In vitro comparison to study the antimicrobial effect of silver nanoparticles gel and its various combinants as an intracanal medicament against Enterococcus faecalis.

Background: Endodontic infections have been clearly described as biofilm-mediated infections. Bacteria and their by-products have been known to cause these infections. With the introduction of new drugs and the use of nanoparticles in recent times, there has been a significant reduction in the bacterial load in endodontic infections. Aims and Objectives: The in vitro study focuses on checking the antibacterial efficacy of silver nanoparticles and its combination with other medicaments against the root canal pathogen - Enterococcus faecalis (E. faecalis). Methodology: In the present study, 140 extracted human teeth were used. The teeth were sectioned, and biomechanical preparation was done. The root canals of the extracted teeth were inoculated with the culture of E. faecalis. The teeth were divided into six groups based on the intracanal medicament used: Group 1 - Silver nanocure gelGroup 2 - Silver nanocure gel + Cavisept gel (1:1)Group 3 - Silver nanocure gel + Aveu-Cal gel (1:1)Group 4 - Silver nanocure gel + Cavisept gel + Aveu-Cal gel (1:1:1)Group 5 - Positive control (specimens were inoculated with Enterococcus faecalis and left untreated to confirm the presence of infection)Group 6 - Negative control (no bacterial contamination of specimens). The colony-forming units were recorded after 48 h of incubation. Results: The statistical analysis of the colony-forming units was done using the Kruskal-Wallis tests. Silver nanocure gel + Cavisept gel + Aveu-Cal gel (1:1:1) showed the least colony-forming units. Conclusion: The present study is an in vitro study, in which we concluded that the combination of all the intracanal medicaments is the best for the elimination of E. faecalis biofilm from the root canal. The above findings need to be tested in vivo also.

Comparative evaluation of cleaning efficiency of single file NiTi rotary system during root canal treatment procedure - A scanning electron microscope study.

Background: Optimal biomechanical preparation, thorough irrigation, proper disinfection, and finally, well-sealed obturation is a must to attain definitive success in root canal procedure. Proper preparation of the root canal is all the more imperative to establish a hermetic apical seal with adequately placed filling materials. The present study was conducted for comparing the Cleaning Efficiency of F360 system and the WaveOne Gold (WOG) system of rotary NiTi instrumentation for a root canal. Materials and Methods: One hundred freshly extracted noncarious mandibular canines were obtained. Access cavity of standard size was made followed by the establishment of working length. Afterward, random division of all the specimens was done into two study groups: group A: the group in which F360 system was used for instrumentation and group B: the group in which the WOG system was used for instrumentation. Irrigations of all the specimens of both the study groups were done followed by root canal shaping by the instrument system of their respective study groups. Scanning electron microscope (SEM) was used for assessment after specimens were cut buccolingually. Debris score and residual smear layer score were used for assessment. Results: Among group A specimens, the mean smear layer score at the coronal third, middle third, and apical third was 1.76, 2.39, and 2.65, respectively. Among group B specimens, the mean smear layer score at the coronal third, middle third, and apical third was 1.34, 1.59, and 1.92, respectively. While analyzing statistically, it was seen that the mean smear layer score was significantly higher among specimens of group A in comparison to group B. While analyzing statistically, it was seen that the mean debris score was significantly higher among specimens of group A in comparison to group B. Conclusion: The cleaning effectiveness of WOG instruments was significantly enhanced in comparison to F360 equipment.

An in vitro evaluation of antibacterial effect of curcumin-loaded chitosan nanoparticle-coated gutta-percha against Staphylococcus aureus.

Background: The persistence of microorganisms in root canal system is pivotal factor pertinent to endodontic failure. Even if you meet the highest technical and asepsis standards and also minimize the procedural errors, failures result. The rapidly increasing antibiotic resistance among these bacteria and the adverse effects of these antibiotics along with their toxicity are the main situations indicating the utmost urgent requirement of a safe, effective, natural phytochemical like curcumin with tremendous medicinal potential. Nanoformulations of curcumin are their improved version with enhanced antibacterial activity. Materials and Methods: A thin layer of nanocurcumin was coated on the surface of gutta-percha cones. To observe the uniformity and adherence of nanocurcumin coating on the exterior surface of gutta-percha, scanning electron microscopy (SEM) was done. Further agar gel diffusion technique was used to assess the antimicrobial activity of nanocurcumin-coated gutta-percha cones and conventional gutta-percha cones and their results were compared statistically. Results: The results of SEM study showed a layer of nanocurcumin adhering uniformly to the surface of gutta-percha cones. Furthermore, the nanocurcumin-coated gutta-percha cones demonstrated higher antibacterial activity as compared to the conventional cones. Conclusions: Our study results reveal that the coating of nanocurcumin on gutta-percha cones has augmented their antibacterial activity.

Recent trends in publications in the Journal of Conservative Dentistry (2018-2022).

Aims and Objectives: The main goal of the present study is to analyze the pattern of article publication in the Journal of Conservative Dentistry (JCD) over 5 years. Materials and Methods: For the study, different parameters such as number of articles published, number of views per journal, types of articles (broadly categorized into editorial, case reports, reviews, and original research), citation of articles, subject of articles (conservative endodontics), and author institution mapping were assessed from the journal's official website. The results were tabulated and individually explained. Results and Conclusion: JCD has delivered broad-based and balanced coverage of endodontics and conservative dentistry between 2018 and 2022. The number of views and citations has increased over the years and JCD has begun to represent the global face of the Indian Association of Conservative Dentistry and Endodontics.

Acquisition of potential reservoirs of nosocomial infection on gadgets and clothing in the dental hospital setting: An epidemiological study.

Introduction: During dental procedures, dental professionals as well as patients are exposed to pathogens and toxic substances, which may be transmitted through direct or indirect contact. Their clothing is visibly soiled during the procedures. Their hands can serve as vectors for the transmission of pathogens. Use of mobiles, laptop, and other gadgets tend to increase the chances of microbial colonization on these surfaces. The objective of the study is to screen for the presence of microorganism the most common items pertaining to our daily personal utility which are being used in the hospital settings, to access the microbial load and their potential hazards. Materials and Methods: In this study, 80 samples were collected from different personal utility items such as white coats, mobiles, hand towels, and laptops. These samples were evaluated for the presence of any microbial colonization on them. Results: All the sampled surfaces showed the presence of microorganisms and all showed polymicrobial growth. Conclusion: These identified surfaces should be cleaned and decontaminated on regular basis to prevent the transmission of pathogens in the dental hospital environment.

Dentinal defects after root canal preparation with rotary nickel-titanium files using different irrigants: An in vitro study.

Aim: This in vitro study aims to detect the dentinal defects associated with different irrigants during biomechanical preparation using rotary nickel-titanium (Ni-Ti) files (Hyflex CM). Materials and Methods: For the study, 120 extracted mandibular incisors were taken. Depending on the irrigant used, teeth were divided into six groups (n = 20). In Group 1, teeth were not biomechanically prepared considered as, control group. In Group 2, Group 3, Group 4, Group 5, and Group 6, biomechanical preparation was with Hyflex CM rotary Ni-Ti files using saline, 3% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA), SmearClear, and 2% chlorhexidine (CHX), respectively, as irrigant. IsoMet Saw was used to section samples at 3, 6, and 9 mm from the apex perpendicular to the long axis of tooth. Segments were seen at 30x magnification under a digital stereomicroscope. Statistical Analysis: Statistical analysis was done using two-tailed t-test. Results: Maximum number of dentinal defects was seen with 17% EDTA, followed by 3% NaOCl, SmearClear, and 2% CHX. Conclusions: Irrigation with 17% EDTA causes more dentinal defects as compared to irrigation with 3% NaOCl, SmearClear, and 2% CHX.

Azadirachta indica A. juss, Morinda citrifolia L. and Triphala as herbal endodontic irrigants: A scoping review.

Background: The success of the root canal treatment depends on the complete elimination of the microflora, biofilms and smear layer from the pulp space. A wide variety of chemical endodontic irrigants are available to achieve disinfection and thorough debridement besides mechanical means. However, detrimental properties such as allergic potential, cytotoxicity, antimicrobial resistance and safety concerns have intrigued researchers over the years to look for safer options. Aim: The review is aimed at providing comprehensive information of the studies evaluating the efficacy of Azadirachta indica A. juss (A. indica), Morinda citrifolia L. (M. citrifolia) and Triphala (fruits of Emblica officinalis Gaertn., Terminalia chebula (Gaertn.) Roxb. and Terminalia belerica Retz.) as herbal endodontic irrigants. Materials and methods: The literature review was conducted using indexed databases (PubMed, Google Scholar, Cochrane) electronically for publications in peer-reviewed journals for relevant articles evaluating the efficacy of A. indica, Triphala, M. citrifolia as endodontic irrigant from the year 1985-March 2020. Results: A total of 58 studies were identified for full text reviewing after duplicate removal and screening title and abstracts. A total of 32 studies were included and processed for data extractions. Conclusion: Various in-vitro/in-vivo studies utilizing these herbal irrigants have documented promising results and hold the potential to replace chemical endodontic irrigants in routine practice but more preclinical and clinical trials are needed to substantiate these results before they can conclusively be recommended as intracanal irrigating solutions.

An in vitro determination of antibacterial effect of silver nanoparticles gel as an intracanal medicament in combination with other medicaments against Enterococcus fecalis.

AIM: The main aim of the study is to compare the antibacterial effect of Silver nanoparticle gel alone and combination of silver nanoparticle gel with various medicaments. MATERIALS AND METHODS: Intracanal dressings: Group 1 -Silver Nanocure gel, Group 2 - Silver Nanocure gel+ Cavisept gel(1:1),Group 3- Silver Nanocure gel+ Aveu-Cal gel(1:1) ,Group 4 - Silver Nanocure gel +Cavisept gel +Aveu-Cal gel(1:1:1) were taken on a culture plate inoculated with E.faecalis. Antibacterial activity was assessed using Agar diffusion test and results were noted as diameter of growth inhibition zone. STATISTICAL ANALYSIS: Student t -test was used to analyse results. RESULTS: The diameter of combination of Silver nanocure gel+Cavisept +Aveu-Cal gel(1:1:1) was highest in comparison to other medicaments tested. CONCLUSION: Intracanal dressing with a combination of all the three {Silver nanocure gel+Cavisept +Aveu-Cal gel(1:1:1) } is the best treatment for elimination of highly resistant Enterococcus faecalis in root canals.

Incidence of dentinal defects during root canal preparation with hand files using different irrigants: An in vitro study.

INTRODUCTION: The purpose of this in vitro study was to compare the incidence of dentinal defects during root canal preparation with hand files using different irrigants. MATERIALS AND METHODS: A total of 120 extracted mandibular incisors were randomly divided into onecontrol group and five experimental groups (n = 20) depending on the irrigant used. Biomechanical preparation was not done in control group. Teeth in experimental groups were prepared with hand K-files to a master apical file #35 with 1-mm increments step-back up to #50. In Group 2, saline was used as an irrigant. In Groups 3, 4, 5, and 6, 3% sodium hypochlorite (NaOCL), SmearClear, 17% ethylenediaminetetraacetic acid (EDTA), and 2% chlorhexidine (CHX), respectively, were used as an irrigant. Specimens were sectioned perpendicular to the long axis at 3, 6, and 9 mm from the apex. Sections were observed under a digital stereomicroscope at 30× magnification. Two-tailed t-test was used for statistical analysis. RESULTS: There was a statistically significant difference between the six groups. Group 5 (17% EDTA) had the highest number of dentinal defects, followed by Group 3 (3% NaOCl), Group 4 (SmearClear), and Group 6 (2% CHX). CONCLUSIONS: 17% EDTA causes more dentinal defects as compared to 3% NaOCl, SmearClear, 2% CHX, and saline.

Biomarkers in triple negative breast cancer: A review.

Breast cancer is an intrinsically heterogeneous disease. In the world about 1 million cases of breast cancer are diagnosed annually and more than 170000 are triple-negative. Characteristic feature of triple negative breast cancer (TNBC) is that it lacks expression of oestrogen, progesterone and human epidermal growth factor receptor-2/neu receptors. They comprise 15%-20% of all breast cancers. We did a systematic review of PubMed and conference databases to identify studies published on biomarkers in TNBC. We included studies with biomarkers including: Epidermal growth factor receptor, vascular endothelial growth factor, c-Myc, C-kit and basal cytokeratins, Poly(ADP-ribose) polymerase-1, p53, tyrosinase kinases, m-TOR, heat and shock proteins and TOP-2A in TNBC. We also looked for studies published on synthetic lethality and inhibition of angiogenesis, growth, and survival pathways. TNBC is a complex disease subtype with many subclasses. Majority TNBC have a basal-like molecular phenotype by gene expression profiling. Their clinical and pathologic features overlap with hereditary BRCA1 related breast cancers. Management of these tumours is a challenge to the clinician because of its aggressive behaviour, poor outcome, and absence of targeted therapies. As the complexity of this disease is being simplified over time new targets are also being discovered for the treatment of this disease. There are many biomarkers in TNBC being used in clinical practice. Biomarkers may be useful as prognostic or predictive indicators as well as suggest possible targets for novel therapies. Many targeted agents are being studied for treatment of TNBC.

Systemic treatment strategies for triple-negative breast cancer.

Triple-negative breast cancer (TNBC) is defined by the lack of immunohistochemical expression of the estrogen and progesterone receptors and human epidermal growth factor receptor 2 (EGFR2). Most TNBC has a basal-like molecular phenotype by gene expression profiling and shares clinical and pathological features with hereditary BRCA1 related breast cancers. This review evaluates the activity of available chemotherapy and targeted agents in TNBC. A systematic review of PubMed and conference databases was carried out to identify randomised clinical trials reporting outcomes in women with TNBC treated with chemotherapy and targeted agents. Our review identified TNBC studies of chemotherapy and targeted agents with different mechanisms of action, including induction of synthetic lethality and inhibition of angiogenesis, growth and survival pathways. TNBC is sensitive to taxanes and anthracyclins. Platinum agents are effective in TNBC patients with BRCA1 mutation, either alone or in combination with poly adenosine diphosphate polymerase 1 inhibitors. Combinations of ixabepilone and capecitabine have added to progression-free survival (PFS) without survival benefit in metastatic TNBC. Antiangiogenic agents, tyrosine kinase inhibitors and EGFR inhibitors in combination with chemotherapy produced only modest gains in PFS and had little impact on survival. TNBC subgroups respond differentially to specific targeted agents. In future, the treatment needs to be tailored for a specific patient, depending on the molecular characteristics of their malignancy. TNBC being a chemosensitive entity, combination with targeted agents have not produced substantial improvements in outcomes. Appropriate patient selection with rationale combinations of targeted agents is needed for success.

An in vitro study of antibacterial effect of calcium hydroxide and chlorhexidine on Enterococcus faecalis.

AIM: To evaluate and compare the antibacterial effects of chlorhexidine and calcium hydroxide on Enterococcus faecalis. MATERIALS AND METHODS: Root canal treatment involves a number of steps. In spite of all the steps done thoroughly, root canal treatment might fail due to the remnant microbes. Of all such bacteria, E. faecalis is found in failed root canals. The study tests the antibacterial activity of various intracanal medicaments. Agar diffusion test was used to evaluate the antibacterial effects of the following antibacterial agents: i. hexidine:0.2% chlorhexidine gluconate; ii. periogard:0.12% chlorhexidine gluconate; iii. calcium hydroxide powder plus sterile water; iv. metapaste plus sterile water; v. calcium hydroxide plus hexidine; vi. calcium hydroxide plus periogard; vii. metapaste plus hexidine; viii. metapaste plus periogard. The size of zones of inhibition was measured. RESULTS: The average size of zones of inhibition after 72 hours were hexidine: 5 mm; periogard: 4.25 mm; calcium hydroxide plus sterile water: 0.5 mm; metapaste plus sterile water: 0.5 mm; calcium hydroxide plus hexidine: 4.7 mm; calcium hydroxide plus periogard: 4 mm; metapaste plus hexidine: 4.65 mm; metapaste plus periogard: 4 mm. Results were subjected to statistical analysis using one way analysis of variance and Tukey tests. CONCLUSION: Chlorhexidine and its preparations are more potent antibacterial agents against E. faecalis in comparison to calcium hydroxide.

Effect of sealers on fracture resistance of endodontically treated teeth with and without smear layer removal: An in vitro study.

AIM: The present study involved the in vitro comparison of root reinforcing abilities of two sealers, i.e., Ketac-Endo and Acroseal, in endodontically treated teeth in the presence and absence of smear layer. MATERIALS AND METHODS: Fifty teeth were taken and sectioned at the cementoenamel junction. The teeth with faults were discarded and a total of 36 teeth were used for study. The samples were biomechanically prepared using step-back technique. In 10 teeth, the smear layer was preserved using sodium hypochlorite. Smear layers were removed from 10 teeth using 17% EDTA, and in another 10 samples, the smear layers were eliminated using 17% EGTA. The remaining samples served as controls. Samples were obturated with sealers using the lateral condensation technique. Ketac-Endo (3M) is a glass ionomer based root canal sealer, and Acroseal (Septodont) sealers were used. The teeth were then tested by using an Instron testing machine. RESULTS: Ketac-Endo shows higher fracture resistance values in comparison to Acroseal. Other factors as the amount of tooth structure remaining, the agents used for the removal of smear layer and instrumentation techniques may alter the tooth resistance to fracture. CONCLUSION: Ketac-Endo shows higher fracture resistance values in comparison to Acroseal.

An in vitro study to determine the sealing ability of sealers with and without smear layer removal.

AIMS/OBJECTIVES: The objective of this in vitro study is to compare the sealing ability of Ketac-Endo and Acroseal. MATERIALS AND METHODS: Seventy teeth were selected and sectioned at the cementoenamel junction. The teeth were cleaned and shaped, and they were divided into five different groups. Group1: 20 teeth in which the smear layer was left intact using sodium hypochlorite. Group 2: 20 teeth in which the smear layer was removed using 17% EDTA. Group 3: 20 teeth in which the smear layer was removed using 17% EGTA. These groups (1, 2, and 3) were further subdivided into two subgroups (a and b) by obturation utilizing lateral condensation with Gutta-percha and Acroseal (subgroup "a") or Ketac-Endo (subgroup "b"). The subgroups contained 10 teeth each. Group 4: 5 teeth that were instrumented but not obturated. Group 5:5 teeth that were neither instrumented nor obturated. The specimens were immersed in methylene blue dye, and microleakage was assessed using a stereomicroscope. RESULTS: The data was analyzed using one way analysis of variance and student's t-test. CONCLUSION: 17% EGTA is a better and potent alternative to 17% EDTA for smear layer removal. Acroseal sealer has less microleakage as compared with Ketac-Endo. Sealing ability of Acroseal sealer is better when it is used in conjunction with 17% EGTA.