Reinforced Immediate Dentin Sealing vs Conventional Immediate Dentin Sealing on Adhesive Behavior of Indirect Restorations: A Systematic Review.

AIM: The aim of this systematic review is to compare the bonding performance of indirect restoration with the reinforced immediate dentin sealing (IDS) method as opposed to the conventional IDS method. MATERIALS AND METHODS: A literature search was conducted in PubMed, Cochrane, and EBSCOHost up to January 31st 2022, accompanied by a hand search in Google Scholar. Inclusion criteria involved studies comparing conventional IDS and reinforced IDS protocol and evaluating various parameters influencing the bonding performance, such as type of indirect restoration, etching protocol, cavity design, tooth surface preparation, method of oral cavity simulation, and processing after luting. The quality of six included studies was appraised using CRIS guidelines. RESULTS: A total of 29 publications was identified, and 6 of them fulfilled the inclusion criteria. All of the included studies were in vitro studies. The predetermined data were independently extracted and evaluated by four reviewers. It was observed that most of the studies showed an improvement in bond strength with reinforced IDS when compared with conventional IDS. Also, etch-and-rinse and 2-step self-etch adhesive protocols have shown better bonding performance than universal adhesive systems. CONCLUSION: Reinforced IDS has similar or better bond strength to that of conventional IDS strategies. The need for prospective studies is highlighted. The future clinical studies for immediate dentin sealing ought to be reported in a uniform and methodological way. CLINICAL SIGNIFICANCE: Application of an additional layer of low-viscosity resin composite provides a thicker adhesive layer, prevents re-exposure of dentin during the final restoration, and allows a smoother preparation in lesser clinical chair time and eliminates any possible undercuts. Thus, reinforced IDS has shown to result in better preservation of the dentinal seal than IDS technique.

Comparative evaluation of the marginal fit of computer-aided design-computer aided manufacturing fabricated crowns from direct and indirect digital impression - A systematic review.

The accuracy of the digital impression method is responsible for fabricating crowns with adequate marginal fit which in turn determines the postendodontic prognosis. This systematic review was undertaken to identify the influence of the two digital impression techniques in producing full coverage crowns with better marginal fit. This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. A detailed search was done in electronic databases (PubMed, EBSCOhost, LILACS, Cochrane) along with hand searches of reference articles. In vivo crossover studies comparing the marginal fit of the computer-aided design-computer-aided manufacturing (CAD-CAM) fabricated crowns from direct and indirect digital impressions published from inception till July 2023 were included in this review. The quality assessment of the included articles was done based on a modified Cochrane collaboration tool for crossover studies. A total of 280 articles were identified, after duplicate removal, title and abstract screening, and full-text evaluation, 7 articles were included in this systematic review. The overall quality of evidence is moderate. The CAD-CAM crowns fabricated from direct digital impressions exhibited a better marginal fit than those crowns fabricated by indirect digital impressions. The overall quality of evidence is moderate. Further clinical studies has to be conducted for evaluating the latest technologies towards achieving the misfit of zero.

Fracture resistance of resin based and lithium disilicate endocrowns. Which is better? - A systematic review of in-vitro studies.

Objectives: The primary objective of this systematic review is to compare the fracture resistance of lithium disilicate (LDS)-based endocrowns and resin-based (RB) endocrowns of in-vitro studies, and the secondary objective is to compare their catastrophic failures. Materials and Methods: The review protocol was registered in the P ROSP ERO database (CRD42020166201). A comprehensive literature search was done in PubMed, Cochrane, EBSCOhost and Google Scholar using key terms. Only in-vitro studies that compared fracture resistance of LDS-based endocrowns and indirect RB endocrowns in molars were included. Data extraction, risk of bias assessment and qualitative analysis of the included studies were performed. Results: Five studies were included in this systematic review. The overall risk of bias for the included studies was moderate. Under axial loading, RB endocrowns showed similar fracture resistance when compared with LDS endocrowns. However, they showed better fracture resistance when compared with zirconia reinforced lithium silicate (ZLS) endocrowns. Furthermore, RB endocrowns showed fewer catastrophic failures than LDS-based endocrowns. Conclusions: RB endocrowns have similar or better fracture resistance and fewer catastrophic failures when compared to LDS-based endocrowns.

Quantification of Fusobacterium nucleatum at Depths of Root Dentinal Tubules in the Tooth Using Real-time Polymerase Chain Reaction: An In Vitro Study.

INTRODUCTION: Microorganisms have been known to cause pain and infection in the tooth. Fusobacterium nucleatum was always found predominantly in failed root canal treatments. OBJECTIVE: The aim of the present study was to quantify Fusobacterium nucleatum at the inner and peripheral half of coronal, middle and apical region of the root by using real-time polymerase chain reaction (qPCR). METHODS: Extracted maxillary incisors were taken. After shaping and cleaning, the root canals were inoculated with Fusobacterium nucleatum. Samples were taken from both the inner and peripheral halves of dentin. The inoculated teeth were maintained in anaerobic jars for two weeks, and the bacterial isolates were changed every third day. The quantification was done using qPCR. RESULTS: The cycle threshold (Ct) value in all groups showed the presence of Fusobacterium nucleatum. CONCLUSION: Fusobacterium nucleatum penetrates to the entire thickness of dentin in the middle and apical region. The coaggregation with other microorganisms could be responsible for the symptomatic endodontic patients.

Comparison of the Antibacterial Efficacy of Alexidine and Chlorhexidine Against Enterococcus Faecalis: An in Vitro Study.

Introduction Root canal irrigants play an important role in reducing intracanal microorganisms, which in turn helps in achieving a successful outcome for the root canal treatment. Objective To compare the antibacterial efficacy of alexidine and chlorhexidine against Enterococcus faecalis. Methods A total of 50 extracted single-rooted teeth were randomly divided into five groups after being infected with Enterococcus faecalis. The groups were based on irrigants used: Group I - 0.4% alexidine; Group II - 1% alexidine; Group III - 1.5% percent alexidine; Group IV - 2% alexidine; Group V - 2% chlorhexidine. Following irrigation, colony-forming units were determined from the dentinal shavings collected at 400 µm depth. Results Use of 2% alexidine reduced the bacteria effectively when compared to 0.4%, 1%, and 1.5% alexidine. A statistically significant difference was not observed between 2% alexidine and 2% chlorhexidine. Discussion Alexidine, due to its higher virulence factors for bacteria and better bacterial penetrability at 400 µm depth of dentin showed better eradication of Enterococcus faecalis in comparison to chlorhexidine. Conclusion The use of 2% alexidine against Enterococcus faecalis at 400 µm depth of dentin has efficacy comparable to chlorhexidine. Hence, alexidine can be used as an alternative irrigant for chlorhexidine during endodontic procedures.