Comparing the Biofilm Removal Capacity of NaOCl, Povidone-Iodine, Chlorhexidine, Curcumin, and Triphala as Endodontic Irrigants.

BACKGROUND AND AIM: A sessile multicellular organism that is immersed in a self-produced matrix of extracellular polymeric substances and has its cells firmly attached to a surface is referred to as a microbial biofilm. When it comes to pulp and periradicular pathosis, biofilms are crucial. To reduce the number of microorganisms in the root canal and assist in treating periapical pathosis, endodontic therapy must include decontamination of the system of tooth root canals through biomechanical preparation and irrigation of the root canal. This study compares sodium hypochlorite (NaOCl), povidone-iodine, chlorhexidine, curcumin, and triphala as endodontic irrigating solutions regarding their capacity to eliminate biofilm from root canals. MATERIALS AND METHODS: A total of 60 patients were included if they had pulpitis. Two specific samples (samples A and B) were chosen for analysis from a collection of samples so that their bacterial composition is most similar to that of acute pulpitis. The suspensions of bacterial cells from this polymicrobial culture have been collected from frozen stock and then regrown by inoculation on Columbia agar base (Basingstoke, UK) with the addition of vitamin K1, hemin, and 5% (v/v) calf blood. The pureness of the suspensions was assessed using colony morphology and Gram staining. Analytical profile index (API) 20A tests or automated test for bacteria (ATB) ID 32A tests were initially used to identify the isolates. These polymicrobial cultures' in vitro biofilms were developed using membrane filters made of cellulose nitrate. The tested irrigating solutions were as follows: 5.25% sodium hypochlorite, 10% triphala, 0.2% chlorhexidine gluconate, 10% povidone-iodine, and 5% curcumin (CUR). On the other hand, phosphate-buffered saline was taken as a control agent. RESULTS: As the standard of excellence in endodontic irrigation, NaOCl has eliminated all germs in sample A following 15 minutes of culture and in both of the specimens after 40 minutes. Iodine also eliminated all germs after 40 minutes of administration, indicating that it would be worth exploring using iodine as a potential endodontic irrigant. Iodine achieved total bacterial elimination after 40 minutes in both samples; however, it was less effective after 15 minutes. Our findings indicate that iodine solution is the most suitable alternative after the supremely effective NaOCl, although it requires longer contact times to generate the necessary and recognized broad-spectrum antibacterial properties, including in the case of biofilms. Furthermore, curcumin also showed significant results after NaOCl and iodine. CONCLUSION: The antibacterial potency of each studied irrigant was significant, supporting their usage in endodontics. It was observed that NaOCl has the maximum antibacterial activity.

Comparison and Evaluation of Effect of Low Level Laser Therapy (LLLT) with Intracanal Medicament on Periapical Healing.

Photobiomodulation (PBM), also commonly referred to as low-level laser therapy (LLLT), uses light energy to elicit biological responses from the cell and normalize cell function. 40 persons with periapical lesions were selected and were assigned randomly into two groups.Group I - Conventional root canal therapy and low-level laser therapy. Group II - Conventional root canal therapy Root canal therapy was completed, and radiographs were obtained and assessed 3, 6, and 9 months postoperative. VAS pain scale was assessed postoperatively on 0, 7th, and 14th days respectively. An independent t-test was used for the evaluation of the data. No significant difference was noted for postoperative pain and PAI scale between both groups Significant difference was noted in the reduction of the periapical lesions for 3 and 9 months follow up, but was not significant for 6 months. The healing was better in Group I which received Low-level laser therapy with the conventional root canal treatment. Low-level laser therapy can be the newer additional treatment modality that can be applied to the periapical lesion for its faster healing.

Quantitative Evaluation of Apically Extruded Debris during Biomechanical Preparation using Hand K-File, Protaper Next, and Waveone - An In Vitro Study.

Background: The instrumentation technique which produces least amount of apically extruded debris is desirable to use in biomechanical preparation of root canal. Aim: To quantitatively evaluate apically extruded debris during instrumentation with hand K-file, ProTaper Next, and WaveOne. Materials and Methods: Forty-five extracted human single-rooted mandibular premolars with straight, single canal and single apical foramen were selected after radiographic evaluation and divided equally into three groups. Cleaning and shaping was done using hand K-files in step-back technique, ProTaper Next, and WaveOne single-file system. Debris extruded apically was collected into Eppendorf tubes and stored in an incubator at 37°C temperature for 5 days for drying. Weight of dry debris was measured using electronic microbalance with an accuracy of 10-5 g. Statistical Analysis: Student's t-test, with P value < 0.05 is statistically significant. Results: Statistically significant (P < 0.05) amount of debris was extruded by all three instrumentation systems: hand K-file- 1.9220 mg, ProTaper Next- 1.4940 mg, and WaveOne- 0.9940 mg. Least amount of debris produced by WaveOne was statistically significant (P < 0.05) when compared with the other two systems. Conclusion: The WaveOne reciprocating system extruded least amount of debris in comparison to hand K-file and ProTaper Next.

A Clinical Evaluation of Onlay and Inlay in the Posterior Ceramic Restorations: An Original Study.

Introduction: The extensively damaged teeth can be treated with the inlay and onlay. The ceramic inlays and onlays can be prescribed for the esthetic needs of the patient. Hence in our study, we aim to evaluate clinically the outcomes of the ceramic inlays and onlays for the posterior teeth. Materials and Methods: We piloted a retrospective analytical study from the departmental records. We included 70 patients who had a total of 160 ceramic inlays and onlays prepared between the years 2010-2020. The survival and the failure rates were noted and compared using the "Kruskal-Wallis H statistics and the Chi-square tests" deliberating P < 0.05 as significant. Results: The mean survival was 6.1 ± 1.8 years. The success rate was 92.21% and the failure was 7.6%. Significant variation was seen with the survival rate between the vital and nonvital teeth and between the molars and premolars. Conclusions: The ceramic inlays and onlays were performed successfully in the posterior teeth with a high survival rate and very low failure.

An In vitro Comparison of Pushout Bond Strength of Resilon with MetaSEAL and AH Plus Sealers.

AIM: The aim of this study is to evaluate and compare the pushout bond strengths of Resilon with two different sealers: Resilon/MetaSEAL (methacrylate based) and Resilon/AH Plus (an epoxy resin-based sealer). MATERIALS AND METHODS: Forty single canal anterior teeth were decoronated at cementoenamel junction and standardized to 10 ± 1 mm length. Working length was determined followed by biomechanical preparation. Then, the specimens were randomly assigned into two groups of 20 teeth each based on the sealer used with Resilon. All canals were obturated using single-cone obturation technique. Root samples were prepared for pushout testing. The universal testing machine gave the debonding force for individual specimen. This was done for all the specimens. STATISTICAL ANALYSIS: This was done by using unpaired Student's t-test. RESULTS: The roots filled with Resilon/MetaSEAL had higher bond strength (1.49 ± 0.09 MPa) compared to Resilon/AH Plus (0.90 ± 0.04 MPa) group. The difference in bond strength was statistically significant (P = 0.0000). CONCLUSION: Through this pushout bond strength test, it could be noted that MetaSEAL did appear to bond to the dentin and could be used as a potential endodontic sealer.

Micro-tensile bond strength of different adhesive systems on sound dentin and resin-based composite: An in-vitro study.

AIM: To analyze the difference in the micro-tensile bond strength of specimens made with two different adhesive systems and compare them with two homogenous substrates. MATERIALS AND METHODS: Sixty permanent mandibular molars were mounted in acrylic blocks and sectioned with exposed dentin surfaces. Samples were then divided into four groups. To Group-I Adper Single Bond 2 and to Group-II Adper Self-Etch plus bonding agents were applied. For Group-I and Group-II beams consisted of resin composite in the upper half and dentin in the lower half. In Group-III beams were made of only dentin. In Group-IV beams were made of only composite. Fifteen specimens of each group were taken for the micro-tensile bond strength test. STATISTICAL ANALYSIS: The results are analyzed using one-way analysis of variance and Critical Difference test. RESULTS: The interface bonded with the two adhesive systems had lower micro-tensile bond strength than those of dentin and resin composite and the self-etching adhesive Adper Self-Etch plus had comparable bond strength with total-etch adhesive Adper Single Bond 2. CONCLUSION: The bond strength values for current adhesive systems cannot be compared to the micro-tensile bond strength of dentin and resin composite, and self-etching adhesives have comparable bond strength with total-etch adhesives.

Mandibular first molar with a radix entomolaris: an endodontic dilemma.

It is known that the mandibular first molar can display significant anatomical variations namely the number of root canals, the number of roots and morphology. Mandibular molars may sometimes have an additional root located lingually (the radix entomolaris) or buccally (the radix paramolaris). If encountered, an awareness and understanding of this unusual root and its canal morphology can contribute to the successful outcome of root canal treatment. This case report discusses endodontic treatment of a mandibular first molar with a radix entomolaris, which is a rare entity and poses as an endodontic dilemma for the clinician with respect to diagnosis and subsequent treatment. Clinicians should be aware of these unusual root morphologies in the mandibular first molar which needs strategic treatment as unfilled canals remain a nidus for infection and can compromise treatment outcome.