Composite resin restorations using the incremental technique are time-consuming and technique sensitive requiring excellent hand dexterity of the clinician for achieving good contacts and contours. “Stamp technique” for posterior composite restoration is a novel method for duplicating occlusal anatomy with near perfection. This technique is indicated when the preoperative anatomy of the tooth is intact. An indirect technique can be used in cases where the occlusal surface is cavitated due to caries. The purpose of this article is to demonstrate the direct and indirect technique of stamp fabrication and restoration using different materials, emphasizing the fact that it is reliable and predictable and, when performed correctly, helps the practitioner to a great extent.

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Aim: The aim of this study was to evaluate apical microleakage in root canals containing broken rotary instruments obturated with cold lateral condensation and thermoplasticized injectable gutta-percha, with different sealers, using glucose penetration leakage study. Materials and Methods: In this in vitro study, 96 extracted human mandibular premolars were decoronated, and the roots were randomly divided into eight groups (n = 12). Root canals were instrumented with #30 4% taper rotary files. The files were scratched 3 mm from the tip by a high-speed handpiece, and they were intentionally broken in the apical third of the canals. The middle and coronal sections of the canals were obturated by cold lateral condensation and thermoplasticized technique, using ZOE, resin, CaOH, and bioceramic sealers. Apical microleakage was measured using the glucose penetration method. Statistical Analysis: Independent Student's t-test and one-way ANOVA followed by Tukey's post hoc analysis were used for statistical analysis. Results: Bioceramic sealer group showed the least apical microleakage and this was then followed by the resin and CaOH groups demonstrating lesser apical microleakage and the highest microleakage was with the ZOE group. Mean apical microleakage scores between lateral and thermoplastic condensation techniques in each group were statistically significant (P < 0.001). Conclusion: Bioceramic sealer demonstrated the least apical leakage, whereas ZOE seal displayed the highest apical leakage.

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Background: Nanotechnology is the specialty associated with material science and biology, rather than a particular field. It entails the method of particles at nanoscale called Nanoparticles, wherein they have control over bulk macroscopic properties of the identical material. The “drug nanocarrier,” selenium possesses strong antibacterial, antioxidant and anti-cancer as well as anti-inflammatory properties. As the medicinal plant Thymus vulgaris possesses a lot of phytochemicals, this study was conducted to assess the anti-inflammatory and antioxidant activity of selenium nanoparticles (SeNps) reinforced with T. vulgaris. Materials and Methods: Anti-inflammatory activity, antioxidant activity of SeNps reinforced with T. vulgaris extract were assessed using bovine serum albumin and 2, 2-diphenyl-1-picrylhydrazyl assay, respectively, at 10, 20, 30, 40, and 50 μL. Results: The values for anti-inflammatory property of nanoparticles were higher than the standard values at 30, 40, and 50 μL concentrations. Percentage of inhibition was highest at 40 μL (87.7%) and 50 μL (92.6%). The values for antioxidant property of nanoparticles were found to be higher than the standard values at 10, 20, and 30 μL concentrations. Percentage of inhibition was highest at 30 μL (68.3%). Conclusion: SeNps reinforced with T. vulgaris extract have a potential as an anti-inflammatory and antioxidant agent and can be used as an alternative to commercially available products.

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Aim: The aim of the study is to evaluate and compare the clinical and radiographic outcome of partial pulpotomy and full pulpotomy in mature permanent molars with symptomatic irreversible pulpitis using biodentine. Materials and Methods: A total of 66 vital mature permanent molars with irreversible pulpitis were randomly allocated to a partial pulpotomy (n = 33) and full pulpotomy group (n = 33). Biodentine was used as a pulp capping material which was covered with resin-modified glass ionomer cement (RMGIC) followed by composite restoration. Clinical and radiographic evaluation was done at 3, 6, and 12 months follow-up for tenderness, periapical radiolucency, dentine bridge formation, and root canal calcification. Data from the study were analyzed using a Friedman and Mann–Whitney test and the success rate was analyzed by Chi-square value. Result: No statistically significant difference was found between partial and full pulpotomy (P > 0.05) and the success rate was 80.7% and 92.8%, respectively, at 12 months follow-up period. Conclusion: Both partial and full pulpotomy can be used as a permanent treatment modality in symptomatic irreversible pulpitis of vital mature permanent molars.

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Aim: The aim of this study was to evaluate and compare the flexural strength of Cention N with resin-modified glass-ionomer cement and nanohybrid composite. Materials and Methods: Samples were prepared by filling the stainless steel mold of dimension 2 mm × 2 mm × 25 mm with cement/composite immediately after mixing. Excess flash if any was removed by abrading it with abrasive paper. Then, the specimens were subjected to flexural strength measurement using universal testing machine. The results were then tabulated and statistically analyzed using one-way ANOVA followed by Tukey's multiple post hoc test. Results: The average flexural strength of NT Premium, Vitremer, and Cention N was 90.39 MPa, 46.59 MPa, and 62.88 MPa, respectively. There was a statistically significant difference between NT Premium and Cention N and NT Premium and Vitremer with P = 0.0002 and 0.0001, respectively. Significance: The flexural strength study can help us to choose a material for restoring Class V lesions and can also confirm whether Cention N, a new material, be a definite replacement for amalgam. Conclusion: Cention N has proved to be a better material and can be a replacement for amagam and GIC.

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The objective of the study is to describe the clinical and radiographic features of nonmalignant nonendodontic periapical lesions (NMNPLs) mimicking lesions of endodontic cause. Five electronic databases, PubMed, Web of Science, Scopus, Embase, and ProQuest, were searched (till July 2021) for case reports, case series, and cross-sectional studies, in English language, reporting NMNPLs, which were clinically and/or radiographically simulating periapical pathosis of endodontic origin. Data extraction was done followed by quality assessment of the included articles using the Joanna Briggs Institute tool for case reports and case series. Seventy-three articles comprising 176 cases were included. Sixty-one articles were case reports, nine articles were case series, and three articles were retrospective studies. Male:female ratio was 1.5:1, with a higher prevalence of lesions occurring in the fourth and second decades of life. The majority of the lesions were located in the anterior maxilla. Radiographically, most of the lesions were well defined, radiolucent, and unilocular. Histologically, 29 different types of NMNPLs were reported, with the most common ones being odontogenic keratocyst (25.56%), dentigerous cyst (17.61%), ameloblastoma (11.36%), nasopalatine duct cyst (10.79%), and adenomatoid odontogenic tumor (5.68%). As all the included studies were observational, the quality of available evidence is considered low. Various features such as loss of tooth vitality, history of trauma, and presence of periapical radiolucency may lead to misdiagnosis of NMNPLs and must be considered during diagnosis of the lesion. Additional imaging modalities and histopathology can aid in right diagnosis.

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Background: The study was conducted to compare and evaluate the disinfecting efficacy of four different herbal oils with standard autoclaving against Enterococcus faecalis (E. faecalis). Fifty round burs were infected with E. faecalis and dipped into the chemical test solution for 10 min. The disinfecting efficacy for each test chemical was checked using culture method on blood agar plate and peptone water test to check for turbidity. Clove leaf oil and Tulsi leaf oil have very good antimicrobial efficacy against E. faecalis which are similar and comparable to that of autoclaving. Aim: This stusy aimed to compare the efficacy of pomegranate peel extract (PPE) oil, Garlic oil, Tulsi leaf oil, and Clove leaf oil with standard autoclaving on dental round burs tested against E. faecalis. Settings and Design: The disinfecting capability of four different experimental oils against autoclave was evaluated on 50 round burs exposed to E faecalis in an In-vitro study. Materials and Methods: A total of 50 round dental burs were exposed to E. faecalis and the disinfecting capability of four different experimental oils against autoclave was evaluated by counting colony-forming units (CFUs) and turbidity test. Statistical Analysis: Statistical analysis was performed using SPSS version 20.0 (IBM), Chicago. The CFUs between the five groups (I, II, III, IV, V) were compared using the Chi-square test. The level of significance was kept at 5%. Results: Clove leaf oil showed the best disinfection efficacy comparable to autoclaving, followed by Tulsi leaf oil with no statistically significant difference between them, whereas garlic oil and PPE oil were significantly less effective against E. faecalis. Conclusion: Clove leaf oil and Tulsi leaf oil can be used for disinfecting dental burs, infected with E. faecalis, as alternatives to autoclaving.

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Aim: The aim of this study was to evaluate and compare the fracture resistance of inlay preparations restored with indirect lab composite, conventional and translucent monolithic zirconia-based ceramics. Materials and Methods: Fifty freshly extracted human maxillary premolars were selected for the study. Standardized inlay cavities were prepared and restored with indirect lab composite, conventional monolithic zirconia-based ceramic and translucent monolithic zirconia-based ceramic. After restoration each sample was subjected to axial compressive load with Universal testing machine. The force required to induce fracture was recorded in Newton (N). Statistical Analysis Used: The data were analyzed using the one-way ANOVA test and Post hoc Bonferroni multiple comparison test. Results: Results revealed that fracture resistance of prepared inlay cavities restored with conventional monolithic zirconia-based ceramics was found to be best followed by other groups. Group I > Group IV > Group V > Group III > Group II. Conclusion: The fracture resistance of conventional monolithic zirconia-based ceramic inlays and translucent monolithic zirconia-based ceramic inlays were comparable with intact teeth but, indirect lab composite inlays showed lower fracture resistance than all.

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Mandibular incisors and canines show variations in their root canal anatomy. It is imperative to be aware of these variations to lower the frequency of missed canals. The objective was to systematically review the existing studies to recognize the root and root canal anatomy of the mandibular incisors and canines among the population of various geographical locations, as studied by different methods. This systematic review was registered in the International Prospective Register of Systematic Reviews database under the number CRD42020185146. An exhaustive search was undertaken in three electronic databases – MEDLINE PubMed, EBSCOhost, and Google Scholar – along with hand-searching for the identification of studies. Studies were selected following strict inclusion and exclusion criteria. Selected studies were scored using the Joanna Briggs Institute Critical Appraisal tool for prevalence studies to determine the risk of bias. This review included data from 26 countries including the analysis of 71,404 mandibular anterior teeth. The risk of bias of all included studies was either low or moderate. Overall, it was seen that the percentage of second canals was higher in lateral than in central incisors. Mandibular canines occasionally showed the presence of two roots. Deviations in anatomy were high in the Middle Eastern European countries and the Indian subcontinent. Limitations are as follows: lack of homogeneity across data reported in the studies concerning the methods used to study the root canal anatomy. Diversities seen in the root canal configurations of mandibular incisors and canines vary according to ethnicity, and thus, one must have a thorough knowledge before commencing endodontic treatment.

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Aim: The aim of the study is to evaluate erbium laser efficiency in removing smear layer from mesial roots of mandibular first molars at different laser settings. Subjects and Methods: One hundred (100) mandibular first molars were selected. Ninety six (96) mesial roots were assigned to two experimental groups according to the laser wavelength applied: I. Er, Cr: YSGG and II. erbium-doped yttrium aluminum garnet laser system. Four samples were used as control group. Samples of each group were distributed into two subgroups (A and B), following specific irrigation protocol. Each subgroup was divided into four subcategories according to the applied power laser. Each subcategory consisted of six samples. Teeth were observed under scanning electron microscope. Statistical Analysis: Results were statistically analyzed with Kruskal–Wallis and Mann–Whitney test (SPSS statistics software). Results: No statistically significant difference was observed between experimental groups I and II. However, statistically significant difference was found among subgroups IA and IB and IIA and IIB. In every root third, groups IIA and IIB had better outcomes but it was not statistically significant. There was no statistically significant difference among subcategories of Group I (IA_1-4 and IB_1-4) and Group II (IIA_1-4 and IIB_1-4). Conclusion: Erbium laser with tested parameters did not completely remove the smear layer from the root canals. Chelating factors can contribute in the laser mechanism of smear layer removal from apical part of narrow and curved root canals.

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Introduction and Aim: Postoperative inflammation and endodontic failure occur due to apical extrusion of debris. The purpose of this in vitro study was to assess the amount of apically extruded debris during the root canal preparation using rotary and reciprocating nickel-titanium instrumentation systems. Materials and Methods: The mesiobuccal canals of seventy five mature, human mandibular molars were randomly divided into three groups (n = 25 teeth/group). Each group was instrumented using one of the three different instrumentation systems: Hyflex EDM (HEDM) rotary file, Flexicon X7 rotary, and Flexicon X1 reciprocating files. The canals were irrigated using distilled water. The debris extruded apically was collected in preweighed Eppendorf tubes and assessed with an electronic balance and compared. Statistical Analysis: Data were statistically analyzed by one-way analysis of variance and the intergroup comparison with single factor ANOVA. Results: The Flexicon X1 reciprocating system showed the maximum amount of apical extrusion of debris among all the groups. The least amount of debris was observed in Flexicon X7 rotary instrument (P > 0.05). Conclusion: Flexicon X7 rotary extruded significantly lesser amount of debris than Flexicon X1 reciprocating and HEDM rotary file systems.

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Background: Enamel is the hardest and vastly mineralized structure of the human body. Inorganic salts make up the majority of it. Water and ions pass right through the enamel. The enamel undergoes demineralization and remineralization cycle throughout life. Recently, the interest in the development of calcium, phosphate, and fluoride remineralization technology has been increased leading to the development and reintroduction of various remineralizing agents such as fluoride, casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF), nano-hydroxyapatite (nano-HA), xylitol, bioglass, Ozone, etc. Aim: The aim of this study is to evaluate and compare the potential remineralization of CPP-ACPF, calcium sucrose phosphate (CaSP), amine fluoride (AmF), and nano-HA. Settings and Design: The design of this research is experimental. This is an in vitro study. The research was carried out at the Dental Teaching Institute. This study involved human teeth. No demographic data were obtained. One hundred and twenty premolars were selected from the tooth bank of the Department of Oral and Maxillofacial Surgery. The teeth included in the study were noncarious, nonrestored, and nonfractured extracted teeth. Teeth excluded from the study were extracted teeth with any visible or detectable caries, white spot lesions, microcracks, attrition, abrasion, erosion, or abfraction. Materials and Methods: One hundred and twenty enamel samples were taken; they were divided into six groups (n = 20). The demineralization process was carried out on Groups II, III, IV, V, and VI. The remineralization process was carried out on Groups III, IV, V, and VI for 14 days using CASP, AmF, and nano-HA, respectively. No surface treatment was performed in Group I causing it a positive control group, whereas Group II was considered a negative control with only enamel surface demineralization and no remineralization. The microhardness of enamel was measured using Vickers microhardness testing machine after a 14-day remineralization regimen. Statistical Analysis: In the statistical analysis, one-way analysis of variance and post hoc Tukey's tests were performed. Results: The mean microhardness values in declining order: positive control > nano-HA > AmF > CaSP > CPP-ACPF > negative control. Conclusion: All remineralizing agents exhibited enhanced surface remineralization. Nano-HA showed the highest remineralization potential followed by AmF, CaSP, and CPPACPF.

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Introduction: This in-vitro study comprises Antimicrobial and Confocal Microscopic analysis of the efficacy of Triple Antibiotic and Toluidine Blue (TBO) loaded chitosan nanoparticles (chnp) activated with photodynamic therapy (PDT) against Enterococcus faecalis (Ef). Methodology: 105 single-rooted extracted teeth were decoronated, cleaned and shaped, and incubated with Ef. The roots were randomly divided into three groups: Group I-Control, Group II-Triple Antibiotic Paste (TAP), Group III: Triple antibiotic-loaded chitosan nanoparticles (tachnp), and Group IV: Tachnp and TBO loaded chnp activated with PDT. Ten specimens from all the groups were subjected to antimicrobial analysis and five specimens were observed under the confocal microscope after 24 h and 7 days. Group IV was additionally analyzed after 24 h and 7 days of laser activation. Results: Group IV C showed the least colony-forming units followed by Group IVB, Group IIIB, Group IVA, and Group IIIA. Group II showed more colony-forming units. On intergroup comparison of mean colony count in control and experimental groups at 24 h and 7 days using one-way ANOVA F test was highly significant P < 0.001. The confocal microscopic images of IV C showed the increased intensity of fluorescent red indicating dead bacteria. Conclusion: Within the limitations of this study, TAP loaded chitosan nanoparticles activated with PDT showed a significant reduction in colony count.

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Context: The physical and chemical properties of root repair materials are adversely affected when placed in areas of inflammation with acidic pH. Aim: To evaluate the role of phosphate-buffered saline (PBS– pH 7.4) on push-out bond strength (POBS) of MTA flow and Biodentine (BD) after acid challenge with butyric acid buffered solution (BABS– pH 5.4). Subjects and Methods: Eighty mid-root dentin slices (2 mm thick; 1.3 mm lumen diameter) were prepared and were divided into two groups (n = 40) based on the type of material used for filling lumen: Group 1-MTA Flow and Group 2-BD. Each group was again divided into four subgroups (n = 10) based on the duration of exposure to storage media: (a) 3 days in PBS, (b) 3 days in BABS, (c) 3 days in BABS followed by 30 days in PBS, and (d) 33 days in PBS. POBS was then measured using the universal strength testing machine. Statistical Analysis Used: Statistical analysis was performed with one-way analysis of variance and post hoc test using SPSS software version 23.0. Results: Group 1b and 2b showed significantly lower bond strength values. No significant difference was observed between Group 1b and Group 1c (P > 0.05), whereas highly significant POBS values were observed between Group 2b and Group 2c (P = 0.000). Among all the tested groups, Group 2d showed the highest POBS values. Conclusion: On storage in PBS after acid challenge, BD attained the highest POBS values while no significant difference was observed in MTA Flow.

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Aim: The purpose of the present study is to evaluate the effectiveness of different irrigation techniques EndoVac, RinsEndo, Canal CleanMax (CCMax), SonicMax, Passive Ultrasonic Irrigation (PUI), and Manual Needle Irrigation (MNI) on dentin erosion and smear layer removal using Scanning electron microscopy (SEM). Materials and Methods: Seventy extracted single-rooted teeth were instrumented with ProTaper rotary instruments. The roots were randomly divided into six experimental groups (n = 10): EndoVac, RinsEndo, CCMax, SonicMax, PUI, and MNI. Final irrigation was performed with NaOCl followed by ethylenediaminetetraacetic acid and NaOCl. Six roots served as control and were irrigated with only NaOCl. Next, the roots were sectioned in a buccolingual direction and the halves were examined by SEM. Smear layer and erosion scores were recorded in the cervical, middle and apical third of the roots. Data analysis was performed using the Kruskal–Wallis and Mann–Whitney U-tests with a level of significance α = 0.05. Results: PUI had the greatest amount of smear layer compared to other groups (P < 0.001). However, SonicMax had the greatest degree of erosion compared to RinsEndo, MNI, PUI, and EndoVac groups (P < 0.001) and CCMax group (P < 0.05). Conclusions: RinsEndo and EndoVac techniques left the least amount of smear layer while causing erosion the least compared to CCMax, PUI, and MNI techniques.

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Context: This is a novel preclinical endodontic model “Vasundhara's model for elementary endodontic training,” featuring easy and convenient way for enhancing the skills of elementary endodontic procedures, simulating the clinical situation for endodontic teaching purposes. This article highlights the need, steps of fabrication of the model, and usage of the same for the universal benefit of the learners of endodontic techniques. Aims: The aim is to describe the design and usage of a novel preclinical endodontic model which is simple, convenient, easy to fabricate, and cost-effective. Settings and Design: Extracted teeth were selected and a pan radiograph was taken. Alginate was poured into metal jaws, followed by embedding of the teeth. Dental stone was then coated over the alginate. This assembly was then screwed to phantom head. A wire was attached to phantom head contacting the alginate for completing the circuit, forming an arc to which lip clip of apex locator could be attached. Conclusions: This novel cost-effective model for practicing preclinical endodontic techniques is simple, easy to design, and is a step forward toward mastering endodontic techniques.

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Aim: The aim of this study was to evaluate whether 2.5% chitosan applied after dentin acid etching or incorporated into the adhesive system interferes with the microtensile strength of the interface tooth-resin. Subjects and Methods: Sixty healthy bovine teeth had the incisal thirds and the roots sectioned and were randomly allocated into three groups (n = 60). G1 (control): acid attack + Clearfil SE Bond + Z350 resin; G2: treatment with 2.5% chitosan + Clearfil SE Bond + Z350 resin; G3: treatment with 2.5% chitosan incorporated into dentin adhesive + Z350 resin. The stick-shaped specimens made in each group were randomly divided into two subgroups and subjected to degradation of the adhesive interface (with aging: specimens immersed in 2.5% sodium hypochlorite for 12 h and washed in distilled water for 1 h, and without aging). The groups were submitted to a microtensile strength test with a 0.5 mm/min speed until rupture. Statistical analysis of the data was performed according to normal distribution. Results: Microtensile data were obtained by calculating the area of each toothpick, obtaining values in megapascal. No aging: G1 – 5251.69, G2 – 5.52 ± 1.46, and G3 – 3.91 ± 1.21. With aging: G1 – 3.45 ± 1.29, G2 – 2.75 ± 0.78, and G3 – 3.53 ± 1.33. Statistical analysis showed that the aging factor and adhesive modification decreased the bonding strength of the resin-dentin (P = 0.001). As well, the interaction between the analyzed factors showed statistically significant differences (P = 0.002). Conclusions: Accelerated aging decreases the adhesion strength in G1, even when chitosan is previously applied to the adhesive system. However, when adding chitosan to the adhesive, adhesion remained similar after aging but lower when compared to the other groups.

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Aim: The aim of this study was to study the prevalence of dens invaginatus (DI) and palatogingival groove (PGG) in maxillary lateral incisors, and the occurrence of apical periodontitis in association with these anomalies in North Indian population. Methodology: Maxillary lateral incisors in 163 cone-beam computed tomography scans were assessed to determine the presence of DI and PGG. Anomalies identified were then classified as per Oehler's and Gu's classification, respectively. Their side and gender predilection and association with apical and lateral radiolucency was also studied. Statistical Analysis: Descriptive data were reported as percentages. Chi-square analysis was used to determine the association with gender and side predilection. Results: DI was present in 13.5% of the scans, while PGG was present in 7.3% of the scans. No significant gender and side predilection was observed. 6.67% of lateral incisors with DI and 25% of lateral incisors with PGG had an associated apical radiolucency. 33.33% of lateral incisors with PGG had an associated lateral radiolucency. Conclusions: There is a high prevalence of DI and PGG in maxillary lateral incisors.

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Background: Mutans streptococci which comprise only 2% have long been presumed to be the specific pathogen responsible for caries. A novel caries associated bacterium namely Scardovia wiggsiae is recognized to be ecologically competitive in active caries lesions. The actual pathogen needs to be identified, so as to specifically target and reduce the prevalence of caries in a given community. Aim: The aim of the study is to evaluate the presence of S. wiggsiae in combination with other bacteria in caries risk adolescence. Methods: Sixty adolescent subjects were screened. Phase I-to determine the prevalence of S. wiggsiae in saliva, plaque and dentinal caries samples of low and high caries risk individuals (n = 30 each) using polymerase chain reaction (PCR); Phase-II-to identify its presence by 16SrRNA metagenomic analysis and quantitatively evaluate the cariogenic pathogen using high-resolution melt curve analysis and real-time PCR. Results: Highest prevalence of S. wiggsiae was observed in dentinal caries followed by plaque and saliva samples of high caries risk individuals under PCR analysis. Metagenomic analysis showed two-fold statistically increased presence of Lactobacilli and Bifidobacteriaceae (S. wiggsiae) in dentinal samples compared to plaque samples (P = 0.05). Mutans streptococcus recorded the minimum. Conclusion: Scardovia wiggsiae is identified as one of the predominant microorganism.xs

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