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Table of Contents
November-December 2019
Volume 22 | Issue 6
Page Nos. 509-611
Online since Thursday, August 20, 2020
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EDITORIAL
From the desk of the editor…
p. 509
Shishir Singh
DOI
:10.4103/JCD.JCD_382_20
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REVIEW ARTICLE
Evaluation of success rate of lesion sterilization and tissue repair compared to vitapex in pulpally involved primary teeth: A systematic review
p. 510
Smital R Agarwal, Vikas D Bendgude, Pradnya Kakodkar
DOI
:10.4103/JCD.JCD_76_20
Background:
Vitapex has been a popular obturating material for several decades. In recent times, lesion sterilization and tissue repair (LSTR) has shown promising results. This technique uses a mixture of 3 antibiotics for sterilization of the root canals and healing of periradicular tissues.
Objective:
The objective of this systematic review was to compile all the literature comparing Vitapex and LSTR for pulpally involved primary teeth and evaluate the success rate in terms of clinical and radiographic outcomes.
Materials and Methods:
This review is based on PRISMA guidelines. The electronic search on MEDLINE via PubMed database and Google scholar, cross-referencing and hand search of journals was carried out for articles from January 1, 2000 to December 31, 2019. Articles only in the English language were selected. Out of the 17 articles, 3 unique articles were identified for the review, of which 2 were randomized controlled trials and 1 was a retrospective study.
Results:
All the three articles were assessed for their quality and all had a low risk of bias. It was found that LSTR and Vitapex had a high clinical success after 12 months. The radiographic success after 6 months was high but decreased after 12 months in both the groups.
Conclusion:
There is no difference in the success rate of LSTR as compared to Vitapex for the treatment of pulpally involved primary teeth.
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ORIGINAL ARTICLES
Comparative evaluation of treatment of noncarious cervical hypersensitivity by a fluoride varnish, a dentin bonding agent, and Er, Cr:YSGG laser: An
in vivo
study
p. 516
Amrita Ghosh, Dibyendu Mazumder
DOI
:10.4103/JCD.JCD_215_20
Context:
Dentin hypersensitivity is one of the most common dental problems encountered regularly. This commonly appearing condition is quite difficult to treat satisfactorily, and so, a large number of techniques and therapeutic alternatives constantly are being proposed to relieve it. However, till date, the search for an ideal agent is on. Various laser systems have been discussed as a new treatment option for dentin hypersensitivity. Researchers are claiming good prognosis with lasers. Treatment with soft tissue lasers is being practiced for some time and is well documented. However, the use of Er, Cr:YSGG laser for desensitization purpose is new, and the available data on clinical outcome are limited.
Aims:
The purpose of this study was to test and compare the efficacy of a fluoride varnish, a dentin bonding agent, and Er, Cr: YSGG laser in treating noncarious cervical hypersensitivity,
in vivo
.
Settings and Design:
Fifty patients aged between 25 and 55 years complaining of dentinal hypersensitivity who reported to the Department of Conservative Dentistry and Endodontics, Dr. R. Ahmed Dental College and Hospital, Kolkata, participated in this study.
Subjects and Methods:
Sensitive teeth in each patient were randomly divided into three treatment groups:
Group 1 treated with fluoride varnish
Group 2 treated with dentin bonding agent
Group 3 treated with Er, Cr: YSGG laser.
Statistical Analysis Used:
The data obtained were tabulated and subjected to statistical analysis using the paired and unpaired
t
-test.
Results:
In all the treatment groups, there was significant decrease in mean hypersensitivity scores from pretreatment values after 4 weeks. The posttreatment hypersensitivity scores of Group 3 were minimum for all three test stimuli followed by Group 2 and Group 1, respectively.
Conclusions:
All the three treatment agents, namely fluoride varnish, dentin bonding agent, and Er, Cr:YSGG laser, were effective in treating dentin hypersensitivity. Least recurrence in hypersensitivity occurred in the laser-treated group. Even where recurrences did occur, hypersensitivity did not return to pretreatment value and occurred more in those cases exhibiting high pretreatment sensitivity.
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Effect of two desensitizing agents on dentin hypersensitivity: A randomized split-mouth clinical trial
p. 522
Angambakkam Rajasekaran PradeepKumar, Venkatnagaraj Viswanath, Kamna Singh, Kuzhanchinathan Manigandan, Haseena Begum Iqbal, Anil Kishen
DOI
:10.4103/JCD.JCD_22_20
Background:
Clinical research is important to evaluate the effect of desensitizing agents.
Aims:
This randomized clinical trial evaluated the immediate and 1 week desensitizing effect of two desensitizing agents Uno Topical Gel and Profluorid.
Materials and Methods:
Thirtyfive patients with teeth presenting with dentin hypersensitivity were included in this clinical trial. Each quadrant in a patient was randomly assigned to one of two groups: Uno Topical Gel or Profluorid Varnish. A VAS score was used to assess tooth sensitivity at baseline, immediately after application of desensitizer and after 1 week. Additionally, 30 dentin discs were prepared, divided into Group 1(Control Group), Group 2 (Profluorid Varnish) and Group 3 (Uno Topical Gel) and examined using scanning electron microscopy (SEM) after 1hour and 24 hours to evaluate tubule occlusion.
Statistical Analysis:
Clinical data were analysed using Friedman's test and Mann – Whitney U test. SEM data was analysed using Student's 2-sample
t
-test.
Results:
Uno group was significantly better to evaporative stimuli immediately (
P
=0.01) after application. After 1 week, Uno group was significantly better to tactile (
P
=0.000) and evaporative (
P
=0.000) stimuli than Profluorid. SEM images showed that 1 hour after application, Uno and Profluorid demonstrated more than 90% and 80% dentin tubule occlusion respectively. At 24 hours, Uno and Profluorid demonstrated more than 50% and 60% dentin tubule occlusion respectively.
Conclusions:
Uno Topical Gel was significantly better than Profluorid in reducing pain of dentin hypersensitivity due to tactile and evaporative stimuli after 1 week.
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Effect of bleaching on color change of composite after immersion in chlorhexidine and coffee
p. 529
Elham Hasani, Alireza Akbarzadeh Baghban, Seyedeh Mahsa Sheikh-Al-Eslamian, Alireza Sadr
DOI
:10.4103/JCD.JCD_37_19
Background:
Since the introduction of resin composites, the staining of resin-based materials by colored solutions such as coffee, tea, chlorhexidine (CHX), and other beverages has become a common concern.
Aim:
The aim of this study was to evaluate the effect of home and office bleaching as a treatment for discoloration of composite after immersion in coffee or CHX.
Materials and Methods:
A microhybrid composite (Z250), nanohybrid composite (Z550), and nanofill composite (ultimate, body shade) were selected. Forty disk shape specimens (8 mm diameter and 2 mm thickness) for each composite were prepared then divided into two groups according to staining solutions (25 g of coffee in 250 ml water, 20 min/day or 0.2% CHX, 1 min/day). Following 1 month staining, specimens were divided into two groups again. Half of the specimens was bleached with in office bleaching agent (Opalescence Boost 40% hydrogen peroxide concentration) 3 times in one visit for 15minutes and the others subjected to home bleaching agent(Opalescence 10% carbamide peroxide) 6h/day until 2 weeks both from Ultradent Products, Inc., South Jordan, UT, USA. Color of the specimens was measured with a spectrophotometer using CIELAB color space at baseline, after 1 month staining, and after ending the bleaching process.
Statistical Analysis:
Analysis of variance was used to analyze the data (
P
< 0.05).
Results:
Coffee and CHX provided significant color changes in all groups (
P
< 0.05). Z550 was the material more prone to discoloration in coffee in comparison with Filtek Ultimate (
P
= 0.003). After bleaching, materials showed significant reduction except stained Z550 by coffee in home bleaching groups. Both home and office bleaching provided significant color changes in all CHX groups (
P
< 0.05).
Conclusion:
Coffee produced more color changes than CHX. The hydrogen peroxide has the same whitening effect in comparison with carbamide peroxide.
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Evaluation of alpha-adrenomimetic agents for gingival retraction: A randomized crossover clinical trial
p. 533
Neha Mehra, Ajita Rathi, Roshni Sharma, Mamta Kaushik, Tanushree Sood
DOI
:10.4103/JCD.JCD_76_19
Context:
The displacement of the gingiva around the tooth allows proper access during preparation, precise impression taking, and cementation procedures that has a direct bearing on the health of the periodontium. Several methods and agents are used for this purpose.
Aims:
The primary aim of the study was to clinically evaluate the efficacy of naphazoline as a gingival retraction agent. The secondary aim was to compare it with tetrahydrozoline and aluminum chloride.
Settings and Design:
Fifteen patients participated in a randomized crossover clinical trial at the Army College of Dental Sciences, Secunderabad, Telangana, India.
Subjects and Methods:
Preliminary maxillary impressions were made with irreversible hydrocolloid for all patients to fabricate custom trays. After that, baseline impressions and cast for control group measurements were prepared. Gingival displacement was carried out in the right maxillary central incisor for all, with retraction cord soaked in three agents, either, aluminum chloride, tetrahydrozoline, or naphazoline. These agents were used in all patients with a washout period of 14 days. Elastomeric monophase impressions and die stone casts were recorded for each group. The central incisors were sectioned, and gingival retraction was measured using a measuring stereomicroscope.
Statistical Analysis Used:
The gingival displacement was statistically analyzed using one-way ANOVA and post hoc Bonferroni.
Results:
Naphazoline had the highest retraction (138.160 μm) followed by tetrahydrozoline (136.039 μm) and aluminum chloride (130.759 μm).
Conclusions:
Naphazoline, tetrahydrozoline, and aluminum chloride show a clinically and statistically significant amount of displacement when compared to control. Among the three agents, naphazoline showed maximum displacement and maybe a good alternative with fewer side effects.
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Chemical constituent, minimal inhibitory concentration, and antimicrobial efficiency of essential oil from oreganum vulgare against
Enterococcus faecalis
: An
in vitro
study
p. 538
Krishnamachari Janani, P Ajitha, Raghu Sandhya, Kavalipurapu Venkata Teja
DOI
:10.4103/JCD.JCD_80_19
Aim:
The purpose of this study was to determine the chemical composition of oregano essential oil, minimal inhibitory concentration (MIC) and to assess its antimicrobial efficiency against
Enterococcus faecalis.
Material and Methods:
Gas Chromatography and Mass Spectrometry (GC-MS) was used to determine the chemical composition of essential oil from oreganum vulgare. Broth dilution and agar diffusion method was used to evaluate the MIC. For Broth dilution, 100 μL of different concentration of oil (6.25, 12.5, 25.0, 50.0, and 100 μg/ml) was tested. Agar diffusion method was utilized to evaluate the antimicrobial efficiency of different concentration of oil (25.0, 50.0, and 100 μg/mL) against
E. faecalis.
Results:
GC-MS analysis revealed that oregano essential oil contained carvacrol (41.2%), γ-terpinene (12.68%), p-cymene (9.47%), α-terpinene (1.19%) as the major compounds and β–caryophyllene (0.83%), β-linalool (0.67%), β–bisabolene (0.601%), α-pinene (0.6%), β-pinene (0.5%), terpinen-4-ol (0.41%), borneol (0.4%), 3-thujene (0.4%), spathulenol (0.4%), myristicin (0.25%), and apiol (0.14%). The results of the present study reported Oregano essential oil possess antimicrobial activity against
E. faecalis
. The MIC was 25 μg/ml and the minimum bacterial concentration (MBC) was 50 μg/ml.
Conclusion:
Oregano essential oil was reported to be an effective antimicrobial agent against
E. faecalis
. The MIC was found to be 25 μg/ml and the MBC was found to be 50 μg/ml.
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Comparative assessment of fluoride release and recharge through newer fluoride releasing posterior restorative materials: An
in vitro
study
p. 544
Siddharth Rai, R Anitha Kumari, N Meena
DOI
:10.4103/JCD.JCD_92_19
Aim:
This study aimed to assess and compare the fluoride release and recharge capacity of CentionN, Zirconomer and Gc Gold Label 9 Extra.
Methodology:
Disk-shaped specimens (
n
= 12) of CentionN, Zirconomer and Gc Gold Label 9 Extra were prepared according to manufacturer's instructions. After setting, each specimen was dipped in a plastic tube containing 5ml deionized water and incubated at 37°C ± 2°C. Every 24 h, the samples were placed in fresh 5 ml deionized water. Mean fluoride release (in ppm) from each material, on day 1 and day 6 was calculated using a spectrophotometer. On day 6, the specimens were recharged with 0.2% neutral NaF solution for 2 min and the fluoride release on day 7 was determined.
Results:
Cention N released significantly greater amount of fluoride on day 1 and day 6, than zirconomer and Gc Gold Label 9 Extra (
P
< 0.001). Cention N showed a better recharge capacity than zirconomer and Gc Gold Label 9 Extra (
P
< 0.001).
Conclusions:
Cention N with a higher fluoride release and recharge capacity can be used as a posterior restorative material in patients with high caries risk, thereby inhibiting secondary caries
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Effectiveness of polyacrylic acid-bioactive glass air abrasion preconditioning with NovaMin remineralization on the microhardness of incipient enamel-like lesion
p. 548
Abdullah Alafifi, Asmaa Aly Yassen, Olfat Elsayed Hassanein
DOI
:10.4103/JCD.JCD_195_19
Background:
Bioactive glass (BAG) remineralization is a promising method for dental hard tissue regeneration. The aim of this study was to evaluate the microhardness of incipient enamel-like lesions with or without preconditioning by air abrasion using polyacrylic acid (PAA)-BAG before application of NovaMin remineralizing agent.
Materials and Methods:
Forty extracted human molars were selected, sectioned mesiodistally obtaining buccal and lingual halves, and embedded in resin molds. Specimens were randomly assigned to four groups (
n
= 10) according to the remineralization protocol: G1 (control, artificial saliva), G2 (preconditioning), G3 (NovaMin), and G4 (preconditioning and NovaMin). Enamel windows 4 mm × 4 mm were done on the buccal and lingual surfaces. Specimens were immersed in a daily renewed demineralizing solution to create white spot lesions. Remineralizing agents were applied according to the manufacturer's instructions, and specimens were stored in a daily renewed artificial saliva. Microhardness was assessed using Vickers hardness number (VHN) at baseline (positive control), after demineralization (negative control), and after 24-h and 1-month remineralization.
Results:
The preconditioning/NovaMin group after 1 month showed a statistically significant high VHN, with no statistically significant difference between it and the positive control. This was followed by the NovaMin group after 1 month, while the lowest VHN was found in the demineralized group, with no statistically significant difference between it and the preconditioning group, whether after 24 h or 1 month.
Conclusions:
Enamel preconditioning with PAA-BAG air abrasion play a major role in enhancement of remineralization when it is accompanied with NovaMin. Furthermore, an extended period of time had helped to attain more benefits from NovaMin remineralization.
Clinical Significance:
Enamel remineralization with NovaMin after conditioning by bioactive glass air abrasion, provides the patients with a fast and durable treatment of incipient enamel lesions, which would reduce the possibility of future progression of demineralization and caries occurrence.
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A comparative evaluation of cyclic fatigue resistance of FlexiCON (Edge Endo) files in rotary versus reciprocating motion at various curvatures – An
in vitro
study
p. 554
Priya Alice Mathew, Rajesh Sasidharan Nair, Jeyabalaji Mano Christaine Angelo, Vijay Mathai, RV Vineet, Sarah Renjelina Christopher
DOI
:10.4103/JCD.JCD_203_19
Aim:
The aim of the study to compare the cyclic fatigue resistance of FlexiCON (Edge Endo) files in rotary versus reciprocating motion in coronal, middle, and apical curvature of the simulated artificial canal.
Materials and Methods:
A total number of 36 new files, 25 mm length of ISO size 25 at the tip and a taper of 0.06, were used for the study and divided into two groups of 18 files each. Group I: FlexiCON X
3
, was used in a rotary motion and Group II: FlexiCON X
1
was used in a reciprocating motion. Cyclic fatigue testing was conducted in a custom-made device that allowed for a reproducible simulation of a curved canal. The canal system, which comprised two adjustable stainless steel blocks, had a 60° angle of curvature and 3 mm width. The groups were further divided into three subgroups with six files in each, representing apical curvature (Group Ia/IIa), middle curvature (Group Ib/IIb), and Coronal curvature (Group Ic/IIc).Using X-Smart plus motor, files were used in rotary and reciprocating mode and the number of cycles to failure was recorded.
Statistical Analysis:
Data were analyzed using ANOVA and
Post hoc
followed by Dunnett's test and unpaired
t
-test using Statistical Package for the Social Sciences 16 version.
Results:
FlexiCON X1 reciprocating files showed the maximum cyclic fatigue resistance at coronal curvature (1936.50 ± 1.09) followed by middle (1514.50 ± 1.07) and apical curvature (1487.50 ± 6.75), while FlexiCON X3 rotary files showed the maximum cyclic fatigue at the middle curvature (1106.00 ± 4.21), followed by coronal (920.00 ± 1.16) and apical curvature (757.00 ± 5.34). The statistical analysis revealed a statistically significant difference (
P
= 0.001) between the two groups.
Conclusion:
FlexiCON X1 reciprocating files showed better cyclic fatigue resistance at coronal, middle, and apical curvature compared to FlexiCON X3 rotary files.
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Comparative evaluation of apical bacterial extrusion following root canal instrumentation using different endodontic file systems: An
in vitro
study
p. 559
Bhavana Vankayala, Kavitha Anantula, Harikrishna Saladi, Leneena Gudugunta, Jeevan Matada Basavarajaiah, Sarjeev Singh Yadav
DOI
:10.4103/JCD.JCD_221_19
Aim:
This study aims to evaluate the amount of apical extrusion of bacteria during root canal instrumentation using K3XF, Protaper Gold, Edge taper platinum, and Hyflex CM Rotary systems.
Materials and Methods:
Sixty freshly extracted maxillary incisors teeth collected in saline. Access cavity prepared and canals were made free of bacterial and pulp. The teeth were mounted on the bacteria collecting apparatus. Root canals were contaminated with the Fusobacterium Nucleatum (ATCC25586) and dried at 37°C for 24 h. In Group 1 (Control group): No instrumentation was done and biomechanical preparation done in all other groups with Group 2: Hand K-files, Group 3: Protaper gold, Group 4: K3XF, Group 5: Edge taper platinum, and Group 6: Hyflex CM rotary file systems. Then, the extrude was collected, and it is incubated in Mueller-Hinton agar for 24 h and the number of colony forming units were counted and statistical comparison was done using Kruskal–Wallis test and Mann–Whitney U test.
Results:
Hand K-files extruded more bacteria when compared to other four rotary systems, K3XF file system extruded least number of bacteria.
Conclusion:
All instrumentation techniques extruded intracanal bacteria apically. However, engine-driven nickel-titanium instruments extruded less bacteria than the manual technique. The K3XF rotary file system comparatively extruded less bacteria than other rotary file systems.
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In vitro
comparative evaluation of antifungal efficacy of three endodontic sealers with and without incorporation of chitosan nanoparticles against
Candida albicans
p. 564
Satabdi Pattanaik, Amit Jena, Govind Shashirekha
DOI
:10.4103/JCD.JCD_242_19
Aim:
The aim of this study was to compare the antifungal efficacy of three endodontic sealers (AH Plus, Apexit Plus, and MTA Fillapex) with and without the incorporation of chitosan nanoparticles against Candida albicans.
Materials and Methods:
The present study was carried out by the Kirby–Bauer method.
C. albicans
were cultured in Sabouraud Dextrose Agar plates. Filter papers (
n
= 10) were placed in the cultured Petri dishes and the sealers were mixed according to the manufacturer's instructions and placed on the top of the filter papers. Group division of sealers is as follows: Group I – AH Plus, Group II – Apexit Plus, and Group III – MTA Fillapex. Group IC, Group IIC, and Group IIIC were the addition of 2% chitosan nanoparticles with respective sealers. Plates were incubated for 18 h, and the zone of inhibition was measured with a measuring scale and values (in millimeter) were recorded. Statistical analysis was done by one-way analysis of variance followed by
post hoc
multiple pair-wise comparisons.
Results:
All the tested groups showed statistically significant difference (
P
< 0.05) from each other. Two percent chitosan-incorporated groups showed superior zone of inhibition compared to sealers used alone. Group IC (16.35 ± 0.71 mm) had the highest zone of inhibition followed by Group I (13.8 ± 0.86 mm). For the remaining groups, the zone of inhibition was in the following order: Group IIC > Group II > Group IIIC > Group III.
Conclusion:
AH Plus sealer mixed with 2% chitosan showed significantly higher antifungal property. Mixing of 2% chitosan with endodontic sealer provides an added advantage so that endodontic re-infections can be minimized and will be helpful in retreatment cases.
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Direct technique premolar coronal restorations: From metallic material to “complete adhesive restoration”
p. 568
Marie Nwon Adou-Assoumou, Stéphane X Djolé, Aline A Krah-Sinan, Jonas A Adou, Dao Siendou, Edmée C Mansilla
DOI
:10.4103/JCD.JCD_330_19
Introduction:
The choice of restorative materials has for a long time been determined by the tooth position. Thus, premolar restoration depended on the practitioner's clinical assessment and practical experience in regard to the material to be handled.
Aim:
The objective of this study was to assess, in the students' practice, the change in the choice of materials used for premolars restoration.
Materials and Methods:
This was a retrospective study based on the available care records in the department of conservative dentistry and endodontics of a dental school. Variables analyzed included the year of restoration, the type of material, the premolar position in the arch, and the coronal restoration site (occlusal, proximal, and cervical). Data collected were processed with the SPSS software version 22 (SPSS Inc., Chicago, IL, USA; 2013). The statistical significance threshold was set at 5% for Pearson's Chi-square test.
Results:
Between 1994 and 2017, 1738 restored premolars were identified. Over the years, amalgam restorations declined from 99.2% in 1994 to 1.3% in 2017, contrary to composite whose frequency increased from 0.6% to 88.6%. Maxillary premolars were exclusively restored with composite in 2017 when amalgam was still, somewhat, used for mandibular premolars.
Conclusion:
The reversal in the choice of materials in favor of composites reflects the global trend. This seems to be related to the current awareness of the prohibition, among others, of medical devices containing mercury.
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Scanning electron microscopy evaluation of chitosan and carboxymethyl chitosan as retrograde smear layer removing agents
p. 573
Ramesh Penumaka, Ravi Kumar Konagala, Jaheer Shaik, CH Ram Sunil, Pramod L Reddy, Madhu K Kiran Naik
DOI
:10.4103/JCD.JCD_50_20
Background:
The smear layer acts as a physical barrier against penetration of root canal medicaments and sealers, thus compromising the seal leading to microleakage.
Objectives:
This study was conducted to evaluate the efficacy of 17% ethylenediaminetetraacetic acid (EDTA), 0.2% chitosan solution, and 0.2% carboxymethyl chitosan (CMC) used as smear layer removing agents in retrograde root canal preparation using scanning electron microscopy (SEM).
Materials and Methodology:
Eighty single-rooted teeth extracted for periodontal reasons were collected for the study. Root canals were prepared and obturated with gutta-percha coated with AH plus resin sealer. Apical 3 mm of each root resected and Class I retrograde preparation carried out using ultrasonic handpiece and ultrasonic retro tips to a depth of 3 mm along the root long axis. In Group 1 (control), normal saline solution alone was used for smear layer removal. In Group II, 17% EDTA, Group III and IV were treated with 5 ml of 0.2% chitosan and 0.2% carboxyl methyl chitosan, respectively, for 3 min. Blinded evaluation of specimens using SEM was performed independently by two operators who registered the amount of the smear layer present on the surface of the canal walls based on the score described by Hülsmann
et al
.
Results:
Group I (saline) was least efficient in the removal of the smear layer. Group II (17% EDTA), Group III (0.2% Chitosan), and Group IV (0.2% CMC) efficiently removed the smear layer from the retrograde cavity with mean scores 1.35, 1.60, and 1.35, respectively. Statistically, no significant difference found in Group II (17% EDTA), Group III (0.2% Chitosan), and Group IV (0.2% CMC).
Conclusions:
About 0.2% CMC and 0.2% chitosan can be better alternatives to 17% EDTA for smear layer removal due to their biological advantages.
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Effect of different obturating techniques and sealers on the removal of filling materials during endodontic retreatment
p. 578
Srividya Athkuri, Jyothi Mandava, Uma Chalasani, Ravi Chandra Ravi, Vamsi Krishna Munagapati, Anusha Reddy Chennareddy
DOI
:10.4103/JCD.JCD_241_19
Background:
Adequate removal of previous root filling materials is an important objective during endodontic retreatment.
Aim:
This study was aimed to evaluate the influence of obturation quality and sealer type on the removal of root filling materials during endodontic retreatment using micro-computed tomography (μ-CT).
Materials and Methods:
Ninety extracted mandibular premolars were randomly assigned to two groups (
n
= 45) based on the type of sealer (AH Plus and BioRoot RCS) and three sub-groups based on the obturating technique used, i.e., cold lateral condensation, warm vertical compaction, and thermoplasticized injectable techniques. Specimens were scanned using μ-CT before and after retreatment to assess the amount of filling material, and time taken for removal was recorded.
Statistical Analysis:
Data were analyzed using two-way analysis of variance and Tukey's multiple
post hoc
test at 5% significance level.
Results:
Filling debris percentage and retreatment time were not significantly affected by the type of sealer (
P
≥ 0.05). The percentage of remaining filling material was higher in teeth obturated with thermoplasticized technique (
P
< 0.05). Significantly more filling material debris was observed in apical third (
P
< 0.05).
Conclusions:
The type of obturating technique used for initial root canal treatment has influenced the amount of remaining filling material and retreatment time. Retreatability of the BioRoot RCS sealer was similar to the AH Plus sealer.
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Evaluation of temperature rise and efficacy of cavity disinfection with diode laser: An
in vivo
study
p. 583
Sakshi Jain, Shivani Mathur, Pulkit Jhingan, Vinod Sachdev
DOI
:10.4103/JCD.JCD_78_19
Background:
Management of caries using minimally invasive dentistry is prevalent in dentistry today. A newer technology is to disinfect/sterilize caries in depth of the dental tissue with diode laser. However, to have a bactericidal effect, increased energy density of light amplification by stimulated emission of radiation (LASER) may be required which in turn may lead to higher thermal load causing harmful effects on vital pulpal tissue.
Aims:
The aim was to evaluate temperature rise and efficacy of cavity disinfection with diode laser.
Materials and Methods:
Twenty permanent molar teeth with dentinal caries were randomly assigned into two groups on the basis of LASER irradiation: Group 1 – at 1 W, Group 2 – at 2 W. The elevation of subsurface temperature during irradiation was measured using thermocouples positioned in the center of a prepared cavity. Dentinal samples were collected before and after disinfection of the cavity. These samples were subjected to microbiological evaluation for
Streptococcus mutans
on Mutans-Sanguis agar and
Lactobacilli
on Rogosa agar.
Statistical Analysis:
Log transformed “
t
”-test and paired “
t
“-test were used for the statistical analysis.
Results:
Although the reduction in microbial count revealed insignificant difference at two different wattages, the rise in temperature with 1 W was less than that with 2 W.
Conclusion:
Efficacy of 1 W and 2 W is similar, but 1 W causes less thermal changes, thus, 1 W is recommended over 2 W.
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Evaluation of remaining dentin thickness following use of three different rotary nickel–titanium retreatment files: A cone-beam computed tomography study
p. 588
Nishita Rajeev Kulkarni, Sharad Basavraj Kamat, Santosh Irappa Hugar, Girish Shankar Nanjannawar, Pranav Devendra Patil
DOI
:10.4103/JCD.JCD_269_19
Aim:
The aim of the study is to measure the amount of remaining dentin thickness (RDT) following retreatment using three different rotary nickel–titanium (NiTi) systems.
Methodology:
Mesiobuccal roots of 45 extracted maxillary first molars were prepared up to F
2
ProTaper File and obturated. After cone-beam computed tomography (CBCT) imaging, to evaluate the obturation, the samples were randomly assigned to three retreatment groups (
n
= 15). Group I was retreated with ProTaper Universal retreatment kit, Group II and III with M
TWO
and D-Race retreatment files, respectively. Postoperatively, all samples were subjected to CBCT imaging and evaluated with AutoCAD software (AutoDesk, Inc.) Mill Valley, California, U.S. to calculate the RDT. Data were statistically analyzed using one-way ANOVA and Tukey's
post hoc
tests, and the level of significance was set at
P
= 0.05.
Results:
The amount of RDT was significantly more in D-Race and M
TWO
groups when compared to ProTaper group.
Conclusion:
D-Race and M
TWO
instruments were associated with significantly more RDT than ProTaper.
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Comparative evaluation of push-out bond strength of gutta-percha using different sealers with lateral condensation and thermoplasticized obturation technique: An
in vitro
study
p. 593
Naushad Ali, Suparna Ganguly Saha, Prashansa Vijayvargiya, Anuj Bhardwaj, Saurabh Shrivastava, Vini Sharma, Harmeet Singh Sachdeva
DOI
:10.4103/JCD.JCD_553_18
Aim:
The study aimed to evaluate and compare the push-out bond strength of gutta-percha using AH plus, Endosequence BC, and Roeko seal sealer with lateral condensation and thermoplasticized obturation technique.
Materials and Methods:
Sixty single-rooted premolars were instrumented and samples were randomly assigned into three groups based on the sealer used (Group A-AH Plus, Group B-Endosequence BC, Group C-Roeko Seal) which were further divided into two subgroups-A1, B1, and C1 were obturated by the lateral condensation technique and A2, B2, and C2 using the thermoplasticized technique. Each sample was sectioned horizontally using a diamond disc, representing apical, middle, and coronal thirds, respectively. Root segments were then mounted on an acrylic block, and push-out bond strength of each sample was tested using the universal testing machine.
Statistical Analysis:
One-way ANOVA, Tukey's test, and unpaired
t
-test.
Results:
For mandibular premolar teeth with a single canal using lateral condensation technique, the highest push-out bond strength was found in the A1 group (7.30 ± 0.61 MPa) at the apical level. While using the thermoplasticized technique, the highest push-out bond strength was found in the B2 group (3.71 ± 0.81 MPa) at the apical level. Overall results showed that the lateral condensation technique showed significantly higher push-out bond strength than thermoplasticized technique (
P
< 0.028).
Conclusions:
The push-out bond strength of AH Plus sealer was higher than the Endosequence BC sealer and Roeko seal sealer. Lateral condensation technique has shown higher push-out bond strength than the thermoplasticized technique.
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Evaluation of indomethacin as matrix metalloproteases inhibitor in human dentin
p. 598
Mashalkar Shailendra, Sarita Bhandari, Sangeeta Kulkarni, K Janavathi, Kiran Ghatole
DOI
:10.4103/JCD.JCD_236_19
Objective:
The objective was to determine a new experimental material, indomethacin's inhibitory effect on the enzymatic activity of dentin collagen.
Materials and Methods:
Fifteen freshly extracted teeth were collected and stored at 4°C until use. Enamel, roots, and remnant pulp tissue were removed, and dentin powder was obtained by pulverizing liquid nitrogen-frozen coronal dentin with a mortar pestle. The obtained protein extract from human dentin powder was treated with indomethacin and incubated. The inhibition of enzymatic activity was analyzed using plate assay method and zymographic analysis.
Results:
Plate assay method and zymograms showed that indomethacin-treated samples inhibited dentin enzymatic activity.
Significance:
Bond strength at the dentin adhesive interface decreases because of the hydrolytic degradation of dentin collagen. The inhibition of enzymes responsible for collagen degradation may improve the bond strength durability. This study demonstrates the efficacy of indomethacin in inhibiting enzymatic activity.
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Antibacterial property of
Azadirachta indica, Ocimum sanctum
, and
Vitex negundo
against oral microbes
p. 602
Chandana Kalita, Dina Raja, Ankumoni Saikia, Anjan Kumar Saikia
DOI
:10.4103/JCD.JCD_268_19
Context:
Plant extracts are used in folklore medicine from time immemorial to treat different oral diseases. Chemical constituents extracted from these natural resources are gifted with huge opportunities.
Aim:
The aim of this study is to assess the antibacterial property of
Azadirachta indica
(Neem),
Ocimum sanctum
(Tulsi), and
Vitex negundo
(Pochotia) against oral microorganisms.
Materials and Methods:
Plant extract was prepared with hot continuous extraction method by the Soxhlet Apparatus. Microorganisms isolated from the oral cavity and identified by Vitek-2. Bacterial inoculums poured and spread into Mueller Hinton plates. Plant extract was poured into prepared wells taking ciprofloxacillin as the positive control and dimethyl sulfoxide as the negative control. The experiment was performed in duplicates with two different concentrations of the extract and mean value of inhibition zone was calculated.
Statistical Analysis:
Paired
t
-test, analysis of variance, and regression analysis.
Results:
Isolated microorganisms were
Klebsiella oxytoca, Kochuria kristinae, Acinetobacter boumani, Sphingomonas paucimobilis, Pseudomonas fluorescens, Streptococcus gordonii, Enterococcus faecalis,
and
Bacillus subtilis.
Higher zone of inhibition was observed against
E. faecalis
by
V. negundo
followed by
A. indica.
Among the aqueous and acetone group, in the aqueous group, the regression models of
K. kristinae
and
B. subtilis
have been found to be statistically significant (
P
= < 0.05), whereas, in the acetone group, the regression model of
B. subtilis
has been found to be statistically significant (
P
= < 0.05).
Conclusion:
All the three plants showed antibacterial potency against the isolated organisms. Acetone group showed better efficacy than the aqueous extract group.
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CASE REPORT
Guided endodontic therapy: Management of pulp canal obliteration in the maxillary central incisor
p. 607
Shubha G Hegde, Gopal Tawani, Manjusha Warhadpande, Abhijeet Raut, Darshan Dakshindas, Sattyam Wankhade
DOI
:10.4103/JCD.JCD_21_20
This is a case report of the management of pulp canal obliteration of maxillary central incisor using guided endodontic therapy. Patient reported with discolored and proclined 11. Intraoral periapical (IOPA) Radiographs and cone-beam computed tomography (CBCT) showed periapical radiolucency. The canal was obliterated till the middle third and was patent in the apical 7 mm. Root canal treatment (RCT) was planned using guided endodontics. Information of CBCT and digital surface scan were integrated using Blue Sky Bio software. A transparent three-dimensional (3D) model of the tooth and stent, designed with a sleeve for insertion of bur, was 3D-printed using clear resin. After orientation was found satisfactory on the 3D model, access opening was initiated with the orientation of round bur through the stent. IOPAs were taken after preparation of every 3 mm. The canal was located in the apical third. Cleaning and shaping were performed, and RCT completed successfully. Guided endodontic therapy is useful in the management of calcifications in anterior teeth
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© 2008 Journal of Conservative Dentistry | Published by Wolters Kluwer -
Medknow
Online since 10
th
June, 2008