Background: Dentinal hypersensitivity (DH) is a common dental problem and is treated non-invasively using topical application of various desensitizing agents. When there is loss of tooth structure or tooth preparation is to be followed by a bonded restoration, it requires application of dentin bonding agent. However, the effect of desensitizers on bond strength is still controversial. Aim and Objective: To evaluate the influence of different desensitizing agents on the bond strength of the dentin bonding agents. Methods and Materials: PICO strategy was used to formulate the research question. In-vitro studies conducted on human teeth to evaluate the bond strength of dentin bonding agent following the application of desensitizing agent were included. Electronic databases PubMed and Cochrane and google scholar were searched using search terms alone or in combination from the year 2010 till 2020. Search was conducted using the key words and MeSH terms (hypersensitivity, bond strength, dental adhesives, dentin bonding agents). The title and abstract were read to verify the inclusion and exclusion criteria and if further any details required, full article was accessed to check the criteria and then included or excluded. Data extraction was done using a customized data extraction form. The risk of bias was evaluated using modified Cochrane Collaboration Quality Assessment tool. Results: Total no of studies identified in the search were 146, after scrutiny 23 articles were eligible to be included in this study. Out of 23 articles, 17 articles were of medium bias and 6 articles were of high risk after risk of bias assessment. Conclusion: According to the various articles included in this study, GLUMA and 8.0%Arginine and CaCO3 when used as desensitizing agents along with different bonding agents, were found to be highly compatible without interfering with the bond strength of the dentin adhesives.

Background: Endodontic success depends on complete sealing of the root canal orifice to prevent re-infection and re-Contamination of the treated teeth through microleakage. Intra-orifice barrier material provides a seal against micro-organisms, its by-products thus, preventing microleakage and subsequent endodontic failure. Several studies have been done to evaluate microleakage after placing various materials as IOB, but still there is no standardization for the same. Thus, this systematic review was conducted to evaluate the microleakage associated with mineral trioxide aggregate (MTA), composite, and glass ionomer cement (GIC) when used as IOB material. Materials and Methods: Protocol was formulated in accordance with PRISMA checklist 2020 and registered on PROSPERO (CRD42021226225). Electronic search from databases such as Medline/PubMed, Scopus, EBSCOhost, Embase, Google Scholar, and Cochrane were performed from the year 2000–2020. In vitro and ex vivo studies evaluating coronal microleakage after placing IOB material using methylene blue dye penetration test under a stereomicroscope were included. A total of 5 studies were included in the systematic review. After assessing the risk of bias using customized criteria referred from JBI critical appraisal tool, characteristics of the included studies, reason for exclusion of the studies, and data extraction sheet were prepared. Results: All studies included in this systematic review reported that placement of an IOB material significantly reduces microleakage as compared to control groups. MTA used as an IOB showed less microleakage than composite and GIC. Conclusion: MTA as IOB material demonstrated the least microleakage in vitro studies. However, in this systematic review, only in vitro studies were included. Thus, more studies in the form of randomized control trials are required to give a conclusive and definitive result.

Context: Manufacturers have produced a wide variety of nickel–titanium (NiTi) alloys, but the available literature is limited on the accuracy of some integrated electronic apex locators (EAL) used with different NiTi heat treatments in working length (WL) determination. Aim: This study aims to evaluate ex vivo, the influence of different heat treatments of NiTi instruments, and the diameter of the apical preparation on the accuracy of an EAL used during root canal preparation using an integrated EAL and motor unit. Materials and Methods: Nineteen extracted human mandibular incisors were included in the study. The WL control was determined by the visual method. Instruments of Mtwo, Reciproc, Reciproc Blue, WaveOne Gold, Twisted File Adaptive, and Hyflex CM systems, with diameters from 0.25 mm to 0.50 mm, were used to measure WL during root canal preparation. The electrical resistivity of instruments with a diameter of 0.25 mm from each system was evaluated using an Inductance, Capacitance, and Resistance (LCR) meter. Statistical Analysis Used: Data were statistically analyzed using Fisher's exact test and Kruskal–Wallis test. Results: The different heat treatments and different diameters did not influence the precision of the EAL (P > 0.05). Conclusion: The heat treatment and the diameter of the apical preparation did not influence the accuracy of WL determination by an EAL integrated with the endodontic motor.

Background: Mastering indirect vision has been a common challenge to undergraduate and postgraduate dental students. Aim: This study assessed the usefulness of Vasundhara's mirror exercise (V-ME) Shield and Sheets for learning indirect vision among dental students. Materials and Methods: One hundred 2^nd year undergraduate students participated in the study who had just started their preclinical operative exercises. All the participants of the study group were asked to prepare a Class I amalgam cavity on maxillary left first molar typodonts followed by evaluation by a single evaluator. Then, all the participants were exposed to 21 days' practice of indirect vision exercises for 15 min using V-ME Shields and Sheets under supervision. Again, all the participants were asked to prepare a Class I amalgam cavity in maxillary left first molar typodonts followed by evaluation by the same evaluator. All the participants were asked about the usefulness of the device by requesting them to fill out the feedback form. The entire results were tabulated and statistically analyzed. Statistical analysis was done by one-way analysis of variance (P < 0.05) using IBM SPSS (version 21.0) software. Results: Students after being trained with the V-ME device performed better in indirect vision. According to the results obtained it is concluded that indirect vision can be mastered by practice and it also helps in precision work in clinical practice. Conclusion: V-ME shields and sheets are novel, simple, and cost-effective way to start practicing mirror vision skills during preclinical studies and to improve neurophysiological adaptation.

Background: Surgical endodontic dissatisfaction is frequently caused by an inadequate seal at the apex. The retrograde filling material utilized should prevent any contaminants from seeping into the periradicular tissue. Aim: (1) To evaluate push-out bond strength of mineral trioxide aggregate (MTA) Angelus, Zirconomer, and Bioactive bone cement as root-end filling material, (2) To compare push-out bond strength of three different retrograde filling materials with a universal testing machine. Materials and Methods: At the cementoenamel junction, 36 removed upper anterior teeth were sliced horizontally. The samples were resected 3 mm at the apical end at a 90° angle along the long axis of the tooth, following the standard protocols. With an ultrasonic tip S12 90ND, a 3 mm root-end cavity was made. The teeth were then divided into three groups at random: Group 1: MTA Angelus, Group 2: Zirconomer, and Group 3: Bioactive bone cement. With the help of small pluggers, each material was compacted in the root-end cavity. Acrylic resin was used to embed the specimens. Each specimen's apical section was sliced into 2-mm thick slices perpendicular to the long axis. A universal testing equipment was used to apply a compressive push-out load, and the push-out bond strength was determined in megapascals. Results: Zirconomer showed higher push-out bond strength when placed in the retrograde cavity preparation, followed by MTA Angelus and then Bioactive bone cement. Conclusion: Zirconomer showed superior resistance to dislodgment when compared to MTA Angelus, followed by Bioactive bone cement.

Background: Postoperative pain can occur because of residual infection even after effective chemomechanical preparation. This study aimed to compare postoperative pain after chemomechanical preparation with placebo and laser irradiation in nonvital teeth having symptomatic apical periodontitis. Materials and Methods: Sixty (n = 30) participants after obtaining written consent were enrolled in the study. In Group 1, chemomechanical preparation followed by mock laser therapy was carried out in which laser tip was applied but not activated. In Group 2, chemomechanical preparation followed by a laser irradiation was applied and activated. Postoperative pain scores were evaluated at baseline, 24 h, 48 h, and 72 h using the Visual Analog Scale. Preoperative and postoperative percussion pain scores were also recorded. Subjects needing rescue medication were recorded as well. Mann–Whitney U test and Wilcoxon test were used for intergroup comparison and intragroup comparison. The Chi-square test was used for comparing rescue medication. Results: There was significant reduction in pain scores in the laser group as compared to placebo group at all time points. There was also significant difference in the preoperative and postoperative percussion pain scores. 9 and 3 subjects required rescue medication in Groups 1 and 2, respectively. Conclusion: Laser irradiation following chemomechanical preparation led to significant reduction in postoperative pain and can be considered as a valuable adjunct.

Introduction: It is still unclear whether the pretreatment for dentin hypersensitivity can interfere with the adhesive–dentin bonding strength. This study aimed to evaluate in vitro the effect of pretreatment with a casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste and diode laser on the shear bond strength of the etch-and-rinse adhesive system in the adhesive–dentin interface. Materials and Methods: Seventy-five bovine root specimens were randomly divided into five experimental groups (n = 15). Samples were eroded by six cycles of immersion in hydrochloric acid solution (0.01M; pH = 1.2) for 20 s each, at 45 min intervals, and treated with: G2 – no treatment, G3 – CPP-ACP, G4 – diode laser (970 nm), and G5 – CPP-ACP + Diode laser. After treatments, the morphology of the specimens was analyzed. Results: The fracture mode of each group was evaluated after restoration with composite resins in the treated area. Data were analyzed by the one-way ANOVA and Tukey's test (P < 0.05). G3 showed the highest values for shear bond strength; there was no significant difference among G1, G3, and G5 (P > 0.05). The adhesive fracture was predominant for all groups. Conclusion: The use of desensitizers containing CPP-ACP, associated or not with a diode laser, increased the bond strength of the etch-and-rinse adhesive system on eroded root dentin.

Background: Commendable aesthetic properties of composites make it a pioneer filling material. However, discoloration of composite resin materials emerges as a major clinical problem in a long term. Aims and Objectives: Aim of the study is to evaluate the color stability of nano filled and micro hybrid dental composite resin in chlorhexidine mouthwash Materials and Methods: 20 specimens of dimension 10*2mm were prepared of A2 shade. All the prepared samples were immersed in 20 ml of distilled water in separate containers according to the group. Further incubation at 37°C for 24 h was done. After 24 h, baseline color values of each sample were recorded using a spectrophotometer. After recording the baseline color measurements, 10 specimens (random selection) from each group were placed in 20 ml of 0.2% chlorhexidine mouthwash for 24 h duration. The L*a*b* system of the Commission Internationale de l'Eclairage (CIE L*a*b* Color Scale) was used for the determination of colorimetric values of the specimens. Results: The color change was displayed by both the samples after immersion in the mouthwash but the change was not statistically significant (0.763). ΔE value for nano filled composites is 3.25 while for the micro-hybrid composites the value is 3.56. Conclusion: The colorimetric values of nano filled composite resins are more stable than the micro hybrid composite due to exposure to chlorhexidine mouthwash.

Aim: The aim of this in vitro study was to compare the efficacy of newly developed irrigation systems, i.e., XP-endo Finisher file (XP-endo), EndoActivator (EA), and Endo-Irrigator Plus (EI) with gold standard passive ultrasonic irrigation (PUI) tip and in removal of calcium hydroxide (CH) from single-rooted teeth with artificial simulated internal resorption cavities. Materials and Methods: One hundred and twenty single-rooted mandibular premolars were decoronated and prepared using the ProTaper Gold system up to F5. Samples were buccolingually sectioned and resorption cavities were prepared. Twenty specimens were served as Group 1 – negative control. In the remaining specimens, CH was delivered and root halves were brought together. Twenty specimens were served as Group 2 – positive control. The remaining specimens were randomly divided into four experimental groups (n = 20), where NaOCl and EDTA were activated using PUI, XP-endo, EA, and EI for 1 min. The remnants of CH were scored and analyzed by employing Kruskal–Wallis H- and Mann–Whitney U-tests. Results: PUI and XP-endo removed more CH than other devices (P < 0.05), showing no significant difference between them. Conclusion: None of the tested systems were able to remove CH completely from resorption cavities. PUI and XP-endo were superior to other tested devices.

Background and Objective: This study aimed to assess the prevalence, extent, risk indicators, and intraoral distribution of underlying dentin shadows (UDS) in the occlusal surfaces of the permanent posterior teeth. Subjects and Methods: A total of 1197 adolescents were included in the study (participation rate of 72.3%). The association between the independent variables, on the one hand, and the prevalence and extent of UDS were assessed using multilevel Poisson regression models. The prevalence ratios (PR), rate ratios (RR), and 95% confidence intervals (95% CIs) were estimated. The overall prevalence of UDS was 8.8% (95% CI = 6.0–11.5), with an overall mean of 0.13 (95% CI = 0.08–0.17) lesions per individual. Those with UDS exhibited a mean of 1.45 (95% CI = 1.28–1.62) lesions. Results: Lower family income (PR = 1.58; 95% CI = 1.03–2.41) and caries activity (PR = 1.53; 95% CI = 1.01–2.31) were significantly associated with UDS prevalence, while age ≥17 years (RR = 1.43; 95% CI = 1.03–1.99) and caries activity (RR = 1.63; 95% CI = 1.55–2.30) were significantly associated with caries extent. The most commonly affected teeth were lower first molars, followed by upper first molars and lower second molars. Conclusion: This study found a low prevalence and extent of UDS in the occlusal surface. Sociodemographic variables and caries activity were associated with the occurrence of UDS.

Objective: The purpose of the study is the evaluation and comparison of surface roughness and bond strength of glass fiber post (GFP) after different types of surface treatment and the application of a universal bonding agent. Materials and Methods: Forty GFPs were divided into four groups based on surface treatment: Group I, silane coupling agent application for 60 s; Group II, air abrasion with 30 μm silicon dioxide powder particles in 2.5 bar pressure from 2 cm distance for 10 s, followed by silane coupling agent application; Group III, 9% hydrofluoric acid application for 10 s, rinsed and air-dried, followed by silane coupling agent application; and Group IV, silane coupling agent application, followed by universal bonding agent application. Surface roughness evaluation is done by a profilometer. All posts were cemented in the root of the maxillary central incisor with resin cement. After that, root was placed in an acrylic mold, and the external end part of the post was mounted on another acrylic mold. Pull-out bond strength was measured by a universal testing machine. Results: Highest surface roughness and bond strength values were found in Group II. Conclusion: Pretreatment of GFP increases the surface roughness of post as well as bond strength of post to root dentin. There is a correlation between surface roughness and bond strength. However, the use of only universal bonding agent also showed comparable pull-out bond strength of GFP, which means only use of universal bonding agent also a new alternative as pretreatment of GFP and helps in increase in bond strength.

Aim: To find out the effects of 2% chlorhexidine (CHX) gel intracanal medicament on the dislodgement resistance of AH Plus, BioRoot RCS, and GuttaFlow 2 Sealer to dentin and on sealer-dentin interface. Materials and Methods: Sixty single-rooted maxillary canine were taken and divided into two groups based on the treatment: Group 1 – control group (no medicament) (n = 30) and Group 2 – (GLUCO-CHeX 2% Gel) (n = 30). Further, the groups were divided according to the sealer used, namely (A) AH Plus sealer, (B) BioRoot RCS Sealer, and (c) Gutta Flow 2 sealer. Teeth were prepared using rotary instrumentation of file size 35 with a taper of 0.06 and obturation was done. 1 mm thick sections were obtained from the roots. All the sections were checked for push out bond strength using Universal testing machine and mode of failure using stereomicroscope. Some samples were evaluated for sealer-dentin interface using field emission scanning electron microscope. Results: AH Plus showed higher bond strength compared to BioRoot RCS and GuttaFlow 2. There was no significant difference in the push out bond strength with or without the prior use of 2% CHX medicament (P > 0.05) and also CHX did not affect the mode of failure. However, sealer-dentin interface gap was increased with application of medicament. Conclusion: Dislodgement resistance of AH Plus sealer is significantly higher than BioRoot RCS and GuttaFlow 2 sealer. The application of 2% CHX intracanal medicament before root canal obturation did not significantly affect the dislodgement resistance of the three tested sealers. 2% CHX medicament did not affect the failure mode of the sealers. Sealer-dentin interface is affected by the use of 2% CHX gel medicament.

Context: The resin–dentin interface is less durable, which reduces the longevity of tooth-colored restorations. To encounter this shortcoming, the use of nanotechnology to mimic biomineralization proves beneficial. Aims: This study was conducted to evaluate the effect of remineralization with strontium-doped nanohydroxyapatite (Sr-nHAp) with chitosan on shear bond strength of resin composite to dentin. Materials and Methods: Sixty five extracted human premolars were divided into five groups (n = 13) based on remineralization protocol as: Group A – 20% (Sr-nHAp) with chitosan, Group B – 10% (Sr-nHAp) with chitosan, Group C – 20% (Sr-nHAp) with simulated body fluid, Group D – 10% (Sr-nHAp) with simulated body fluid, and Group E – control. Following bonding, resin composite of specified dimension was built and was subjected to shear bond strength test after 24 h and 1 week using Universal Testing Machine, and mode of failure was assessed. ANOVA and paired sample t-test were used for analyzing the data, and the level of significance was set at 5%. Results: The highest value of shear bond strength was obtained from Group A after aging for a week, and there is a significant increase in the value of all the groups as compared to the control group after 1 week of storage than 24 h. Conclusions: Remineralization with Sr-nHAp and chitosan has positively improved the bond strength of resin to dentin at the end of 1 week.

Aim: The aim of the present study was to assess the efficacy of articaine versus mepivacaine administered as different supplementary local anesthetic techniques after a failed inferior alveolar nerve block (IANB) with lidocaine in patients with irreversible pulpitis. Materials and Methods: A total of 120 patients were included in the study. Patients were given IANB with 2 ml of 2% lidocaine hydrochloride with 1:80,000 epinephrine. Patients who showed subjective symptoms of IANB but did not secure pulpal anesthesia were randomly allocated to one of the following four groups by random sampling for supplementary local anesthesia – Group 1: buccal infiltration (BI) with 4% articaine with 1:100,000 epinephrine, Group 2: four-site intraligamentary (IL) injection with 4% articaine with 1:100,000 epinephrine, Group 3: BI with 2% mepivacaine with 1:100,000 epinephrine, and Group 4: four-site IL injection with 2% mepivacaine with 1:100,000 epinephrine. Results: Group 1 – BI with articaine provided anesthesia success in 27 cases (90%, n = 30). Group 2 – IL injection with articaine provided anesthesia success in 20 cases (66.67%, n = 30). Group 3 – BI with mepivacaine provided anesthesia success in 21 cases (70%, n = 30). Group 4 – IL injection with mepivacaine provided anesthesia success in 15 cases (50%, n = 30). A significant difference between the four groups was found. Conclusion: In patients with a mandibular first molar exhibiting symptomatic irreversible pulpitis, block injection with lidocaine along with supplemental BI with articaine allowed more pain-free treatments. Articaine showed better results when compared with mepivacaine.

Aim: The purpose of this study was to evaluate the effect of light-curing units (LCUs) on the degree of conversion (DC) and microhardness of composites with varying photoinitiator systems. Materials and Methodology: Two groups were formed based on LCU – monowave (Group M) and polywave (Group P). Each group was further divided into two subgroups based on photoinitiator systems – combination of camphorquinone (CQ), Ivocerin, and 2,4,6-trimethylbenzoyl diphenylphosphine oxide (Subgroup CIT) and only CQ (Subgroup C) in the composite. Samples prepared were 4 mm thick. Microhardness was measured at bottom surface by Vickers hardness tester, and DC was evaluated by Fourier transformation infrared spectroscopy. Statistical Analysis: Kolmogorov–Smirnov test was used. Results: Both the mean microhardness and DC of composite in subgroup C were similar (P > 0.05) in Group M (52.42 ± 2.67 and 48.30 ± 5.81) and Group P (51.77 ± 1.96 and 48.50 ± 4.87). The mean microhardness of composite containing a combination of photoinitiators was more in Group P (57.09 ± 2.61) as compared to Group M (47.37 ± 3.51). The mean DC was higher in Group P (59.75 ± 5.30) as compared to Group M (39.70 ± 3.57), and these differences were statistically significant (P < 0.05). Conclusion: The type of LCU affects DC and microhardness only in the case of composites containing a combination of photoinitiators.

Aim: The aim of this study is to evaluate the push-out bonding strength of class II cavities of maxillary molars restored with different concentrations of chitosan nanoparticles (CSN) incorporated in universal composite resin and eighth-generation dentin bonding agent (DBA). Materials and Methods: Seventy extracted human maxillary first molar teeth were cleaned and mounted in acrylic mold up to 2 mm below cementoenamel junction and mesio-occlusal Class II cavities with standard measurements were prepared. CSN 2% and 0.25% powder were added to the DBA and composite resin. The samples then arbitrarily divided into three groups for restoration: Group 1: composite restoration without CSN (control group) (n = 10), Group 2: 2% CSN (n = 30), and Group 3: 0.25% CSN (n = 30). Groups 2 and 3 were further subdivided into three subgroups (n = 10 each) subgroup A. CSN incorporated in composite resin. B. CSN incorporated in DBA and C. CSN incorporated in composite and DBA. After restoration, push-out bond strength was evaluated in each sample using a universal testing machine, and data collected were statistically analyzed by one-way analysis of variance and Post hoc Tukey tests (P ≤ 0.05). Results: Subgroup 3A (0.25% CSN + composite) has shown an increase in bond strength among all experimental groups with no significant difference between group 1 (control group). Conclusion: CSN 0.25% incorporated in composite or DBA exhibits no harmful effect on the bond strength of class II restorations. Hence, it can be used to improve the antibacterial action and longevity of composite resin.

Background and Aim: Complete removal of gutta-percha and sealer is an important step during retreatment. The aim of this study was to assess the efficacy and time taken by full counterclockwise rotary motion of a reciprocating file in the removal of gutta-percha and BioRoot™ RCS bioceramic sealer. Materials and Methods: Thirty-six extracted human mandibular premolars were instrumented with Mtwo rotary files and obturated using lateral condensation technique with gutta-percha and BioRoot™ RCS bioceramic sealer. The teeth were divided into three retreatment groups (n = 12) based on the kinematics used: Group I, Mtwo retreatment (Mtwo-R) files; Group II, Reciproc files used in reciprocation mode (Reciproc-R); and Group III, Reciproc files used in full counterclockwise motion (Reciproc-CCW). The efficacy of gutta-percha and bioceramic sealer removal was assessed by volume of gutta-percha removed using cone-beam computed tomography and area of remaining gutta-percha and bioceramic sealer using ImageJ software after longitudinal sectioning. Statistical analysis was done by one-way analysis of variance test and Tukey's multiple post hoc tests. Results: Reciproc-CCW motion was significantly efficient in the removal of gutta-percha and bioceramic sealer in comparison to Mtwo-R files and Reciproc-R. The time taken for gutta-percha and sealer removal was least for Reciproc-R (325.5 ± 101.68 seconds) and was statistically significant in comparison to the other groups. Conclusion: Within the limitations of the study, Reciproc-CCW was an effective method of removal of gutta-percha and bioceramic sealer during retreatment.

A broad classification of the various dental restorative materials has been proposed for easy understanding for undergraduate students. A comprehensive search of the literature was conducted for the various dental materials available. The literature search revealed the classifications of individual materials based on their composition, use, and techniques employed. The proposed classification will facilitate effective communication and easy understanding of the various dental restorative materials as a whole.