Effect of Laser Photobiomodulation on Postoperative Pain in Endodontics: A Systematic Review.

Objective: Photobiomodulation therapy has proven benefits in various dental treatments. The current systematic review aims to explore the role of laser photobiomodulation in modulating postoperative pain followed by endodontic treatment. Methods: In this systematic review, randomized controlled clinical trials on low-level laser therapy/photobiomodulation in endodontic therapy were analyzed. Database search was performed in PubMed/Medline, Web of Science, Scopus, and Cochrane Library, followed by literature search in Google Scholar. Results: A total of 12 studies were included as per the set criteria. The included studies utilized diode laser (808-970 nm) and indium gallium aluminum. All the included studies evaluated postendodontic pain after root canal therapy and endodontic surgery. A majority of the included studies showed significant benefits of photobiomodulation in postoperative pain management in endodontic therapy.Heterogeneity of the laser parameters and lack of power calculations for sampling among the included studies preclude solid recommendation of use of photobiomodulation therapy (PBMT) for postendodontic pain management. Conclusions: Although PBMT has proven potential benefits being a possible adjunct in postoperative pain management in endodontic therapy, it requires robust standardized randomized control trials to confirm the results of the systematic review.

Quantification of Calcium Ions From the Irrigants Activated With Erbium-Doped Yttrium Aluminum Garnet (Er:YAG) Laser in the Root Dentin: An In Vitro Atomic Absorption Spectrophotometer Study.

OBJECTIVE: The present study aims to assess the quantity of calcium cation eliminated from the root canal by 0.2% chitosan nanoparticles (CNPs) (Sigma Aldrich, Mumbai, Maharashtra, India) and 17% ethylenediaminetetraacetic acid (EDTA) (Pyrax 17% EDTA Solution, Pyrax Polymars, Roorkee, Haridwar, Uttarakhand, India) which are activated with an erbium-doped yttrium aluminum garnet (Er:YAG) laser (LiteTouch™, Light Instruments Ltd., Yokneam Elite, Israel) for smear layer removal using a flame atomic absorption spectrophotometer (AASF) (Deeksha Analytical Pvt Ltd, Gokula Extension, Bengaluru, Karnataka, India). METHODOLOGY: Using the crown-down technique, 60 non-carious single-rooted premolars were instrumented with rotary files and irrigated with 3% sodium hypochlorite. Based on the type of irrigation activation used, all the specimens were arbitrarily divided into five groups with 12 teeth in each group, as follows: G1, 17% EDTA activated with Er:YAG laser; G2, 17% EDTA without laser activation; G3, 0.2% CNP activated with Er:YAG laser; G4, 0.2% CNP without laser activation; and G5, controlled-deionized water. The AASF analysis for the removal of calcium ions in the irrigants was evaluated by collecting the overall quantity of each irrigating solution from the root canals. A one-way analysis of variance (ANOVA) and a Tukey post hoc test were done to determine the AASF data. RESULTS: 17% EDTA activated with Er:YAG laser (130.18 ± 10.3) and 0.2% CNP activated with Er:YAG laser (121.13 ± 3.9) showed the greatest concentration of calcium ions with no statistically significant difference. The lowest concentration of calcium ions was observed in 0.2% CNPs without laser activation (118.64 ± 2.9), while 17% EDTA (125.50 ± 3.0) without laser activation showed an intermediate outcome. The control group did not remove any calcium ions. CONCLUSION: The findings in the present study suggest that EDTA and CNPs, which were activated with lasers, yielded the greatest release of calcium ions equally. Hence, laser-activated CNPs can be employed for essential smear layer removal.

Quantitative assessment of transforming growth factor-ß1 release from dentin matrix upon conditioning with ethylene diamine tetra-acetate, doxycycline hydrochloride, and propolis: An in vitro study.

Background: Transforming growth factor-beta 1 (TGF-ß1) is a key morphogen in regenerative endodontics that plays a central role in regulating cellular functions. Various chelating agents have been shown to release this growth factor upon conditioning. The objective of the study was to evaluate TGF-ß1 release from the dentin matrix upon conditioning with ethylene diamine tetra-acetate (EDTA), doxycycline hydrochloride, and propolis. Materials and Methods: Forty-two human 3rd molar teeth were collected and coronal portion of the teeth was sectioned to obtain dentin blocks with dimensions 2 mm × 2 mm × 2 mm. The blocks were then randomly divided into three groups depending on the conditioning agent used; Group 1: 17% EDTA, Group 2: doxycycline hydrochloride (100 mg/mL), and Group 3: propolis (250 µg/mL). Conditioned blocks were placed in 0.5 mL of phosphate buffered saline and incubated for 1 week for quantification. Results: Highest TGF-ß1 release was noted for propolis (0.21 ng/mL), followed by doxycycline hydrochloride (0.18 ng/mL) and 17% EDTA (0.14 ng/mL). Conclusion: Doxycycline hydrochloride and propolis significantly enhanced the release of TGF-ß1 from the dentin matrix compared to EDTA (P < 0.05). No significant difference was observed between doxycycline hydrochloride and propolis (P > 0.05). Doxycycline and propolis can be used as effective alternatives to EDTA during regenerative endodontic procedures.

Zirconia surface infiltration with low-fusing glass: A surface treatment modality to enhance the bond strength between zirconia and veneering ceramic.

Background: The pursuit of esthetics and superior mechanical properties prompted the layering of Yttrium stabilized Zirconia with ceramic material. However, the bioinert nature of zirconia causes the chipping off of this ceramic layer. Selective infiltration etching (SIE) of zirconia provides good bond strength between zirconia and veneering ceramic. Materials and Methods: One hundred and fifty zirconia specimens of dimensions 5 × 5 × 10 mm were divided into 5 groups. Group 1: Air abrasion with 30 µ Al2O3 for 15 s with 0.4 bar pressure. Group 2: SIE and heat-induced maturation (HIM) as demonstrated by Abousheilb. Group 3: Sintered zirconia specimens were taken up for air abrasion followed by SIE/HIM. Group 4: Air abrasion and SIE performed on unsintered specimens followed by heat treatment at 1500°C. Group 5: Air abrasion performed on unsintered zirconia specimens followed by heat treatment at 1500°C followed by SIE/HIM. The samples were then layered with ceramic and subjected to shear bond strength (SBS) analysis. Results: The mean and standard deviation were calculated for the data. The mean SBS among the groups was compared using ANOVA. The post hoc Bonferroni test was applied to compare between the groups. The mean SBS was highest for Group 5 (47.89 ± 6.53) followed by Group 2 (34.94 ± 3.04), Group 3 (32.56 ± 6.04), Group 1 (29.12 ± 7.37), and Group 4 (27.56 ± 7.54). ANOVA test showed statistically significant differences among the groups (F = 48.86, P = 0.00). Conclusion: SIE/HIM when combined with sandblasting with appropriate heat treatment demonstrated a significant increase in bond strength. This prolongs the longevity of the restoration, thereby meeting the clinical needs.

Effect of triple antibiotic paste and calcium hydroxide on the rate of healing of periapical lesions: A systematic review.

Aim: The rate of healing of periapical lesion after the antibacterial dressing with triple antibiotic paste and calcium hydroxide was assessed. Materials and Methods: Case reports which used triple antibiotic paste and calcium hydroxide as the intracanal dressing was searched in PubMed, Google Scholar and Cochrane Oral Health's Trials Register up to August 2020, without language and period restriction. Two authors independently reviewed all identified titles and abstracts for eligibility. Tables were generated to summarize the included studies. Results: Sixteen (n = 16) articles met the eligibility criteria. Nonsurgical endodontic treatment was carried out in eleven cases with triple antibiotic paste and in nineteen cases calcium hydroxide was used. Results of the study after analyzing the case reports indicate that both triple antibiotic paste and calcium hydroxide are equally effective as intracanal medicament. In cases where calcium hydroxide failed to eliminate symptoms, triple antibiotic paste was found to be effective. Conclusion: As far as the effect on the healing of the periapical lesions is concerned, all the studies showed a high success rate. Available scientific data indicates nonsurgical treatment can be adopted as a routine measure to conservatively treat large periapical lesions of endodontic origin.

'Nanodentistry': Exploring the beauty of miniature.

Feynman's early vision in 1959 gave birth to the concept of nanotechnology. He saw it as an unavoidable development in the progress of science and said that there is plenty of room at the bottom. Since then, nanotechnology has been part of mainstream scientific theory with potential medical and dental applications. Numerous theoretical predictions have been made based on the potential applications of nanotechnology in dentistry, with varying levels of optimism. While a few layers of nanotechnologic capability have become a reality for oral health in the last decade, many of these applications are still in their puerile stage .The most substantial contribution of nanotechnology to dentistry till date, is the more enhanced restoration of tooth structure with nanocomposites. The field of nanotechnology has tremendous potential, which if harnessed efficiently, can bring out significant benefits to the human society such as improved health, better use of natural resources, and reduced environmental pollution. The future holds in store an era of dentistry in which every procedure will be performed using equipments and devices based on nanotechnology. This article reviews the current status and the potential clinical applications of nanotechnology in dentistry. Key words:Nanotechnology, nanodentistry, nanocomposites.