Degradation of Resin Restorative Materials by Streptococcus Mutans: A Pilot Study.

OBJECTIVE: To evaluate the degradation of three resin based restorative materials by S Mutans. STUDY DESIGN: Class I cavity was prepared in extracted premolars and were randomly divided into 3 groups (Group I - Conventional composite (CC), Group II - Resin Modified GIC and Group III-Giomer). Teeth were then restored by respective restorative material and equally divided in two subgroups (Control and Experimental). Experiment subgroup samples were then incubated in 2 ml of BHI with 1:10 dilution of SM (MTCC-497) grown overnight in BHI whereas control subgroup samples were incubated in BHI without SM. The incubation solution was collected at 2,14 and 30 days interval, and the analysis for identification and quantification of Bis-HPPP was done by High performance Liquid Chromatography. RESULTS: Statistical analysis of the collected data revealed a statistically increased Bis HPPP production in the presence of SM in all the tested materials, with minimum in Resin Modified GIC and a maximum in Conventional Composite (CC). CONCLUSION: SM degrades the resin based restorative materials & among the tested materials Resin Modified GIC appears to be most Biostable.

Bacterial penetration along different root canal fillings in the presence or absence of smear layer in primary teeth.

AIMS: To study the effect of the smear layer on the penetration of bacteria along different root canal fillings and to compare the sealing ability of new endodontic material Apexit plus as compared to Zinc Oxide Eugenol (ZOE) in primary teeth. STUDY DESIGN: A total of 60 human root segments were instrumented for endodontic treatment. Half of the sample size was irrigated with normal saline and in other half 3% NaOCl, 3% H2O2 and 17% EDTA was used alternatively as irrigant during instrumentation. The roots were rinsed thoroughly with distilled water and sterilized by autoclaving for 20 min at 121 +/- 2 degrees C. Roots with and without smear layer were obturated with Apexit plus, Zinc oxide eugenol. Following storage in humid conditions at 37 degrees C for 2 days, the specimens were mounted into a bacterial leakage test model for 180 days. RESULTS: At 180 days, there is statistically significant difference with a P value of < 0.05 among all groups except ZOE-smear and -nonsmear. In the presence of smear layer Apexit plus demonstrated more leakage. No leakage was observed in ZOE groups. ZOE demonstrated better sealing ability than Apexit plus. CONCLUSIONS: Removal of smear layer helps in better resistance to bacterial penetration along Apexit plus root canal fillings but no effect is seen along ZOE root canal fillings.

Nonsurgical Treatment of Oral Mucocele With Intralesional Corticosteroid Injections: A Case Report.

Oral mucoceles are common lesions resulting from alterations in minor salivary glands due to mucus accumulation. Deleterious habits such as lip biting, sucking, or trauma from oral appliances can result in the occurrence of mucoceles. Although conventional surgical removal has been the preferred treatment option, it is associated with drawbacks, including the risk of damaging nearby ducts and the formation of satellite lesions. A 13-year-old male patient visited the department with a sessile, nodular, and exophytic lesion on the lower lip and a persistent history of traumatic lip biting. The treatment involved the administration of intralesional injections of triamcinolone acetonide at the base of the lesion. A significant reduction was noted after the first injection, with the lesion showing complete resolution within two weeks. No recurrence was observed during the six-month follow-up period. This case highlights the effectiveness of intralesional corticosteroid injections as a non-surgical treatment option for mucoceles. This treatment modality, due to its non-invasive nature, can be particularly considered as the primary treatment choice in the pediatric population, facilitating effective behavior management.

Comparative evaluation of bioactivity, fluoride release, shear bond strength, and compressive strength of conventional glass ionomer cement incorporated with three inorganic bioactive nanoparticles: An experimental analysis.

Background: Over the course of four decades, the bioactive materials have changed. They have become more specialized, more manageable, possessing superior qualities. Thus, it should be encouraged to conduct ongoing research to improve these materials even further in order to meet the growing clinical and restorative needs. Aims and Objectives: To evaluate and compare bioactivity, fluoride release, shear bond strength and compressive strength of conventional GIC incorporated with three inorganic bioactive nanoparticles. Materials and Methods: For the study, total of 160 samples were included. The samples were divided in four groups (40 samples per group) i.e. 3 wt% of forsterite (Mg2SiO4) (Group 2), wollastonite (CaSiO3) (Group 3) and niobium pentoxide (Nb2O5) (Group 4) nanoparticles incorporated into GIC (Group 1). The bioactivity (FEG-SEM and EDX analysis), fluoride release (ion-selective electrode), shear bond strength testing (UTM followed by evaluation under stereomicroscope) and the compressive strength (UTM) was checked for each group. Results: Wollastonite nanoparticles (3wt %) incorporated to GIC showed maximum increase in the apatite crystal formation,Ca and P content and highest fluoride release. Mean shear bond strength was highest in niobium pentoxide nanoparticles (3wt %) incorporated to GIC while mean compressive strength was highest in forsterite nanoparticles (3wt %) added to GIC. Conclusion: Positive results were observed which showed increase in the bioactivity alongwith enhancement of the fluoride release, shear bond strength and compressive strength but further research on these materials is warranted before its use in clinical practice.

Effect of non-thermal atmospheric pressure plasma and ErCr:YSGG LASER activation of three fluoride varnishes on surface re-mineralization of enamel: A SEM-EDX analysis.

Background: Dental remineralization is the process of transporting minerals from the surrounding environment (i.e., saliva and biofilm) into partially demineralized tooth structures. Remineralization can be induced by professional therapies such as fluoride-based treatments that have the highest level of supporting evidence. High-intensity LASER and nonthermal atmospheric pressure plasma therapy have been known to increase the resistance of enamel to demineralization by surface modification. Aim: The aim of the study was to evaluate and compare the surface remineralization of enamel using ErCr:YSGG LASER and nonthermal atmospheric pressure plasma (NTP) activation with three different fluoride varnishes. Methodology: Sixty-eight extracted premolars were used which were sectioned mesiodistally to obtain 135 specimens and artificial caries were induced on the experimental surface. They were then randomly divided into three groups (n = 45): MI Varnish (GC Japan), Vanish Varnish (3M ESPE), and Embrace Varnish (Pulpdent). After varnish application, these groups were further divided into three subgroups based on the activation therapy used. Fifteen samples from each group were treated with ErCr:YSGG LASER, 15 samples with NTP, and 15 samples were the control that did not undergo activation. After 9 days of pH cycling, the mean ion concentration of the surface calcium and phosphate ions was recorded using FEG-SEM and EDX analysis. The data were statistically analyzed. Results: One-way ANOVA and post hoc Tukey test accepting P < 0.05 were performed for comparisons between all analyses groups. Vanish Varnish showed a higher Ca/P ratio in LASER, NTP, and control subgroups, followed by MI Varnish and Embrace Varnish. ErCr:YSGG LASER therapy showed an improved Ca/P ratio in all varnishes than NTP therapy and control. Conclusion: ErCr:YSGG LASER therapy showed positive effects toward improving the Ca/P, followed by NTP therapy as compared to control in all three varnishes indicating their role in enhancing the effects of remineralization. Vanish Varnish showed a higher Ca/P ratio indicating better remineralization post activation.

Evaluation of primary tooth enamel surface morphology and microhardness after Nd:YAG laser irradiation and APF gel treatment--an in vitro study.

OBJECTIVE: Laser irradiation and fluoride has been used as a preventive tool to combat dental caries in permanent teeth, but little has been done for primary teeth which are more prone to caries. The purpose of this study was to evaluate microhardness alterations in the primary tooth enamel after Nd-YAG laser irradiation alone and combined with topical fluoride treatment either before or after Nd-YAG laser irradiation. METHOD: Ten primary molars were sectioned and assigned randomly to: control group, Nd-YAG laser irradiation, Nd-YAG lasing before APF and APF followed by Nd-YAG lasing. The groups were evaluated for microhardness. Surface morphological changes were observed using SEM. RESULTS: Statistical comparisons were performed. The control group's SEM showed a relatively smooth enamel surface and lasing group had fine cracks and porosities. In the lasing + fluoride group a homogenous confluent surface was seen. In the fluoride + lasing group an irregular contour with marked crack propagation was noted. There was a significant increase in the microhardness of the treatment groups. CONCLUSION: Nd-YAG laser irradiation and combined APF treatment of the primary tooth enamel gave morphologically hardened enamel surface which can be a protective barrier against a cariogenic attack.

Talon cusps: conservative management.

Talons cusp is an uncommon developmental dental anomaly characterized by presence of an accessory cusp like structure projecting from tooth neck towards incisal edge. This anomaly commonly affects permanent dentition than primary dentition. This article describes early diagnosis and management of two patients with talons cusp. Conservative treatment by selective grinding, followed by fluoride varnish application was done. The patients were followed up for one year without any complications. This indicates conservative means of management to be the most desirable way of managing such anomalies.

Comparative evaluation of antibacterial efficacy different bioactive smart composites: An in vitro study.

BACKGROUND: Composites are the widely used restorative materials, and over the year, newer restorative composites have been introduced to eliminate the drawbacks of previous ones. The recent advance in restorative dentistry is bioactive restorative materials. However, bacterial plaque formation on these restorations is the primary reason for secondary caries. AIMS AND OBJECTIVES: The purpose of this study was to do the comparative evaluation of bioactive restorative composites (Beautifil Flow Plus, Activa BioACTIVE, and Filtek Z250 XT as control) for their antibacterial efficacy under in vitro conditions. MATERIALS AND METHOD: Thirty material blocks were used for this evaluation. Antibacterial efficacy was checked against Streptococcus mutans and observed under confocal laser scanning microscopy. RESULTS: The results showed that Activa BioACTIVE shows maximum number of dead bacteria on the material surface compared to other groups. CONCLUSION: It can be concluded as it has maximum antibacterial efficacy among tested materials.

Apexification with MTA using internal matrix: report of 2 cases.

Calcium hydroxide (CH) has been reported to have several drawbacks when used for apexification. Mineral Trioxide Aggregate (MTA) has generated considerable interest as an alternative. Two different cases are reported using MTA for apexification. In the first case an incomplete CH barrier was used as a matrix against which MTA could be condensed. In the second case internal matrix was formed using absorbable collagen sponge and a comparable result could be achieved. Further studies are needed to develop it into a standardized method, akin to that of matrices used in class II restoration.

Comparative evaluation of calcium release of the apical plugs formed by mineral trioxide aggregate, Biodentine, and EndoSequence root repair material with and without 2% triple antibiotic powder: An in vitro study.

BACKGROUND: Apical plug formation by mineral trioxide aggregate (MTA), Biodentine, and EndoSequence root repair material (RRM) is an excellent alternative technique to the conventional apexification procedure. Several antimicrobial agents have been incorporated in MTA and Biodentine to boost their antimicrobial efficacy. Considering the polymicrobial nature of root canal infection, a combination of potent antimicrobials like triple antibiotic powder (TAP) would be needed to address the diverse flora encountered. Calcium release is the consequential factor in the clinical excellence of these cements. AIM: The aim of the study was to evaluate and compare the calcium released from the apical plugs formed by MTA, Biodentine, and EndoSequence RRM with and without incorporation of 2% TAP. METHODS: Ninety single-rooted teeth were divided into (n = 15) Group A: MTA + 2% TAP, Group B: MTA, Group C: Biodentine + 2% TAP, Group D: Biodentine, Group E: EndoSequence RRM + 2% TAP, and Group F: EndoSequence RRM to form the 4 mm apical plugs. Each sample tooth was then immersed in 10 ml of deionized water. Evaluation of calcium release was done on days 7, 15, and 30 using an atomic absorption spectrophotometer. Data were analyzed using one-way analysis of variance, post hoc test, and unpaired t-test. RESULTS: Calcium released was maximum for Group E compared to Group F (P < 0.05), maximum for Group C compared to Group D, and was maximum for Group A compared to Group B (P < 0.05) at days 7, 15 and 30. CONCLUSION: Incorporation of 2% TAP resulted in increased calcium ions released from MTA, Biodentine, and EndoSequence RRM.

Evaluation of Change in Microhardness by Application of MI Varnish on Primary Tooth Enamel, Affected by Use of Frequently Prescribed Paediatric Syrups: An In Vitro Study.

Introduction Dental erosion is considered as an irreversible progressive loss of tooth structure due to chemical dissolution by acids not of bacterial origin. Frequent intake of syrups can be an effective factor in tooth erosion when prescribed for illnesses. In the acidic environment, MI Varnish releases calcium, phosphate and fluoride from the covering layer and the teeth can be prevented from such acidic attacks from the erosive content of the syrups. Aim  To evaluate change in microhardness by application of MI Varnish on primary tooth enamel, affected by use of frequently prescribed paediatric syrups. Method  The effects of three paediatric syrups (Ibugesic Plus, Novamox, Becozinc H) and distilled water (control group) with different ingredients on primary tooth enamel were evaluated. Immersion cycles were applied three times a day for one minute. The measurements of the samples prepared were taken on 0 (baseline), third, fifthand seventh day. Microhardness was measured using a Vickers hardness tester. Then, those samples were coated with MI Varnish, and changes in microhardness were evaluated using the Vickers hardness tester after one week (14th day). The pH, titratable acidity and buffer capacity of the syrups were also evaluated. Results  There was a significant decrease in microhardness in all the syrups (p < 0.001) on days 3, 5, 7 and 14. Novamox syrup and distilled water (control group) were the least erosive on the primary tooth enamel and Becozinc H syrup being the most erosive on primary tooth enamel was seen. MI Varnish remineralized the enamel but not with any significant difference. Conclusion  In our findings, Novamox syrup showed the least erosion on primary tooth enamel compare to other syrups. Enamel microhardness was significantly reduced on all days after immersion in all syrups. Application of MI Varnish to enamel resisted erosion but was not significant. Paedodontists should be aware of the erosive potential of all the frequently prescribed syrups and stress on compliance with oral hygiene measures and application of varnishes releasing fluoride, calcium and phosphate on the tooth.

A review of tobacco cessation services for youth in the dental clinic.

Tobacco use is one of the leading preventable causes of illness and death. The most powerful predictor of adult smoking is smoking during adolescence. While general and pediatric dentists have a positive attitude regarding tobacco cessation counseling, the same is not extrapolated into practice. Several barriers to counseling in the dental clinic have been identified and research into some of these has been conducted. Evidence-based cessation programs are still in the nascent stage, but this should not hinder dental professionals from rendering these services to the child and adolescent populations. Brief interventions, self-help materials, and nicotine replacement therapy for established nicotine dependence form the mainstay of therapy. The purpose of this paper is to identify the several barriers encountered in providing cessation and discuss the current status of its implementation in the dental clinic.

Effect of lactoperoxidase system containing toothpaste on cariogenic bacteria in children with early childhood caries.

BACKGROUND AND OBJECTIVES: Lactoperoxidase system contains Lactoperoxidase, Hydrogen peroxide and Thiocyanate ions, which have inhibitory action against cariogenic oral microflora. The present study was undertaken to assess the effect of lactoperoxidase system containing toothpaste on cariogenic microflora in children with early childhood caries. METHODS: Study group included 30 children with Early Childhood Caries. 15 were considered as test group who used the test product Biotene toothpaste and other 15 as control group who used Colgate Active as control product. Salivary samples were analyzed for mutans streptococci (MS) and Lactobacilli, and for the levels of Thiocyanate ions. RESULTS: Showed significant increase in the levels of Thiocyanate ion in saliva during experimental period. Compared to the control group test group showed significant increase in the levels of thiocyanate ions during experimental and washout period, whereas the number of colonies of MS and Lactobacilli were significantly reduced in test group during experimental period. CONCLUSION: The levels of thiocyanate ions can be increased in vivo by supplementing the saliva with natural enzymes like lactoperoxidase. This increased concentration of thiocyanate will reduce the number of cariogenic microflora in children with Early Childhood Caries.

Chocolate mouth rinse: Effect on plaque accumulation and mutans streptococci counts when used by children.

BACKGROUND: Glucosyltransferases (GTF) play an important role in the adherence of bacteria to acquired pellicle. Cocoa bean husk extract (CBHE) has been shown to possess anti-glucosyltransferase and antibacterial activity. AIM: This study aimed to evaluate the effect of CBHE on plaque accumulation and mutans streptococcus count when used as a mouth rinse by children. MATERIALS AND METHODS: Scaling of the teeth of the selected children was done and the children were instructed to refrain from their routine oral hygiene practices till the morning of the fourth day; they were instead given a placebo mouth rinse for use during this period. On the fourth day, saliva was collected from each subject for microbiological analysis and plaque was disclosed and scored using the modified Quigley and Hein plaque index; later, the teeth were cleaned. After 1 week, scaling of the subjects was done and they were given CBHE mouth rinse to rinse their mouth, following the above protocol. The data was statistically analyzed using Wilcoxon's signed rank test. RESULTS: There was a 20.9% decrease in mutans streptococci counts and a 49.6% decrease in plaque scores in the CBHE group as compared to the placebo group, which was highly significant (P value Conclusion: CBHE is highly effective in reducing mutans streptococci counts and plaque deposition when used as a mouth rinse by children.

Papillon-Lefevre syndrome: Report of two cases in the same family.

Papillon-Lefevre syndrome is a very rare syndrome of autosomal recessive inheritance characterized by palmar-plantar hyperkeratosis and early onset of a severe destructive periodontitis, leading to premature loss of both primary and permanent dentitions. Various etiopathogenic factors are associated with the syndrome but a recent report has suggested that the condition is linked to mutations of the cathepsin C gene. Two cases of Papillon-Lefevre syndrome in the same family, having all of the characteristic features, are presented. An 11-year-old girl and a 9-year-old boy presented with the complaints of loose teeth. Both expressed hyperkeratosis of palms, soles, and knees. Severe generalized periodontal destruction, with mobility of teeth, was evident on intraoral examination; orthopantomograph examination showed severe generalized loss of alveolar bone in both the patients.

Progression of artificial caries in fluorotic and nonfluorotic enamel: an in vitro study.

BACKGROUND AND OBJECTIVES: Fluorosis is an important clinical and public health problem in several parts of the world. Although the relationship of fluoride level in drinking water to dental caries and dental fluorosis is known, relationship of fluorosis with the caries is not clear. This study was conducted to evaluate and compare the thickness of enamel and depth of lesion after inducing artificial caries in fluorotic and non-fluorotic teeth. METHODS: Study group included 15 fluorosis affected and 15 normal teeth. Artificial caries was induced and teeth were sectioned to 150 microns and observed under polarized light microscope to measure the enamel thickness and depth of lesion in microns. RESULTS: Statistical analyses of the measurements were made using student's unpaired t-test. Thickness of the enamel of nonfluorotic teeth was found to be significantly more when compared with the fluorotic teeth (p-value 0.0404) and depth of lesion was significantly more in fluorotic teeth when compared with the nonfluorotic teeth (p-value 0.0218). CONCLUSION: Although fluoride is acknowledged as an essential factor in the prevention of dental caries there has to be careful balance in the amount consumed to ensure that fluorosis does not occur.

A clinical trial comparing antimicrobial efficacy of "essential oil of Ocimum sanctum" with triple antibiotic paste as an intracanal medicament in primary molars.

OBJECTIVES: To evaluate the aerobic and anaerobic antimicrobial efficacy of Ocimum Sanctum (Tulsi) essential oil and compare it with that of triple antibiotic paste (TAP) by collecting microbiological samples from the root canals of primary molars. STUDY DESIGN: Forty children were selected for the study and were randomly divided into two groups of twenty each, namely, TAP group and O. sanctum group (basil). Six intracanal samples were collected for every patient, comprising of two each after access opening, irrigation and after 3 days of intracanal medicament placement. These samples were cultured in aerobic and anaerobic environment and later colony-forming units (CFUs) were counted and intragroup as well as intergroup comparison was done. RESULTS: Analysis of the results showed that there was a statistically significant reduction in CFUs after using essential oil of O. sanctum as an intracanal medicament. Saline use also leads to a statistically significant reduction in CFUs irrespective of the intracanal medicament used. TAP showed better antibiotic properties in comparison with that of O. sanctum. CONCLUSION: Antibiotic use is often associated with the adverse effects and development of resistance due to injudicious use. O. sanctum can be used in cases of long-standing infection owing to its antimicrobial efficacy and anti-inflammatory potential as an intracanal medicament in primary teeth.

An insight into diagnosis of a hidden entity: Impacted food material.

INTRODUCTION: Foreign bodies and tissue reactions to foreign materials are commonly encountered in the oral cavity. Exogenous materials causing foreign body reactions may be metallic (amalgam) or nonmetallic (suture materials, vegetable matter). Implantation of food particles in the oral tissues has been known to cause reactive lesions such as oral pulse granuloma. Implantation could be through extraction sockets, deep periodontal pockets, associated with tumor growth, interdental areas of teeth, unfilled root canals, and grossly decayed teeth. These get rapidly digested and altered by host responses. Cellulose persists as hyaline material and invokes chronic granulomatous response. This change may mimic other pathologies. MATERIALS AND METHODS: Representative specimens from commonly consumed food groups were selected, fixed in 10% neutral buffered formalin, processed, sectioned, stained with hematoxylin and eosin stain and observed under light microscope. RESULTS: Each specimen revealed unique, distinct histology of each food type. The plant materials had a characteristic appearance of rigid double cell wall while rigid regular partitions containing nutrient material were revealed in seeds and beans. Starch-contained lentils exhibited clear spaces. Following is a brief description of some of the significant histological findings of each of the specimens processed and stained. CONCLUSION: Thus, the study of histological structure of vegetables and legumes will enable their easy recognition in oral biopsy samples and help in distinguishing them from other pathologies and artifact.

Effect of antiasthmatic medication on dental disease: dental caries and periodontal disease.

The prevalence of asthma has been increasing since the 1980s. Asthma and tooth decay are the two major causes of school absenteeism. There are few studies present in the literature. The objectives of the present study were to know the severity of dental caries and periodontal problems in children before and after taking antiasthmatic medication. The present study was conducted on 105, six- to fourteen-year-old asthmatic children to determine the condition of their dental caries and their periodontal status before and after taking antiasthmatic medication, for a period of 1 year and these were matched with their controls. The results showed that salbutamol inhaler shows increased caries rate with high significance over other groups, which was followed by salbutamol tablets and beclamethasone inhaler respectively. It has been concluded that antiasthmatic medication has its effects on dental caries and periodontal disease and asthmatic patients are recommended to adopt more precautionary oral hygiene practices and keep their caries activity and periodontal health under constant check.

Comparison of antibacterial properties of two fluoride-releasing and a nonfluoride-releasing pit and fissure sealants.

Occlusal pits and fissures are the most susceptible sites for the development of dental caries and prevention is difficult in the areas of occurrence. Although only 12.5% of all the tooth surfaces are occlusal, these surfaces develop more than two-thirds of total caries experienced by children. The fate of the bacteria is of significance when they are inadvertently sealed by a dental sealant. This study aimed in examining the antibacterial properties of three commercially available sealants, viz., Teethmate-F, Helioseal-F and Helioseal. Antibacterial testing was done by disc diffusion method. Selective agars were used to grow Streptococcus mutans and Lactobacillus acidophilus, which are implicated in the pathogenesis of dental caries. Statistical analysis was carried out using student's t test. The study proved that Helioseal-F and Helioseal did not possess antibacterial properties and Teethmate-F was the only sealant that showed antibacterial properties.