Comparative Evaluation of Postoperative Sensitivity Following Restoration of Class I Lesions with Different Restorative Materials: An In Vivo Study.

AIM AND OBJECTIVE: This study was undertaken to compare postoperative sensitivity in posterior class I restorations using etch-and-rinse and self-etch composite resins, GC Fuji IX, and Cention-N. MATERIALS AND METHODS: The sample size consisted of 160 participants. After clinical and radiographic examination, the participants were randomly assigned to four groups consisting of 40 participants each according to the restorative materials used. Class I cavity was prepared and was restored on each patient and after restoration postoperative sensitivity was evaluated at 24 h, 48 h, and 7 days using the visual analog scale (VAS). The results were tabulated and statistically analyzed using analysis of variance (ANOVA) and post-hoc multiple comparison tests. RESULTS: There were significant differences present between the groups at 24 h, 48 h, and 7 days. We found that the materials causing least postoperative sensitivity are ranked according to superiority as GC Fuji IX > nano-hybrid composite using self-etch adhesive > Cention-N > nano-hybrid composite using etch-and-rinse adhesive. CONCLUSION: Both GC Fuji IX and self-etch adhesive showed less postoperative sensitivity as compared to etch-and-rinse and Cention-N at 24 h. With GC Fuji IX and self-etch adhesive postoperative sensitivity was decreased while Cention-N also showed good results at 48 h and 7 days. Etch-and-rinse adhesive showed maximum postoperative sensitivity as compared to other groups at 24 h, 48 h, and 7 days. CLINICAL SIGNIFICANCE: Teeth restored with resin composites are susceptible to sensitivity. The restorative material used and their handling can influence postoperative sensitivity.

Pulp Regeneration in an Immature Maxillary Central Incisor Using Hyaluronic Acid Hydrogel.

Pulp regenerative procedure is one of the treatment options for endodontically involved immature permanent teeth. The regenerative endodontic procedure was performed in a child of 9 years. After thorough canal disinfection using triple antibiotic paste for 21 days, bleeding was induced from the apex to provide for the stem cells. After that hyaluronic acid (HA) hydrogel was introduced into the canal space to act as injectable scaffold for pulp regeneration. This was followed by mineral trioxide aggregate placement to provide tight seal from the coronal aspect. Later, the tooth was restored with composite restoration. This approach offers the clinicians great opportunity to physiologically strengthen the immature root walls. The present report presents a regenerative endodontic procedure with HA hydrogel for a traumatized central incisor with arrested root development. The continued root development in the present case suggests that this treatment option may be able to resume the root maturation process in immature teeth with open apices.

Impact of Different Antioxidants on the Bond Strength of Resinbased Composite on Bleached Enamel-An In Vitro Study.

AIM: The aim of this in vitro investigation was to assess the impact of various anti-oxidants namely 5% proanthocyanidin, 10% sodium ascorbate, 10% alpha tocopherol, and 10% green tea on the bond strength of resin-based composite on bleached enamel. MATERIALS AND METHODS: One hundred twenty human maxillary central incisors which were freshly extracted for periodontal reasons, having intact labial surface were us ed in this study. Specimens were randomly divided into six groups (n = 20). Group A: negative control-no bleaching treatment, group B-positive control -bleaching, group C-bleaching + 5% proanthocyanidins, group D-bleaching +10% green tea, group E - bleaching +10% alpha -tocopherol, group F-bleaching + 10% sodium ascorbate. Surfaces were etched followed by application of total-etch bonding system, and composite resin cylinders were bonded. Specimens were tested for shear bond strength using the universal testing machine. STATISTICAL ANALYSIS USED: The data obtained were subjected to ANOVA and post hoc Tukey's test for statistical analysis. RESULTS: After using bleaching agents and antioxidants for the different groups, Group A has the highest bond strength and group B has the lowest bond strength. Amongst the antioxidants group D showed significantly higher bond strength as compared group C, group E, and group F. CLINICAL SIGNIFICANCE: Use of antioxidants instantly following the bleaching procedure and before resin bonding reverses the compromised bond strength of composite resin on bleached enamel without sitting tight for a time of one day to one month. CONCLUSION: Bleaching of enamel reduced the shear bond strength. All the antioxidants used in this study increased the bond strength of bleached enamel. Among the antioxidant groups, green tea extract showed significantly higher bond strength compared to proanthocyanidin, tocopherol, and sodium ascorbate.

Effectiveness of Controlled Release Chlorhexidine Chip as an Adjunctive to Scaling and Root Planning for the Treatment of Chronic Periodontitis.

BACKGROUND: Chlorhexidine is considered one of the options for the management of periodontal diseases. This present study was conducted to assess the usefulness of controlled-release chlorhexidine chip in addition to scaling and root planning (SRP) while comparing with SRP alone in the treatment of chronic periodontitis clinically, microbiologically and radiographically. MATERIALS AND METHODS: This study included 20 patients age ranged from 30 to 55 years with chronic periodontitis. A total of 40 sites were selected. Two bilateral pockets with probing depth 4-6 mm were put in test and control groups in all subjects. SRP plus Periochip™ was used in the test group and SRP alone in the control group. In all subjects, all the analysis such as clinical parameters, the radiographic and anaerobic culture of P. gingivalis, T. denticola, and T. forsythia were performed and compared in both groups at baseline and 3 months interval. RESULTS: There was a significant improvement in all clinical and radiographic parameters in the test group in comparison to control group. Total colony counts also reduced significantly. At baseline, Tf was recovered from 15 test group sites and 16 control group sites, Pg from 14 test group and 14 control group sites, Td from 16 test group and 15 control group sites. At 3 months, Tf was recovered from 4 test group and 10 control group sites, Pg from 3 test group and 9 control group sites, Td from 4 test group and 8 control group site. CONCLUSION: Periochip™ placement as an adjunct to SRP, showed promising results when compared to SRP alone. CLINICAL SIGNIFICANCE: Periochip is considered the best treatment option in the treatment of chronic periodontitis.