Aims: The aim of this study was to evaluate and compare the remineralization potential of bioactive-Glass (BAG) (Novamin^; /Calcium-sodium-phosphosilicate) and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) containing dentifrice. Materials and Methods: A total of 30 sound human premolars were decoronated, coated with nail varnish except for a 4 mm Χ 4 mm window on the buccal surface of crown and were randomly divided in two groups (n = 15). Group A - BAG dentifrice and Group B - CPP-ACP dentifrice. The baseline surface microhardness (SMH) was measured for all the specimens using the vickers microhardness testing machine. Artificial enamel carious lesions were created by inserting the specimens in de-mineralizing solution for 96 h. SMH of demineralized specimens was evaluated. 10 days of pH-cycling regimen was carried out. SMH of remineralized specimens was evaluated. Statistical Analysis: Data was analyzed using ANOVA and multiple comparisons within groups was done using Bonferroni method (post-hoc tests) to detect significant differences at P < 0.05 levels. Results: Group A showed significantly higher values (P < 0.05) when compared with the hardness values of Group B. Conclusions: Within the limits; the present study concluded that; both BAG and CPP-ACP are effective in remineralizing early enamel caries. Application of BAG more effectively remineralized the carious lesion when compared with CPP-ACP.

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Aim: The aim of this study is to evaluate the enamel remineralization after treatment with three different remineralizing agents using surface microhardness assessment. Materials and Methods: This in vitro study involves 50 enamel samples divided into five groups of 10 samples each. The positive control group consisted of intact enamel and a negative control group consisted of demineralized enamel samples. All groups excluding the positive control group were subjected to demineralization following which three of these groups were remineralized using remineralizing agents (casein phosphopeptide amorphous calcium phosphate [CPP-ACP] [GC tooth mousse], casein phosphopeptide amorphous calcium phosphate with fluoride [CPP-ACPF] [GC tooth mousse plus], sodium fluoride [phos-flur]). The groups treated with remineralizing agents were subjected to pH cycling over a period of 28 days. This was followed with assessment of surface microhardness (Micro Vickers Hardness tester, Matsuzawa Co., Ltd, Toshima, Japan). Statistical Analysis: One-way analysis of variance test and posthoc Tukey test were conducted for multiple group comparison. Results: There was an improved enamel remineralization in the group, remineralized using CPP-ACPF in comparison with the other groups. Conclusion: Casein phosphopeptide with fluoride is a promising material for remineralization of enamel subsurface lesions.

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Objective: The aim of this in vitro study was to evaluate and compare the effect of 10% sodium ascorbate, 6.5% proanthocyanidin, and 5% lycopene on the bond strength of composite resin to bleached enamel. Materials and Methods: Labial enamel surfaces of 100 extracted human maxillary central incisors were used in this study. Twenty teeth served as group I (control) and received no bleaching treatment. The remaining 80 teeth were randomly divided into four groups of 20 teeth each, based on the antioxidant used as follows: group II- bleaching with 35% carbamide peroxide gel for 30 min without the use of an antioxidant, group III- bleaching followed by use of 10% sodium ascorbate solution, group IV- bleaching followed by use of 6.5% proanthocyanidin, and group V- bleaching followed by use of 5% lycopene. These groups were further subdivided into two subgroups of 10 teeth each, based on whether composite buildup was done immediately (subgroup A) or after a delay of 2 weeks (subgroup B) post bleaching. Shear bond strength of the specimens was tested under universal testing machine. The data were tabulated and statistically analyzed. Results: Significantly higher shear bond strength values were observed in teeth treated with control group prior to bonding, followed by sodium ascorbate group. Conclusion: Within the limitations of this study, it can be concluded all the antioxidants used in this study increased the bond strength of bleached enamel. Among the antioxidant groups, sodium ascorbate showed significantly higher bond strength compared to proanthocyanidin and lycopene.

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Purpose: The present study was aimed to evaluate and compare the color stability of two hybrid tooth-colored restorative materials, namely, resin-modified glass ionomer cement (GC Fuji II LC Capsules - GC Corporation, Tokyo, Japan) and giomer (Beautifil II - Shofu Inc, Kyoto, Japan) when subjected to immersion in various children's beverages. Materials and Methods: Standardized disc specimens were prepared using the test restorative materials. After preparation and rehydration of the specimens, baseline color evaluations were performed using spectrophotometer. The readings were recorded according to CIELAB color space. The experimental groups were further subdivided for immersion in orange juice, bournvita milk, and coke. Subsequent to immersion and pH cycling, new color evaluations were carried out after 1 week and 4 weeks for all the experimental groups. The mean color change values were calculated. Results: The obtained data was subjected to statistical analysis. The results indicated that giomer specimens exhibited less color change as compared to RMGIC specimens indicating better color stability. The maximum color changes were found with the use of coke for a period of 4 weeks. Conclusion: Amongst the two materials, giomer showed less color changes as compared to RMGIC indicating a better color stability.

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Palatogingival groove is an anatomical malformation that often causes severe periodontal defects. Treatments of such an anomaly present a clinical challenge to the operator. Careful endodontic and periodontal procedures may restore the form and function. In the present case; root canal therapy, apicectomy, and sealing of the groove with Biodentine ^TM were done. Bone graft was placed followed by platelet-rich fibrin (PRF) membrane. This treatment modality resulted in gain in attachment, reduction in pocket depth, and deposition of bone in the osseous defect. A 24 month follow-up is included.

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Background: Endodontic obturating materials should form monoblocks, reinforcing the treated teeth against fracture. Aim: To evaluate and compare the effect of two resin sealers and a MTA sealer on the fracture resistance of endodontically treated teeth. Materials and Methods: Fifty single-rooted mandibular premolars, decoronated at cemento-enamel junction, were divided into 5 groups (n = 10 each). Group 1 and group 2 served as negative and positive controls. Cleaning and shaping of root canals was done using ProTaper rotary files and 3% sodium hypochlorite irrigation. Obturation was done using AH plus (Dentsply, Germany) (group 3), MetaSEAL (Parkell, USA) (group 4), MTA Fillapex (Angeles, Brazil) (group 5) sealers and gutta-percha. Teeth were subjected to vertical loading using a universal testing machine and the point at which fracture of the roots occurred was recorded. The data was subjected to statistical analysis using one way analysis of variance (ANOVA) followed by pair-wise comparison using Tukey's Post-hoc test. Results: AH Plus showed better fracture resistance among the sealer groups. Statistically, no significant difference was found between MetaSEAL and Fillapex groups. Conclusion: MTA Fillapex as a root canal sealer was not able to reinforce the tooth against fracture.

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Aims: To compare the shear bond strength of sixth generation and seventh generation bonding agents to dentin. Materials and Methods: Eighty human maxillary premolars were reduced to expose flat surface of dentin and divided into four equal groups, which were bonded using following bonding agents: Sixth generation bonding agents, Adper SE Plus and Xeno III and Seventh generation bonding agents, Adper Easy One and Xeno V. Composite cylinders were then built using a plastic mould on these prepared dentinal surfaces. Samples were stored in distilled water for 24 hours and tested for shear bond strength with universal testing machine. Shear force was applied perpendicular to the long axis of composite cylinder at adhesive-tooth interface until debonding occurred. The data so obtained were tabulated and analyzed statistically using independent-samples t test and analysis of variance (ANOVA) test Results: The seventh generation adhesives showed significantly higher shear bond strength to dentin compared to sixth generation adhesives (P < 0.01). The highest value of shear bond strength was obtained from Adper Easy One system, while Adper SE Plus gave the lowest shear bond strength values. Conclusions: Seventh generation adhesives are more advantageous than sixth generation adhesives in dentin bonding as it requires less time, fewer steps, and better bond strength.

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Aims and Objectives: To evaluate the effect of saliva contamination on the shear bond strength of a new two-step self-etch adhesive (P90 system adhesive) to dentin and to determine the effect of contaminant removing treatments on the recovery of bond strengths. Materials and Methods: The buccal surfaces of 40 human premolars were ground to expose dentin. The specimens were randomly divided into four groups. Group 1 is uncontaminated and serves as the control group. Further groups were divided based on the step in the bonding sequence when the contamination had occurred as follows: Group 2 (primer, saliva contamination, rinse and dry), group 3 (after procedure of group 2, reapplication of primer), and group 4 (after procedure like in control group, saliva contamination, rinse and dry). Filtek P90 composite resin cylinders of 3 mm diameter and 3 mm length were fabricated on the surfaces. Shear bond strength testing was done in an Instron Universal Testing Machine and the data were subjected to one-way analysis of variance (ANOVA) and Student's t-test. Results: With P90 system adhesive, group 2 and group 4 showed lower shear bond strength than group 1 (control) and group 3 (P < 0.05). Conclusion: Saliva contamination significantly decreased the shear bond strength of the adhesive to dentin.

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Objective: To evaluate the effect of final rinsing solution on smear layer removal through penetrability of the root canal sealer. Materials and Methods: Each of the 30 teeth selected was decoronated and the root length standardized at 16 mm measured from the apex of the tooth to the cementoenamel junction (CEJ). A size 10-k file was used and working length was determined by subtracting 1mm from the measured length so that the length of the sample was 15mm. A combination of step back and crown down technique was done and apical portion was prepared till H-file no. 30. 3% NaOCl was used during cleaning and shaping of the canals. Finally the teeth were divided into three groups of 10 teeth each. Group-I was irrigated with 17% EDTA, Group-II with TUBLICID plus, and Group-III with Biopure MTAD^® . ISO 30 size gutta-percha points were selected as master cones. The Acroseal sealer was mixed with approximated concentration 0.1% fluorescent rhodamine B isothiocyanate dye. Obturation was done and after 48 hours, the roots were sectioned and subjected to confocal laser scanning microscopy. Results: Comparisons among the three groups were done by two-way analysis of variance (ANOVA) and Newman-Keuls multiple post-hoc procedures. The two-way ANOVA showed statistically highly significant results. The maximum depth of sealer penetration was observed in Group II followed by Group III and Group I. Conclusion: The use of -Tubulicid plus as a final irrigant provided better smear layer removal than Biopure a mixture of doxicycline, citric acid and a detergent (Tween 80) (MTAD^® ) and 17% EDTA.

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Aims: To evaluate the effect of storage pH on solubility of white mineral trioxide aggregate (WMTA), bioaggregate (BA), and nano WMTA cements. Materials and Methods: Forty-eight moulds randomly allocated into three groups of pH 4.4 (group A), 7.4 (group B), and 10.4 (group C); and one empty as control in each group. Each group was further divided into three subgroups according to the material studied; WMTA, BA, and nano WMTA. The specimens in subgroup A were soaked in butyric acid buffered with synthetic tissue fluid (STF) (pH 4.4), while the samples in subgroups B (pH 7.4) and C (pH 10.4) buffered in potassium hydroxide for 24 h and then the loss of cement was determined. A two-way analysis of variance (ANOVA) and Tukey post-hoc statistical tests were used to detect any statistically significant differences among the groups/subgroups. Results: Statistical analysis has showed the highest solubility in acidic pH for all tested materials. Nano WMTA samples in pH = 10.4 had the lowest and BA samples in pH = 4.4 showed the highest cement loss. Conclusion: The solubility of all tested cements can be jeopardized in acidic environment which might affect on their sealing characteristic in clinical scenario. However, nano WMTA cement due to its small size particles and different additives was capable of producing lower porosity in set material, which resulted in showing more resistance in acidic environment.

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Aims: The aim of this study was to assess the influence of temperature and concentration on the dynamic viscosity of sodium hypochlorite in comparison with 17% EDTA and 2% chlorhexidine gluconate. Settings and Design: In vitro Materials and Methods: Dynamic viscosity measurements of sodium hypochlorite [NaOCl (5.25%, 2.6%, 1.25%)], EDTA (17%), and chlorhexidine gluconate [CHX, 2%] were measured using a rotational digital viscometer at room temperature (25°C). The influence of temperature (45°C, 60°C) and concentration (5.25%, 2.6%, and 1.25%) on the dynamic viscosity of NaOCl was also evaluated. The measurements were performed using a circulating water bath calibrated with a thermostat, and the dynamic viscosity measurements were noted in Centipoise (Cps). Statistical Analysis Used: The tests used for the statistical analysis were Kolmogorov- Smirnov and Shapiro Wilk tests, one-way ANOVA, and independent sample t-test. Results: Viscosity statistically increased with NaOCl concentration and decreased with increasing temperature. Amongst the tested NaOCl groups, 5.25% NaOCl at room temperature was significantly the most viscous (μ =1.5300 Cps) while 1.25% NaOCl at 60°C was significantly the least viscous (μ =1.1800 Cps). Conclusions: 5.25% NaOCl and 17% EDTA are significantly viscous at room temperature. Elevating the temperature of 1.25% NaOCl to 60°C significantly reduces the viscosity of the NaOCl.

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Unusual anatomical configurations must be considered in the radiographic and clinical evaluation during the endodontic treatment. The canal anatomy maxillary first and second premolar has been studied extensively and the presence of three canals is relatively rare especially in the maxillary second premolar. The occurrence of three canals with separate foramina in both the first and second premolar is shown to be in extremely low percentages and has been documented as practically non-existent in Asian populations. This article describes a case of a maxillary first and second premolar with three canals each

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Aim: To compare and assess the fracture resistance of endodontically treated teeth with those that have been subjected to endodontic retreatment. Materials and Methods: 30 extracted mandibular premolars were decoronated at cementoenamel junction and randomly divided into 2 groups. In Group I endodontic treatment was performed with ProTaper rotary system till size F2 and obturated. In Group II, cleaning and shaping was done and teeth were subjected to Spiral CT to assess the remaining dentin thickness and obturated. Later retreatment was done using Protaper Universal Retreatment system and final shaping was performed till size F3. Remaining dentin thickness was again assessed using Spiral CT and then obturated. All the specimens were subjected to fracture resistance using universal testing machine. The results were statistically analyzed using Independent Samples t-test for analysis of remaining dentin thickness using SCT within Group II and Paired Samples t-test was used for assessment of fracture resistance between Group I and II (P < 0.05). Results: In Group II, the intra group comparison of the remaining dentin thickness in the coronal third reveals statistical significance, with a significant difference noted in the apical third. Results of the fracture resistance reveal a statistically significant difference (P < 0.05) between Groups I and II with the mean fracture resistance of Group I being higher than Group II. Conclusion: Endodontically retreated teeth have shown significantly decreased resistance to fracture and this has a positive correlation to the increased loss of root dentin during the retreatment procedures

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Aims: The purpose of this study was to evaluate the efficacy of nickel-titanium rotary retreatment systems versus stainless steel hand retreatment system with or without solvent for gutta-percha removal during retreatment. Materials and Methods: Sixty extracted human mandibular molar teeth with single canal in a distal root was prepared with ProTaper rotary nickel-titanium files and obturated with gutta-percha and sealer. The teeth were randomly divided into six groups of 10 specimens in each groups. The volume of filling material before and after retreatment were evaluated in cm ³ using the computed tomography (CT) scanner proprietary software. Results: Maximum amount of filling material removed during retreatment with ProTaper retreatment system with solvent and minimum with hand retreatment system with solvent. Conclusions: None of the technique was 100% effective in removing the filling materials, but the ProTaper retreatment system with solvent was better.

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Aims & Objectives: The purpose of this study was to investigate the effects of 5.25% sodium hypochlorite (NaOCl) and 2% chlorhexidine (CHX) on Gutta-percha and Resilon cones using an atomic force microscope (AFM). Materials and Methods: Gutta-percha cones (n = 15) and Resilon cones (n = 15) were cut 3 mm from their tip, attached to a glass slide with cyanoacrylate glue and immersed in 5.25% NaOCl and CHX for 1, 5, 10, 20 and 30 min. Five each of Gutta-percha and Resilon cones not treated with any disinfectant were used as control. The analysis of the surface topography was performed on the region between 1 and 2 mm from the tip using the AFM. The root mean square (RMS) parameters for contact mode imaging were measured. The differences between RMS values were tested by SPSS-16.0 version statistical software [IBM SPSS (Statistical Product and Service Solutions) Data Software, Chicago, US] using Kruskal-Wallis ANOVA, Mann-Whitney U-test and Wilcoxon matched pairs test. Results: There was no deterioration in the surfac e topography of Gutta-percha and Resilon when treated with 2% CHX in comparison to baseline (P < 0.05). Resilon exhibited no deterioration in topography when immersed in 5.25% NaOCl. There was a significant decrease in the mean RMS values of Gutta-percha treated with NaOCl from the control at time intervals of 1, 5, 10, 20 and 30 min.

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This article suggests a simplified technique of orthograde MTA obturation in less accessible canal(s) of posteriors teeth without using costly ultrasonics or specialised carrier. Essentially few finger pluggers, absorbent points and a simple canal projection method were used. The orifice(s) of the elected canal(s) to be obturated with MTA were projected onto the external occlusal surface for easy delivery and predictive instrumentation. The idea was based on 'easy access', 'working one canal with one mix at one time', 'thorough condensation' and 'removal of excess moisture'. In case I, palatal canal of tooth no. 2 with gross apical perforation and suspected VRF was obturated with MTA. And in Case II, tooth no. 19 presented with incomplete furcal fracture extending into the canal was obturated with MTA in all 3 canals unitarily. Dense homogenous MTA obturation was achieved and both cases healed uneventfully.

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Background: The radiopacity of contemporary adhesive systems has been mentioned as the indication for replacement of restorations due to misinterpretation of radiographic images. Aims: This study aimed to evaluate the radiopacity of contemporary bonding agents and to compare their radiodensities with those of enamel and dentin. Methods and Materials: To measure the radiopacity, eight specimens were fabricated from Clearfil SE Bond (CF), Xeno V (XE), Adper SE Bond (ASE), Magic Bond (MB), Single Bond 2 (SB), Scotchbond Multipurpose (SM), and gutta-percha (positive control). The optical densities of enamel, dentin, the bonding agents, gutta-percha, and an aluminium (Al) step wedge were obtained from radiographic images using image analysis software. Statistical Analysis: The radiographic density data were analyzed statistically by analysis of variance and Tukey's test (α =0.05). Results: Significant differences were found between ASE and all other groups tested and between XE and CF. No statistical difference was observed between the radiodensity of 1 mm of Al and 1 mm of dentin, between 2 mm of Al and enamel, and between 5 mm of Al and gutta-percha. Five of the six adhesive resins had radiopacity values that fell below the value for dentin, whereas the radiopacity of ASE adhesive was greater than that of dentin but below that of enamel. Conclusion: This investigation demonstrates that only ASE presented a radiopacity within the values of dentin and enamel. CF, XE, MB, SB, and SM adhesives are all radiolucent and require alterations to their composition to facilitate their detection by means of radiographic images.

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Aim: The aim of this study was to compare the canal transportation, canal centering ability, and time taken for preparation of curved root canals after instrumentation with ProFile GT Series X (GTX) files, Revo-S files, twisted files, and Mtwo files by using cone-beam computed tomography (CBCT). Materials and Methods: Forty mesiobuccal canals of mandibular molars with an angle of curvature ranging from 20 to 40 were divided according to the instrument used in canal preparation into four groups of 10 samples each: GTX (group I), Revo-S (group II), twisted file (group III), and Mtwo (group IV). The teeth were instrumented according to manufacturer's guidelines, with all groups being prepared to size 30, 0.06 taper master apical file. Canals were scanned using an i-CAT CBCT scanner (Imaging Science International, Hatfield, PA, USA) before and after preparation to evaluate the transportation and centering ratio at 3 mm, 5 mm, 7 mm, 9 mm, and 11 mm from the apex. The data collected were evaluated using one-way analysis of variance (ANOVA) with Tukey's honestly significant difference (HSD) test. Results: Twisted file system showed significantly least canal transportation and highest canal centering ability values as compared to GTX, Revo-S, and Mtwo file systems. Overall, GTX, Revo-S, and Mtwo showed comparable results with respect to canal transportation and centering ability. Conclusion: The innovative method of manufacturing the TF system resulted in superior shaping ability in curved canals, with the instruments remaining more centered and producing less canal transportation than GTX, Revo-S, and Mtwo file systems.

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To present a case report describing successful removal of a 16 mm long pulp stone in a single mass from a maxillary left first molar and its endodontic management. In the presented case, the conventional approach of dissecting the pulp stone was not considered, as radiographically the calcification was extending up to the apex of the palatal root canal and the separation of the coronal and radicular pulp stone would have risked the obliteration of its orifice. A new set of ultrasonic endodontic tips were used for the removal of significantly large pulp stone in single mass.

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This case report describes a rare treatment modality for Turner's hypoplasia done with a very conservative approach for the esthetic and functional problem of the defect. Diagnosis was made as Turner's hypoplasia of upper two central incisors with proximal caries. Treatment planning was done after considering many factors such as conservation of tooth structure, esthetics, occlusion and economy. Tooth preparation was done to receive Edge-up, all ceramic partial crowns for both the upper central incisors,using pressable all ceramic material and cemented with resin cement.

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Aim: To evaluate and compare the influence of various accelerators, 15% disodium hydrogen phosphate (Na ₂ HPO ₄ ), 10% calcium chloride (CaCl ₂ ) and 23.1 wt% calcium lactate gluconate (CLG), on the immediate (after 72 h) and delayed (after 2 months) sealing ability of white ProRoot mineral trioxide aggregate (WMTA) when it is used as an apical plug. Materials and Methods: Eighty, single-rooted mandibular premolars were instrumented and standardized artificial open apices were created. The samples were then randomly assigned into four experimental groups and two control groups. WMTA was mixed with the respective accelerators and an apical plug of 4-mm thickness was fabricated. The remaining canal spaces were then backfilled. The samples were stored for the stipulated time periods and then immersed in 0.2% Rhodamine B solution for 72 h. Dye leakage was analyzed using a stereomicroscope. Results: Mean microleakage values of all experimental groups revealed that MTA + 23.1 wt% CLG showed the least leakage, followed by MTA + 15% Na ₂ HPO ₄ and MTA + 10% CaCl ₂ with MTA + deionized water showing the maximum leakage at both the time intervals (P < 0.001). All the samples stored for a period of 2 months showed less leakage as compared with the samples stored for 72 h (P < 0.05). Conclusions: It was found that all three accelerators significantly accelerated the set of WMTA, of which 23.1 wt% CLG showed the best results, followed by 15% Na ₂ HPO ₄ and 10% CaCl ₂ . The sealing ability of all the experimental groups was significantly superior after 2 months as compared with that after 72 h.

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