Comparative Evaluation of the Antimicrobial Effect of Mangosteen, Triphala, Chitosan, and 2% Chlorhexidine on Mono- and Dual-Species Biofilms of - and Candida albicans: An in Vitro Study.

OBJECTIVE: The purpose of this in vitro study was to compare the antimicrobial effectiveness of 2% chlorhexidine gel, 0.5% chitosan, ethanol extract of mangosteen pericarp, and Triphala used as intracanal medicaments against Enterococcus faecalis and Candida albicans in mono- and dual-species biofilms. METHODS: Bioactive components in the ethanol extract of mangosteen pericarp and Triphala were evaluated by gas chromatography-mass spectrometry (GCMS). Quantitative assessment of the biofilm formations of E. faecalis and C. albicans and as a dual-species in the presence of test medicaments was carried out using a crystal violet (CV) assay in a microtiter plate. Following this, 246 single-rooted premolar teeth were collected, and root specimens were prepared. C. albicans and E. faecalis mono- and dual-species biofilms were grown in the root specimens. At the end of 21 days, the samples were divided into five groups and subjected to different types of medicaments: Control group- distilled water; Chlorhexidine group- 2% chlorhexidine gel; Chitosan group- 0.5% chitosan; Mangosteen group- ethanol extract of mangosteen pericarp; and Triphala group- ethanol extract of Triphala. Colony-forming units (CFUs) were assessed on the first and fifth day after medicament placement. RESULTS: Microbial population reduction was measured by one-way analysis of variance, followed by post-hoc Tukey's multiple comparison test (P<0.05). Chlorhexidine showed maximum log reduction in CFUs of microorganisms, followed by chitosan, which showed a similar log reduction (P>0.05) for both mono- and dual-species biofilms. However, in the mangosteen and Triphala extract groups, the CFU/mL for dual-species on both days did not have a significant reduction in count (P<0.05) when compared to chlorhexidine and chitosan. CONCLUSION: Chlorhexidine showed maximum antimicrobial activity, followed by chitosan, on both mono- and dual-species biofilms. Mangosteen and Triphala had good antimicrobial action on the mono-species biofilm.

Management of Three Rooted Mandibular First Molar with Six Canals: A Case Report.

The objective of dentists is to preserve teeth affected by either caries, trauma, or any other pathological condition. Teeth with deep carious lesions often require endodontic treatment to preserve their form and function. Sound knowledge of root canal anatomy, endodontic pathology, and proper treatment protocol are vital in endodontic treatment success. Currently, there has been an ongoing trend of case reports that highlight the presence of extra canals, which in turn, cautions the clinician to be more prudent. Any missed canal during root canal therapy is the common cause of treatment failure. This case report emphasizes the fact that proper understanding of pulp anatomy combined with the use of modern diagnostic aids and proper treatment protocol is essential for treatment success. This case report describes successful management of three rooted mandibular first molar with extra canals.

Modified putty index matrix technique with mylar strip and a new classification for selecting the type of matrix in anterior proximal/incisal composite restorations.

Matrix technique described in this article combines the advantages of both flexible and rigid matrix in anterior composite restorations. Using mylar strip provide advantages, of one utilizing the mylar strip for contouring the labial aspect of restoration thereby, and overcomes the problem in adapting the teflon tape around the tooth.

To Evaluate the Efficacy of an Innovative Irrigant on Smear Layer Removal - SEM Analysis.

INTRODUCTION: The goal of endodontic therapy is to completely eliminate the microorganisms and the smear layer from the root canal in order to provide a good seal of the root filling materials. AIM: The aim of this study was to find a viable alternative irrigant, which is easily available with less erosion and clinically acceptable smear layer removal by comparing the efficacy of EDTA and commercially available super-oxidized water, named Oxum, as a final rinse on smear layer removal and erosion in relation to coronal, middle and apical thirds of radicular dentin using Scanning Electron Microscope (SEM) analysis. MATERIALS AND METHODS: Freshly extracted 30 human lower second premolar teeth with straight roots and type I canal anatomy were selected. The root canals were cleaned and shaped using Universal Protaper Rotary System. Irrigation was performed with 1 ml of 2.5% of NaOCl solution after each instrument change. The final irrigation (5 ml) sequence was as follows: Group I- 17% EDTA, Group II - OXUM, and Group III - 0.9% saline (control) for one minute. Then, the root canals were finally irrigated with 5ml of distilled water to remove any precipitate. The roots were then gently split into two halves using a chisel and subjected to SEM analysis. RESULTS: The SEM photomicrographs were evaluated by two independent examiners and Mann Whitney results showed that there was no statistically significant difference between the two examiners. Non-parametric statistical analysis of all experimental groups showed significant difference between coronal, middle and apical third for smear layer removal with p-value<0.05. For erosion, in group II (oxum) showed statistically significant difference between coronal, middle and apical third and it showed significantly less dentine erosion when compared to EDTA. CONCLUSION: Within the limitations of the present study, Oxum the commercially available super-oxidized water proved to be equally effective in smear layer removal with less erosion when compared to EDTA.

Evaluation of surface roughness of three different composite resins with three different polishing systems.

AIM: The aim of this study was to evaluate the surface roughness of three composites with three different polishing systems. MATERIALS AND METHODS: Composite specimens were made from the Teflon mold with a standardized cavity size (6 mm diameter and 3 mm height). Group I - Filtek Z350XT (Nano clusters), group II - T-Econom plus (Microhybrid), group III - G-aenial Flo (True Nano). The samples were cured for 30 s from both sides with the matrices in place. The 60 samples were divided into 3 groups (N = 20), which accounted for 40 surfaces, (n = 20 × 2 = 40) in each groups. Each group were subdivided into four subgroups based on the type polishing material, subgroup A - Control, subgroup B - Astrobrush, subgroup C - Astropol, and subgroup D - Soflex spiral wheel. The samples of all groups except group A (control) were finished and polished according to the manufacture's instruction. RESULTS: After polishing, the roughness (Ra) of the resin composite of all the specimens were measured using a profilometer. Soflex spiral wheel (group D) significantly had the least roughness (Ra) value as compared to the other groups. CONCLUSION: Among the three resin composites tested, G-aenial Flo exhibited least Ra value due to its reduced filler size and its uniform distribution.