The role of fluoride to reduce demineralization and enhance remineralization of dental hard tissue has been well documented. Different forms of fluoride solutions have been topically used in dentistry as prophylactic agents against tooth decay. In the recent past, metal fluorides, especially titanium tetrafluoride, have become popular in the fraternity of dental research due to their unique interaction with dental hard tissue. Many studies on titanium tetrafluoride, with positive and negative conclusions, have been published in many research journals. This gives the reader a plethora of inconclusive results with one study neutralizing the outcome of other, which confuses us regarding the present status of titanium tetrafluoride in the field of dentistry. This is an endeavor to organize and present the various studies of this unique compound, to provide us with a lucid overall review of its versatile potential application in dentistry, along with its fallacy/drawbacks. We have discussed its role as a cariostatic agent, pit and fissure sealant, tooth desensitizer, against dental erosion, as a root canal irrigant and others.

Aim : To compare the difference in microleakage values using conventional and new low-shrink Silorane composites using the dye penetration method. Background : With improvement in adhesive technology, problems associated with composites have been largely overcome. However, microleakage due to polymerization shrinkage still remains a challenge. New Silorane-based composites are alleged to have less than 1% polymerization shrinkage, which would potentially decrease the microleakage, and hence, resolve this longstanding issue. Materials and Methods : The teeth were randomly divided into three groups (A,B, and C). Group A was restored with conventional composite (Valux ^TM Plus), with a total-etch protocol, Group B was restored with conventional composite, with a self-etch protocol, and group C were restored with a silorane-based composite (Filtek TMP90). Thermocycling at 200 cycles between 5 and 55°C ± 2°C with a dwell time of 60 seconds was conducted. The teeth were stained with methylene blue dye and then sectioned and viewed under a dissection microscope, afer which the microleakage was evaluated. Results : The interexaminer reliability was evaluated using the kappa score, which was acceptable (61 - 78%). The total-etch group performed statistically and significantly better (P < 0.001) at the occlusal margin and was marginally and statistically significant (P = 0.05) at the gingival margin compared to the self-etch conventional and Silorane groups. Conclusions : The Silorane composite did not perform better than the conventional composites, however, it may have its uses and requires further research.

Aim : To assess the biocompatibility of two endodontic pastes based on calcium hydroxide and propolis, using two vehicles - non-fractionated Copaiba-oilresin (A) and volatile fraction of Copaiba-oilresin (B), in the connective tissue of rats. Materials and Methods : Fifteen rats had four polyethylene tubes implanted in their backs; each pair of tubes contained one of the pastes. The tube side was considered the control. After 7, 21, and 42 days, the animals were euthanized. Results : The inflammatory reaction was moderate at seven days for A and severe for B. At 21 days, it was slight for A and moderate for B; and at 42 days, it was slight for A and B. Tissue reaction ranged from slight (7 / 21 days) to no inflammation (42 days) for the control group. Statistical analysis (Kruskal-Wallis test, P < 0.01) demonstrated no significant difference between the pastes and control group (P > 0.01). Conclusion : Both pastes presented satisfactory tissue reaction in the connective tissue of rats.

Aim : Indirect pulp capping (IPC) preserves the pulp vitality by disinfecting and remineralizing remaining carious dentin. In the present study, glass ionomer (GC, FUJI VII) and silver diamine fluoride (SDF) were tested and compared to calcium hydroxide for their antimicrobial efficacy and remineralizing potential. Materials and Methods : Dentin disks prepared from 45 freshly extracted first premolars were divided into three groups (n = 15). Each disk was cut into two equal parts, in which one half formed the control. Thirty dentin samples were used for ion estimation and the other 15 for microhardness testing. Atomic absorption spectrophotometry, colorimetric and potentiometric titration analyses were performed for calcium, phosphate and fluoride ion detection, respectively. The antimicrobial efficacy was analyzed using pure culture of Streptococcus mutans and mixed flora. Results : Increase in the levels of calcium and phosphate ions was the highest in calcium hydroxide group. Both SDF and GC VII groups showed significant increase in fluoride ion levels. Samples treated with GC VII showed maximum increase in micro hardness. The highest zone of bacterial inhibition was found with SDF group. Conclusions : This in vitro study documented the remineralizing, re-hardening and antimicrobial efficacy of both SDF and GC VII and hence can act as effective IPC materials.

Aim : The aim of this study was to evaluate the cutting efficiency of rotary nickel-titanium (NiTi) instruments K3, NiTi Tee, Profile, and Quantec with taper size 04/25. Materials and Methods : The number of samples was 10 for each group (n = 10). The cutting efficiency was measured by the mass loss from each acrylic resin block after instrumentation of a simulated canal using the Crown-down technique. Results : The analysis of variance (ANOVA) showed that there was a statistically significant difference among the studied groups. The Tukey's test showed that the acrylic resin blocks prepared with instruments K3 (0.00369 ± 0.00022), NiTi Tee (0.00368 ± 0.00023), and Profile (0.00351 ± 0.00026) presented the greatest mass loss, showing no statistically significant difference among them (P < 0.05). The lowest mass loss was found in the blocks prepared with Quantec instruments (0.00311 ± 0.0003) (P < 0.05). Conclusions : It could be concluded that the K3, NiTi Tee, and Profile instruments presented a greater cutting efficiency than the Quantec instruments.

Aim : The aim of this study is to show that a change in occlusal contacting pattern of tooth has definite influence over the behavior of orofacial musculature, resulting deleterious effect on it. Keeping this in view, the electromyographic (EMG) activity of temporalis and masseter muscles in rest position of mandible, maximum clenching and chewing, was studied in total 24 subjects--14 subjects with normal occlusion and rest 10 with normal occlusion and one tooth carious which was prepared to receive an inlay with high point. This high point or occlusal interference was introduced intentionally to have a change in occlusion or "altered dentition". The subjects were all male medical volunteers with average age group of 20 years. A particular variety of chewing substance - chewing gum was used in this study. No EMG activity was detected in the rest position of mandible. In maximum clenching, balanced type of activity was seen bilaterally in normal occlusion.Whereas in changed occlusion, an unbalanced type of muscle activity was seen in temporalis muscle during maximum clenching. There was an overall decrease in activity in both the muscles during maximum clenching and during chewing. This decrease in activity was statistically significant in most of the times. A non-specific pattern of muscle activity resembling spasm in skeletal muscle -- a state of "hyperactivity" was also found during chewing in presence of occlusal interference. This spasm-like activity may cause pain in the muscles of masticatory apparatus. All these abnormal types of behavior of muscle were abolished after removal of high point and establishing the previous normal occlusion. It is therefore, for the clinicians to understand the importance of establishing occlusal equilibrium in day to day practice.

Aim : This study compares the compressive strength and microleakage of three nanofilled composites using radioactive isotope  Ca ^45. Materials and Methods : Thirty-six freshly extracted human premolars were used in this study. Standardized Class I preparation was carried out and then randomly divided into three different groups: A, B, and C with 12 teeth in each group which were restored with nanofilled composite restoration and then subjected to thermocycling. Microleakage was tested using radioactive isotope Ca ⁴⁵ . Kruskal-Wallis and Mann-Whitney tests were used to compare the microleakage scores of the three groups. For measuring the compressive strength of three nanofilled composite resin restorations, 12 specimens of each material were prepared in customized stainless steel cylindrical moulds of 6 mm Χ4 mm. The compressive test was performed using the Universal Testing Machine. The values were analyzed with ANOVA and Bonferroni's test. Results : The findings of this study indicate that the synergy has the least microleakage and highest compressive strength followed by the Grandio and Filtek Z-350. Conclusions : Introduction of nanocomposites (packable) appears to have improved the performance of both anterior and posterior restorations with regard to mechanical properties, marginal integrity, and esthetics.

Objectives : To evaluate the influence of the grain size coating and shaft angulation of ultrasonic and high-speed diamond burs on the dental cutting effectiveness. Materials and Methods : For the grain size evaluation, cavities were prepared on 40 incisors using high-speed (1092 and 1093F KG Sorensen^® ) and ultrasonic tips (8.2142 and 6.2142-CVDentus^® ). For the shaft angulation evaluation, cavities were prepared on 40 incisors using uniangulated (T1-CVDentus^® ) and biangulated (T1-A CVDentus^® ) ultrasonic tips. The cavities were bisected and examined at Χ50 magnification. The width and depth of cavities were measured by Leica QWin software. Kruskal-Wallis non-parametric test was used for analysis. Results : The grain size did not affect the cutting effectiveness, but the high-speed burs promoted deeper and wider cavities than the ultrasonic tips. The shaft angulation did not affect the cutting effectiveness; both the angulated and biangulated tips had greater cutting efficiency in dentin than in enamel. Conclusions : Ultrasonic tips promoted more conservative preparations and seemed promising for cavity preparation.

Aim : Light-emitting diode light curing units (LED LCUs) have become more popular than halogen LCUs in routine dental restorative treatment. The aim of the study was to compare the effects of two conventional halogen (Hilux Plus and VIP) and two LED (Elipar FreeLight 2 and Smart Lite) light curing units on the depth of cure and the microhardness of various esthetic restorative materials. Materials and Methods : The curing depth and microhardness of a compomer (Dyract Extra), a resin-modified glass ionomer (Vitremer), a packable composite (Sculpt It), an ormocer (Admira), a hybrid composite (Tetric Ceram), two microhybrid composites (Miris and Clearfil Photo Posterior) and, a nanofil composite (Filtek Supreme) were determined using a scraping method and a hardness tester. A total of 320 samples were prepared using the eight different materials (n = 10 samples for each subgroup). The scraping test was based on ISO 4049:2000. Vicker's microhardness testing was carried out using hardness tester (Zwick 3212). Data were analyzed using one-way analysis of variance (ANOVA), Bonferroni and the Kolmogorov-Smirnov tests. Results : Best microhardness results were obtained with the LED light curing units and Tetric EvoCeram and Filtek Supreme achieved the highest hardness values. The nanofil composite, Filtek Supreme, showed the best curing depth results in all the tested light curing systems. Conclusions : The LEDs were found to be more successful than the halogen units with respect to both curing depth and microhardness properties.

Aim and Objectives : To evaluate bone regeneration in endodontically induced periapical lesions using Hydroxyapatite, Platelet-Rich Plasma (PRP), and a combination of Hydroxyapatite and Platelet-Rich Plasma for a period of one year. Materials and Methods : Twenty systemically healthy patients of both genders between the ages 20 and 40 years were included. To qualify, the patient had to have a tooth where non-surgical root canal therapy had failed, periapical radiolucency was present, and periapical root end surgery was required. The bony defect had to be confined to the apical area, with the bone covering the entire root surface coronally, with an intact lingual cortical plate. Patients were randomly divided into four groups, with five patients each, as follows: Group I - Replacement with Hydroxyapatite, Group II - Replacement with PRP, Group III - Replacement with PRP and Hydroxyapatite, and Group IV - Control group with no substitutes. The patients were evaluated both clinically and radiographically. Results : The radiographic evaluation revealed that Group I patients showed complete bone regeneration with evidence of a trabecular pattern, at the end of one year, Group II patients showed complete bone regeneration at the end of nine months, Group III patients showed complete bone regeneration at the end of six months, and Group IV patients showed bone regeneration, which was not satisfactory even after one year. Conclusions : The PRP and Hydroxyapatite combination facilitated better and faster bone regeneration when compared to PRP alone.

Aims and Objectives : To compare tensile bond strength of an 'etch-and-rinse' bonding agent (Single bond,3M ESPE, MN, USA) with an 'all-in-one' bonding agent (iBond, Heraeus Kulzer, NY, USA) on cut and uncut enamel surfaces. The null hypothesis tested is that the 'all-in-one' bonding agent matches the 'etch-and-rinse' bonding agent in terms of tensile bond strength to enamel. Materials and Methods : Forty extracted human mandibular teeth were used for the study. Twenty teeth with intact enamel surfaces were divided into two groups of 10 teeth each. The enamel surfaces of the 20 teeth were prepared and assigned to two more groups of 10 teeth each. One group each of intact and prepared enamel surfaces were used to bond with the 'etch-and-rinse' bonding agent [Single bond (SB), 3M ESPE, MN, USA] and the other two groups one each of intact and prepared enamel surfaces were used to bond with the 'all-in-one' bonding agent [ iBond (IB), Heraeus Kulzer, NY, USA]. The tensile bond strength was measured on the universal testing machine (Unitek, 9450 PC, FIE, INDIA) at a cross head speed of 1 mm / minute. Results : The results were statistically analyzed using a one-way ANOVA and student 't' test. The values for the 'etch-and-rinse' bonding agent SB were significantly higher for both the cut and uncut surfaces, compared to the 'all-in-one' bonding agent IB (P < 0.05). The all-in-one bonding agent resulted in a higher bond strength on the cut enamel surfaces. Conclusions : Based on the results, it is advisable to use the 'etch-and-rinse system' in a clinical situation requiring bonding on enamel alone.

Aims : To determine whether the frequency and amplitude of vibration and the use of surfactant has any effect on the formation of voids on the cast surface, poured from a polyvinyl siloxane impression material, using a mechanical model vibrator. Materials and Methods : A total of 100 impressions of a master die were made using Reprosil, Type 1, Medium Viscosity, Regular body, and Dentsply Caulk. The test group was subdivided into a surfactant and non-surfactant group, 50 impressions each. The impressions were poured in a dental stone with a mechanical model vibrator that was set at a vibration frequency of 3000 cycles / minute (low) and 6000 cycles / minute (high) with the help of a knob. The resultant casts were examined with a Stereomicroscope (LABOMED CZM4) under x10 magnifications. Results : For the low and high frequencies, when surfactant and non-surfactant groups were compared, for all the amplitudes and for both the material groups, the surfactant groups resulted in fewer void formations and showed very high statistical significance (P-value = 0.001). Conclusions : The lowest mean voids were obtained for high frequency surfactant groups. Reprosil: High frequency amplitude 2 being the most prominent, produced the least mean voids (mean = 23.2000, P = 0.001, very highly significant). In comparison, the surfactant groups produced the least voids for both frequencies.

The study evaluated the compatibility of chloroform, ether, and xylene with poly(dimethyl siloxane) (PDMS) based sealer. Freshly mixed sealer was placed in 90 glass molds with 5 mm diameter and 2 mm thickness. All samples were stored in 75% relative humidity at 37ºC for 2 weeks. All the samples were divided into three groups: group A - chloroform; group B - ether, and group C - xylene and immersed in fresh solvent at room temperature. The specimens were weighed before and after immersion for each group at the end of 2, 5, and 10 min. The swelling ratio was calculated for all the groups. Intergroup comparison revealed no difference in the mean swelling ratio for 2, 5, and 10 min (P > 0.001; Tukey HSD Post Hoc). Intragroup comparison revealed significant difference in swelling ratio between 2 and 5 min for group B and group C (P < 0.001; Paired t test). Ether has the highest compatibility with PDMS-based sealer after 2 min followed by xylene after 5 min.

Introduction : Thorough disinfection of the root canal system is essential for the success of root canal therapy. Enterococcus faecalis is the most frequently found species in persistent/secondary intracanal infection associated endodontic treatment failure. The aim of this study was to evaluate the disinfection of dentinal tubules using 10% Chlorpromazine, 4% Lignocaine gel, 5% Amiloride hydrochloride in comparison with 2% chlorhexidine gel. Materials and Methods : The antibacterial efficacy of the four medicaments against Enterococcus faecalis was assessed in vitro using extracted human first and second mandibular premolar teeth at the depths of 200 ΅m and 400 ΅m. Results : The overall percentage inhibition of bacterial growth was 100% with 2% chlorhexidine gel followed by 10% chlorpromazine (88.8%), 4% lignocaine gel (76.4%) and 5% amiloride hydrochloride (71.4%). Conclusion : 2% chlorhexidine gel was most effective against E. faecalis followed by the newer non- antibiotic medicament 10% chlorpromazine when compared to the other medicaments tested.

Aims : This in vitro study compared the effects of different layering techniques on the microleakage of silorane-based resin composite using confocal laser scanning microscope. Materials and Methods : Forty caries free premolars extracted for orthodontic reasons were used. A class V cavity was prepared on the buccal surface in each of the premolars, with the gingival margin of the cavity being 1 mm above cementoenamel junction. The cavities were restored with a silorane-based resin composite (Filtek™ P90 Silorane Low Shrink Restorative, 3M ESPE) using two different layering techniques - split incremental and oblique layering technique. All samples were subjected to 1000 thermal cycles of 5°C/55°C in water with a 30 second dwell time, and after the procedure, the teeth were immersed in 0.6% aqueous rhodamine dye for 48 hours. Sectioned samples were examined under a Confocal Fluorescence Imaging Microscope (Leica TCS-SP5, DM6000-CFS) at 10Χ magnification, and microleakage scores were analyzed statistically using paired " t" test and Mann-Whitney test. Width of interface between the tooth surface and resin composite was measured using a digital scale (Snagit digital scale). Results : Microleakage was seen along the entire perimeter of restoration irrespective of the layering technique used. The microleakage score was same in both the groups. Statistical analysis of width of interface showed significant difference between the two layering techniques. The width was significantly less in split incremental technique, indicating less polymerization shrinkage. Conclusions : This in vitro study showed that the silorane-based resin composite shows microleakage irrespective of the layering technique used for class V cavities. However, this problem can be minimized significantly by using split incremental technique for restoration of class V lesions.

Context : Cryogenic methods have been used to increase the strength of metals. Aim : The aim of this study was to evaluate the effect of deep dry cryotherapy on the cyclic fatigue resistance of rotary nickel titanium instruments. Materials and Methods : Twenty K3, RaCe and Hero Shaper nickel titanium instruments, size 25, 0.06 taper, were taken for this study. Ten files were untreated (control group) and 10 files were deep dry cryogenically treated. Both the untreated and cryotreated files were subjected to cyclic fatigue evaluation. Cyclic fatigue was evaluated as the number of cycles it took for fracture of the instrument within a stainless steel shaping block of specific radius and angle of curvature. Statistical Analysis : Mean values were compared between different study groups by using one-way analysis of variance (ANOVA) with P < 0.05 considered as the level of significance. Results : The results showed a significant increase in the resistance to cyclic fatigue of deep dry cryotreated NiTi files over untreated files. Conclusions : It may thus be concluded that deep cryotherapy has improved the cyclic fatigue of NiTi rotary endodontic files.

Aim : The purpose of this study was to evaluate and compare the apical microleakage of Resilon to Thermafil, Gutta-flow and Cold lateral condensation using a dye penetration method. Materials and Methods : Sixty extracted human maxillary single rooted teeth with intact roots were selected. Decoronation was followed by canal preparation upto ISO size 50. Teeth were then randomly divided into four groups for obturation. Group I - Cold lateral condensation with AH Plus, Group II - Gutta-flow with master cone, Group III- Thermafil with AH Plus, Group IV- Resilon with Self-etch epiphany. Apical microleakage was assessed by dye penetration test under stereomicroscope. Result : The result was analyzed statistically and showed that Resilon provides a best seal. Gutta-flow exhibited maximum microleakage. All the four groups at some level or the other exhibited some percentage of microleakage. Conclusions : None of the methods showed a fluid-tight seal.

Aims and Objectives : To compare the microleakage in class II nanocomposite restorations without liner, with resin-modified glass ionomer liner and flowable composite liner. Materials and Methods : Thirty-six sound premolars extracted for orthodontic reasons were selected and randomly assigned into three groups of 12 teeth each (Group I, II and III). Class II cavities of specified dimensions were prepared with margins located in the enamel. Cavities in group I were lined with resin modified glass ionomer (GC Fuji II LC-Improved), group II were lined with flowable composite (Filtex Z350 Flowable Restorative) and no liner was placed for cavities in group III. All the teeth were restored with nanocomposite (Z 350 Universal Restorative). The teeth were immersed in 0.5% methylene blue dye, sectioned mesiodistally and observed under stereomicroscope. Results : Group III showed maximum leakage compared to group I and II which was statistically significant. Microleakage was lesser in group lined with resin-modified glass ionomer as compared to flowable composite group but not statistically significant. Conclusions : Placement of liner beneath nanocomposite restoration results in significant reduction in microleakage. Both resin-modified and flowable composite liners under nanocomposite restorations result in comparable reduction of microleakage.

Aim: To evaluate the disinfection of dentinal tubules using calcium hydroxide with propylene glycol and calcium hydroxide with iodoform in silicone oil, as compared to 2% chlorhexidine gel. Materials and Methods: The antimicrobial efficacy of the medicaments against E.faecalis and C.albicans were assessed in vitro, using a dentinal tubule model at depths of 200 μm and 400 μm in extracted single rooted teeth. Saline was taken as the negative control (Group I) Results: All three medicaments used in this study exerted antibacterial and antifungal activity. Group II (calcium hydroxide with propylene glycol) and Group IV (2% chlorhexidine gel) had the highest antimicrobial activity and the differences between their antibacterial activities were not statistically significant. Group III (calcium hydroxide with iodoform in silicone oil) and Group IV had the highest antifungal activity and the differences between their antifungal activities were not statistically significant. The inhibition of growth at 200 μm and 400 ΅m was uniform, with no statistical difference. Conclusions: Two percent chlorhexidine gel was effective against both E.faecalis and C.albicans. Calcium hydroxide with propylene glycol was the most effective intracanal medicament along with 2% chlorhexidine against E.faecalis, whereas, calcium hydroxide with iodoform in silicone oil was the most effective intracanal medicament along with 2% chlorhexidine against C.albicans.

Aim: To evaluate and compare the amount of debris and irrigant extruded quantitatively by using two hand and rotary nickel-titanium (Ni-Ti) instrumentation techniques. Materials and Methods: Eighty freshly extracted mandibular premolars having similar canal length and curvature were selected and mounted in a debris collection apparatus. After each instrument change, 1 ml of distilled water was used as an irrigant and the amount of irrigant extruded was measured using the Meyers and Montgomery method. After drying, the debris was weighed using an electronic microbalance to determine its weight. Statistical analysis used: The data was analyzed statistically to determine the mean difference between the groups. The mean weight of the dry debris and irrigant within the group and between the groups was calculated by the one-way ANOVA and multiple comparison (Dunnet D) test. Results: The step-back technique extruded a greater quantity of debris and irrigant in comparison to other hand and rotary Ni-Ti systems. Conclusions: All instrumentation techniques extrude debris and irrigant, it is prudent on the part of the clinician to select the instrumentation technique that extrudes the least amount of debris and irrigant, to prevent a flare-up phenomena.

Aim: The study aims to evaluate and compare total gap surface area formed after restoration of class II cavities with Filtek Z350 and P60 at room temperature, 37°C and 54°C. Materials and Methods: Thirty extracted maxillary and mandibular molars were taken and divided into six groups of five teeth each. Standardized class II cavities were made and were restored with Filtek Z350 and P60, both at room temperature, 37°C and 54°C. Group 1(a) was restored with Filtek Z350 at room temperature, Group 1(b) with Filtek Z350 at 37°C and Group 1(c) with Filtek Z350 at 54°C. Group 2(a) was restored with P60 at room temperature, Group 2(b) with P60 at 37°C and Group 2(c) with P60 at 54°C. After storing the samples in distilled water at room temperature for 48 hours, longitudinal sectioning was done to obtain tooth restoration interface. The interfaces were then examined under compound light microscope with digital output and analyzed using Image J analysis software. Results: The results demonstrated better adaptation and less total gap area formation at 54°C as compared to room temperature and 37°C. Conclusions: Based on the results of this study, it is suggested that use of P60 is better suited for posterior restorations at 54°C as compared to Filtek Z350 universal nanohybrid at room temperature.

The use of spiral computed tomography serves as a boon in endodontic diagnosis of complex anatomic variations. The present case demonstrates the spiral tomographic evaluation and endodontic management of a mandibular first molar with 5 canals (2 mesial and 3 distal canals), which is a very rare anatomic variant. Such anatomic variations should be taken into account in day to day endodontic practice to ensure a high degree of clinical success.

The complex anatomy of the blunderbuss root canal often poses a major challenge to accomplish adequate obturation for a biological seal. Moreover, the roll-cone, Gutta-percha obturation technique, which is routinely practiced, also results in a mismatch and failure to configure to the canal volume in the absence of an apical barrier. Hence, an attempt has been made to tailor-make a heat polymerized polymethyl methacrylate resin as an endodontic obturator, to match the canal volume, which has been ascertained by Spiral computed tomography and mathematical integration. A one-year follow-up examination has revealed that the tooth is asymptomatic, with the repair of the lesion evident radiographically.