the eligibility criteria, a total of 71 articles retrieved through database search and backward citation search were included in this scoping review. The major themes ranged from individual to diverse sociodemographic factors acting as barriers to and facilitators of access to dental care. Deficiencies in human resources for oral health, along with a wide diversity in dental service provision and dental education were other major themes contributing to inequality. Subsequently, this has resulted in recommendations on restructuring the dental workforce and their development and modifications in oral health care policies and practices. The qualitative synthesis demonstrates the intertwined nature of the multiple factors that influence the goal of achieving an affordable, accessible, extensive and inclusive oral healthcare system in India. CONCLUSIONS: This comprehensive review provides a broad perspective on oral health inequalities in India, providing valuable insights for both researchers and policymakers in this area and guiding their efforts towards achieving universal oral health coverage in the Indian context.

Antimicrobial efficacy of Kerr pulp canal sealer (EWT) in combination with 10% amoxicillin on Enterococcus faecalis: A confocal laser scanning microscopic study.

Background: Sealers with antimicrobial properties play an important role in endodontic therapy success especially against Enterococcus faecalis infection found in failed root canal therapy. Addition of antibiotic agents to endodontic sealers may show significant increase in their antibacterial properties both against anaerobic and aerobic microbes. The purpose of the present study was to evaluate antimicrobial efficacy of Kerr pulp canal sealer (EWT) in combination with 10% amoxicillin against E. faecalis and post-root canal treatment viability of Enterococcus faecalis on the first and seventh day. Methods: A total of 60 extracted human mandibular premolar teeth were decoronated after initial decontamination with 1% NaOCl. Root length standardized to 12 mm. Canal instrumentation was done using ProTaper Universal file system till size F2 using 5.25% NaOCl. It was then infected with a pure strain of E. faecalis for a period of four days. Obturation was done using plain sealer, (n=30) and sealer-antibiotic combination, (n=30). Half of the teeth were sectioned at 24 hours (S, SA) and other half were sectioned seven days after obturation (S7, SA7). All samples were stained with SYTO9 and propidium iodide for imaging under Confocal Laser Scanning microscope. Statistical analysis was performed with the statistical software SPSS v. 17.0 (SPSS for Windows; SPSS Inc, Chicago, IL). Data was analysed using One Way ANOVA and post hoc Tukey test to determine statistical significance with p value < 0.01 considered significant. Results: Statistically significant differences were observed in green to red ratio between group S (9.561976) and S7 (0.435418) (p < 0.01). There was no difference found between SA (mean of green to red ratio, (0.70431) and SA7 (mean of green to red ratio, 0.85184). Conclusions: Antibiotics added to the sealer effectively eradicated of E. faecalis 24 hours post-obturation. However, after seven days, plain sealer was as effective as sealer-antibiotic combination.

Comparing the disinfecting efficacy of pomegranate peel extract oil, Garlic oil, Tulsi leaf oil, and Clove leaf oil with standard autoclaving on dental round burs tested against Enterococcus faecalis: An in vitro study.

Background: The study was conducted to compare and evaluate the disinfecting efficacy of four different herbal oils with standard autoclaving against Enterococcus faecalis (E. faecalis). Fifty round burs were infected with E. faecalis and dipped into the chemical test solution for 10 min. The disinfecting efficacy for each test chemical was checked using culture method on blood agar plate and peptone water test to check for turbidity. Clove leaf oil and Tulsi leaf oil have very good antimicrobial efficacy against E. faecalis which are similar and comparable to that of autoclaving. Aim: This stusy aimed to compare the efficacy of pomegranate peel extract (PPE) oil, Garlic oil, Tulsi leaf oil, and Clove leaf oil with standard autoclaving on dental round burs tested against E. faecalis. Settings and Design: The disinfecting capability of four different experimental oils against autoclave was evaluated on 50 round burs exposed to E faecalis in an In-vitro study. Materials and Methods: A total of 50 round dental burs were exposed to E. faecalis and the disinfecting capability of four different experimental oils against autoclave was evaluated by counting colony-forming units (CFUs) and turbidity test. Statistical Analysis: Statistical analysis was performed using SPSS version 20.0 (IBM), Chicago. The CFUs between the five groups (I, II, III, IV, V) were compared using the Chi-square test. The level of significance was kept at 5%. Results: Clove leaf oil showed the best disinfection efficacy comparable to autoclaving, followed by Tulsi leaf oil with no statistically significant difference between them, whereas garlic oil and PPE oil were significantly less effective against E. faecalis. Conclusion: Clove leaf oil and Tulsi leaf oil can be used for disinfecting dental burs, infected with E. faecalis, as alternatives to autoclaving.

Carnosic Acid as an intracanal medicament performs better than triple antibiotic paste and calcium hydroxide to eradicate Enterococcus faecalis from root canal: An in vitro confocal laser scanning microscopic study.

Background: Carnosic acid is an herbal derivative with potent antioxidant, anti-inflammatory, antimicrobial, and anticancer properties. Aim: Comparative evaluation of the antimicrobial potential of carnosic acid, calcium hydroxide, and triple antibiotic paste as intracanal medicaments against Enterococcus faecalis. Settings and Design: Department of Conservative Dentistry and Microbiology, an in vitro study. Materials and Methods: Fifty-two extracted single-rooted human teeth were decoronated and chemomechanical preparation was performed. The specimens were secured in the center of screw-capped vials and autoclaved. A strain of E. faecalis was inoculated into the canals and grown for 72 h. The teeth were divided into: Group I-Ca(OH)2, Group II- triple antibiotic paste (TAP), Group III-Carnosic acid, and Group IV-Negative control. The medicaments were applied in the canal and left for 14 days. The specimens were sectioned transversely at three levels to create dentinal discs and observed under the confocal laser scanning microscopic (CLSM). Images were analyzed, and quantification of bacteria was done using the Image J software. Statistical Analysis: Mean percentage of live/dead bacteria was analyzed using One-way ANOVA and Post hoc Tukey test. Results: Mean percentages of live and dead bacteria were seen under CLSM in Group I, Group II, and Group III were (4.44 ± 2.87, 4.56 ± 2.93, 1.61 ± 1.90), and (4.59 ± 3.04, 4.25 ± 2.98, 1.70 ± 1.99), respectively, with least mean percentages for live and dead bacteria in carnosic acid (Group III). Conclusion: Carnosic acid showed better antimicrobial efficacy against E. faecalis than TAP and Ca(OH)2 by showing a low percentage of both live and dead bacteria.

Endodontic Management of Mandibular anterior teeth and premolars with Vertucci's Type VIII canal morphology: A Rare Case.

A thorough knowledge of variable and complex tooth morphology, detailed exploration of the internal anatomy and underlying pathology, proper interpretation of radiographic images, conservative access to explore all the canals, thorough debridement and disinfection of canal system, three-dimensional seal by obturation, and good coronal seal by final restoration are essential steps in the management for a successful endodontic treatment outcome. Clinical management of rare case with extra canals in the lower anterior teeth and premolars had to undergo root canal therapy has been described. Referring to the hard-tissue repository of the human dental internal morphology, carefully interpreting multiangled radiography/cone-beam computed tomography, using tools such as magnifying loupes with illumination and ultrasonics, thermoplasticized gutta-percha system to obturate, are very helpful to the clinician can achieve this goal. This article describes and illustrates the management of a rare case with Vertucci's Type VIII canal anatomy in lower anterior teeth and premolars.

Biofilm models in endodontics-A narrative review.

The knowledge of biofilm and its eradication from the root canal system are of utmost importance in the clinical practice of an endodontist. Various treatment strategies and protocols have been demonstrated and discussed by numerous clinicians and researchers, on these models, that play an important role in the treatment outcome . Once a biofilm model is developed by considering various factors, several methods can be used to assess the biofilms formed on these models. This review discusses the importance of biofilm models in endodontics, types of biofilm models and factors associated with developing and the methods to evaluate these models.

Critical Assessment on Unmet Oral Health Needs and Oral Health-related Quality of Life Among Old Age Home Inhabitants in Karnataka, India.

PURPOSE: To critically assess the unmet oral health needs and oral health-related quality of life among old age home inhabitants in Karnataka, India. METHODS: A total of 96 older adults (males=32, 33.33%, females=64, 66.67%) aged 60 years and above, residing in old age homes were included in this cross-sectional study. The mean age of the participants included in the study was 69.25±7.99 years. Oral health status and dental needs were assessed using the Oral Hygiene Index Simplified (OHIS) and the WHO Oral Health Assessment forms. Oral health-related quality of life was evaluated by administrating the Geriatric Oral Health Assessment Index (GOHAI) questionnaire through an interview format. STATISTICAL ANALYSIS: The Statistical Package for Social Sciences (SPSS) version 17 was used. Descriptive statistics was tabulated for oral health status and GOHAI scores. Student's t-test and ANOVA were applied to check the association of the GOHAI responses with the number of years of residence in old age homes, age groups, gender, and dentition status. RESULTS: The mean age of the participants included in the study was 69.25±7.99 years. Twenty-six (27.1%) participants reported diabetes mellitus and hypertension. Most of the participants 89 (91.7%) visited the dentist when they had dental complaints. Among the dentulous study population, the majority of the participants had untreated dental caries indicated for dental extraction and needed periodontal therapy. Amongst the participants, 68 (70.82%) required prosthetic rehabilitation. More than 10 years of residence in old aged homes, over 80 years of age, being female, and completely edentulous groups showed lower total GOHAI scores compared to their counterparts. CONCLUSION: The majority of the participants showed unmet oral health needs and lower GOHAI scores indicating poor oral health-related quality of life.

Histological analysis of human pulp following direct pulp capping with different materials: An ex vivo study.

Background: The predictability of direct pulp capping (DPC) depends on the quality of the dentin bridge formation and the inflammatory response to the capping material. Various materials are available with variable success. Aim: The aim of this study is to evaluate histologically the effectiveness of calcium hydroxide, mineral aggregate, and dentin bonding agent when used as DPC in mechanically exposed adult pulp tissue. Materials and Methods: Pulpal exposures were made in 45 intact human premolars, scheduled for extraction for orthodontic purposes. Teeth were capped with hard setting calcium hydroxide (Dycal), mineral trioxide aggregate (ProRoot MTA), and dentin bonding agent (adper Single Bond). The final restoration was done with posterior composites using resin-modified glass-ionomer cement as a base. Pulps of teeth were evaluated histologically at the 15th and 45th day for inflammatory cell response and dentin bridge formation according to the criteria described by Cox et al. The statistical analysis of data was done using Chi-square test and P ≤ 0.05 was considered statsiticlly significant. Results: MTA as DPC agent showed milder inflammatory response compared to Dycal and Single Bond. The quality of bridge formation by MTA was similar to Dycal, which took the least time. Adper Single Bond Plus and Dycal showed a significantly higher degree of pulpal inflammation. Among all materials used, Adper Single Bond Plus took the longest time for both the resolution of pulpal inflammation and improvement of the quality of bridge formation. Conclusion: Based on the result, it can be concluded that Dycal and MTA produce similar types of dentin bridge formation when used a DPC agent. Adper Single Bond has the potential to be used as DPC agents, but it takes a longer time for the resolution of inflammation and dentin bridge formation.

Evaluation of the antimicrobial efficacy of 20% Punica granatum, 0.2% chlorhexidine gluconate, and 2.5% sodium hypochlorite used alone or in combinations against Enterococcus faecalis: An in-vitro study.

OBJECTIVES: The study was aimed at evaluating the antimicrobial efficacy of 20% Punica granatum, 0.2% chlorhexidine (CHX) gluconate, and 2.5% sodium hypochlorite used alone or in combinations against Enterococcus faecalis. MATERIALS AND METHODS: Aqueous extract of pomegranate peel was prepared in the Pharmacology Departmental Laboratory. A total of 240 wells were prepared (40 for each group) with 5 wells per with a diameter of 6 mm and depth of 4 mm at equidistant from each other. Using a pipette, each well was filled with 50 µl of the test irrigant solution. CHX (0.2%), 2.5% sodium hypochlorite, and aqueous extract of pomegranate peel and their combinations were tested as root canal irrigants against a standard strain of E. faecalis (ATCC 29212) on sheep blood agar plate by calculating the zones of inhibition. The mean diameter of zones was calculated and tabulated. Data were analyzed using one-way analysis of variance and Tukey's post hoc test. Descriptive statistics was obtained using SPSS software (version 11.5) with P established at < 0.05. RESULTS: Combination of Punica granatum with sodium hypochlorite and CHX showed maximum mean zones of inhibition with mean of 23.9 and 25.7 mm, respectively, and showed significantly better results than all other groups either irrigants used alone or in combinations. CONCLUSIONS: Punica granatum and CHX was proved to be a very good combination among experimental groups against E. faecalis, and sodium hypochlorite was least effective against E. Faecalis.

Association of level of education and utilization of restorative dental care among rural women in India: Cross-sectional study.

BACKGROUND: The utilization of restorative dental care is very scarce in rural India. Association between level of education and health of a person has been well-documented in many countries and time periods with a range of potential factors shaping the connection between both. OBJECTIVES: This cross-sectional survey was conducted to evaluate an association between the level of education (educational qualification) and utilization of restorative dental care among rural women associated with self-help groups. MATERIALS AND METHODS: A semi-structured questionnaire was administrated to 660 rural women associated with self-help group by trained research assistants. The 604 completed questionnaires were received and reviewed. The education levels were divided into three groups: Group 1 - illiterates (17.2%), Group 2 - school educated (69.4%), and Group 3 - college educated (13.4%). Chi-square test was applied to evaluate the utilization of dental services by rural women, and logistic regression was applied to evaluate the influence of their educational qualifications on utilization. RESULTS: A total of 604 properly filled questionnaires out of 660 (91.51% response rate) were included in the analysis. Only 56.9% of the sampled rural women indicated that they have visited dentists earlier. The maximum number of individuals who have never visited the dentist belonged to illiterate group (55.7%), and the association was statistically significant (0.004) when compared with educated individuals. CONCLUSION: The results of this study concluded that the level of education has a significant influence on the utilization of dental care.

An in vitro comparative evaluation of physical properties of four different types of core materials.

INTRODUCTION: Compressive and tensile stresses of core materials are important properties because cores usually replace a large bulk of tooth structure and must resist multidirectional masticatory forces for many years. MATERIAL AND METHODS: The present study was undertaken to find out the best core build up material with respect to their physical properties among resin-based composites. Individual compressive, tensile, and flexural strength of fiber-reinforced dual cure resin core build up material, silorane-based composite resin, and dual curing composite for core build up with silver amalgam core was used as control were evaluated and compared using universal testing machine. Data were statistical analysed using Kruskal-Wallis test to determine whether statistically significant differences (P < 0.05) existed among core materials. Both dual cure composite materials with nanofillers were found superior to amalgam core. The silorane-based material showed the highest flexural strength, but other mechanical properties were inferior to dual cure composite materials with nanofillers.

A comparative evaluation of microleakage around class V cavities restored with different tooth colored restorative materials.

OBJECTIVES: To evaluate and compare microleakage around class V cavities restored with silorane and dimethacrylate-based composite resins. METHODS: Standard Class V cavities were prepared on the buccal surface of 60 non-carious human molars. Teeth were randomly divided into 3 groups (n=20) depending on the restorative materials used, Silorane-based composite resin (Filtek P90-SIL), dimethacrylate-based composite resin (Solare P-SOLP) and light-cure glass ionomer cement (GC Fuji II LC -LCGIC). The restored teeth with these tooth-coloured restorative materials were thermo-cycled and then immersed in 2% Rhodamine B dye under vacuum pressure for 48 hours. All teeth were bisected longitudinally in a bucco-lingual direction and observed under stereo-microscope at 30X magnification for the evidence of dye penetration. The data were analysed using one-way analysis of variance (ANOVA) and Tukey's Post Hoc tests (α=0.05). RESULTS: SIL composite resin showed the least microleakage in Class V cavity restorations with a statistically significant difference to SOLP and LCGIC. Sixty five percent of specimens in SIL group, 30% in SOLP group and 5% in LCGIC group showed dye penetration up to one-third of the cavity depth, while 5% in SIL group, 5% in SOLP group and 35% in LCGIC group showed dye penetration up to two-thirds of the cavity depth, and 30% in SIL group, 65% in SOLP group and 60% in LCGIC group showed dye penetration up to the axial wall. CONCLUSIONS: Silorane-based composite exhibited least microleakage in restoring class V cavities compared to dimethacrylate-based composite resin and light-cured glass ionomer cement.

Endodontic management of dilacerated and bayonet shaped roots / Tratamento endodôntico de raízes dilaceradas e em forma de baioneta

Successful root canal therapy requires a thorough knowledge of root anatomy and root canal morphology which may be quiet variable. The significance of internal root canal morphology has been emphasized by studies demonstrating that variations in canal morphology may affect the endodontic outcome. Consequently, in treating each tooth the clinician must assume that complex anatomy occurs often enough to be considered normal. Root dilaceration is one of the variations that may complicate the endodontic therapy. It is important for a clinician to have complete knowledge of internal anatomy relationships, careful interpretation of radiographs; proper access preparationand a detailed exploration of the interior of the tooth to achieve a successful treatment outcome. This paper reports successful endodontictherapy of severe dilaceration of the root of mandibular first molar and bayonet shaped root of maxillary first premolar and highlights theclinical considerations to be followed during the endodontic procedures to get the successful outcome.

Um tratamento de canal bem sucedido requer conhecimento profundo da anatomia da raiz dentária e morfologia do canal radicular, que pode ser variável. A importância da morfologia interna do canal radicular tem sido enfatizada por estudos que demonstram que as variações na morfologia do canal podem afetar o resultado do tratamento endodôntico. Consequentemente, no tratamento de cada dente, o clínico deve assumir que uma anatomia complexa ocorre com frequência suficiente para ser considerada normal. A dilaceração da raiz dentária é uma das variações que podem complicar o tratamento endodôntico. É importante para o clínico ter conhecimento completo das relações da anatomia interna, fazer uma interpretação cuidadosa de radiografias; preparar adequadamente o acesso e realizar uma exploração detalhada do interior do dente para conseguir um resultado de tratamento bem sucedido. Este artigo relata casos de terapia endodôntica bem sucedida de dilaceração severa da raiz do primeiro molar inferior e de raiz em forma de baioneta de um primeiro pré-molar superior e destaca as considerações clínicas a serem seguidas durante os procedimentos endodônticos para se obter êxito no tratamento.

Mineral trioxide aggregate: a review of physical properties.

The purpose of this two-part series is to review the composition, properties, products, and clinical aspects of mineral trioxide aggregate (MTA) materials. Electronic search of scientific papers from January 1991 to May 2010 was accomplished using PubMed and MedLine search engines to include relevant scientific citations from the peer-reviewed journals published in English. MTA is a refined form of the parent compound, Portland cement (PC). It demonstrates a strong biocompatible nature owing to the high pH and its ability to form hydroxyapatite. MTA materials provide a better seal than traditional endodontic materials as observed in dye leakage, fluid filtration, protein leakage, and bacterial penetration leakage studies, and it has been recognized as a bioactive material. Currently a variety of MTA commercial products are available, including Proroot Gray MTA and White MTA both from DENTSPLY Tulsa Dental Specialties (www.DENTSPLY.com), and MTA Angelus (Angelus,www.angelus.ind.br). Although these materials are indicated for various dental uses/applications, long-term in-vivo clinical studies are still needed to claim the same. This first of this series highlights and discusses the composition, physical, and/or chemical properties of MTA. A subsequent article will offer an overview of the material aspect (commercial products) and clinical considerations for MTA materials.

Sound levels in conservative dentistry and endodontics clinic.

AIM: To evaluate the sound levels generated in dental clinics of conservative dentistry and endodontics. MATERIAL AND METHODS: A decibel-meter with digital readout was used to measure sound levels at different time intervals at the chairside and at the center of the clinic. Minimum and maximum readings during a 3 min interval were recorded. RESULTS: In the post-graduate (PG) clinic, there was significant difference in noise levels between the chairside (66-81 dB[A]) and the center of the clinic (66-67 dB[A]) at certain times. In the under graduate (UG) clinic, noise levels with suction and either high/slow speed handpieces (67-80 dB[A]) were significantly higher than the center of clinic. Suction alone in the UG clinic (63-75 dB[A]) was significantly quieter than in the PG clinic (69-79 dB[A]). CONCLUSIONS: (1) Mean sound levels in the working clinics ranged from 63.0 dB[A] to 81.5 dB[A]. These are within the recommended range for dental equipment. (2) With suction and either low/high speed handpiece combination, the PG clinic was significantly noisier than the UG clinic at several time periods.

Mineral trioxide aggregate: part 2 - a review of the material aspects.

The purpose of this two-part series is to review the composition, properties, and products of mineral trioxide aggregate (MTA) materials. PubMed and MedLine electronic databases were used to identify scientific papers from January 1991 to May 2010. Based on the selected inclusion criteria, citations were referenced from the scientific peer-reviewed dental literature. Mineral trioxide aggregate is a refined form of the parent compound, Portland cement (PC), and demonstrates a strong biocompatibility due to the high pH level and the material's ability to form hydroxyapatite. Mineral trioxide aggregate materials provide better microleakage protection than traditional endodontic materials as observed in findings from dye-leakage, fluid-filtration, protein-leakage, and bacterial penetration-leakage studies and has been recognized as a bioactive material. Various MTA commercial products are available, including gray mineral trioxide aggregate (GMTA), white mineral trioxide aggregate (WMTA), and mineral trioxide aggregate-Angelus (AMTA). Although these materials are indicated for various dental uses and applications, long-term in-vivo clinical studies are needed. Part 1 of this article highlighted and discussed the composition and characteristics of the material. Part 2 provides an overview of commercially available MTA materials.

Calcific metamorphosis. Literature review and clinical strategies.

UNLABELLED: Calcific metamorphosis (CM) is a commonly observed phenomenon following traumatic injuries like concussion, subluxation and luxation. Depending on the severity of the injury and the developmental stage of the tooth, there can be either complete or partial obliteration of root canals. However, histologically, there is always persistence of fine residual filaments of pulp tissue or tracts of organic material without the presence of any inflammatory component. A periodic clinical and radiographic follow-up examination is preferred and usually, for cosmetic reasons, only a conservative aesthetic treatment is required. Endodontic treatment is only advocated if there is development of apical periodontitis and, if executed properly, can be highly successful. CLINICAL RELEVANCE: Appropriate management of calcific metamorphosis can present a clinical dilemma to the clinician. Thus a judicious and prudent decision should be made between endodontic intervention for the involved tooth and other available restorative (and/or aesthetic) treatment options.

Assessment of genotoxic effect of maleic acid and EDTA: a comparative in vitro experimental study.

OBJECTIVES: This study aims to evaluate and compare the genotoxic and apoptotic effect of aqueous solutions of ethylenediaminetetraacetic acid (EDTA) with that of maleic acid (MA) using Chinese hamster lung fibroblast (V79) cells growing in vitro. MATERIALS AND METHODS: Exponentially growing V79 cells were treated with various concentrations of EDTA or MA alone for 30 min, and genotoxic effect was analyzed by micronucleus as well as comet assays and the type of cell death by apoptotic cell measurements using microscopic and flow cytometric methods. For all the experiments, H2O2 was used as a positive control. RESULTS: Treatment of V79 cells with H2O2 resulted in significantly (P < 0.001) increased micronuclei and levels of DNA damage, whereas, EDTA/MA alone treated cells did not show significant increase of MN frequencies and comet parameters even at their higher concentrations when compared with that of untreated control. V79 cells treated with EDTA/MA for 30 min showed a nonsignificant increase in the percentage of apoptotic and necrotic cells at their lower concentrations (0.025 and 0.05 % for EDTA and MA, respectively). However, at higher concentrations, i.e., >IC50 (0.1 and 0.5 %) for EDTA and MA resulted in increased number of apoptotic and necrotic cells when compared with the untreated group. CONCLUSIONS: This study clearly demonstrates that MA and EDTA are not potentially genotoxic agents and MA induced lesser apoptotic/necrotic death than that of EDTA at their clinically relevant doses. CLINICAL RELEVANCE: MA may have a better clinical acceptability with comparable smear layer removal ability. Hence, the results presented here might be an additional supporting evidence for the use of MA in endodontic practice.

Regenerative endodontics as a tissue engineering approach: past, current and future.

With the reported startling statistics of high incidence of tooth decay and tooth loss, the current interest is focused on the development of alternate dental tissue replacement therapies. This has led to the application of dental tissue engineering as a clinically relevant method for the regeneration of dental tissues and generation of bioengineered whole tooth. Although, tissue engineering approach requires the three main key elements of stem cells, scaffold and morphogens, a conductive environment (fourth element) is equally important for successful engineering of any tissue and/or organ. The applications of this science has evolved continuously in dentistry, beginning from the application of Ca(OH)(2) in vital pulp therapy to the development of a fully functional bioengineered tooth (mice). Thus, with advances in basic research, recent reports and studies have shown successful application of tissue engineering in the field of dentistry. However, certain practical obstacles are yet to be overcome before dental tissue regeneration can be applied as evidence-based approach in clinics. The article highlights on the past achievements, current developments and future prospects of tissue engineering and regenerative therapy in the field of endodontics and bioengineered teeth (bioteeth).

An in vitro evaluation of shear bond strength of silorane and bis-GMA resin-based composite using different curing units.

AIM: To evaluate shear bond strength of silorane and bis-GMA based composite resins using self-etch and total-etch adhesive systems, and compare the effect of Quartz-tungten-halogen (QTH) and Light emitting diode (LED) on the shear bond strength of the experimental materials. MATERIALS AND METHODS: Flat dentin surfaces were exposed on intact extracted molars and composite resin was built 2 mm in diameter. Teeth were divided randomly into four groups. Groups 1 and 2 were restored with P90 system adhesive and Filtek P90 and cured with QTH and LED units respectively. Groups 3 and 4 were restored with total etch adhesive and Filtek Z100 and cured with QTH and LED units respectively. Specimens were subjected to shear bond strength testing using Instrom Universal testing machine. RESULTS: Data was subjected to one-way analysis of variance. Total-etch groups gave significantly higher shear bond strength values than the self-etch groups. No significant difference in shear bond strength was found between Groups 3 and 4, while Group 1 showed significantly higher values than Group 2. CONCLUSION: Type of light curing unit is not a significant factor affecting shear bond strength for bis-GMA RBCs using total-etch technique; while for curing silorane resin based composite (RBCs), conventional halogen curing units showed better results.