Comparative Evaluation of Push-out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, and Two Novel Antibacterial-enhanced Mineral Trioxide Aggregates.

AIM: To evaluate the push-out bond strength of two newly modified mineral trioxide aggregates (MTAs) with conventional MTA and biodentine. MATERIALS AND METHODS: Material preparation: Two commercially available bioactive bioceramics: Group I: Mineral trioxide aggregate; Group II: Biodentine; and two newly formulated modified MTAs: Group III: Doxycycline incorporated MTA formulation; Group IV: Metronidazole incorporated MTA formulation was used in the present study. All the test materials were then carried using a plastic instrument to the desired experimental design. Teeth sample preparation: A total of 120 teeth samples were collected and divided into four groups of test materials with 30 teeth samples per group. Single-rooted permanent teeth, that is, incisors were collected and stored in saline until the study was performed. Sectioning of the teeth into 2.0 ± 0.05-mm thick slices was performed perpendicular to the long axis of the tooth. The canal space was instrumented using Gates Glidden burs to achieve a diameter of 1.5 mm. All four prepared materials were mixed and placed in the lumen of the slices and placed in an incubator at 37°C for 72 hours. Push-out test and bond failure pattern evaluation: The push-out test was performed using a universal testing machine. The slices were examined under a scanning electron microscope (SEM) at 40× magnification to determine the nature of bond failure. All the collected data were recorded and statistically analyzed. RESULTS: The mean push-out bond strength was found to be the highest for group II (37.38 ± 1.94 MPa) followed by group III (28.04 ± 2.22 MPa) and group IV (27.83 ± 1.34 MPa). The lowest mean push-out bond strength was noticed with group I (22.89 ± 2.49 MPa). This difference was found to be statistically significant (p = 0.000). Group I samples had the predominantly adhesive type of failure (86.4%), while group II samples showed the cohesive type of failure (94.2%). Both the modified MTAs (groups III and IV) primarily showed mixed types of failures. CONCLUSION: Both the antibacterial-enhanced MTAs had better pushout bond strength compared to conventional MTA but did not outperform biodentine. Hence, it could serve as a substitute for conventional MTA due to its augmented physical properties. CLINICAL SIGNIFICANCE: Carious pulp exposure and nonvital open apices pose a critical challenge to pediatric dental practitioners. In such circumstances, maintaining the vitality of pulp and faster healing would help in a better prognosis. Novel MTAs without any cytotoxic components, and enhanced antibacterial contents with augmented physical properties can help in treating such clinical conditions. How to cite this article: Merlin ARS, Ravindran V, Jeevanandan G, et al. Comparative Evaluation of Push-out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, and Two Novel Antibacterial-enhanced Mineral Trioxide Aggregates. J Contemp Dent Pract 2024;25(2):168-173.

Comparative evaluation of volumetric changes between two pediatric rotary files (Kedo-S plus, Kedo-SG blue) and manual files (hand K-files) during canal preparation of primary mandibular molars: an in-vitro nano-CT analysis.

Pediatric endodontics has become popular due to advancements in cleaning, shaping and irrigation systems, resulting in faster and effective removal of infected pulp, saving time, and creating a pathogen-free environment. The patented rotary file system, Kedo-S, designed for primary teeth, introduced a single file generation for efficient pulp therapy. However, there are currently no studies assessing canal preparation in primary mandibular molars using nano-CT (computed Tomography). To evaluate the volumetric changes of two recently introduced pediatric rotary file systems in comparison with conventional hand file systems in primary mandibular molar using an ultra-high resolution nano-CT. This in-vitro study was performed in extracted primary mandibular molar based on certain inclusion and exclusion criteria. Samples were prepared and working length was determined before the pre-operative scan using a high resolution nano-CT device (SkyScan 2214, Bruker, Kontich, Belgium). A single well-experienced pediatric dentist prepared the canals using three file systems: Kedo-S plus, Kedo-SG blue and Hand K-files. A post-operative scan was performed similar to pre-operative scan. Image reconstruction was performed with NRecon software for 3D volumetric visualization and analysis of the root canals. Kedo-SG blue file systems had the highest mean difference in the canal volume (8.85%). Hand K-files had the least difference at (1.24%) of canal volume. Kedo-S plus file system had a mean canal volume difference (6.14%) which is closer to hand K-files. Rotary file systems resulted in a significant enlargement of canals compared to hand files.

Age Determination in Children Using Camirere's Indian Specific Formula: A Radiographic Study Using Orthopantomographs.

AIM: Determination of age is a pivotal part of forensic dentistry. Since many dental age determination methods are invasive, Cameriere introduced a radiographic method where age evaluation was carried out using an orthopantomogram (OPG). An adaptation of the same formula was later formulated by Rai et al. for the Indian population. The aim of the study was to assess the age and to dictate the efficiency of the Indian version of Cameriere's formula in the Chennai subpopulation. MATERIALS AND METHODS: This study consisted of radiographs belonging to 50 individuals with an age range of 5-15 years. Radiographs were taken using the OPG and the soft copies obtained were analyzed. The variables such as seven left and right permanent mandibular teeth and the number of teeth with closed apical, and with open apical, ends of roots were examined and measured. The obtained data, after substituting in the formula was statistically analyzed using paired and unpaired t-test and Pearson's correlation coefficient test. RESULTS: On comparing dental age and chronological age, statistically significant results were obtained on both sides of the radiograph. Between genders, both sides of the radiograph showed non-significant results. On correlating the sides, the left side showed greater accuracy in age determination compared to the right side of the OPG. CONCLUSION: Age estimation using Indian-specified formula provides a near good estimate and hence can be a reliable method to measure the chronological age of the participants. CLINICAL SIGNIFICANCE: The Indian version of the Cameriere's formula can be used as a rational tool to assess the age of young children and adolescents.

Revolutionizing Pulpectomy: An Observational Overview of Multigenerational Kedo Rotary File Systems in Primary Molars.

A 4.5-year-old female child presented to the Department of Pediatric Dentistry with the chief complaints of sharp, localized pain in her lower left and right back teeth persisting for a week, indicative of irreversible pulpitis in teeth 74, 75, and 85. A single-visit pulpectomy was planned for all affected teeth, followed by full coronal restoration in two separate visits. Before the procedure, informed digital consent was taken from the parents. A topical anesthetic agent and inferior alveolar nerve block were administered for effective anesthesia. Rubber dam isolation was performed to ensure aseptic conditions, and access cavity preparation was carried out using appropriate burs. Biomechanical preparation (BMP) was performed using Kedo S Square (Kedo Dental, Chennai, India) in tooth 74, Kedo S Plus (Kedo Dental) in tooth 75, and Kedo Nano Plus (Kedo Dental) in tooth 85, with specific instrumentation techniques as per literature guidelines. The root canals were thoroughly cleaned and shaped to facilitate optimal disinfection and obturation. This case demonstrates the successful management of irreversible pulpitis in the lower primary molar using single-visit pulpectomy with Kedo single filing systems, highlighting the importance of effective BMP in pediatric endodontics.

Longitudinal Study on Dental Status, Caries Risk Assessment, and Oral Health-Related Quality of Life in 3-6-Year-Old Children Receiving Nitrous Oxide Inhalational Sedation.

Introduction Dental caries prevention in early childhood is crucial, necessitating timely assessments by dental professionals and parents. The oral health of children during their early years can significantly impact both the children themselves and their parents' quality of life. This study seeks to assess the changes in oral health-related quality of life after treatment under nitrous oxide sedation in anxious preschool children, for whom treatment otherwise is quite difficult chairside. Aim The aim of this study is to assess the association between dental caries status, risk assessment, and oral health-related quality of life (OHRQoL) in 3-6-year-old children, before and after undergoing treatment under nitrous oxide inhalation sedation. Materials and methods Eighty children were assessed for caries risk and dental status using the caries risk assessment for treatment (CRAFT) tool. Nitrous oxide sedation was employed for dental treatment, and assessments were conducted pre-treatment and post-treatment. Statistical analyses performed were paired t-tests, correlation analyses, and Chi-Square tests. Results The study revealed a mean age of 4.033 ± 0.96, with a balanced gender distribution (47.5% boys, 52.5% girls). Post-treatment, significant negative correlations were observed between OHRQoL and treatment outcomes, emphasizing improved oral health-related quality of life. Associations were found between OHRQoL, pufa index, and caries risk post-treatment. Conclusion The current research suggests that treatment done under nitrous oxide sedation could improve the OHRQoL in preschool children. Integrating risk assessment and OHRQoL enhances understanding, facilitating targeted prevention and treatment strategies. Addressing untreated dental caries is imperative for optimizing the overall well-being of children in this age group.

Evaluation of Forensic Luminol in Detection of Blood Stains in Instruments Following Dental Treatment.

Background Saliva and blood, being biological materials with a high potential for infectious transmission in dental environments, pose significant risks to dental professionals, assistants, and patients alike. Therefore, practitioners must adopt stringent security measures to ensure patient care, considering all parties as potential carriers of microorganisms capable of causing infectious diseases. Currently, various methods of disinfection and sterilization are employed to maintain the aseptic chain effectively. Having reliable methods for detecting substances in liquids, particularly body fluids, is crucial and highly convenient. Luminol, a chemiluminescent agent widely used in forensic science for detecting minute traces of blood that are invisible to the naked eye, presents itself as a valuable tool. Blood, a major bodily fluid often present in instruments following dental procedures, underscores the importance of its detection. Hence, in this study, luminol was utilized to detect blood traces in dental instruments following dental treatment, both before and after sterilization or disinfection. Objective Blood and saliva splashes, together with highly contagious aerosols, are always a part of dental procedures. The objective of the current study is to detect traces of blood stains on face shields, surgical instruments, and endodontic files using luminol before and after sterilization. Materials and methods Sample size calculation was done with G*Power software (Version 3.1.9.4, Düsseldorf, Germany), and a total of 30 instruments were selected for the study. In the present study, a total of 30 items were collected and utilized, including 14 instruments used after implant placement, 12 endodontic files employed after root canal treatment, and four face shields utilized during these procedures. Meanwhile, a freshly prepared luminol solution was applied to these instruments, and they were viewed in a dark environment both before and after sterilization procedures. Luminescence generated by luminol was observed in the instruments, indicative of the presence of blood not visible to the naked eye. Statistical analysis for both groups was done with IBM SPSS Statistics for Windows, Version 16.0 (Released 2007; SPSS Inc., Chicago, IL, USA). Intragroup comparison was done using the Friedman test, and intergroup comparison was done using the Wilcoxon signed-rank test. Results Blood stains and chemiluminescence were visualized in two out of 10 endodontic files (one #15 K-file and #20 K-files) and two out of four face shields. The intragroup comparison was done using the Friedman test, and it was found to be statistically significant (p < 0.05). Intergroup comparison was done using the Wilcoxon signed-rank test and was found to be statistically insignificant (p > 0.05). Conclusion Following sterilization and disinfection, there were no visual blood stains or chemiluminescence. Therefore, luminol was found to be effective in detecting blood stains in endodontic files, surgical instruments, and face shields, as well as in validating the sterilization and disinfection processes. Hence, sterilization in dentistry stands as a critical measure to guarantee patient safety, halt the dissemination of infections, and uphold exemplary clinical care standards.

Role of Mandibular Parameters in Gender Determination: A Systematic Review and Meta-Analysis.

Forensic anthropology and forensic medicine both have been fascinating fields that deal with mandibular characteristics and sex determination. Researchers may determine an individual's biological sex with amazing precision by examining the size, shape, and proportions of the mandible. This information is useful for anthropological studies and criminal investigations. This systematic review aims to evaluate the consistency and validity of using mandibles as a method for gender determination across different populations. A systematic search was conducted in PubMed, Web of Science, and Scopus databases. Further, a manual search was carried out to find additional studies. Mandibular parameters and other relevant data about research were extracted from the included studies. Random effects meta-analysis was carried out for four parameters. A total of nine studies were included in the systematic review out of 76 initial search results. All studies were in vitro. Nine studies were included in the qualitative analysis, whereas only seven studies were included in the meta-analysis. A total of 2385 individuals (1193 male and 1192 female) were evaluated in the included studies. The parameters assessed were as follows: minimum ramus breadth (MiRB), maximum ramus breadth (MaRB), projective ramus height (PRH), bigonial width (BGW), gonial angle (GA), and antegonial angle (AGA). Meta-analysis was conducted for four parameters out of six. For the two parameters, meta-analysis was not conducted as only one study was evaluated. Meta-analyses of PRH obtained a high degree of heterogeneity (99%), mean difference (MD) of 4.06 mm, and p-value of p=0.09. Meta-analysis of BGW obtained 93% heterogeneity, MD of 9.03 mm, and p=0.0007. Meta-analysis of GA showed 99% heterogeneity, MD of 3.44 mm, and p=0.66. Meta-analysis of AGA obtained a low heterogeneity of 30%, MD of -0.77 mm, and p=0.23. The parameter, BGW, can be considered a useful tool in identifying sex. The parameters, PRH, GA, and AGA, cannot be preferred as a reliable tool in identifying the sex of an individual in forensic contexts.

Gonial Angle in Forensic Anthropology to Determine Age and Gender: A Population-Specific Analysis.

Background The study highlights the gonial angle as a key craniofacial landmark for age and gender determination in forensic cases. It emphasizes population-specific analysis, enhancing precision by recognizing variations between populations. By clarifying the gonial angle's forensic use, the study offers clear guidelines, improving forensic practices. Moreover, the gonial angle and age and gender correlations are thoroughly examined, offering important information on their forensic relevance. The results highlight how crucial population-specific research is to improving the precision and dependability of forensic age and gender estimation techniques, which advances forensic anthropology and supports forensic investigations around the globe. Aim and objective The purpose of this study is to assess the accuracy of age and gender estimates using gonial angles. The objectives of this research are to evaluate the precision of age and gender estimates utilizing the gonial angle. Materials and methods This present study comprises two groups based on age groups: Group I belongs to 51 to 60 years of age, and Group II belongs to 61 to 70 years of age. Making use of G-Power software (version 3.1.9.4, Düsseldorf, Germany), the sample size was determined. The calculation ensured 95% statistical power at a significance level (alpha error probability) of 0.05. To achieve sufficient statistical power, a total of 1000 samples were included, with a projected required sample size of 92. A total of 1000 samples, consisting of 500 male and 500 female panoramic radiographs, were meticulously selected for the study. The samples picked were within the age range of 51 to 70 years. Orthopantomograms were determined using Planmeca software (Planmeca Romexis®, Version 6.0, USA Inc.). Descriptive statistics, including prediction classification analysis of age and gender, were conducted using SPSS Statistics version 16.0 (SPSS Inc., Released 2007, SPSS for Windows, Version 16.0, Chicago, SPSS Inc.). Results According to this study, the mean gonial angle of males aged 51 to 60 years is larger (124.7370 degrees) than that of females (119.6371 degrees). The female group's mean estimates are more accurate, as seen by the smaller standard error (0.20844) compared to the male group's (0.60998). A statistically significant difference in mean gonial angles between the genders is evident, with males having a larger gonial angle (p-value <0.001). In the age range of 61 to 70 years, the mean gonial angle of females is higher (128.4322 degrees) than that of males (124.0529 degrees). In this instance, the male group's standard error is smaller (0.14968) than the female group's (0.30028), indicating more accurate mean estimates. Once more, a statistically significant difference is indicated by a p-value of less than 0.001, with females having a larger gonial angle than males. Conclusion Our study revealed that the gonial angle of the mandible can be considered a reliable parameter for gender identification. The study's limitation is its inability to reliably identify gender in the subadult population and in cases of edentulousness. An orthopantomogram is a trustworthy and accurate method for taking the different measurements needed to identify the gender of a particular mandible.

Gender Determination Through Mandibular Features on Orthopantomograms: A Preliminary Study.

Introduction Determination of gender can be highly accurate with a complete adult skeleton, but in scenarios like mass disasters, only fragmented bones might be available. In such cases, identifying gender relies significantly on which parts of the skeleton are found. The mandible is a notably distinct bone in the skull and can be key in determining gender, especially when the entire skull is not available. The mandibular features provide clues that can help forensic experts determine the gender of an individual. Aim of the study This preliminary study aimed to determine the gender of an individual using mandibular parameters such as coronoid ramus height, condylar ramus height, projective ramus, minimum ramus breadth, and maximum ramus breadth. The objectives of this study were to (i) determine the gender of an individual using various mandibular parameters, (ii) evaluate the effectiveness of these mandibular parameters in distinguishing between male and female individuals, and (iii) establish a reliable method for gender identification based on the measured mandibular parameters. Materials and methods Since it was a preliminary study, the sample size calculation was done using G*Power software (Version 3.1.9.4; Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany). The sample size was determined to guarantee a 95% statistical power at a significance level (alpha error probability) of 0.05. To ensure sufficient statistical power, a total of 100 samples were included, with a projected sample size of 92. A total of 100 samples, evenly split between 50 males and 50 females aged 20 to 30 years, were analyzed. Orthopantomograms (OPGs) showing pathologies, fractures, developmental disturbances of the mandible, and edentulous mandibles were excluded from the study. Statistical analysis was performed using SPSS for Windows, Version 16.0 (Released 2007; SPSS Inc., Chicago, IL, USA). Additionally, an accuracy test, analysis of variance (ANOVA), multiple regression, and discriminant analysis for gender were performed on individual data. Results In this study, five mandibular parameters were analyzed for gender such as coronoid ramus height, condylar ramus height, projective ramus, minimum ramus breadth, and maximum ramus breadth showed a positive correlation comparatively, and a novel formula was developed.  Conclusion According to the present study, panoramic radiography can be considered a valuable tool in sex determination (with an accuracy of 90%), and all parameters of the mandible exhibited sexual dimorphism, showing they are reliable parameters with a total accuracy of 90%. However, coronoid ramus height, projective ramus, and maximum ramus breadth played a significant role in identifying gender in this particular study.

Forensic Gender Prediction by Using Mandibular Morphometric Indices: A Panoramic Radiograph Study.

Aim and objective This study aims to assess the accuracy of gender estimation using gonial and antegonial angles and determine the gender of the given samples using gonial and antegonial angles. Introduction An essential component of the human skull, the mandible, exhibits sexual dimorphism, making it a valuable tool in forensic and anthropological investigations for detecting sex. This procedure can be especially difficult in situations where there are large numbers of casualties, natural disasters, or widely dispersed remains. The mandible is an accurate indicator of age and sex because it responds to patterns of growth. Sex determination through the gonial angle and antegonial angle involves analyzing the angles formed by the lower jaw bone in individuals. Examining these angles contributed to remarkable accuracy. Materials and methods A total of 500 samples, 250 male and 250 female panoramic radiographs, were carefully chosen for the study. The chosen samples ranged in age from 20 to 30 years. Orthophantomograms were measured in Planmeca software (Planmeca Romexis®, Version 6.0, USA INC.) and the descriptive statistics (paired t-test) were performed in SPSS Statistics version 16.0 (SPSS Inc. Released 2007. SPSS for Windows, Version 16.0. Chicago, SPSS Inc.). Results Gonial angle for males obtained the highest value of 127.27±5.29, followed by females at 127.08±5.18. This was followed by the antegonial angle for males of 10.74±3.14, and the least value was obtained by females of 10.67±3.30. The p-value for the gonial angle showed no statistical significance for males or females (p=0.679). Antegonial angle showed statistical significance in both males (p=0.008) and females (p=0.001). Conclusion Among both the parameters considered, the antegonial angle showed significance in determining the gender of the given samples. Hence, to assess the accuracy of gender estimation, the antegonial angle can be used as a parameter.

Evaluation of Sexual Dimorphism Using Condylar and Coronoid Mandibular Parameters in Orthopantomograms: A Pilot Study.

Background Gender determination is critical to forensic science and medico-legal applications. Given that it is the most dimorphic bone in the skull and is frequently found intact, the mandibular bone may be extremely important in determining gender. Orthopantomograms (OPGs) are quite helpful in accurately estimating age and sex in this regard. It is a laborious task for forensics to determine the gender of victims of mass casualties, natural disasters, and severely dismembered bodies. The mandible, which is susceptible to development spurts, has a high degree of accuracy for determining sex. Aim  This study aims to evaluate the potential use of coronoid height and condylar height as reliable anatomical markers for determining gender. Materials and methods In this study, 100 samples were used as study samples, 50 of which were male and 50 of which were female, in the age group of 20-30 years. The OPGs were obtained using a Planmeca Promax Scara 3 Digital OPG Machine (Planmeca, Helsinki, Finland), with settings of 70 kVp, 8 mA for 0.9 seconds, ensuring a 1:1 ratio. The images were then transferred to Planmeca Romexis® Viewer Software, Version 6.0 (Planmeca Oy, Helsinki, Finland) for measurement recording. Results Descriptive statistical analysis was done for this study and discriminant analysis was also done to create a population-specific formula. Results showed that the standard mean error for males concerning condylar height was 2.3 and coronoid height was 0.7. The standard mean error for females by condylar height was 1.6 and coronoid height was 0.6. The p-value was significant for coronoid height in both males and females. The p-value was not clinically significant for condylar height in both males and females. Conclusion The study's findings indicate that a larger mandibular angle is advantageous for gender assessment and helps with gender dimorphism. Out of both the parameters evaluated, coronoid height has shown statistical significance in both males and females. Hence, the study concludes that the parameter, coronoid height can be utilized to assess the gender of an individual.

Quantifying Sexual Dimorphism by Analyzing Ramus Flexure and Bigonial Width in Orthopantomography.

Introduction The mandible constitutes one of the skull's largest and strongest bones. Growth spurts can influence it, and it has a variety of dimorphic traits that can be used to identify sex. In addition to observing, comparing, and evaluating the potential for mandibular ramus flexure and bigonial breadth to discriminate between sexes using digital orthopantomograms (OPG), a retrospective study was conducted to examine the validity of this method for sex estimation in the Indian population. Aim and objective This study aims to quantify sexual dimorphism by analyzing two mandibular parameters, the ramus flexure and the bigonial width, using orthopantomography (OPG). The objective is to determine the accuracy of sex determination using the ramus flexure and bigonial width. Materials and methods A total of 500 OPG images (250 males and 250 females) were analyzed using the Planmeca software (Helsinki, Finland). The ramus flexure was measured as the angle formed between the tangent to the inferior border of the mandible and the tangent to the posterior border of the ramus. The bigonial width was measured as the distance between the left and right gonion points. A statistical analysis was performed to assess sexual dimorphism and determine the accuracy of sex determination using these parameters. The study employed descriptive statistics, such as means and standard deviations, and an independent t-test to determine the significance of the characteristics in relation to males and females. Results The mean bigonial width for females was 193.3068 mm (SD = 13.51669 mm) and for males was 217.6308 mm (SD = 10.87453 mm), with a statistically significant difference (p = 0.000). The 95% confidence interval for the difference in the bigonial width between males and females was between -49.97173 mm and -43.93787 mm. For the ramus flexure, the mean was 0.0000 for both males and females (SD = 0.00000), with a significant difference between males and females (p = 0.003). The 95% confidence interval for the difference in the ramus flexure between males and females was between -0.59543 and -0.12457. Conclusion The results indicated significant sexual dimorphism in both the ramus flexure and bigonial width. This study demonstrated that the ramus flexure and bigonial width, measured using orthopantomography (OPG), exhibited significant sexual dimorphism. The analysis of these mandibular parameters provided valuable information for sex determination in forensic and anthropological contexts.

Analyzing Mandibular Characteristics for Age and Gender Variation Through Digital Radiographic Techniques: A Retrospective Study.

Background Forensic odontology has emerged as a crucial method for identifying skeletal or dental remains. Due to the restricted accuracy of current techniques for estimating age at death, researchers have endeavored to illustrate age-related alterations in dental hard tissues. Bone remodeling constitutes an ongoing and intricate process throughout our lifespan. It is believed that morphological changes in the mandible during an individual's lifetime are influenced by both dental condition and the individual's age. Objectives This study aims to evaluate the efficacy of mandibular parameters such as projective ramus height (PRH), maximum ramus breadth (MaRB), bigonial width (BGW), antegonial depth (Ant.D), and antegonial angle (Ant.A), as a gender-determining tool and compare and analyze the mandibular parameter measurements using digital orthopantomography. Methodology In this study, the total number of samples used was 500 out of which 250 were males and 250 were females. Planmeca software (Version 6.0, Planmeca Romexis, Charlotte, NC) was used and the accuracy test, analysis of variance (ANOVA), multiple regression, and discriminant analysis for gender were performed using SPSS for Windows, Version 16.0 (SPSS Inc., Chicago, IL). Results For age estimation, the least standard error of 0.008 was observed for BGW. A maximum standard error of 0.230 was observed for Ant.D. For sex determination, the coefficient function was positive for PRH, BGW, and Ant.A, with values of 0.202, 0.805, and 0.052, respectively. Ant.D and MaRB both exhibited negative values of -0.204 and -0.379, respectively.  Conclusions Out of all the parameters assessed, BGW is the most preferred parameter for age estimation and Ant.A can be preferred for sex estimation. Age and gender can be estimated using the two parameters in the Indian population.

Comparative Evaluation of Wear Strength and Compressive Strength of Two Pit and Fissure Sealants with a Nanofilled Resin Coating: An In Vitro Study.

Introduction: The role of sealants for pits and fissures has been emphasized in caries prevention. Considering the advantages of a surface sealer and the effects of its application over restorative materials; the study is aimed at evaluating two pit and fissure sealants with a nanofilled resin coating. Materials and methods: In this in vitro double-blinded study, a total of 60 caries-free extracted third molars were collected and divided into two groups of 30 each receiving either a resin-based sealant (Helioseal F) or a glass ionomer-based sealant (GC Fuji VII). Each sample was then applied with GCoat Plus surface sealer. 15 samples each containing GC Fuji VII and 15 containing Helioseal F were then subjected to wear. Another 15 samples of GC Fuji VII and 15 of Helioseal F were subjected to compressive load. Results: On assessing the wear strength, the weight loss in group I (resin sealant with surface sealer) was 1.73 ± 0.50 (µg) which was statistically significant (p = 0.023). There was no significant difference in comparing the wear depth between both groups. There was a high statistically significant difference when assessing the compressive strength, group II (glass ionomer sealant with surface sealer) had 3566.4 ± 757 (µm) when compared to group I (resin sealant with surface sealer) 1568.53 ± 680 (p ≤ 0.01). Conclusion: Sealants are known for their poor retention and keeping that in mind we designed this study to evaluate the physical properties of sealants with a resin coating over them. Within the limitations of this study, the conclusions are glass ionomer sealant showed greater resistance to wear when compared to the resin-based sealant and the resin-based sealant showed higher compressive strength values than the glass ionomer sealant. How to cite this article: Gunasekaran R, Sharmin D, Baghkomeh PN, et al. Comparative Evaluation of Wear Strength and Compressive Strength of Two Pit and Fissure Sealants with a Nanofilled Resin Coating: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(1):31-35.

Comparative Evaluation of Push-Out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, a Modified Mineral Trioxide Aggregate, and Two Novel Antibacterial-Enhanced Mineral Trioxide Aggregates.

Background The challenges associated with incorporating antimicrobial agents, such as the potential diminishment of the cement's physical properties, highlight the need for comprehensive evaluations. Balancing antimicrobial efficacy with the maintenance of structural integrity is a crucial aspect of material development. The acknowledgment of cytotoxic properties associated with tricalcium aluminate, a major constituent in conventional mineral trioxide aggregate (MTA), is critical in terms of long-term evaluation of treatment procedures. The primary focus of the push-out test is to evaluate the resistance of the tested material to dislodgement. Greater push-out strength implies stronger adhesion between the tested material and the tooth surface. Aim This study aims to evaluate the push-out bond strength of two antibacterial-enhanced MTAs with conventional MTA and Biodentine. Material and methods A total of five materials were tested: a) modified MTA, b) doxycycline-enhanced MTA, c) metronidazole-enhanced MTA, d) conventional MTA, and e) Biodentine. All the materials were mixed based on a predetermined powder:liquid ratio and then carried using a plastic instrument to the desired experimental design. Single-rooted permanent teeth, preferably incisors, were used in the present study. Teeth were embedded vertically in a rubber mold, and sectioning of the tooth was performed. A single operator instrumented the canal space in each slice using Gates-Glidden burs, and the mixed cements were placed in the respective groups and stored for 72 hours. A push-out test was carried out using a universal testing machine. Following the bond failure, the slices were examined under a stereomicroscope to determine the nature of the bond failure. The collected data was subjected to a one-way analysis of variance test, post hoc test, and chi-square test for statistical analysis. Results The mean push-out bond strength was found to be the highest for Biodentine (43.25 ± 0.62 megapascals (MPa)), followed by doxycycline- and metronidazole-enhanced MTAs (39.54 ± 0.65 MPa and 39.29 ± 0.16 MPa, respectively), modified MTA formulation (37.75 ± 0.73 MPa), and the lowest for conventional MTA (25.93 ± 0.7 MPa). Conventional MTA samples had an adhesive failure (89.4%), while Biodentine samples had a cohesive failure (80.3%). Mixed failures were noticed with the samples containing modified MTA formulation (71.3%), doxycycline-enhanced MTA (76.6%), and metronidazole-enhanced MTA (78.0%). Conclusion Despite not surpassing Biodentine in bond strength, antibacterial-enhanced MTAs are considered potential alternatives to conventional MTA in day-to-day clinical practice.

Exploring Age and Gender Identification Through Mandibular Parameters Using Orthopantomography: An Observational Study.

Aim This study aims to examine five mandibular parameters: coronoid ramus height, condylar ramus height, projective ramus height, minimum ramus breadth, and gonial angle, using orthopantomography (OPG). Introduction The mandible, a crucial part of the human skull, demonstrates sexual dimorphism, which makes it an important tool for determining sex in forensic and anthropological investigations. Its form and structure are relatively resistant to significant changes after death. Among all skeletal components, the mandible stands out as a primary indicator of sexual differences. In forensic investigations, establishing the age and sex of an individual is considered a crucial initial step. This process can be particularly challenging in scenarios involving mass casualties, natural calamities, or extensively fragmented remains. Due to its responsiveness to growth patterns, the mandible is adept at accurately determining both age and sex. Materials and methods This study employed a sample size of 500 individuals, split equally between males and females, with 250 participants each. The age bracket chosen for this cohort ranged from 20 to 30 years, considering that bone growth characteristics within this range can assist in sex determination. The height of the mandibular ramus was assessed using Planmeca software, and subsequent data analysis was conducted using SPSS. Results When estimating age, the condylar ramus height exhibited the smallest standard error (0.010), whereas the maximum standard error for the gonial angle was 0.028. Positive t values were observed for the gonial angle (1.182), minimum ramus breadth (0.114), and coronoid ramus height (0.733). In terms of determining sex, the gonial angle, coronoid ramus height, and projective ramus height demonstrated positive coefficient functions, specifically 0.676, 0.090, and 0.286, respectively. Conversely, both the minimum ramus breadth and the condylar ramus height displayed negative values of -0.385 and -0.126, respectively. Conclusion Among the parameters evaluated, condylar ramus height emerges as the most suitable choice for estimating age, while gonial angle, coronoid ramus height, and projective ramus height are preferable for determining sex.

Histologic Assessment of a Fast-Set Mineral Trioxide Aggregate (MTA) and Two Novel Antibacterial-Enhanced Fast-Set MTAs for Apexification and Periapical Healing of Teeth With Incomplete Root Formation in a Rat Model: An In Vivo Animal Study.

Background Pulp necrosis in incomplete root formation halts dentine development, resulting in larger canals with fragile walls and an open apex, complicating canal instrumentation and apical stop formation. Bioactive endodontic cements such as mineral trioxide aggregate (MTA) are crucial for creating artificial apical barriers or inducing apical foramen closure, but challenges remain regarding their antimicrobial efficacy and cytotoxicity. Modifications to MTA formulations aim to address these concerns. Methods This in vivo animal study involved 80 Wistar albino rats, with incomplete root formation induced by pulp exposure. Rats were divided into four groups receiving different MTA formulations for apexification: conventional MTA, modified MTA, and MTA enhanced with metronidazole or doxycycline. Histopathological evaluations were conducted at seven and 28 days post-treatment to assess calcific barrier formation, inflammatory reactions, and antimicrobial efficacy. Results By day 7, modified MTA formulations exhibited enhanced antibacterial activity compared to conventional MTA (p = 0.000), with fewer inflammatory reactions and microorganisms. By day 28, modified formulations showed superior calcific barrier formation, particularly in the metronidazole- and doxycycline-enhanced groups compared to conventional MTA (p = 0.000). These outcomes suggest that modifications to MTA formulations improve antimicrobial efficacy and calcific barrier formation in vivo. Conclusion Novel modified MTA formulations, particularly those enhanced with metronidazole or doxycycline, exhibit superior antibacterial efficacy and calcific barrier formation compared to conventional MTA. Further long-term studies are warranted to validate these findings for potential clinical translation.

Comparative Evaluation of the Physical and Antimicrobial Properties of Mineral Trioxide Aggregate, Biodentine, and a Modified Fast-Setting Mineral Trioxide Aggregate Without Tricalcium Aluminate: An In Vitro Study.

Background Tricalcium aluminate, one of the major constituents of mineral trioxide aggregate (MTA), has been shown to have cytotoxic properties. Mineral trioxide aggregate has moderate to low antimicrobial activity against the most common endodontic pathogen, Enterococcus faecalis. Aim To assess the physical and antimicrobial properties of a newly modified formulation of mineral trioxide aggregate. Materials & methods The final setting time, compressive strength, and antimicrobial properties were tested for three groups of materials. The material used for Group 1 was mineral trioxide aggregate (white MTA, Angelus, Londrina, Brazil); the material for Group 2 was Biodentine (Septodont, Saint Maur des Fossés, France); and for Group 3, a modified MTA formulation was used. Results Group 1 had the longest setting time, and Group 2 had the shortest setting time. Group 3's material was set at 83.65 ± 0.28 minutes. This difference among the groups was statistically significant (p < 0.05). The highest mean compressive strength during all the time periods was seen in Group 2, followed by Group 3, and the least in Group 1. This difference in compressive strength was statistically significant (p=0.001). The largest zone of inhibition against Enterococcus faecalis, Candida albicans, and Streptococcus mutans was seen in Group 3, followed by Group 2 and Group 1. Conclusion Under the limitations of the present study, the newly modified MTA could serve as an alternative to the conventional MTA in terms of faster setting, higher strength, and better antimicrobial properties.

The Cytotoxic Assessment of Antibacterial-Enhanced Mineral Trioxide Aggregate Compared to Commercially Available Bioceramic Cements by Using Methyl-Thiazoldiphenyl-Tetrazolium (MTT) Assay on Human Dental Pulp Stem Cells: An In Vitro Study.

Background and objective Preserving the vitality of the tooth is of prime significance during therapies such as direct pulp capping and pulpotomy that promote tertiary dentine formation and healing of pulp stumps. Procedures like apexogenesis and apexification also stimulate dentin and bone formation for root growth and closure. Conventional mineral trioxide aggregate (MTA) has good biocompatible and physical properties like longer setting time, presence of a cytotoxic component, i.e., tricalcium aluminate (TCA), moderate compressive strength, and moderate antimicrobial activity. Eliminating TCA and the addition of antibacterial components would improve the properties of the cement. In this study, we aimed to assess the cytotoxicity of MTA Angelus, Biodentine, and two antibacterial-enhanced MTAs by using methyl-thiazoldiphenyl-tetrazolium (MTT) assay. Materials and methods Human dental pulp was extirpated from extracted third molars, and human dental pulp stem cells (HDPSCs) were isolated and characterized by flow cytometry. HDPSCs were treated with MTA, Biodentine, or two antibacterial-enhanced MTAs depending on the study group. The control group constituted the untreated HDPSCs. The cell viability of HDPSCs was assessed using an MTT assay on days one, three, and seven. Results Varied levels of cytotoxicity were noticed at different time periods assessed using the tested materials, which was statistically significant (p=0.01). At all time periods assessed, the highest cell viability was noticed with Biodentine (88.7% on the first day, 80.4% on the third day, and 91.8% on the seventh day). Antibacterial-enhanced MTAs, either added with metronidazole or doxycycline, had more mean viable cells compared to conventional MTA on the third and seventh day (p=0.043 and 0.018 respectively). Conclusion Antibacterial-enhanced MTAs showed reduced cytotoxic properties when compared to conventional MTA. Biodentine was associated with the highest cell viability at all time periods.

Comparative Evaluation of Extrusion of Apical Debris in Primary Maxillary Anterior Teeth Using Two Different Rotary Systems and Hand Files: An In Vitro Study.

Successful outcome of pulp therapy depends on good chemomechanical preparation of the canals. This is completed with the help of various upcoming rotary and hand files. However, during this preparation, there might be an apical extrusion of the debris which may result in postoperative complications. The aim of this study was to evaluate and compare the number of debris apically extruded during canal preparation using two different pediatric rotary file systems and conventional hand file systems in primary teeth. 60 primary maxillary central incisors that were extracted due to trauma or untreated dental caries with no signs of resorption were taken. Canal preparation was executed using three different file systems: Group A: Group A hand K file system, Group B Kedo S Plus, Group C Kedo SG Blue. For each of these files using the Myers and Montgomery model, the pre- and post-weight of the eppendorf tube was assessed to quantify the number of apical debris. The maximum extrusion of apical debris was noticed with the Hand K-file system. The least debris was noticed in the Kedo S Plus file system. Statistical analysis revealed that there were highly significant differences in apical extrusion and debris when comparing hand files and rotary files and also between the two rotary files used. Apical debris collection is an unavoidable outcome of canal instrumentation. Among the file systems compared, rotary files had lesser extrusion when compared to hand files. Among the rotary files, Kedo S plus showed normal extrusion compared to SG Blue.