Comparison of Antibacterial Efficacy of Triple Antibiotic-Loaded Hydrogel Versus Modified Triple Antibiotic-Loaded Hydrogel as Intracanal Medicament Against Enterococcus faecalis: An In vitro Study.

OBJECTIVE: Triple antibiotic paste (TAP) is known to have an essential role in the success of endodontic treatment by eliminating pathogens from the root canal system. Unfortunately, it causes discolouration and cytotoxicity at high concentrations. The objective of this research was to assess and compare the antimicrobial effectiveness of various concentrations (1 mg, 5 mg, 10 mg) of TAP, TAP hydrogel (TAPH), M-TAP, and M-TAP hydrogel (MTAPH) against Enterococcus faecalis. METHODS: The agar well diffusion method was used to assess the antibiotic sensitivity of the following intracanal medicaments: TAP (ciprofloxacin, metronidazole, and minocycline) mixed in a ratio of 1: 1: 1; TAPH, M-TAP (ciprofloxacin, metronidazole, and amoxicillin), M-TAPH and plain hydrogel. Each tested medicament was individually evaluated for its antimicrobial activity against Enterococcus faecalis. Structural and topographical characterisation were analysed using a Scanning Electron Microscope (SEM) and interpreted using ImageJ software. A microdilution broth test was performed to examine the minimum inhibitory concentration and minimum bactericidal concentration (MBC) of M-TAP and TAP. RESULTS: Except for the plain hydrogel, M-TAP and hydrogel and TAP and hydrogel showed significantly varied inhibitory zones at different concentrations. M-TAPH showed the highest mean zone of inhibition of 21.6, 33.33 and 38.0 mm at a concentration of 1, 5, and 10 mg/mL when compared to TAPH, which showed a mean zone of inhibition of 3.3 mm,12.3 mm, 21.3 mm at the respective concentrations. The MIC study shows that more than 75% of Enterococcus faecalis growth was inhibited by M-TAP at a concentration of 5 µg/mL, whereas TAP showed inhibition at a concentration of 35 µg/mL. MBC results indicate that almost 99.9% of the bacterial population was killed at a concentration of 100 µg/mL (10-1) for TAP and 10 µg/mL (10-2) for M-TAP. CONCLUSION: The antibacterial efficacy of M-TAP was significantly higher than TAP. Application of M-TAP at lower doses is advised to overcome the disadvantages seen with TAP.

Knowledge, attitude, and practice survey on the use of stamp technique for the management of Class I caries in molars among undergraduate students in dental schools.

Stamp technique is a recently developed technique that involves of creating an index which records the occlusal anatomy of posterior teeth before cavity preparation. This technique is beneficial in cases where the caries is involving the occlusal surface with little or no damage to the occlusal anatomy or the marginal ridges. The aim of the study is to assess the knowledge and practice on the use of stamp technique for the management of Class 1 caries in molars among undergraduate students. A questionnaire-based study was conducted among 100 dental students in Saveetha Dental College. The questionnaire contained 17 questions that were circulated through Google Forms and received dichotomous responses. The data were collected as an ordinal variable and the collected data were analyzed using SPSS software, and Chi-square test and descriptive analysis were done. This study shows that almost 37% of the respondents were interns and final-year students, 62% of them felt carving would be easier to attain the proper occlusal morphology, 55% of them prefer both flowable and packable composites, and 63% felt stamp technique would be technique sensitive. There was a significant association between the year of study and difficulties faced in occlusal stamp technique (P = 0.014 < 0.05). Undergraduate students were moderately aware of the stamp technique in composite restorations. More detailed knowledge on composite finishing and polishing should be emphasized in the undergraduate curriculum.