Background : Veneer restorations provide a valid conservative alternative to complete coverage as they avoid aggressive dental preparation; thus, maintaining tooth structure. Initially, laminates were placed on the unprepared tooth surface. Although there is as yet no consensus as to whether or not teeth should be prepared for laminate veneers, currently, more conservative preparations have been advocated. Because of their esthetic appeal, biocompatibility and adherence to the physiology of minimal-invasive dentistry, porcelain laminate veneers have now become a restoration of choice. Currently, there is a lack of clinical consensus regarding the type of design preferred for laminates. Widely varying survival rates and methods for its estimation have been reported for porcelain veneers over approximately 2-10 years. Relatively few studies have been reported in the literature that use survival estimates, which allow for valid study comparisons between the types of preparation designs used. No survival analysis has been undertaken for the designs used. The purpose of this article is to attempt to review the survival rates of veneers based on different incisal preparation designs from both clinical and non-clinical studies. Aims and Objectives : The purpose of this study is to review both clinical and non-clinical studies to determine the survival rates of veneers based on different incisal preparation designs. A further objective of the study is to understand which is the most successful design in terms of preparation. Materials and Methods : This study evaluated the existing literature - survival rates of veneers based on incisal preparation designs. The search strategy involved MEDLINE, BITTORRENT and other databases. Statistical Analysis : Data were tabulated. Because of variability in the follow-up period in different studies, the follow-up period was extrapolated to 10 years in common for all of them. Accordingly, the failure rate was then estimated and The weighted mean was computed. Conclusions : The study found that the window preparation was of the most conservative type. Incisal coverage was better than no incisal coverage and, in incisal coverage, two predictable designs - incisal overlap and butt were reported. In butt preparation, no long-term follow-up studies have been performed as yet. In general, incisal overlap was preferred for healthy normal tooth with sufficient thickness and incisal butt preparation was preferred for worn tooth and fractured teeth.

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This case report explains about an innovative treatment strategy for the management of damaged anterior teeth with reduced incisal clearance by means of a single-unit all-ceramic post-core-crown zirconia ceramic restoration fabricated by Computer-aided designing and computer-aided manufacturing (CAD/CAM) technology. The reinforced zirconia ceramics allow fabrication of durable esthetic restorations in cases with high functional loading and the unification of the post, core, and crown in a single unit decreases the frequency of failure by creating a monobloc effect. In addition, the use of CAD/CAM technology for designing and fabricating ceramic restorations offers the option of expeditiously preparing these high-strength all-ceramic restorations.

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Objectives : The objective of this study was to evaluate the influence of caries detection dye on the in-vitro tensile bond strength of adhesive materials to sound and carious affected dentin. Materials and Methods : Forty healthy and carious human molars were ground to expose superficial sound dentin and carious affected dentin. Caries Detector dye was applied to sound and carious affected dentin and rinsed. Subsequently the dentin was etched with 37% phosphoric acid and rinsed leaving a moist dentin surface. The adhesive (Single bond) was applied in single layers and light cured. A posterior composite (Filtek Z 250) were used to prepare the bond strength specimens with a 3 mm in diameter bonding area. Control and experimental groups were made with and without application of dye respectively. Each group includes both sound and carious affected dentin. After 24 hour immersion in distilled water, tensile bond strength (MPa) was measured using an Instron testing machine. Results : Analysis of variance (ANOVA) was used to evaluate the data. The tensile bond strength were significantly less in experimental subgroup than control subgroups. Conclusion : The tensile bond strengths were higher in sound and carious affected dentin without application of caries detection dyes.

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Root perforation repair has historically been an unpredictable treatment modality, with an unacceptably high rate of clinical failure. Recent developments in the techniques and materials utilized in root perforation repair have dramatically enhanced the prognosis of both surgical and nonsurgical procedures. Mineral Trioxide Aggregate is a relatively new material that is being successfully used to repair perforations. Technological advancements such as the use of a Dental Operating Microscope for correction of these inevitable procedural errors are a major breakthrough in dentistry today. This article presents one clinical case of nonsurgical root perforation repair by Mineral Trioxide Aggregate, using the Dental Operating Microscope.

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Aim: To evaluate and compare the sealing ability between the conventional cold lateral condensation technique and two different obturating techniques - Obtura II and GuttaFlow under a stereomicroscope at 40΄ magnification. Materials and Methods: Sixty single-rooted teeth were selected and the canals were shaped with ProTaper rotary files. Irrigation was performed with 5% sodium hypochlorite and 17% EDTA. The teeth were then separated into three groups depending on the type of obturation technique. Group A (n = 20) - obturated using the Lateral condensation technique and AHplus sealer, Group B (n = 20) - obturated with Obtura II injection-molded thermoplasticized technique and AHplus sealer, and Group C (n = 20) obturated using GuttaFlow. After storing the teeth in 100% humidity for seven days at 37⁰C, the roots of the teeth were sectioned at five levels. The sections were then observed under a stereomicroscope at 40 × magnification and the images were analyzed for area of voids (AV) and frequency of voids. Statistical Analysis Used: The data was statistically analyzed using the SPSS version 17 software. The 95% confidence intervals (CI) were calculated. One-way analysis of variance with post-hoc test and non-parametric Mann-Whitney U test was carried out, to compare the means. Results: The lowest mean of AV was recorded in the Obtura II group, 1.0% (95% CI = 0.5 - 1.5). This was statistically and significantly different from the GuttaFlow group, 3.0% (95% CI = 2.1 - 3.9). There was no significant difference between the Obtura II group and the lateral condensation group, 1.6% (95% CI= 1.0 - 2.2) with regard to the area of voids, but there was a statistically significant difference between the Lateral condensation and GuttaFlow groups. The GuttaFlow group showed the maximum number of voids, 56% (95% CI = 48 - 64), which was significantly higher than those in the lateral condensation, 26% (95% CI= 19 - 34), and Obtura II, 15% (95% CI= 10 - 21) groups. Conclusion: The Obtura II technique utilizing the injection-molded thermoplasticized gutta-percha had better adaptability to the canal walls when compared to the GuttaFlow obturation and lateral condensation techniques.

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Aim : The purpose of the study is to assess and compare compressive strength of newer nanocomposites (FiltekZ350, Ceram X Mono, Ceram X Duo) with microhybrid (Tetric Ceram) and to compare difference in compressive strength of newer nanocomposites. Materials and Methods : Forty eight specimens of composite were fabricated using customized biparpite brass mold measuring 5mm x 5mm and were grouped with twelve specimens in each Group I : Tetric Ceram, Group II: Filtek Z 350, Group III : Ceram X Mono, Group IV : Ceram X Duo. Composite resins are placed in cylindrical recesses and covered with mylar strip and are cured using QHL light curing unit. Compressive strength is evaluated using Instron machine. Results are statistically analyzed using One way Anova and Student t test. Analysis demonstrated that nanocomposites have better compressive strength than micro hybrid (P<0.001). Results : Within the limitations of the study, it can be concluded that nanocomposites have better compressive strength than microhybrid composite and nanocomposite showed optimal compressive strength of 312 - 417 Mpa.

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Aim : The clinical performance of the combined composite - amalgam restorations in posterior teeth was evaluated. Materials and Methods : One hundred carious posterior teeth were randomly divided into four groups of 25 teeth each. In Group A, the teeth were restored with composite Z250 and amalgam FusionAlloy. In Group B, composite Surefil and amalgam were used. In Groups C and D, the teeth were restored with composite Surefil and amalgam FusionAlloy, respectively. The restorations were evaluated at 3, 6, 12, and 15 months, using the Ryge criteria. Results : Combined restorations and amalgam restorations showed better contact and contour than the composite restorations. No statistically significant difference was observed among the groups. Three amalgam restorations exhibited loss of retention. Conclusion : The combined composite-amalgam restorations performed better for contact and contour and retention than composite and amalgam restorations, respectively.

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This case report describes a pulpotomy treatment of a permanent mature molar tooth with established irreversible pulpitis and condensing apical periodontitis, using calcium-enriched mixture (CEM) cement. Clinical examination revealed that the first right lower molar had a large carious lesion with history of spontaneous/lingering pain; radiographic examination showed condensing apical periodontitis. Pulpotomy was opted as the treatment; cervical pulpotomy was carried out. Following hemostasis, the radicular pulp stumps were covered with ~2-mm-thick layer of the prepared CEM cement; the tooth was restored with amalgam. Two-year follow-up showed that the treated tooth had been symptomless, and there were no clinical signs/symptoms of either inflammation or infection. Radiographically, the periradicular lesion was completely healed with reconstruction of bone structures to normal appearance; the root canals were not calcified. According to chemical, physical, and biological properties of the CEM cement, this novel biomaterial may be suitable for endodontic treatment.

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To report a rare case of maxillary canine with two root canals. The case describes the treatment of a maxillary canine with two root canals which was referred from department of prosthodontia for intentional root canal treatment for prosthetic rehabilitation. Clinical examination revealed a maxillary canine with carious lesion and responded within normal limits to electric pulp test. Radiographic examination revealed a distal carious lesion (close proximity to pulp) and also appeared to be an additional canal in this permanent maxillary canine.

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Objective : To evaluate the apical sealing ability and adaptation of three resin-based sealers to the dentine. Materials and Methods : A total of 66 recently extracted human maxillary anterior teeth were subjected for the study. The teeth were prepared and obturated with gutta-percha by a lateral condensation using AH Plus, Endorez and Epiphany sealers. Fifteen teeth from each group were used for the apical leakage test and the remaining five teeth from each group were used for examination under the scanning electron microscope. Data were analyzed using one-way ANOVA and the Student Newman-Keuls test. Results : Epiphany sealer showed better sealing ability and adaptation to dentine. Conclusion : The Epiphany sealer has a better apical sealing ability and adaptation to dentine than the AH Plus and Endorez sealers.

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Aim: The purpose of this study is to critically evaluate the factors that affect the bond strength of one-step and two-step self-etch adhesives by using meta-analysis. Materials and Methods: Potential papers that were selected according to inclusion and exclusion criteria from articles were published in 13 peer-reviewed journals using "PubMed data base". From each report, means and standard deviations of bond strengths were extracted and tabulated with corresponding experimental conditions. Results: All the studied parameters showed no significant difference, except for dentin origin/site and bonding area. In addition, statistical analysis done with ANOVA showed statistical significance between the one-step and two-step self-etch adhesives. Conclusions: Our analysis has showed that two-step self-etch adhesive system showed a superior in vitro performance in comparison to one-step self-etch system. Nevertheless, certain factors such as dentin origin, site and area of bonding affect the bond strength of adhesives.

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Background: One of the major disadvantages associated with using composites is polymerization shrinkage; stresses are generated at the margins, and if these stresses exceed the bond strength, microleakage occurs at the tooth restoration interface which causes ingress of cariogenic bacteria, post-operative sensitivity, and secondary caries. LED offers several curing modes: constant cure, ramped cure, and soft start cure. It is claimed that soft start polymerization mode produces less polymerization shrinkage and consequently less postoperative sensitivity. Objective: To compare the postoperative sensitivity in Class V composite restorations using soft start and constant LED curing modes. Materials and Methods: Using the appropriate burrs cavity was prepared and filled with composite Z 100(3M-ESPE) using a incremental technique. Each increment of 2 mm was cured either with soft start or constant cure. All patients were evaluated at day 2 for postoperative sensitivity. Results and Discussion: Out of 124 restorations that were placed, only three restorations presented with postoperative sensitivity, each one being in mild, moderate, and severe categories, respectively. No relationship was seen between the sensitivity and tooth type. There was no statistically significant difference in postoperative sensitivity in either of the treatment modalities (constant or soft start). Conclusion: We conclude that restorations placed with the soft start curing technique did not show significant changes in postoperative sensitivity when compared to the constant curing technique.

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Aim : To examine the influence of different post-surface treatments on the interfacial strength between epoxy resin-based fiber posts and methacrylate-based resin composites that are employed as core build-up materials. Materials and Methods : Forty clear posts were divided into four groups of 10 each. The different surface treatments used were etching with alkaline potassium permanganate, 10% hydrogen peroxide, 37% phosphoric acid, and silanization alone. After etching and thorough rinsing, a single layer of silane was applied to the post surface. Then the post was placed in a rectangular plastic matrix and core bulid-up was done using Multi Core, a dual cured composite resin. A slab of uniform thickness, with the post in the center and the core build-up composite on either side was created. The specimens were cut so as to obtain microtensile sticks that were loaded in tension at a cross-head speed of 1 mm/min until failure. The statistical analysis was performed using two-way ANOVA and the paired T test for post-hoc comparisons. Results : The results achieved with potassium permanganate had a significant influence on microtensile interfacial bond strength values with the tested material. Conclusion : Surface chemical treatments of the resin phase of fiber posts enhance the silanization efficiency of the quartz fiber phase, so that the adhesion in the post/core unit may be considered as a net sum of chemical and micromechanical retention.

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Aim : The purpose of this study was to evaluate the antibacterial efficacy of 3% sodium hypochlorite (NaOCl), high-frequency alternating current (HFAC) (Endox Endodontic System), 2% chlorhexidine (CHX) in elimination of Enterococcus faecalis from experimentally infected root canals, in vitro.0 Materials and Methods : Eighty extracted, single rooted permanent upper anterior teeth were instrumented up to size 50, teeth were sterilized and inoculated with E.faecalis, subcultured in BHI broth which had its optical density adjusted to approximately 1.5Χ10 ⁸ colony forming units (CFUs) ml ^-1 by comparing its turbidity to a McFarland 0.5 BaSO ₄ standard solution. After incubation for 24 h, the contaminated root canals were divided into four groups and subjected to action of NaOCl 3%, CHX 2%, and HFAC with physiological saline as a positive control. Sterile paper points were selected to take the sample of the bacteria and transferred to tubes containing 5ml of BHI broth and then incubated for 24 and 48 h, followed by agar plating of the resultant broth turbidity on Enterococcus confirmatory agar. Results : Data obtained were analyzed statistically for differences using chi-squared test, comparing different groups, with a significance level established at P<0.05 and 3% NaOCl showed no growth postoperatively, CHX and HFAC showed reduction of postoperative growth compared to physiological saline and, were statistically significant (P<0.05). Conclusion : In the present study, sodium hypochlorite, CHX, HFAC all were significantly effective in eliminating E. faecalis and sodium hypochlorite showed the maximum anti-bacterial activity against E. faecalis.

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Objective : The present study was undertaken to evaluate the effect of hydroxyapatite (HA) and calcium sulfate (CS) on the sealing ability of mineral trioxide aggregate (MTA) and light cured glass ionomer cement (LC GIC) when used to repair furcation perforations. Materials and Methods : The study was conducted on 70 human molars. Sixty teeth with furcal perforations were randomly divided into six groups of 10 teeth each and repaired with MTA or LC GIC either alone or over an internal matrix, i.e., CS or HA. Access openings were filled with composite resin. Five teeth with unrepaired perforations were used as positive controls and five teeth without perforations were used as negative controls. The teeth were immersed in a solution of 2% methylene blue dye for 2 weeks. The samples were then sectioned and evaluated for linear dye leakage and analyzed statistically. Results : MTA showed the best sealing ability followed by LC GIC, MTA + CS, MTA + HA, LC GIC + CS and LC GIC + HA. Conclusion : Neither of the two internal matrices improved the sealing ability of the repair materials used.

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Background and Objective : The objective of this study was to compare bacterial leakage using streptococcus mutans through gutta-percha and a thermoplastic synthetic polymer based root canal filling material (Resilon) using two filling techniques. Materials and Methods : A total of 90 single-rooted extracted human teeth were subjected for the study. Teeth were divided into 6 groups of 10 and 3 control groups of 10 teeth each. All the samples were decoronated and the coronal surfaces of the roots were prepared perpendicular to the long axis of the root with a high-speed handpiece and a multipurpose bur using air water spray. The length of all the roots was prepared approximately 16 mm from the coronal surface to the apex of the root. Roots were filled using lateral and vertical condensation techniques with gutta-percha and AH26 sealer (Group 1 and 2) or with gutta-percha and epiphany sealer (Group 3 and 4). Group 5 and 6 were filled with Resilon and epiphany sealer using the lateral and vertical condensation techniques. A split chamber microbial leakage model was used in which S. mutans placed in the upper chamber could reach the lower chamber only through the filled root canal. Group 7 and 8 (positive control) were filled with Resilon and gutta-percha without sealer and tested with bacteria, whereas Group 7 (negative control) was sealed with wax to test the seal between the chambers. Data were analyzed using Kruskal-Wallis test and Mann-Whitney U test. Results : All positive groups (Group 7 and 8) showed leakage within 1 hour of the start of the study (100%), whereas none of the negative control (Group 9) leaked. The roots obturated with Resilon and epiphany (Group 5 and 6) showed minimal leakage, i.e., each with 6 leakages, which was significantly less than gutta-percha (Group 1-4), in which approximately 80% of specimens with either sealer or techniques leaked. Kruskal-Wallis test showed statistical significance when all groups were compared (P<0.05). Mann-Whitney U test compared the respective groups and found Resilon groups superior to gutta-percha groups (P<0.05). Interpretation and Conclusion : This study demonstrated that the new polymer-based Resilon and epiphany sealer using two obturating techniques, i.e., lateral as well as vertical condensation found to be significantly better than the gutta-percha.

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Aim: to evaluate and compares the healing clinically and radiographically following periapical surgery with and without using hydroxyapatite graules. Materials and Methods: Twenty patients were selected for the study & the nature of healing is compared with that of conventional periapical surgery. In the present clinical study chitra hydroxyapatite granules, a freeze-dried hydroxyapatite, is used to fill the osseous defects following periapical surgery. Following surgery all patients were assessed both clinically & radiographically for a period of nine months. Results: On clinical evaluation the test group did not show any significant immediate or delayed local tissue reactions. Radiographically in the follow up period of 6 - 9 months the bone graft became indistinguishable from the surrounding bone which indicates complete bone regeneration. Where as in the control group ever after 9 months the radiographs showed inadequate bone fills. Conclusion: The bone regeneration following periapical surgery can be facilitated by using bone graft. Hydroxyapatite is found to be very effective alloplastic material. Based on this study it might be concluded that in large bone destruction caused by periradicular lesion bone regeneration can be facilitated by effective bone replacing materials like hydroxyapatite.

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Aim :This study has been designed to evaluate the effect of strong (MTAD) or soft (1- hydroxyethylidene - 1, 1-bisphosphonate (HEBP) final irrigating solution on the shear bond strength of AH plus sealer to coronal dentin. 17% EDTA was used as the reference. Materials and Methods : Forty freshly extracted human maxillary first premolars were prepared using different irrigation protocols (n=10). All the test groups had 1.3% NaOCl as initial rinse and followed by specific final rinse for each group: G1 - distilled water(control), G2 - 17% EDTA, G3- 18% HEBP and G4 - MTAD. Sections of polyethylene tubes that are 3mm long were filled with freshly mixed sealer and placed on the dentin surfaces. The bonding between the sealer and dentine surface was evaluated using shear bond testing. The values were statistically evaluated using one-way ANOVA followed by Tukey's test. Result : Significant difference was found among the irrigating regimes. EDTA showed highest bond strength followed by HEBP and MTAD

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Aim : This study evaluated the effect of thermal and mechanical loading on marginal adaptation and microtensile bond strength in total-etch versus self-etch adhesive systems in caries-affected dentin. Materials and Methods : Forty class II cavities were prepared on extracted proximally carious human mandibular first molars and were divided into two groups: Group I - self-etch adhesive system restorations and Group II - total-etch adhesive system restorations. Group I and II were further divided into sub-groups A (Without thermal and mechanical loading) and B (With thermal and mechanical loading of 5000 cycles, 5 ± 2°C to 55 ± 2°C, dwell time 30 seconds, and 150,000 cycles at 60N). The gingival margin of the proximal box was evaluated at 200X magnification for marginal adaptation in a low vacuum scanning electron microscope. The restorations were sectioned, perpendicular to the bonded surface, into 0.8 mm thick slabs. All the specimens were subjected to microtensile bond strength testing. The marginal adaptation was analyzed using descriptive studies, and the bond strength data was analyzed using the one-way analysis of variance (ANOVA) test. Results and Conclusions : The total-etch system performed better under thermomechanical loading.

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Aim: This study was designed to evaluate the influence of different time intervals of a vital home bleaching procedure on the fracture toughness of bovine enamel. Materials and Methods: Labial aspects of 48 bovine incisors were prepared and stored in artificial saliva. The samples were divided into four groups (n = 12) according to the different time intervals of the bleaching procedure: 0, 2, 4, and 6 weeks. The experimental groups were subjected to the bleaching agent; 15% Opalescence PF according to manufacturer's instructions. The fracture toughness (FT) of enamel was assessed using Vickers hardness indentation. Then, FTs were compared statistically by one-way ANOVA (a = 0.05). Results and Discussion: Different tested time intervals did not significantly influence the fracture toughness of bovine enamel following treatment with 15% carbamide peroxide (P > 0.05) Conclusion: 15% Opalescence PF after 6 weeks did not reduce the fracture toughness of human enamel compared with the baseline, 2 and 4-week values.

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Aims : The objective of thisstudy is to evaluate and compare 4% titanium tetrafluoride with 2% Sodium fluoride, and the bond strength of composite resin with dentin and their effects on the smear layer. Materials and Methods: Fifty freshly extracted non-carious molar and premolar teeth were selected. The occlusal surfaces of the teeth were ground, to prepare flat dentin surfaces at a depth of 2 mm and were randomly grouped with 10 specimens in each. Group I (Etching + Adhesive + Composite resin) was taken as a control group. In Group II, 4% titanium tetrafluoride was applied before etching and in Group III, 4% titanium tetrafluoride was applied after etching. In Group IV, 2% Sodium fluoride was applied before etching and in Group V, 2% Sodium fluoride was applied after etching. Shear bond strength was tested using the Lloyds Universal testing machine and was recorded in MPa. Results : The results were statistically analyzed using the one-way Anova test. Group III showed the highest bond strength among the experimental groups, but less than the control group. Conclusions : Under the conditions of this in vitro study, titanium tetrafluoride did not significantly affect the bond strength of the composite. Sodium fluoride was found to deleteriously affect the bond strength of the composite.

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