Effect of remineralizing agent on laser and nonlaser bleached enamel surfaces subjected to erosion: An in vitro study.

Aim: Assessment of remineralizing agent's effect on laser and nonlaser bleached enamel surfaces subjected to erosion. Materials and Methods: In this study, 80 extracted human permanent anteriors were collected and divided into 4 groups with 20 teeth per sample. Enamel specimen of 3 mm × 3 mm were made using polyvinyl chloride rings and acrylic and randomly divided into four groups. Then the specimens were subjected to initial microhardness test using Vicker's hardness tester (AVK-CO, Mitutoyo, Japan). Two indentations were placed at 100 mm from one another in the center of all the samples. Bleaching with laser and without laser using hydrogen peroxide was performed followed by remineralization in the groups (Groups 1a and 2a) and then were subjected to erosion. The final hardness was measured using the above method used for initial microhardness. Results: Microhardness in the remineralized groups showed least variation. The group in which laser bleaching was performed along with remineralization as compared with nonlaser bleaching group with remineralization showed improvement in microhardness but the data was not statistically significant. A significant difference was noted between the laser and remineralization group when compared with the groups in which no remineralization was done. Conclusion: After bleaching the enamel surface is more prone to erosion, so to improve the microhardness of bleached enamel a remineralizing agent should be used. A combination of diode laser bleaching and remineralizing agents leads to improved microhardness of the bleached enamel thus proving this combination to be efficacious.

Comparison of single and multiple file rotary endodontic instruments for debris and irrigant extrusion: An in vitro study.

Aim: The aim of this study was to assess and compare the quantity of apically debris which was extruded apically by TruNatomy (TN), ProTaper Next (PTN), HyFlex electric discharge machining (EDM), and HyFlex controlled memory (CM), following root canal preparation. Materials and Methods: Sixty extracted single-canal mandibular premolars were used. The root canal preparation was done with TN, HyFlex EDM, PTN, or HyFlex CM files. The preweight debris, which was extruded apically, was collected in the Eppendorf tube and later on incubated at 670°C for 3 days and weighed again to record the extruded debris. Results: The result showed that there was a significant reduction in debris extrusion by TN system, followed by PTN system, HyFlex EDM, and maximum extrusion in HyFlex CM (P < 0.05). Between the PTN and TN groups as well as between the HyFlex EDM and HyFlex CM groups, statistically significant difference was not observed (P > 0.05). Conclusion: Apical debris extrusion is the inherent nature of the all file systems. Nevertheless, the TN file system produced substantially minimum debris extrusion among other systems compared in the study.

Comparative evaluation of fracture resistance among conventional versus herbal irrigants in root canal treated teeth: In vitro study.

To evaluate the efficacy of conventional irrigants and herbal extracts materials which helps to resist fracture of endodontically treated teeth. 75 maxillary human permanent incisor teeth instrumented using ProTaper rotary files till apical size(F4). Instrumented samples divided into 5 groups with n = 15 based on various irrigants used. Group I: normal saline, Group II: 5% sodium hypochlorite (NaOCl), Group III: 2% chlorohexidine, Group IV: 10% Azadirachta indica (neem extract) and Group V: 10% Ocimum sanctum (tulsi extract).After that, root canals were proceeded to be filled by using single gutta-percha cone and Sealapex sealer. Specimens were then prepared and loaded until root fracture occurred. Maximum mean flexural strength of dentin (fracture resistance) was obtained from group treated with 2% chlorohexidine and 10% neem extract. Least fracture resistance was observed with 5% NaOCl. Herbal irrigants can be used as an alternative to NaOCl as they exhibit high fracture resistance.

Comparative evaluation of effect of chlorhexidine, Azadirachta indica (neem), and Aloe barbadensis miller (Aloe vera) on resin-dentin bond stabilization using shear bond testing: An in vitro study.

INTRODUCTION: Cavity disinfectants help to remove the microbial remnants; hence, its use prior to any restoration is valuable, and a search for alternative to chlorhexidine (CHX) is required which may be more efficacious and can overcome the drawbacks of CHX. OBJECTIVE: The aim of this study was to evaluate the effect of application of three different cavity disinfectants in a clinically relevant time period on the immediate and delayed shear bond strengths (SBSs) of an etch-and-rinse adhesive system to dentin. MATERIALS AND METHODS: For SBS testing, flat coronal dentin surfaces were prepared in two hundred extracted human molars. Specimens were randomly assigned to four groups according to the disinfectant used: Group I: Control (no disinfectant), Group II: 2% CHX solution, Group III: Aloe barbadensis miller (Aloe vera) solution, and Group IV: Azadirachta indica (neem) solution. Specimens were bonded using Prime and Bond NT adhesive which was employed according to the manufacturer's instructions. Resin composite cylinder buildups were done in all the samples. The modes of failure were noted after visual examination using a binocular stereomicroscope. Samples were also analyzed under scanning electron microscope for observation of resin-dentin interface. SBS results were analyzed using one-way ANOVA followed by Tukey's post hoc test. RESULTS: The results showed that CHX, Aloe vera, and neem had improved bond strengths as compared to the control group for both immediate and delayed SBSs. CONCLUSION: From the results of the study, the authors concluded that Aloe vera and neem can be used as alternative cavity disinfectants to CHX.

Comparative evaluation of the effect of different disinfecting agents on bond strength of composite resin to dentin using two-step self-etch and etch and rinse bonding systems: An in-vitro study.

OBJECTIVE: This study was carried out to examine the effect of the application of different disinfecting agents on the shear bond strength (SBS) of an etch-and-rinse system. MATERIALS AND METHODS: A total of 120 dentin surfaces of human molars were taken. Sixty samples were taken for immediate (testing was done after 24 h) and delayed (testing was done after 6 months) each. Further, they were divided into three subgroups (n = 20) according to the disinfectant used: Group I: control (no disinfectant); Group II: chlorhexidine based; and Group III: Aloe barbadensis miller (Aloe vera) based. Dentine bonding agent was applied, and resin composite build-ups were done for SBS testing. Samples were examined under scanning electron microscope for observing the gap formation for dentin-restoration interface. SBS results were statistically analyzed. RESULTS: The results of the study showed that both chlorhexidine and aloe vera had improved bond strength as compared to the control group both for immediate and delayed SBSs. CONCLUSION: Thus, aloe vera can be used as an alternative to chlorhexidine for cavity disinfection.

Disinfection of dentinal tubules with 2% Chlorhexidine gel, Calcium hydroxide and herbal intracanal medicaments against Enterococcus faecalis: An in-vitro study.

AIM: This in vitro study was conducted to evaluate the disinfection of dentinal tubules using 2% Chlorhexidine gel, Honey, Aloe vera gel, Curcuma longa, Propolis gel and Calcium hydroxide against Enterococcus faecalis. MATERIALS AND METHOD: Two hundred and ten human mandibular first premolars were infected with Enterococcus faecalis for 21 days. Samples were divided into 7 groups. Group I- Saline (negative control), Group II- 2% Chlorhexidine gel(CHX), Group III- honey, Group IV- Aloe vera gel, Group V- 20% Curcuma longa gel, Group VI- Propolis gel and Group VII -Calcium hydroxide (CH). At the end of 1, 3 and 5 days, the antimicrobial efficacy of medicaments against E.faecalis was assessed at the depths of 200µm and 400µm. RESULTS: 2% Chlorhexidine gel was most effective followed by Propolis and Curcuma longa. CONCLUSION: 2% Chlorhexidine gel gave the best results. Among the herbal extracts Propolis and Curcuma longa hold a promising future but to implement their use as sole intracanal medicaments clinically, further in vivo and long term studies are warranted.

Evaluation of antibacterial efficacy of Chitosan, Chlorhexidine, Propolis and Sodium hypochlorite on Enterococcus faecalis biofilm : An in vitro study.

BACKGROUND: Long term successful root canal treatment requires effective debridement and disinfection of root canal system. Persistent periradicular lesions are usually associated with Enterococccus faecalis. Prompt research for natural alternatives for irrigation is mainly due to the constant increase in antibiotic resistant strains and side effects caused by synthetic drugs. Sodium hypochlorite; the gold standard for irrigation has many disadvantages. Therefore, the present study was aimed to explore newer irrigants probably be as more effective and at the same time would be less irritating to the tissues than NaOCl. MATERIAL AND METHODS: Ninety extracted human mandibular premolars were biomechanically prepared, vertically sectioned, placed in tissue culture wells exposing the root canal surface to E. faecalis to form a biofilm. At the end of 3rd week, all groups were irrigated with 3 ml of test solutions and control for 10 minutes. The samples were then scraped with a scalpel, inoculated on tryptone soy agar plates and incubated for 24 hours at 37ºC. The plates were then subjected to digital colony counter and evaluated for E. faecalisgrowth. The growth was statistically analysed by ANOVA & Post Hoc Tukey tests. RESULTS: Chitosan + Chlorhexidine, NaOCl and Chlorhexidine showed no statistically significant difference, whereas all the other inter­group differences were statistically significant (P<0.05). CONCLUSIONS: Chitosan + Chlorhexidine, Chlorhexidine and Propolis were found to be as efficacious as sodium hypochlorite. The use of natural alternatives as root canal irrigation solutions might prove to be advantageous considering several unfavorable properties of NaOCl. Key words:Antibacterial efficacy, Chitosan, Enterococcus faecalis, Root canal irrigation.

Comparative evaluation of the effect of chlorhexidine and Aloe barbadensis Miller (Aloe vera) on dentin stabilization using shear bond testing.

INTRODUCTION: The main objective of adhesive dentistry is to create an effective, durable union between the tooth structure and restorative material. However, degradation of adhesive dentine interface remains largely responsible for the relatively short lifetime of tooth colored resin restoration. AIM: The aim of the study is to compare the dentin collagen stabilization property of Chlorhexidine (CHX) and Aloe barbadensis Miller using shear bond strength testing. MATERIALS AND METHODS: Occlusal reduction was done in sixty extracted human mandibular molars to expose the mid coronal dentin and divided into three groups n = 20. Following the surface pretreatment (Group 1 = control, Group 2 = CHX, Group 3 = Aloevera), dentine bonding agent and composite resin were applied and cured. The specimens were then subjected to shear bond strength testing. RESULTS: From the results analyzed, it was noted that there was statistically significant difference between the groups Control and CHX and Control and A. barbadensis Miller (P < 0.05), specifically the values of Control < CHX and Control < A. barbadensis Miller (P < 0.05). However, there was no statistically significant difference between CHX and A. barbadensis Miller (P > 0.05). Hence, the following result for the shear bond strengths to dentin was obtained: Control < CHX ≈ A. barbadensis Miller. CONCLUSION: CHX and A. barbadensis Miller, as pretreatment agents of acid demineralized dentin collagen, has no adverse effect on the immediate shear bond strength of a two-step etch and rinse adhesive to dentin.

Endodontic Management of Maxillary First Molar with Five Root Canals, Including Two Distobuccal Root Canals: A Case Report.

Multiple canals in the root are part of the normal morphology of the tooth. A canal may sometimes be overlooked, however, and this may lead to failure of treatment. The first step in successful endodontic treatment, therefore, is gaining access to the pulp chamber and locating all the canals. In order to achieve this goal, practitioners need to be familiar with all possible variations in root canal morphology, and should thoroughly explore roots to ensure that all canals are identified, debrided, and obturated. Here, we report the diagnosis, treatment planning, and endodontic management of a maxillary first molar with five root canals, including two distobuccal root canals, in a 22-year-old woman.

Root and canal morphology of maxillary first premolar teeth in north Indian population using clearing technique: An in vitro study.

AIM: The purpose of this study was to determine the root form and canal configuration in maxillary first premolars. MATERIALS AND METHODS: A total of 250 extracted human adult maxillary first premolar teeth from North Indian population were collected. Access cavities were prepared and the coronal pulp tissue was extirpated. The samples were stored in 5% nitric acid solution for 5 days. They were then rinsed, dried, and dehydrated using increasing concentrations of ethanol (70, 80, and 95%) successively for 1 day. Teeth were rendered transparent by immersing in methyl salicylate. India ink was then injected. The root canal morphology was examined under stereomicroscope. RESULT: 53.6% were single rooted followed by fused root form followed by two root form. 0.4% had three rooted maxillary first premolar. Variable root canal configurations were also found. Type IV configuration was most prevalent (33.2%). Two teeth showed an additional configuration. Lateral canals were present in 34.8% of the samples and intercanal communications in 16%. CONCLUSION: Within the limitations of this study, it was concluded that in North Indian population, there was an increased propensity for types IV, I, II, and III canal morphologies in maxillary first premolars. Single root form was most common.

Influence of cervical preflaring using different rotary instruments on the accuracy of apical file size determination: A comparative in-vitro study.

AIM: To investigate the influence of cervical preflaring using different rotary instruments on apical file size determination. MATERIALS AND METHODS: Extracted human molar teeth were randomly divided in to eight groups (N = 10): Control group (CG); LA Axxess group (LA); HyFLex group (HF); GatesGlidden group (GG); ProTaper group (PT); Race group(RC); FlexMaster group (FM); and K3 group (K3). Patency was maintained and working length was established under magnification. All instruments were used according to manufacturer's instructions. Steriomicroscopic images were taken to determine the discrepancies in diameters. ProPlus software (USA) was used to determine the diameter of the root canal. ANOVA test and Post Hoc Tests-Bonferroni Multiple Comparisons were used for statistical analysis. RESULTS: Canals preflared with LA Axxess burs showed the best results. Control group that is, the canals with no cervical preflaring showed the maximum discrepancy between the initial apical file diameter and apical canal diameter. CONCLUSION: Cervical preflaring plays an important role in reducing the discrepancy between initial apical file diameter and apical canal diameter.

Comparison of antimicrobial efficacy of propolis, Morinda citrifolia, Azadirachta indica (Neem) and 5% sodium hypochlorite on Candida albicans biofilm formed on tooth substrate: An in-vitro study.

INTRODUCTION: Endodontic infections are polymicrobial in nature. Candida albicans is the most common fungus isolated from failed endodontic cases. The constant increase in antibiotic resistant strains and side-effects caused by synthetic drugs has prompted researchers to look for herbal alternatives such as propolis, Morinda citrifolia and Azadirachta indica (Neem) etc., since, the gold standard for irrigation, i.e., sodium hypochlorite has many disadvantages. MATERIALS AND METHODS: Extracted human mandibular premolars were biomechanically prepared, vertically sectioned, placed in tissue culture wells exposing the root canal surface to C. albicans grown on Sabouraud Dextrose Agar to form a biofilm. At the end of 2 days, all groups were treated with test solutions and control for 10 min and evaluated for Candida growth and number of colony forming units. The readings were subjected to statistical analysis using analysis of variance and post hoc Tukey tests. RESULTS: Sodium hypochlorite and propolis groups exhibited highest antimicrobial efficacy against C. albicans with no statistically significant difference. It was followed by the A. indica (Neem) group. M. citrifolia had limited antifungal action followed by the negative control group of saline. CONCLUSION: According to the results of this study, propolis can be used as an effective antifungal agent similar to that of sodium hypochlorite, although long-term in vivo studies are warranted.