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Table of Contents
September-October 2016
Volume 19 | Issue 5
Page Nos. 383-494
Online since Wednesday, September 7, 2016
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INVITED REVIEW
Sleep bruxism: Current knowledge and contemporary management
p. 383
Adrian U.J. Yap, Ai Ping Chua
DOI
:10.4103/0972-0707.190007
PMID
:27656052
Bruxism is defined as the repetitive jaw muscle activity characterized by the clenching or grinding of teeth. It can be categorized into awake and sleep bruxism (SB). Frequent SB occurs in about 13% of adults. The exact etiology of SB is still unknown and probably multifactorial in nature. Current literature suggests that SB is regulated centrally (pathophysiological and psychosocial factors) and not peripherally (morphological factors). Cited consequences of SB include temporomandibular disorders, headaches, tooth wear/fracture, implant, and other restoration failure. Chairside recognition of SB involves the use of subjective reports, clinical examinations, and trial oral splints. Definitive diagnosis of SB can only be achieved using electrophysiological tools. Pharmacological, psychological, and dental strategies had been employed to manage SB. There is at present, no effective treatment that “cures” or “stops” SB permanently. Management is usually directed toward tooth/restoration protection, reduction of bruxism activity, and pain relief.
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ORIGINAL RESEARCH ARTICLES
Comparative evaluation of effect of preoperative alprazolam and diclofenac potassium on the success of inferior alveolar, Vazirani-Akinosi, and Gow-Gates techniques for teeth with irreversible pulpitis: Randomized controlled trial
p. 390
Pratibha Shetkar, Ganesh Ranganath Jadhav, Priya Mittal, Saikalyan Surapaneni, Dheeraj Kalra, Mohan Sakri, A Basavaprabhu
DOI
:10.4103/0972-0707.190013
PMID
:27656053
Introduction
: In teeth with irreversible pulpitis, successful local anesthesia is hard to achieve irrespective of the amount of local anesthesia and technique used. Such cases can be managed by concoction of pre-medications like anxiolytics, analgesics and effective local anesthesia. This double-blind, placebo-controlled study was planned to evaluate the effect of oral administration of alprazolam and diclofenac potassium on the success rate of inferior alveolar nerve block (IANB), Gow-Gates (GG) and Vazirani-Akinosi (VA) techniques for the root canal treatment of mandibular molars with irreversible pulpitis.
Method
: 198 emergency patients with symptomatic irreversible pulpitis were randomly divided into three groups as – A, B and C receiving IANB, GG or V-A respectively using 2% lidocaine with 1: 100,000 epinephrine. These groups were sub-divided into sub-groups I and II as control and pre-medication groups. Patients who did not react to the stimulus made by an explorer between the canine and first premolar and showing subjective lip and tongue numbness were included in the study.
Result
: All sub-groups showed statistically significant reduction in VAS score. However sub-groups V and VI (that is GG with and without pre-medication respectively) showed best improvement in initial severe pain in mandibular molars with irreversible pulpitis. Moreover, all pre-medication sub-groups showed better pain control compared to respective control groups.
Conclusion
: It was concluded that use of pre-medications in the form of combination of anxiolytics and analgesics improves the success rate of local anesthesia in teeth with irreversible pulpitis. Use of anxiolytics eases the patient in endodontic emergencies. Also use of GG along with pre-medication is the best method for effective pain management of acute pain in irreversible pulpitis.
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Effect of apical clearing technique on the treatment outcome of teeth with asymptomatic apical periodontitis: A randomized clinical trial
p. 396
Priya Mittal, Ajay Logani, Naseem Shah, RM Pandey
DOI
:10.4103/0972-0707.190006
PMID
:27656054
Aim:
This study aims to compare the periapical healing of teeth with asymptomatic apical periodontitis treated either by conventional apical preparation (CAP) or apical clearing technique (ACT).
Materials and Methods: T
wenty subjects with bilateral nonvital similar teeth exhibiting comparable periapical index (PAI) score were enrolled and randomly allocated. Group I (CAP,
n
= 20): Apical preparation three sizes greater (master apical file [MAF]) than the first binding file at the established working length. Group II (ACT,
n
= 20): Apical preparation three sizes greater than the MAF that was followed by dry reaming. Root canal therapy was accomplished in single-visit for all the teeth. They were pursued radiographically at 3, 6, 9 and 12 months. Pre- and post-treatment PAI scores were compared. To ascertain the proportion of healed teeth between the two groups, McNemar Chi-square test was applied.
Results:
At 3, 6, and 9 months' time interval the proportion of healed teeth for Group II (ACT) was greater in comparison to Group I (CAP) (
P
< 0.05). However, at 12 months follow-up period this difference was not significant (
P
= 0.08).
Conclusion:
ACT enhanced the healing kinetics. However, the long-term (12 months) radiographic outcome was similar for either technique.
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Comparative evaluation of the accuracy of two electronic apex locators in determining the working length in teeth with simulated apical root resorption: An
in vitro
study
p. 402
Vidya Saraswathi, Archit Kedia, Tina Puthen Purayil, Vasudev Ballal, Aakriti Saini
DOI
:10.4103/0972-0707.190002
PMID
:27656055
Introduction:
Accurate determination of working length (WL) is a critical factor for endodontic success. This is commonly achieved using an apex locator which is influenced by the presence or absence of the apical constriction. Hence, this study was done to compare the accuracy of two generations of apex locators in teeth with simulated apical root resorption.
Materials and Methods:
Forty maxillary central incisors were selected and after access preparation, were embedded in an alginate mold. On achieving partial set, teeth were removed, and a 45° oblique cut was made at the apex. The teeth were replanted and stabilized in the mold, and WL was determined using two generations of apex locators (Raypex 5 and Apex NRG XFR). Actual length of teeth (control) was determined by visual method.
Statistical Analysis:
Results were subjected to statistical analysis using the paired
t
-test.
Results:
Raypex 5 and Apex NRG was accurate for only 33.75% and 23.75% of samples, respectively. However, with ±0.5 mm acceptance limit, they showed an average accuracy of 56.2% and 57.5%, respectively. There was no significant difference in the accuracy between the two apex locators.
Conclusion:
Neither of the two apex locators were 100% accurate in determining the WL.
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Comparative evaluation of the effect of chlorhexidine and
Aloe barbadensis
Miller (
Aloe vera
) on dentin stabilization using shear bond testing
p. 406
Dakshita Joy Sinha, Natasha Jaiswal, Agrima Vasudeva, Paridhi Garg, Shashi Prabha Tyagi, Priyanka Chandra
DOI
:10.4103/0972-0707.190017
PMID
:27656056
Introduction:
The main objective of adhesive dentistry is to create an effective, durable union between the tooth structure and restorative material. However, degradation of adhesive dentine interface remains largely responsible for the relatively short lifetime of tooth colored resin restoration.
Aim:
The aim of the study is to compare the dentin collagen stabilization property of Chlorhexidine (CHX) and
Aloe barbadensis
Miller using shear bond strength testing.
Materials and Methods:
Occlusal reduction was done in sixty extracted human mandibular molars to expose the mid coronal dentin and divided into three groups
n
= 20. Following the surface pretreatment (Group 1 = control, Group 2 = CHX, Group 3 =
Aloevera
), dentine bonding agent and composite resin were applied and cured. The specimens were then subjected to shear bond strength testing.
Results:
From the results analyzed, it was noted that there was statistically significant difference between the groups Control and CHX and Control and
A. barbadensis
Miller (
P
< 0.05), specifically the values of Control < CHX and Control <
A. barbadensis
Miller (
P
< 0.05). However, there was no statistically significant difference between CHX and
A. barbadensis
Miller (
P
> 0.05). Hence, the following result for the shear bond strengths to dentin was obtained: Control < CHX ≈
A. barbadensis
Miller.
Conclusion:
CHX and
A. barbadensis
Miller, as pretreatment agents of acid demineralized dentin collagen, has no adverse effect on the immediate shear bond strength of a two-step etch and rinse adhesive to dentin.
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Effect of ProTaper and Reciproc preparation and gutta-percha cone on cold lateral compaction
p. 410
Mario Tanomaru-Filho, Daniela Vilas Boas Trindade, Larissa Torres de Almeida, Camila Galletti Espir, Idomeo Bonetti-Filho, Juliane Maria Guerreiro-Tanomaru
DOI
:10.4103/0972-0707.190015
PMID
:27656057
Context:
The effectiveness of cold lateral compaction depends on the root canal preparation and used gutta-percha cone.
Aims:
The aim of this study is to evaluate finger spreader penetration into root canals prepared with ProTaper (PT) or Reciproc (Rec) systems and filled with gutta-percha cones with different tapers.
Materials and Methods:
Twenty-four simulated root canals in resin blocks with 30° curvature were prepared up to PT F2 or Rec R25. They were divided into four experimental groups according to the master gutta-percha cone and preparation (25.02 or F2/PT, and 25.02 or R25/Rec). Cold lateral compaction was performed using a stainless steel finger spreader size B. The set cone-finger spreader-resin block was placed in a universal test machine, and a load up to 1.5 kg was applied on the finger spreader. The final distance between the finger spreader and apical preparation after load application was obtained. For comparison among the groups, data were submitted to ANOVA and Tukey's tests, with a significance level of 5%.
Results:
Greater finger spreader penetration was observed for 0.02/Rec and 0.02/PT, followed by F2/PT and R25/Rec.
Conclusion:
The use of cones associated with PT and Rec preparations does not allow the finger spreader penetration up to the apical third.
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Effect of ceramic type, thickness, and time of irradiation on degree of polymerization of dual - cure resin cement
p. 414
Rashi Bansal, Sonali Taneja, Manju Kumari
DOI
:10.4103/0972-0707.190010
PMID
:27656058
Aim
: The aim of the study is to evaluate the effect of ceramic type, thickness, and time of irradiation on degree of polymerization of dual-cure resin cement.
Materials and Methods:
Dual-cure resin cement (SoloCem) was used to prepare disk-shaped samples (0.5 mm thick × 5 mm diameter). Study group samples (
n
= 5) were light-cured for 40, 60, and 80 s through all ceramic leucite-reinforced (Cergo Kiss), lithium disilicate-reinforced (IPS e.max), and monolithic zirconia-reinforced (Ziecon) of three thicknesses (2, 3, and 4 mm). Negative control group samples were cured through metal disks and positive control samples were cured without the presence of ceramic. The degree of conversion (DC) was evaluated by Fourier transform infrared spectrometer. The recorded data were subjected to one-way analysis of variance, followed by
post hoc
analysis (Tukey HSD).
Results and Conclusion:
Greatest light transmission and DC were seen through Cergo Kiss, followed by IPS e.max Press and Ziecon, with insignificant difference between the latter two. The attenuation of light irradiance increased with increasing thickness of ceramic disks, with statistically significant values between 3 and 4 mm. Increasing time of irradiation to cure dual-cure resin cement did not always result in greater degree of polymerization.
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Effects of simplified ethanol-wet bonding technique on immediate bond strength with normal versus caries-affected dentin
p. 419
Vivek Aggarwal, Mamta Singla, Ritu Sharma, Sanjay Miglani, Saranjit Singh Bhasin
DOI
:10.4103/0972-0707.190009
PMID
:27656059
Aim:
The aim of the present study was to evaluate whether the use of simplified ethanol-wet bonding (EWB) technique improved the immediate microtensile bond strength (μTBS) between resin composite and caries-affected dentin (CAD).
Materials and Methods:
Twenty-four extracted carious human permanent molars were sectioned to expose the carious lesion. The carious dentin was excavated until CAD was exposed. The samples were divided into two groups: water-wet bonding with Adper Scotchbond Multi-Purpose and a simplified EWB (three 100% ethanol applications for 30 s each), followed by application of an experimental hydrophobic primer and restoration. The samples were vertically sectioned to produce 1 mm × 1 mm thick slabs. The normal dentin (ND) slabs and CAD slabs were identified and were subjected to μTBS evaluation. Slabs from four teeth (two from each group) were evaluated under microscope. Data were analyzed using two-way ANOVA and
post hoc
Holm–Sidak test at
P
< 0.05.
Results:
EWB improved the μTBS in ND but not in CAD group. The dentinal tubules in CAD group showed sclerotic activity with minimal or no hybrid layer.
Conclusions:
Simplified ethanol bonding does not improve the bond strength in CAD.
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Effect of diode laser and ultrasonics with and without ethylenediaminetetraacetic acid on smear layer removal from the root canals: A scanning electron microscope study
p. 424
Khalid Amin, Ajaz Masoodi, Shahnaz Nabi, Parvaiz Ahmad, Riyaz Farooq, Aamir Rashid Purra, Fayaz Ahmad Ahangar
DOI
:10.4103/0972-0707.190005
PMID
:27656060
Aim
: To evaluate the effect of diode laser and ultrasonics with and without ethylenediaminetetraacetic acid (EDTA) on the smear layer removal from root canals.
Materials and Methods
: A total of 120 mandibular premolars were decoronated to working the length of 12 mm and prepared with protaper rotary files up to size F3. Group A canals irrigated with 1 ml of 3% sodium hypochlorite (NaOCl) followed by 3 ml of 3% NaOCl. Group B canals irrigated with 1 ml of 17% EDTA followed by 3 ml of 3% NaOCl. Group C canals lased with a diode laser. Group D canals were initially irrigated with 0.8 ml of 17% EDTA the remaining 0.2 ml was used to fill the root canals, and diode laser application was done. Group E canals were irrigated with 1 ml distilled water with passive ultrasonic activation, followed by 3 ml of 3% NaOCl. Group F canals were irrigated with 1 ml EDTA with passive ultrasonic activation, followed by 3 ml of 3% NaOCl. Scanning electron microscope examination of canals was done for remaining smear layer at coronal middle and apical third levels.
Results
: Ultrasonics with EDTA had the least smear layer scores.
Conclusion:
Diode laser alone performed significantly better than ultrasonics.
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Effect of bleaching agents having a neutral pH on the surface of mineral trioxide aggregate using electron microscopy and energy dispersive X-ray microanalysis
p. 428
Nooh Kazia, Nithin Suvarna, Harish Kumar Shetty, Pradeep Kumar
DOI
:10.4103/0972-0707.190004
PMID
:27656061
Aim:
To investigate the effect of bleaching agents having a neutral pH on the surface of mineral trioxide aggregate (MTA) used as a coronal seal material for nonvital bleaching, beneath the bleaching agent, with the help of energy dispersive X-ray microanalysis and scanning electron microscopy (SEM).
Materials and Methods:
Six samples of plastic tubes filled with white MTA (Angelus white) were kept in 100% humidity for 21 days. Each sample was divided into 2 and made into 12 samples. These were then divided into three groups. Group A was exposed to Opalescence Boost 40% hydrogen peroxide (HP) (Ultradent). Group B to Opalescence 10% carbamide peroxide (Ultradent) and Group C (control group) not exposed to any bleaching agent. After recommended period of exposure to bleaching agents according to manufacturers' instructions, the samples were observed under SEM with an energy dispersive X-ray microanalysis system (JSM-6380 LA).
Results:
There were no relevant changes in color and no statistically significant surface structure changes of the MTA in both the experimental groups.
Conclusion:
The present findings suggest that even high concentration HP containing bleaching agents with neutral pH can be used on the surface of MTA without causing structural changes. The superior sealing ability of MTA and the high alkalinity would prevent cervical resorption postbleaching.
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A comparative evaluation of the increase in root canal surface area and canal transportation in curved root canals by three rotary systems: A cone-beam computed tomographic study
p. 434
Nalam NVD Prasanthi, Tanikonda Rambabu, Girija S Sajjan, K Madhu Varma, R Kalyan Satish, M Padmaja
DOI
:10.4103/0972-0707.190003
PMID
:27656062
Aim:
The aim of this study was to measure the increase in root canal surface area and canal transportation after biomechanical preparation at 1, 3, and 5 mm short of the apex with three different rotary systems in both continuous rotary and reciprocating rotary motions.
Materials and Methods:
Sixty freshly extracted human mandibular molars with mesial root canal curvatures between 20° and 30° were included in the study. Teeth were randomly distributed into three groups (
n
= 20). Biomechanical preparations were done in all the mesial canals. In Group 1, instrumentation was done with ProTaper universal rotary files, Group 2, with K3XF rotary files, and Group 3, with LSX rotary files. Each group was further subdivided into subgroups A and B (
n
= 10) where instrumentation was done by continuous rotary and reciprocating rotary techniques, respectively. Increase in root canal surface area and canal transportation was measured using the preoperative and postoperative cone-beam computed tomography scans.
Statistical Analysis :
The data were analyzed by one-way ANOVA followed by Tukey pairwise multiple comparison tests.
Results:
Increase in root canal surface area was significantly more (
P
< 0.05) in ProTaper and K3XF groups when compared to LSX group. Canal transportation was significantly more (
P
< 0.05) in ProTaper group when compared to K3XF and LSX groups. There was no significant difference (
P
> 0.05) in increase of root canal surface area and canal transportation between continuous rotary and reciprocating rotary techniques for ProTaper Universal, K3XF and LSX groups.
Conclusion:
LSX rotary system showed minimal increase of root canal surface area and minimal canal transportation when compared to ProTaper and K3XF rotary systems.
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Comparative evaluation of canal transportation, centering ability, and remaining dentin thickness between WaveOne and ProTaper rotary by using cone beam computed tomography: An
in vitro
study
p. 440
Aditi Jain, Hemant Asrani, Abhinav Chand Singhal, Taranjeet Kaur Bhatia, Vaibhav Sharma, Pragya Jaiswal
DOI
:10.4103/0972-0707.190024
PMID
:27656063
Aims:
To compare the canal transportation, centering ability, and remaining dentin thickness of WaveOne and ProTaper systems using cone beam computed tomography.
Subjects and Methods
: Forty extracted human single-rooted premolars were used in the present study. Preinstrumentation scanning of all teeth was taken; canal curvatures were calculated, and the samples were randomly divided into two groups, with twenty samples in each group; one group was instrumented with WaveOne system and the other group with ProTaper rotary system. Postinstrumentation scans were performed, and the two scans were compared to determine canal transportation, centering ability, and remaining dentin thickness at 3 mm, 6 mm, and 9 mm from the root apex.
Statistical Analysis Used:
Student's unpaired
t
-test.
Results:
Using Student's unpaired
t
-test, results were as follows: for canal transportation, Group 1 showed significant difference at 3 mm and 6 mm and insignificant difference at 9 mm while Group 2 showed insignificant difference in all the three regions. For centering ability and remaining dentin thickness, Group 1 showed insignificant difference at 3 mm and 9 mm while significant difference at 6 mm was obtained. When comparison of remaining dentin thickness was done at three levels using two groups WaveOne and ProTaper, there was no significant difference between two groups.
Conclusions:
(1) WaveOne single reciprocation file system respected better canal anatomy better than ProTaper. (2) Individually, centering ability of WaveOne was better at 3 mm, 6 mm, and 9 mm levels. (3) However, ProTaper individually was better centered at 3 mm (apical third) and 9 mm (coronal 3
rd
) levels than 6 mm level (middle third).
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Vitality of
Enterococcus faecalis
inside dentinal tubules after five root canal disinfection methods
p. 445
Niranjan Ashok Vatkar, Vivek Hegde, Sucheta Sathe
DOI
:10.4103/0972-0707.190019
PMID
:27656064
Aim:
To compare the vitality of
Enterococcus faecalis
within dentinal tubules after subjected to five root canal disinfection methods.
Materials and Methods:
Dentin blocks (
n
= 60) were colonized with
E. faecalis
. After 4 weeks of incubation, the dentin blocks were divided into one control and five test groups (
n
= 10 each). The root canals of test groups were subjected to one of the disinfection methods, namely, normal saline (NS), sodium hypochlorite (NaOCl), chlorhexidine digluconate (CHX), neodymium-doped yttrium aluminum garnet (Nd: YAG) laser, and diode laser. The effect of disinfection methods was assessed by LIVE/DEAD BacLight stain under the confocal laser scanning microscopy to determine the “zone of dead bacteria” (ZDB). Mean values were calculated for ZDB and the difference between groups was established.
Results:
Penetration of
E. faecalis
was seen to a depth of >1000 μm. Viable bacteria were detected with NS irrigation. NaOCl and CHX showed partial ZDB. When the root canals were disinfected with Nd: YAG and diode lasers, no viable bacteria were found.
Conclusion:
E. faecalis
has the ability to colonize inside dentinal tubules to a depth of >1000 μm. In contrast to conventional irrigants, both Nd: YAG and diode lasers were effective in eliminating the vitality of
E. faecalis
. NS, NaOCl, and CHX showed viable bacteria remaining in dentinal tubules.
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Cone beam computed tomographic evaluation of two access cavity designs and instrumentation on the thickness of peri-cervical dentin in mandibular anterior teeth
p. 450
Vinny Sara Varghese, John V George, Sylvia Mathew, Shruthi Nagaraja, HN Indiresha, KS Madhu
DOI
:10.4103/0972-0707.190018
PMID
:27656065
Background and Objectives:
The aim of the study was to determine the effect of two access cavity designs on the peri-cervical dentin thickness before and after instrumentation using cone beam computed tomography (CBCT).
Materials and Methods:
Sixty mandibular anterior teeth were divided into two groups of thirty teeth each: Group I: conventional access cavity preparation, where access was prepared just above the cingulum and Group II: incisal access cavity preparation, where access was prepared in proximity to the incisal edge. CBCT scans were taken preoperatively, following access cavity preparation and post instrumentation. 200 μm thick slices were obtained 4mm apical and coronal to the cemento-enamel junction. The peri-cervical dentin thickness was calculated on the facial, lingual, mesial, and distal for all the three obtained scans.
Results:
The analysis showed that access cavity preparation and instrumentation resulted in a significant loss of tooth structure in Group I on all surfaces, but in Group II, there was a significant loss of tooth structure only in the mesial, lingual, and distal surfaces (
P
< 0.05).
Conclusion:
Incisal access cavity preparation resulted in lesser loss of dentin in the peri-cervical region.
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Effect of dentin on the antimicrobial efficacy of 3% sodium hypochlorite, 2% chlorhexidine, 17% ethylenediaminetetraacetic acid, and 18% etidronic acid on
Candida albicans
: An
in vitro
study
p. 455
Rupali Karale, Kamal Maldebhai Odedra, A Srirekha, C Champa, Ashwija Shetty, S Pushpalatha, Rini Sharma
DOI
:10.4103/0972-0707.190023
PMID
:27656066
Aim
: The aim of this study was to evaluate the effect of dentin on the antimicrobial efficacy of 3% sodium hypochlorite, 2% chlorhexidine, 17% EDTA and 18% etidronic acid against
C.albicans
.
Methodology:
Dentin powder was prepared from mandibular first premolar using electrical grinder and sterilized. 3% NaOCl, 2%CHX, 17% EDTA and 18% etidronic acid were tested against
C.albicans
in the presence and absence of dentin, in eppendorf tubes. Group 1 (presence of dentin):- 100ul dentin powder + 100ul
C.albicans
suspension + 100ul irrigating solution. Group 2 (absence of dentin):- 100ul
C.albicans
suspension+ 100ul irrigating solution. Control group:- 100ul
C.albicans
suspension.+ 100ul sterile saline Suspension was thoroughly mixed, submitted for serial dilution upto10-5 after 1 min and colony forming units were counted.
Results:
In group 2 (without dentin powder), 3% NaOCl and 2% CHX showed the lowest bacterial count compared to group 1 (with dentin powder). Dentin had a significant inhibitory effect on 3% NaOCl (
P
<0.001) and 2% CHX (P<0.001). 17% EDTA showed lowest bacterial count in group 1 (with dentin powder) compared to group 2 (without dentin powder). 18% Etidronic acid showed similar bacterial counts in the both the groups. No reduction was observed in the control group.
Conclusion:
NaOCl & EDTA showed measurable antimicrobial effect even in the presence of dentin which can be promising in the reduction of
C.albicans
in root canal therapy.
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Comparison of bond strength of different endodontic sealers to root dentin: An
in vitro
push-out test
p. 461
G Vijaya Madhuri, Sujana Varri, Nagesh Bolla, Pragna Mandava, Lakshmi Swathi Akkala, Jaheer Shaik
DOI
:10.4103/0972-0707.190012
PMID
:27656067
Aim:
To compare the bond strength of four different endodontic sealers to root dentin through push-out test design.
Materials and Methods:
Forty single-rooted teeth with completely formed apices were selected. Teeth were decoronated, and working length was determined. Instrumentation and irrigation were performed. The teeth were divided into four groups based upon the sealer used. Group 1: Bioceramic sealer (Endosequence), Group 2: Mineral trioxide aggregate (MTA) based sealer (MTA Fill apex), Group 3: Epoxy resin based sealer (MM-Seal), and Group 4: Dual cure resin-based sealer (Hybrid Root Seal). Manipulation and application of the sealer was done as per the manufacturer instructions. All the teeth were obturated using 6% gutta-percha. After obturation, each tooth was prepared for push-out test with root slices of 2 mm thickness using universal testing machine.
Results:
The highest bond strength was found in Group 1 (Endosequence) (
P
< 0.05) compared to other groups. The lowest bond strength was found in Group 2 (MTA Fill apex). Statistical analysis is done by two-way ANOVA and Newman-Keuls multiple
post hoc
.
Conclusion:
The push-out bond strength of Bioceramic sealer was highest followed by resin-based sealer and lowest bond strength was observed in MTA-based sealer.
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Capacity of a hydroxyapatite–lysozyme combination against
Streptococcus mutans
for the treatment of dentinal caries
p. 465
Sérgio Luiz Pinheiro, Nathany Nunes da Rocha, Mariane de Lourdes Hernandes Martins Peres
DOI
:10.4103/0972-0707.190026
PMID
:27656068
Background:
One current strategy for the treatment of carious lesions is the use of biomaterials with antimicrobial activity.
Aims:
The aim of this study was to evaluate a combination of hydroxyapatite and lysozyme for the treatment of dentinal caries by measuring
Streptococcus mutans
counts before carious tissue sealing, and 24 h, 1 month, and 6 months after treatment.
Materials and Methods:
Forty permanent third molars were selected, and flat dentin surfaces were prepared. The teeth were exposed to a cariogenic challenge with
S. mutans
. After challenge, the dentinal caries were collected from five specimens. The remaining specimens were treated with a mixture of hydroxyapatite and lysozyme in sodium laureth sulfate and sealed with composite resin.
S. mutans
counts were obtained 24 h, 1 month, and 6 months after sealing.
Statistical Analysis:
The results were evaluated by descriptive statistics and Wilcoxon signed-rank test.
Results:
a significant reduction in
S. mutans
(CFU/mL) was observed in dentinal lesions 1 month after treatment with hydroxyapatite/lysozyme in sodium laureth sulfate (
P
= 0.0254). Comparison of
S. mutans
counts obtained 24 h, 1 month, and 6 months after treatment revealed reductions only at the 1-month time point (
P
= 0.0318).
Conclusions:
the combination of hydroxyapatite and lysozyme may be an alternative for reducing the
S. mutans
burden in dentinal caries.
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ORIGINAL ARTICLES
Overall pattern of publication in Journal of Conservative Dentistry
p. 469
Umesh Kumar Dharmani, T Premlata Devi, Sh. Priyadarshini , Ganesh Jadhav, Charan Kamal Kaur Dharmani, Bishnupati Singh, Vinay Kumar
DOI
:10.4103/0972-0707.190027
PMID
:27656069
Background:
The Journal of Conservative Dentistry (JCD) has been online since 2008.
Materials and Methods:
This paper reviews the publication in this journal over a 5-year period (2011–2015). It assesses the types of articles published, coverage of various types of subjects of endodontics, and conservative dentistry in the journal and explores the authorship patterns in the publication and citation of the journal over this period.
Results and Conclusion:
JCD has delivered broad-based, balanced coverage of endodontics and conservative dentistry between 2011 and 2015, with contributions from all over India, as well as abroad. Although a maximum number of articles were from India, the publications from other countries are also on an increase. Thus, the widespread coverage of this journal suggests that JCD has begun to represent the global face of the Indian Association of Conservative Dentistry and Endodontics.
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Effect of chitosan-ethylenediamine tetraacetic acid on
Enterococcus faecalis
dentinal biofilm and smear layer removal
p. 472
Nagarajan Geethapriya, Arunajatesan Subbiya, Kesavaram Padmavathy, Krishnan Mahalakshmi, Paramasivam Vivekanandan, Virudhachalam Ganapathy Sukumaran
DOI
:10.4103/0972-0707.190022
PMID
:27656070
Objective:
The objective of the study was to evaluate the effectiveness of chitosan and chitosan-ethylenediamine tetraacetic acid (EDTA) (3:1,1:1,1:3) in comparison with 5.2% sodium hypochlorite (NaOCl) in disinfecting
Enterococcus faecalis
biofilm on root canal dentin and in the removal of smear layer with minimal erosion.
Materials and Methods:
Seventy single-rooted extracted human mandibular premolars (
n
= 70) were selected for the study. Forty tooth samples were biomechanically prepared, vertically sectioned, and sterilized by autoclaving. The tooth sections were artificially infected with
E. faecalis
(ATCC 29212 [
n
= 35] and clinical isolate [SBEF2,
n
= 35]) to form mature dentinal biofilm
in vitro
. The tooth samples were treated with the test solutions: chitosan and chitosan-EDTA (3:1, 1:1, 1:3), and the killing time was determined. The smear layer removal ability of the test solutions (Group A: chitosan-EDTA [1:1], Group B: EDTA, Group C: control) (
n
= 10 tooth/group) was assessed.
Results:
Chitosan and chitosan-EDTA (3:1, 1:1, 1:3) exhibited antibacterial activity against both the strains of
E. faecalis
. Chitosan and chitosan-EDTA caused 3 log reduction in the viable count of the sessile cells of
E. faecalis
at 15 min while 5.2% NaOCl exhibited 99.98% inhibition at 15 min. Chitosan-EDTA (1:1) was found to be effective in removing the smear layer and showed lesser erosion than EDTA at the coronal and middle portions.
Conclusion:
Chitosan-EDTA (1:1) is a potential root canal irrigant that performs a dual role – root canal disinfection and smear layer removal.
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Centering and transportation:
in vitro
evaluation of continuous and reciprocating systems in curved root canals
p. 478
Beatriz Vilas Navós, Carolina Bender Hoppe, Leticia Boldrin Mestieri, Daiana Elizabeth Böttcher, Marcus Vinicius Reis Só, Fabiana Soares Grecca
DOI
:10.4103/0972-0707.190008
PMID
:27656071
Context:
One of the goals of endodontic therapy is the shaping and cleaning of the root canal system. In recent years, there has been multiple systems instrumentation, and changes in their dynamics are central to maintain the original shape of the canal after preparation.
Aims:
The aim of this study was to evaluate centering and transportation in curved root canals after using ProTaper
®
and MTwo
®
in continuous rotation, Reciproc
®
in reciprocating motion, and a step-down manual instrumentation technique.
Settings and Design:
Mesiobuccal roots of human extracted the first and second maxillary molars were selected and the canals (
n
= 60) were divided into four groups according to the preparation techniques: PT-ProTaper
®
; MT-MTwo
®
; RE-Reciproc
®
; MI-manual instrumentation.
Subjects and Methods:
The final apical diameter was standardized to a size 25. Centering and transportation were evaluated by cone-beam computed tomography and Adobe Photoshop 8.0 software.
Statistical Analysis Used:
The data were statistically analyzed by ANOVA and Tukey
post hoc
.
Results:
Results of transportation showed no statistical differences (
P
> 0.05) between groups, and significantly, difference (
P
< 0.05) between ProTaper
®
and Reciproc
®
was found when evaluating centering ability in the apical third.
Conclusions:
We concluded that there were no differences in transportation between the evaluated systems for the preparation of curved root canals with an apical instrumentation diameter of #25. For centering ability, in the apical third, ProTaper
®
presented worst behavior when compared to Reciproc
®
.
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Leaching of monomers from bulk-fill composites: An
in vitro
study
p. 482
Ankit Rajesh Sajnani, Mithra Nidharsh Hegde
DOI
:10.4103/0972-0707.190020
PMID
:27656072
Aim and Objectives
: To evaluate the elution of bisphenol A-glycidyl methacrylate (BisGMA) and triethylene glycol dimethacrylate (TEGDMA) from two bulk-fill composites at different polymerization times, for different storage periods when cured with quartz-tungsten-halogen (QTH) curing unit.
Materials and Methods
: Tetric N-Ceram bulk fill and EverX Posterior were analyzed using high-performance liquid chromatography unit. Totally, 68 samples were prepared, two groups (
n
= 17) from both the composites, one for each tested polymerization time. Each sample was cured with a QTH curing unit, using soft-start curing technique and stored in 2 ml of ethanol for 24 h. Storage medium was renewed and then stored again for 1 week. Data acquired were statistically analyzed.
Results
: The elution of BisGMA was significantly higher from Tetric N-Ceram bulk fill and BisGMA and TEGDMA from EverX Posterior composite at the end of 24 h, irrespective of the curing time. In EverX Posterior, a higher amount of TEGDMA was eluted at the end of 24 h, while at the end of 1 week, significantly higher amount of BisGMA was released.
Conclusion
: A significant amount of the release of BisGMA as well as TEGDMA was seen from both the composites when stored for different time intervals.
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CASE REPORTS
Dens in dente: A minimally invasive nonsurgical approach!
p. 487
Vivek Hegde, Abdul Morawala, Abhilasha Gupta, Naqiyaa Khandwawala
DOI
:10.4103/0972-0707.190014
PMID
:27656073
Dens invaginatus, also known as dens in dente, is a rare anomaly affecting human dentition. The condition results in invagination of an amelodental structure within the pulp. This case report discusses the current management protocol of dens invaginatus using a minimally invasive and nonsurgical treatment option. As with most conditions, early diagnosis and preventive measures help minimize complications in dens invaginatus cases.
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The stamp technique for direct Class II composite restorations: A case series
p. 490
Saaid Ayesh Alshehadat, Mohamad Syahrizal Halim, Koh Carmen, Chew Shi Fung
DOI
:10.4103/0972-0707.190021
PMID
:27656074
Background:
“Stamp” technique is a new method for placing large composite restorations with accurate occlusal topography. It was introduced mainly to restore Class I cavities and erosively damaged teeth. This technique is indicated when the preoperative anatomy of the tooth is intact and not lost due to the carious lesion. A precise tooth-like filling an accurate functional occlusion is obtained when the stamp technique is applied. However, using this technique to restore Class II cavities is not established yet.
Aim:
To introduce modifications of the stamp technique that make it applicable to restore Class II composite restorations.
Materials and Methods:
The traditional materials and tools used for direct composite restorations are needed with no additional instruments. Clinical illustrations and step-by-step description are provided in this paper.
Results and Conclusion:
Using the stamp technique to restore Class II cavities is achievable, simple and practical, and result in a very accurate anatomical restoration.
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BOOK REVIEW
Grossman's Endodontic Practice - 13
th
Edition
p. 494
James L Gutmann
DOI
:10.4103/0972-0707.190011
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© 2008 Journal of Conservative Dentistry | Published by Wolters Kluwer -
Medknow
Online since 10
th
June, 2008