The objective of the present systematic review is to evaluate the success of pulpotomy in mature permanent teeth presented with irreversible pulpitis. The following databases were searched: PubMed, Oral and Dentistry Database, Cochrane, and CINAHL plus. We included studies published in the English language only. However, narrative reviews and case reports/series were excluded. The first electronic and hand search yielded a total of 2851 articles. After going through extensive screening and eligibility process, only six articles were finally selected for the review. The follow-up period ranged from 1 to 10 years. Randomized controlled trial compared pulpotomy with the root canal treatment and reported comparable and even better success of the pulpotomy (78% success). All the other studies have also shown better clinical and radiographic success of pulpotomy (68%–100%). Pulpotomy can be considered an alternative option for mature permanent teeth with irreversible pulpitis.

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Background: In an oval-shaped canal, no single instrumentation systems were effective in absolute removing obturation. Aim: The aim of the study was to evaluate the performance of ProTaper Universal Retreatment (PTUR) system, XP-endo Shaper (XPS), XP-endo Finisher (XPF), and XP-endo Finisher-R (XPF-R) in removing root-canal filling material and preservation of sound dentin during retreatment procedure. Methodology: Root-canal preparation was performed on 60 mandibular premolars with oval-shaped canals using the ProTaper Gold file system. Preobturation scans were performed to measure canal volume of the canal and recorded. Obturation was performed and the samples were randomly assigned into four groups according to the retreatment protocol used (n = 15): H-file, PTUR files, PTUR followed by XPF file, and XPS supplemented with XPF-R file. After retreatment, the specimens were re-scanned and volumetric analysis of remaining root filling material, volume of the canal space were measured using EZ-3Di Software Version 5.0.0.2. All the data were subjected to one-way ANOVA and post hoc Tukey's test with a significance of 5%. Results: XPS + XPF-R showed promising results in the removal of obturating material and preservation of root dentin than any other group. The difference is statistically significant. Conclusion: XPS + XPF-R removed gutta-percha more significantly without sacrificing the sound dentin along with instrumentation.

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Introduction: The postendodontic pain is caused by either microbial, mechanical, or chemical factors or combinations of these. The incidence of postoperative pain ranges from 1.4% to 53%. The management of postendodontic pain is a crucial factor for a successful practitioner. Cryotherapy is a new therapeutic option applied in sports medicine and surgery for the management of pain and for postoperative care. Aim: The purpose of this study was to evaluate and to compare the effect of intracanal cryotreated sodium hypochlorite and room temperature sodium hypochlorite on postoperative pain after root canal treatment. Materials and Methods: Sixty-four patients were selected according to inclusion criteria and baseline score was recorded. After obtaining consent, the access cavity was opened under local anesthesia. On the completion of cleaning and shaping, the patients were randomly divided into two groups: Group A: Normal Room temperature NaOCl and Group B: Cryotreated NaOCl (2°C–4°C), each of the canals further received 20 ml of the respective irrigants based on the groups allocated. The final rinse was done with saline, and canals were dried and obturated in the same appointment. Postoperative visual analogue scale pain levels were recorded at 6, 24, and 48 h over the phone. Results: The data were analyzed using SPSS software. The results of the present study showed that cryotherapy group showed a statistically significant reduction in postoperative pain levels at all tested time intervals and reduced analgesic intake at 6 h postoperatively. Conclusion: Cryotherapy could be used as an easy and cost-effective technique for controlling postendodontic pain in the day-to-day clinical practice.

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Background: Chemomechanical caries removal has been a new leaf for caries excavation in this ultraconservative era of dentistry. BRIX3000 & Carie Care are papain based gel formulations while Smart Burs are polymer burs with self limiting ability. Aim: To compare & evaluate the caries excavation efficacy of BRIX3000, Carie Care & Smart burs. Materials & Methods: 45 patients with wide class 1 carious lesions were selected and equally divided into 3 groups: BRIX 3000, Carie Care & Smart Burs. Caries excavation was performed in accordance with manufacturer's instructions in each group & evaluation for reduction in bacterial count & mean working time was done. Statistical Analysis: Data was analysed by One way ANOVA, Paired t-Test & Tukey's Post Hoc test. Results: The highest reduction in bacterial count was achieved by BRIX3000(156.93 × 10⁴) followed by Smart Burs(139.07× 10⁴)& Carie Care(135.80×10⁴) with p>0.5. Mean working time in minutes for excavation was : BRIX3000(13.66), Carie Care(18.30) &Smart Burs(20.60) with p<0.5. Conclusion: All the techniques reduced bacterial count potentially. BRIX 3000 proves the most effective among three.

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Introduction: To compare and evaluate the shear bond strength of sixth- and seventh-generation bonding agents with varying pH – an in vitro study. Materials and Methods: Eighty extracted human premolar teeth were collected and cleaned and polished with pumice and water. The root portion of teeth was resected, and only the coronal portion was embedded in the cold-cure acrylic resin. The labial surface of mounted teeth was prepared with a high-speed handpiece using #245 carbide bur. The samples prepared were divided into four groups, with 20 specimens in each group:

• Group A: Sixth-generation bonding agent, Adper Prompt L-Pop (APLP) (3M ESPE)
• Group B: Sixth-generation bonding agent, Xeno III (X III) (Dentsply)
• Group C: Seventh-generation bonding agent, Adper Easy One (AEO) (3M ESPE)
• Group D: Seventh-generation bonding agent, Xeno IV (X IV) (Dentsply).

Tooth surface were rinsed and dried, and bonding agents were applied on tooth surface. Composite resin (Z-350 XT, 3M ESPE) was placed in a two-layer increment on tooth and was light cured. Specimens were subjected to the universal testing machine in a compression mode force at a crosshead speed of 1 mm/min keeping blade parallel to the adhesive–dentin interface. Shear force required to debond the specimen was recorded in megapascal. The data obtained were analyzed statistically using ANOVA and post hoc test. Results: AEO (pH = 2.3, Group C seventh generation) showed higher bond strength, and pH values did not influence the shear bond strength significantly in the tested adhesive systems. Conclusion: The pH values did not influence the shear bond strength significantly in the tested adhesive systems. ADPER EASY ONE (pH= 2.3, GROUP C Seventh Generation) showed higher bond strength followed by XENO IV(pH = 2.1, GROUP D) ,XENO III (pH = 1.5, GROUP B) on dentinal surface ,where as ADPER PROMPT L POP (pH =0.7 to 1 Sixth Generation, GROUP A) showed lower bond strength.

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Autogenous transplantation is a fast and economical option when a suitable donor tooth is available for the replacement of nonsalvageable teeth. The preservation of the periodontal ligament (PDL) cells is considered to be critical for the success of a transplanted tooth. This article presents a successful case report of autotransplantation of a mandibular third molar using a novel technique to store the donor tooth extraorally during the surgical procedure and preserve the viability of PDL cells. One year of clinical and radiographic examination revealed no signs or symptoms suggestive of any pathology and the marginal adaptation of gingiva around the donor tooth appeared to be satisfactory. Inappropriate cases, this treatment approach may be considered as an alternative to conventional prosthetic rehabilitation or implant treatment.

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Introduction: This study aims to compare the efficacy of a combination of an inferior alveolar nerve block (IANB) plus buccal infiltration using 4% articaine versus 2% lignocaine in achieving anesthesia of lower first molar teeth with irreversible pulpitis. Materials and Methods: Seventy adult patients were selected. A random sequence list was employed to administer IANB plus buccal infiltration. After the onset of lip numbness, cold test and electric pulp testing were performed. Five patients, four missed blocks and one no bleeding, were excluded. Heft Parker Visual Analog Scale scores during pulp extirpation were recorded. The data of sixty-five patients were statistically analyzed using Chi-square and Mann–Whitney U-test. Results: The success rate after lip-numbness for articaine is 91.42% and for lignocaine is 94.28%. The difference is statistically, not significant (P = 0.6425). During access, the success rate for lignocaine is 96.87%, whereas 96.96% for articaine. This difference is also not significant (P = 0.982366). Conclusion: IANB plus buccal infiltration using articaine or lignocaine is equally effective in anesthetizing mandibular first molar with irreversible pulpitis.

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Background: Thorough cleaning of the pulp space is a challenging task. The mechanical instrumentation alone is usually not sufficient to completely debride the canals, and therefore, it requires the chemical action of irrigants also to disinfect the difficult to reach areas. Aim: The purpose of this study was to determine apical extrusion and assess irrigant penetration through cone-beam computed tomography (CBCT) for EndoActivator (EA) and XP Endo Finisher (XP). Materials and Methods: Sixty single-rooted mandibular premolars with oval-shaped canals were equally divided into three groups after instrumentation, based on the final irrigation: Group-1 syringe needle (30G Max-I-probe), Group-2 EA, and Group-3 XP. After the final irrigation, the weight of the extruded sodium hypochlorite was calculated. The prepared canals were then irrigated with a radiopaque contrast medium, which was activated according to the group of the sample (Group-1, 2, or 3). The volume of irrigant filled in the canal, especially in the apical third was determined through special tools in CBCT imaging. Statistics: One-way ANOVA test was used to compare the different groups. Results and Conclusion: Significantly more apical extrusion was seen in XP (P < 0.001). Both XP and EA have shown complete penetration of irrigant in the canal (100%).

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Background: The growing demands for esthetic restorations have stimulated intensive research in the field of adhesive dentistry. Dental adhesive systems are used to promote adhesion between composite resins and dental structure. In the fundamental principles of adhesion, the primary mechanism contributing to the formation of adhesion is micromechanical bonding between the restoration and the tooth. The bond strength of self-etching adhesives to dentin was found to be almost equal to that of total-etch adhesives. The aim of the present prospective, double-blind, randomized controlled clinical trial was to evaluate and compare the clinical performance of two self-etch adhesive systems with total-etch adhesive system in noncarious cervical lesions (NCCLs). Materials and Methods: In each patient, three teeth were randomly assigned according to the adhesive system used to Group A (total-etch adhesive system), Group B (two-bottle self-etch adhesive system), and Group C (one-bottle self-etch adhesive system). The clinical efficacy of these adhesive systems was determined by evaluating the retention rate, marginal integrity, and postoperative sensitivity at the following three levels: baseline, 6 months, and 18 months by following the Modified USPHS criteria introduced by Vanherle et al. Results: In the present study, the retention rate at 18 month in Group A, Group B, and Group C of 96%, 92%, and 92% was observed, respectively. A marginal integrity at 18 months was 88%, 80%, and 84% for Group A, Group B, and Group C, respectively. Postoperative sensitivity at 18 months was 16%, 12%, and 12% for Group A, Group B, and Group C, respectively. Conclusion: The clinical performance of total-etch and self-etch adhesive systems in NCCLs did not differ significantly with regard to the evaluated parameters – retention, marginal integrity, and postoperative sensitivity.

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Background: Pulp capping should always be considered as the primary treatment of choice for teeth without irreversible pulpitis in lesions approaching dental pulp. The predictability of vital pulp therapy has improved with the introduction of newer bioceramic materials. Aim: The purpose of this randomized controlled trial was to compare the outcomes of mineral trioxide aggregate (MTA) (Angelus, Londrina, Brazil) and a pozzolan-based cement (ENDOCEM-Zr^® [Maruchi, Wonju, Korea]) as an indirect pulp capping (IPC) material. Materials and Methods: IPC was performed in forty patients who were randomly divided into ENDOCEM-Zr^® and MTA groups. The outcome was assessed using clinical and radiographic tests at different time intervals. The prognostic factors on the outcome of IPC were also evaluated. Results and Conclusions: The success rate of ENDOCEM-Zr^® and MTA groups was 94.7% and 89.4%, respectively. The results were not statistically significant. Binary logical regression showed that the age of the patient and the status of the pulp before treatment were deciding variables for the outcome of the study. Therefore, it was concluded from the study that the evaluated pozzolan-based cement could be used as an alternative to MTA because of its faster setting time and lower discoloration potential. In addition, pulp capping should be performed with caution in individuals above 40 years and in teeth with reversible pulpitis.

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Developmental anomalies are marked deviations from normal size, shape, contour, and various other parameters. An understanding of these anomalies and its application has been a clinical challenge. With the advances in diagnostic technology, the field of endodontics has been evolving with new treatment protocols, which gives promising results. The aim of this article is to present a case report on tooth anomaly that is taurodontism and its management in a patient with multiple taurodont teeth. This article brings discussion on anatomical variations of the taurodont teeth and the techniques related to the endodontic treatment of the same and how it differs from normal teeth.

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Aim: The aim of this study is to compare the microleakage of bulkfill composite activated by modulated photoactivation between fluorosed and nonfluorosed teeth using the confocal laser scanning microscope. Methodology: One hundred and twenty intact human premolar teeth with Thylstrup and Fejerskov index fluorosis index 0–4 were stored in 0.5% thymol at the room temperature until further use. Standardized Class V preparations of 2 mm depth, 3 mm width, and 2 mm height were prepared on the buccal surface. The cavities were etched with 37% phosphoric acid, rinsed and primed with Tetric N bond, cured for 20 s with Quartz Tungsten Halogen (QTH) variable intensity light-curing unit spectrum-800 operating at 450 mW/cm². Later, bulk fill composite was placed in the cavity and cured. Depending on the curing mode used, all the fluorosed and nonfluorosed teeth were divided into three subgroups each (n = 20) – Conventional light curing, stepped curing, and pulse delayed curing. All samples were stored in distilled water at the room temperature for 24 h and subjected to 500 thermocycles. The prepared teeth were placed in 0.6% rhodamine solution for 48 h; sectioned longitudinally using a hard-tissue microtome and scanned under a confocal laser scanning electron microscope. Data were analyzed using the one-way ANNOVA, Wilcoxson signed-rank test, and Kruskal–Wallis test. Results: Significant differences were observed between fluorosed and nonfluorosed groups. Intragroup comparisons showed significant differences between fluorosed step and conventional subgroups. Conclusion: Fluorosed teeth had higher microleakage values than nonfluorosed teeth. Pulse-delayed subgroup had the least microleakage to that of conventional and stepped curing subgroups, in both fluorosed and nonfluorosed groups.

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Aims: This study determined the corrosion rate by mass loss caused by oral strains of sulphate-reducing bacteria (SRB) in Kerr endodontic files (KF), aiming the development of a biopharmaceutical that facilitates the removal of endodontic limb fragments from root canals. Materials and Methods: Nine new KF were analyzed after immersion in the modified Postgate E culture medium inoculated with Desulfovibrio desulfuricans oral (84 days), Desulfovibrio fairfieldensis in the consortium (84 days) and environmental D. desulfuricans (119 days). Results: Optical microscopy revealed corrosion suggestive areas in all files submitted to immersion in SRB cultures, presenting a statistical difference (P < 0.05) between the samples environmental D. desulfuricans and KF control and between oral D. desulfuricans and KF control. Epifluorescence microscopy revealed an active SRB biofilm over the entire metal surface of the KF, as evidenced by the SYTO^® 9 fluorophore. Conclusion: SRB were capable of promoting biocorrosion in Kerr type endodontic files, but with low rate.

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Aim: The purpose of this study was to evaluate and compare the effectiveness of phytic acid and ethylendiamine tetraacetic acid (EDTA) in the removal of calcium ion from radicular dentin during endodontic procedure. Materials and Methods: Twenty-five single-rooted mandibular premolar teeth were decoronated, and the roots were split longitudinally into two halves. Among obtained specimens, 45 specimens were randomly selected and divided into three groups (n = 15): Group 1 – distilled water, Group 2 – 17% EDTA, and Group 3 – 1% phytic acid. Samples in each group were immersed in the test solutions for specific time intervals, after which the same solution samples were subjected for the evaluation of amount of calcium ion release into the solution by Atomic Absorption Spectrophotometer. Data were analyzed using the one-way analysis of variance test. Results: The use of 17% EDTA resulted in more calcium ion loss as compared to 1% phytic acid and distilled water. Conclusion: One percent phytic acid seems to be an appropriate irrigating solution because of its less demineralizing effect as compared to 17% EDTA on radicular dentin.

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Coronavirus disease 2019 (COVID-19) has been a major health concern globally ever since it was declared as Pandemic by the World Health Organization in March 2020. Due to the evolving and contagious nature of coronavirus, it continues to remain a threat for dental health-care personnel. As the virus travels from person-to-person via direct contact through droplet inhalation, cough, and sneeze or through contact transmission, it remains infectious even through inanimate surfaces. A seemingly healthy asymptomatic person may have the potential to trigger the spread of this disease. Coronavirus has the capability of spreading through community transmission. There is no specific treatment or vaccine as of now for stopping the spread of COVID-19, hence universal precautions and awareness with mass involvement is required to ward off this pandemic. Dental health-care personnel are at immense risk due to the near proximity with patients and continual exposure to saliva, blood, and other body fluids. Management protocol regarding awareness and preventive measures should be laid down for dental clinic/hospital to contain the outspread of this infectious disease.

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Background: Excessive torque is associated with engine-driven file fracture. Aims: The aim of this study to evaluate the real-time torque of rotary and reciprocating instruments, working time, and the occurrence of procedural errors during root canal preparation of simulated canals by an endodontist and a general dentist. Methods: Thirty-six commercially available simulated “J-shaped” root canals in resin blocks were used. Instrumentation was performed using WaveOne, WaveOne Gold, ProTaper Next, Reciproc, Reciproc Blue, and Mtwo. The real-time torque analysis and the number of times the maximum torque applied to the instrument were evaluated. Images were obtained to assess the occurrence of procedural errors, and working time was recorded. Statistical Analysis: The one-way analysis of variance with a Bonferroni post hoc test, Mann Whitney test and the t-test was used for statistical analysis (P < 0.05). Results: Reciprocating instruments showed lower values in the number of times that reached maximum torque and percentage time in the area of critical torque, with significant differences compared to rotary instruments (P < 0.05). Operators influenced torque values only with rotary motion instruments. There was no significant difference in mean working time between the operators or instruments. No fracture of instruments or canal transportation occurred. Conclusions: Rotary instruments were associated with higher peaks in real-time torque variation during the preparation of simulated root canals.

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Aim: This study was conducted to evaluate the effect of mechanical alteration of enamel surface on shear bond strength in different bonding techniques. Materials and Methods: Seventy samples were fabricated and randomly divided into three groups: Group A (n = 30) – prepared enamel surfaces, Group B (n = 30) – unprepared enamel surfaces, and Group C (n = 10) – prepared enamel surfaces + etch and rinse which served as a control group. Group A and Group B were further divided into three subgroups (n = 10), sub-Group A1, B1 (nanohybrid composite + self-etch), sub-Group A2, B2 (self-adhering composite), and A3, B3 (self-adhering composite + self-etch). Teflon ring molds were used to make composite resin cylinders with the specific bonding protocol of each group. Shear bond strength testing was conducted, and data were analyzed. Results: Mean shear bond strength values were as follows: C> A1> A3>A2>B1> B3> B2. Conclusions: Prepared enamel surfaces resulted in higher shear bond strength values as compared to unprepared enamel surfaces. Prior application of self-etch agent resulted in higher shear bond strength values of self-adhering composite in prepared and unprepared enamel surfaces.

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Aim: The purpose of this study was to evaluate the impact of 7% maleic acid (MA), 17% ethylenediaminetetraacetic acid (EDTA) solution, 10% citric acid (CA), or 2.25% peracetic acid (PAA) on the dislodgment resistance of a silicone-based root canal sealer. Materials and Methods: Ninety-five mandibular incisors were shaped to size R50. The specimens were randomly assigned to the following five groups (n = 15) based on the final irrigation solution: 5% sodium hypochlorite (NaOCl), 17% EDTA, 7% MA, 10% CA, and 2.25% PAA. Four specimens from each group were examined under scanning electron microscope. All the remaining canals were obturated with GuttaFlow^® Bioseal. Bond strength was assessed using the push-out test. The data were analyzed statistically by two-way analysis of variance and Bonferroni tests at the significance level of P = 0.05. Results: The roots irrigated with chelators showed statistically significantly higher bond strength than the roots irrigated with NaOCl (P < 0.05). Overall, MA showed the highest bond strength, but there was no statistically significant difference among the other chelating solutions (P > 0.05). Conclusions: The bond strength of the GuttaFlow Bioseal to the root canal dentin may increase by the removal of smear layer. Final irrigation with the investigated chelators resulted in similar bond strength of the GuttaFlow Bioseal.

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Aim: The aim of the study was to compare the fracture resistance of endodontically treated teeth with simulated invasive cervical resorption cavities, restored with different restorative materials, namely, conventional glass-ionomer cement (CGIC), resin-modified glass-ionomer cement (RMGIC), flowable composite (FC), and giomer. Methods: Sixty extracted human permanent maxillary central incisor teeth were assigned to six groups,which were, Group 1 (intact teeth, control), Group 2 (teeth with biomechanical preparation and resorption cavity), Group 3 (CGIC), Group 4 (RMGIC), Group 5 (FC), and Group 6 (giomer). Except for Group 1, other groups were subjected to endodontic treatment. Teeth of Group 2 were left unobturated and teeth of Groups 3–6 were obturated. A simulated resorption cavity was prepared labially in the specimens belonging to Groups 2–6 and restored with respective restorative materials. The specimens were subjected to compressive load until failure in an Instron testing machine and the load at failure was recorded in Newtons. Statistical Analysis: The data obtained were statistically analyzed using one-way ANOVA, pair-wise comparison was made with Tukey's multiple comparison test, and P < 0.05 was considered statistically significant. Results: There was a statistically significant difference in the fracture resistance of intact teeth and endodontically treated teeth with simulated invasive cervical resorption cavities restored with different adhesive restorative materials. Among the restored teeth, there was no significant difference. Conclusion: Intact teeth were found to have the highest resistance to fracture followed by those restored with giomer, FC, RMGIC, and CGIC in that order.

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