Background: Advances in adhesive technologies and escalation in esthetic demands have increased indications for tooth-colored, partial coverage restorations. Recently, material knowledge has evolved, new materials have been developed, and no systematic review has answered the question posed by practitioners: Is the clinical efficacy of resin or ceramic better, for inlay, onlay, and overlay in the long run? Aim: The aim of this systematic review and meta-analysis was to evaluate the clinical performance of ceramic and resin inlays, onlays, and overlays and to identify the complication types associated with the main clinical outcomes. Materials and Methods: Two reviewers (VN and AJ) searched PubMed, Embase, and Cochrane Central registry of controlled trials for published articles between 1983 and 2020 conforming to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines for systematic reviews. Only clinical studies which met the following criteria were included (1) studies regarding ceramic and resin inlays, onlays, and overlays were included; (2) randomized controlled trials, retrospective or prospective studies conducted in humans; (3) studies with a dropout rate <50% 4) studies with a follow-up higher than 5 years. Results: Of 1718 articles, 21 articles were selected. At 5 years, the estimated survival rates for resin (n = 129) was 86%, feldspathic porcelain (n = 1048) was 90%, and glass ceramic (n = 2218) was 92%; at 10 years, the survival of resin was 75% (n = 115), feldspathic porcelain was 91% (n = 1829), and glass ceramic was 89% (n = 1075). Conclusion: The meta-regression indicated that ceramic partial coverage restorations (feldspathic porcelain and glass-ceramic) outperformed resin partial coverage restorations both at 5-year and 10-year follow-up. When compared between ceramic types, glass ceramics outperformed feldspathic porcelain at 5 years' follow-up and feldspathic porcelain outperformed glass ceramics at 10 years' follow-up. The failures were mostly due to fractures (6.2%), endodontic problems (3%), secondary caries (1.7%), and debonding which was 0.9%.

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Background: Despite constant advances in science, obscurity remains in the efficient removal of pulp stones to aid in successful root canal treatment. In this context, chemical means of dissolving pulp stones were explored. Aim: The aim of this study is to evaluate and to compare the efficacy of decalcifying agents on the dissolution of pulp stones. Materials and Methods: The study was divided into two groups for pulp stone analysis (21 samples) and dentin analysis (54 samples). Twenty-one pulp stones from patients aged 18–70 who underwent root canal treatment were collected and divided into three subgroups (n = 7) randomly. They were subjected to chemical treatment in a labeled glass container with 5 ml of the respective chemical agents, such as 17% ethylenediaminetetraacetic acid solution (positive control), no treatment (negative control), and newly developed Physiological Simulated Decalcifying Agent (PSDA). At the end of the study period (24 h), the samples were removed, rinsed with deionized water, and subjected to physical analysis, scanning electron microscopy (SEM), and Energy –dispersive X-ray spectroscopy (EDS) analysis. Under dentin analysis, 54 maxillary premolars scheduled for orthodontic extraction without caries or extensive restorations were selected, following which 2-mm thick transverse dentinal sections at the cementoenamel junction level were obtained and randomly divided into two groups for SEM (n = 21) and microhardness analysis (n = 33). The samples were subjected to respective chemical treatment groups similar to pulp stones for 24 h and analyzed using SEM, EDS, and microhardness analysis. Results: Postchemical treatment with the newly developed decalcifying solution, the pulp stones showed the absence of nodular crystallites and surface softening under SEM and a decrease in the calcium level under EDS analysis. Concerning the microhardness of dentin, no significant changes could be observed. Conclusion: The newly explored PSDA was found to be efficacious in the decalcification of pulp stones at a clinically relevant time of 24 h, without significantly affecting the structural integrity and the hardness values of dentin.

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Objectives: The objective of this study is to compare the efficacy of chitosan (CS) nanoparticles (CNPs), citric acid (CA), and ethylenediaminetetraacetic acid (EDTA) in removing the smear layer using two different irrigation needles. Materials and Methods: Palatal roots of 70 maxillary first molars were decoronated, instrumented, and divided into four experimental groups (n = 20) and one control group (n = 10). The groups received a final rinse of 0.5% CNPs, 10% CA, 17% EDTA, and distilled water for 3 min. Every group was subdivided into two subsections: IrriFlex^® endodontic or ProRinse^® irrigation needles. Specimens were divided lengthwise and viewed under a scanning electron microscope for evaluation. Statistical Analysis Used: Nonparametric Kruskal–Wallis and Mann–Whitney U-tests were used to compare the results (P < 0.05). Results: CNPs were as efficient as CA and EDTA as a chelating agent. However, significantly more efficient apically. At all three levels, there was no significant difference between A1 and A2. At the coronal and middle levels, there was a significant difference between B1 and B2, as well as apically between C1 and C2. Conclusions: CNPs remove the smear layer with the same efficiency as other irrigants utilized in this study at coronal and middle levels and more efficiently at the apical levels. IrriFlex^® was more effective than ProRinse^® in removing the smear layer when used with EDTA and CA, while there was no difference when used with CNPs.

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Aim: The aim was to evaluate the effect of bulk-fill composites – Activa and Smart Dentin Replacement (SDR) on cuspal deflection in endodontically treated teeth with different access cavity designs. Materials and Methods: Forty-two maxillary first premolar teeth were randomly divided into three experimental groups based on different access designs as Group I – conservative endodontic cavities (CECs), Group II – traditional endodontic cavities, and Group III – CECs with diverging walls and two subgroups, based on the different access cavity restorations subgroup A-Activa and subgroup B-SDR with n = 7 per group. Root canal treatment was completed under the dental operating microscope. Cuspal deflection was assessed by measuring the distance between the glass beads using an optical microscope and micrometer immediately after a Root canal treatment and final measurements after access restorations. Data were statistically analyzed and tabulated. Results: Results showed that the access cavity restored with Activa showed the highest cuspal deflection than SDR in all the groups (P < 0.05). Conservative access designs showed the least cuspal deflection among other groups. Conclusion: CEC designs showed lesser cuspal deflection than traditional endodontic cavity designs. SDR can be considered as a choice of material for access restorations.

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Background: Incorporation of chromotherapy is an established modality in medical science. However, its use in adult dentistry is an unexplored area. Aim: This study aimed to clinically evaluate and compare the effect of chromotherapy on anxiety levels in patients undergoing endodontic treatment. Materials and Methods: Using computer randomization, the included 90 patients were divided into three groups: Group – 1: Blue, Group – 2: Pink, and Group – 3: Control. Patients were given a preoperative Modified Dental Anxiety Scale questionnaire. Preoperative assessment of heart rate, systolic blood pressure (BP), and diastolic BP was followed by color therapy. Assessment of all the parameters was done at three levels, i.e., preoperative, post chromotherapy session, and after endodontic treatment. Statistical Analysis: Obtained data were tabulated and subjected to ANOVA and post hoc Tukey's test, with P < 0.05 considered statistically significant. Results: The present study demonstrated that patients subjected to blue and pink color therapy had a statistically significant reduction in anxiety as compared to the control group after chromotherapy and post endodontic treatment (P < 0.05). However, between the pink- and blue-colored groups, no statistically significant difference was found (P > 0.05). Conclusions: Chromotherapy plays a pivotal role in anxiety reduction before and during the dental treatment procedure and can be effectively incorporated during routine practice.

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Context: Dentinal Hypersensitivity is the most common dental problem, in order to find a suitable treatment plan this study was conducted incorporating LASER and desensitizing agents on the patients complaining of dentinal hypersensitivity in cuspids and bicuspids. Most of the desensitizing agents provided incomplete relief hence the combination of LASER and Desensitizing agents proved to be successful. Aim: The aim of this study is to evaluate and compare the efficacy of individual desensitizing agents and c (LASER) and also to know their potential in reducing dentinal hypersensitivity when both desensitizing agents and LASER are combined together and applied on cuspids and bicuspids. Setting and Design: Sixty patients with sensitivity only in cuspids and bicuspids and not having caries, restoration, or undergoing any desensitizing therapy were selected. Patients were divided into 5 groups with 12 patients in each group. Materials and Methods: Air blast stimulus was given for 10 s from 1 cm distance on the affected group. Verbal analog score was recorded. Treatment was carried on according to the groups mentioned: Group I – nanohydroxyapatite was applied for 15 min; Group II – biosilicate was applied for 15 min; Group III – LASER application was done twice for 60 s in noncontact mode; Group IV – Nanohydroxyapatite plus LASER application; and Group V – biosilicate plus LASER application. Desensitizing agent was applied with the applicator tip and was left for 15 min. It was then rinsed and again the stimulus was given, and the score was recorded. The same treatment procedure was repeated on 1^st, 7^th, and 14^th day and the score was recorded and analyzed using ANOVA. Results: The maximum reduction in sensitivity score was observed in patients where nanohydroxyapatite and LASER application was done. Conclusion: All the investigated treatments have promising desensitizing potential, but maximum was found in Group IV > Group V > Group III > Group I > Group II.

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Aim: The aim of this systematic review was to compare the effect of body temperature (I) on the cyclic fatigue resistance (O) of nickel–titanium (NiTi) endodontic instruments (P) to that of room temperature (C). Methods: The study was registered in the PROSPERO database (CRD42020204286). A systematic search in PubMed, Scopus, Web of Science, Google Scholar, and OpenGrey was conducted in English until December 31, 2021. In vitro studies comparing the cyclic fatigue resistance of NiTi instruments at the body (35°C ± 2°C) and room temperature (20°C–25°C) were included. Eligible studies were evaluated for risk of bias and meta-analyzed to estimate the effects. Results: Twenty-one studies out of 347 met the criteria for inclusion. The meta-analysis included six studies (n = 215) with comparative study parameters. The overall effect sizes (5.49; 95% confidence interval [CI]: 4.04–6.93) were significantly different (P < 0.001), indicating that the mean values at room temperature were significantly (P < 0.001) higher. The effect sizes for full rotary motion (standardized mean difference [SMD]: 4.80; 95% CI: 3.04–6.56) and reciprocating motion (SMD: 6.37; 95% CI: 3.63–9.11) were not significantly different (P = 0.346). Heterogeneity was high (I² = 94%). Sensitivity analysis revealed that the SMD values were not significantly different (P > 0.05) from the overall effect size, indicating that none of the studies had an effect on the overall effect size. Conclusions: Within the limitation of the study, the cyclic fatigue resistance of heat-treated NiTi endodontic files is significantly reduced at body temperature when compared to room temperature. Cyclic fatigue testing should be conducted at simulated body temperature.

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Context: Silver is known for its antibacterial properties since ages. As nanoparticles have smaller size and greater surface area, silver has been utilized in the form of nanoparticles to enhance its antibacterial properties. Calcium hydroxide is a well-known intracanal medicament and serves as a gold standard for root canal disinfection. Using herbal extracts as reducing agents for nanoparticle synthesis appears to be an ecofriendly approach. Aim: The aim of this study was to synthesize calcium hydroxide-based silver nanoparticles using herbs as reducing agents and to test the cytotoxic levels and antimicrobial activity against oral microbes. Materials and Methods: The calcium hydroxide-based silver nanoparticles were synthesized using the leaves of Andrographis paniculata and Ocimum sanctum Linn. Various properties of the synthesized nanoparticles were also characterized by ultraviolet (UV) spectrophotometer analysis, transmission electron microscopy (TEM), X-ray diffraction (XRD), and Fourier-transform infrared spectroscopy (FTIR) analysis. The cytotoxic effects of these nanoparticles were analyzed using brine shrimp and MTT assay. Antimicrobial activity was assessed by measuring the zone of inhibition. The statistical analysis was done using parametric independent t-test. P value was set at < 0.05. Results: The calcium hydroxide-based silver nanoparticles were successfully synthesized and were confirmed by UV spectrophotometer analysis, TEM, X-ray diffraction (XRD), and FTIR analysis and showed a minimal cytotoxic effect. They also showed a good antimicrobial activity and a remarkable antifungal activity. Conclusions: The green synthesis of CaOHAgNPs yielded an effective nanoparticle preparation that could be used against common oral pathogens as a potential therapeutic agent in the form of root canal irrigant or intracanal medicament in the field of dentistry.

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Background: The effectiveness of endodontic retreatment essentially depends on the cleaning and/or disinfection processes. In this context, the removal of root canal filling materials plays a crucial role. Aims: To assess the efficacy of passive ultrasonic irrigation (PUI), EndoActivator system (EAS), and XP-endo Finisher R (XPEFR) as additional cleaning techniques to remove the remaining root canal filling materials from flattened root canals. Subjects and Methods: Thirty-six similar flattened distal root canals of extracted human first lower molars were selected by micro-computed tomography (micro-CT) and then instrumented and filled. After the initial retreatment procedures, the residual volume of root canal filling materials was assessed by micro-CT (V1). Then, the specimens were divided into three groups (n. 12), according to the additional cleaning technique and submitted to another micro-CT scan (V2). Statistical Analysis Used: Analysis of variance and Games-Howell tests (P < 0.05). Results: The percentage reduction in the residual volume of root canal filling materials reached by PUI, EAS, and XPEFR was 28.38%, 28.12%, and 43.52%, respectively, considering the total space of the root canal (P > 0.05). In the apical third, these values were 20.05%, 21.54%, and 48.82% (P < 0.05). Conclusions: Additional cleaning techniques enabled removing a greater amount of root canal filling material from flattened distal root canals of extracted human first lower molars. Considering the total space of the root canal, there were no statistically relevant differences among the groups. In the apical third, XPEFR performed better.

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Background: Various irrigation techniques have been proposed to improve the effectiveness of root canal debridement. Aims: The aim of the study was to compare the antimicrobial effect on Enterococcus faecalis and smear layer removal efficacy in curved canals by different irrigation techniques. Materials and Methods: Eighty extracted permanent maxillary molars with curved mesiobuccal roots were inoculated with E. faecalis. The tooth samples were then divided into four groups: Group A – EndoVac, Group B – Passive Ultrasonic Irrigation (PUI), Group C – Photodynamic Therapy (PDT), and Group D – Laser Irrigation with Photon-Induced Photoacoustic Streaming (PIPS). The percentage of bacterial reduction was calculated. The presence of smear layer from coronal, middle, and apical sections was evaluated through scanning electron microscopy. Statistical Analysis: Statistical analysis was performed using Kruskal–Wallis test. Intergroup comparison was made with Mann–Whitney U-test. Results: Although statistically insignificant, the irrigation techniques have shown considerable reduction in E. faecalis biofilm (P > 0.05). EndoVac, PUI, and PIPS have shown significantly higher efficacy in removing smear layer from apical third than PDT (P < 0.001). Conclusion: The newer PIPS technology can be used as an efficient tool in the decontamination of root canals. However, more clinical studies in this aspect are required to ensure more thorough debridement and disinfection of the root canal system.

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Background: The success of endodontic treatment mainly depends on the eradication of microorganisms from the root canal system. The use of intracanal medicaments plays a crucial role in eliminating resistant bacteria such as Enterococcus faecalis. Intracanal medicaments similar to herbal compounds can be used as a substitute for conventional calcium hydroxide (CaOH2) to prevent toxicity. The existing study aimed to compare and evaluate the antimicrobial activity of four different intracanal medicaments against E. faecalis. Objectives: The objective of this study is to compare and evaluate the antimicrobial efficacy of CaOH2, extracts of mushroom, aloe vera, and Curcuma longa as intracanal medicaments against E. faecalis. Materials and Methods: A total of 120 extracted human permanent premolars were decoronated, and chemomechanical preparation of the root canal was performed. After sterilization of the samples, pure cultures of E. faecalis were inoculated and incubated. Then, samples were separated randomly into five groups (n = 24). The antibacterial efficacy of the different intracanal medicaments was recorded at the end of days 1, 7, and 14 by determining the % reduction colony count. Data were statistically analyzed using a one-way analysis of variance, a Chi-square test for association, and a comparison of means using a t-test. Results: Curcuma longa exhibited an increased percentage reduction in colony counts compared to other herbal extracts against E. faecalis. Conclusion: Antibacterial action of the C. longa extract was uppermost followed by CaOH2, A. vera, and mushroom against E. faecalis.

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Background: Instrumentation and irrigation of the root canal facilitating effective debridement is considered the most important single factor in the prevention and treatment of endodontic diseases. Aim: The aim of the study was to evaluate the depth of penetration of the irrigant depending on the final activation using Waterpik device modified with NaviTip needle, passive irrigation, and manual dynamic activation using the radiopaque solution in conjunction with digital dental radiography. Materials and Methods: Ninety freshly extracted single-rooted mandibular premolars based on the inclusion and exclusion criteria were used for this study. Access cavity preparation was done for all the samples, and the working length of each sample was determined using a size 10-k file. The radiopaque solution (Urografin) was delivered into (Groups A, B, and C) prepared canal of samples at the rate of 1 ml in 30 s with up-and-down motion. Results: The test results showed that Waterpik WP-100 group showed significantly high infiltration index values as compared to passive irrigation and manual irrigation group at P < 0.002 and P = 0.007, respectively. Conclusion: Sonic irrigation using a Waterpik device modified with a NaviTip needle permits better infiltration of the irrigant.

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Aim: The aim of this study was to evaluate and compare eighth-generation bonding agent (G-Premio BOND) modified with 7% arginine and 0.12% chitosan for antibacterial property and microtensile bond strength. Methods: To evaluate antibacterial property, the sterile 96-microtiter plate was taken. The sidewalls of nine wells were coated with 15 μl of adhesive from each group. Suspension of Streptococcus mutans bacteria was placed on each group of adhesive and antibacterial property was checked using Spectrophotometer. Thirty-three healthy extracted premolars were taken and adhesive from each group was applied on the exposed surface of dentin, and the specimens were tested using a universal testing machine at crosshead speed of 1 mm/min. Results: The least antibacterial efficacy was seen with unmodified eighth-generation bonding agent. This result was statistically significant when all study groups were compared. Microtensile bond strength was evaluated and the highest mean value (5.07) was seen with adhesive modified with 7% arginine, followed by adhesive modified with 0.12% chitosan (mean value: 4.14), and unmodified adhesive had the lowest mean bond strength value (4.07). Conclusions: The eighth-generation bonding agent modified with 7% arginine and 0.12% chitosan showed antibacterial efficacy against S. mutans. In addition to this, they also had higher tensile bond strength values as compared to unmodified adhesive.

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Aim: The aim of this study was to evaluate and compare the prevalence of postoperative pain after single- and two-visit endodontic therapy in controlled Type 2 diabetic and nondiabetic individuals in multirooted teeth with irreversible pulpitis. Materials and Methods: Ninety patients with irreversible pulpitis (30 controlled diabetics and 60 nondiabetics), between 18 and 60 years were included in the study. After obtaining initial pain scores, patients were randomly allocated to single-visit or two-visit root canal treatment (RCT) groups to receive standardized treatment. After the first visit, patients were given visual analog scale form to mark pain intensity at 1 h, 6 h, 12 h, 24 h, 48 h, 72 h, and 1 week. The compiled data collected were statistically analyzed using 20 SPSS software. Results: In both groups, for patients undergoing single-visit and multi-visit RCT, pain intensity was highest on 1^st day of treatment and dropped afterward. A comparison of pain between single-visit and two-visit patients revealed no significant difference in pain scores for the respective time intervals. Intergroup comparison between controlled diabetics and nondiabetics showed no significant difference in pain reported between both groups. Conclusion: According to the results of this study, being diabetic or nondiabetic, no difference in pain perception was seen between single- and multiple-visit endodontics suggesting that single-visit as well as two-visit endodontic treatment can be done in controlled diabetic patients.

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Aims and Objectives: This study aimed to evaluate and compare the effect of different surface treatments of the salivary contaminated dentin on the shear bond strength of one-step self-etch adhesives. Materials and Methods: The coronal buccal surfaces of 50 human mandibular molars were ground to expose dentin. The specimens were randomly divided into five groups. Ten teeth were left uncontaminated and served as control group. Rest of the teeth were then divided based on the decontamination method used as follows: Group II (no decontamination done), Group III (decontamination with rinsing), and Group IV (decontamination with etching), Group V (decontamination with ethanol). Composite resin cylinders of 4 mm diameter and 4 mm length were fabricated on the surfaces. Shear bond strength testing was done in a universal testing machine, and the data were subjected to a one-way analysis of variance and KruskalWallis test. Intergroup comparison was made using MannWhitney U-test. Results: The highest bond strength was seen in Group 1, followed by and least in Group II. The difference was found to be statistically significant among all the groups. Group II and Group IV showed lower shear bond strength than Group I (control) and Group III (P < 0.05). The intergroup comparison shows significant differences between Group I with all the other groups. Conclusion: It was concluded that the use of decontaminant improved the bond strength to salivary contaminated dentin in self-etch adhesives.

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Aim: The study aims to measure the surface roughness (Ra) of three resin composites subsequent to polishing with diamond-impregnated polishing paste. Materials and Methods: Sixty specimens (10 mm × 2 mm) were prepared in metal molds using three nanocomposites: GC Sculpt, Filtek Z350 XT, and Tetric N Ceram. Specimens were then subjected to baseline roughening with #600 grit sandpaper and were polished with DirectDia paste according to the manufacturer's instructions. After polishing, the Ra of resin composites of all the specimens was measured using profilometer and the surfaces were seen under scanning electron microscope. Results: Tetric N Ceram specimens were significantly smoother and had the least R_a value compared to other groups. Conclusion: Among the three resin composites tested, Tetric N Ceram exhibited the least R_a value owing to the small size of inorganic filler particles.

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Introduction: Chlorhexidine (CHX) is a commonly used root canal irrigant with high surface tension which prevents its penetration into the isthmus and fins of the root canal. Surfactants have known to reduce the surface tension of the liquid. Cetylpyridinium chloride (CPC) is a cationic surfactant. The aim of this study is to assess the contact angle formed and depth of penetration of the endodontic irrigant with and without the addition of surfactant. Methods: Contact angle analysis – Ninety-nine freshly extracted and cleaned single-rooted mandibular premolars were obtained. Thirty-three teeth were sectioned longitudinally and then transversely. The sections were mounted on an acrylic block, polished to obtain a flat dentin surface. Five microliter of Group 1: 2% CHX as control, Group 2: 2% CHX + 0.1% CPC, and Group 3: 2% CHX + 0.2% CPC were placed on the dentin surface and subjected to contact angle analysis. Depth of penetration – Access cavity was prepared in sixty-six teeth and instrumented to working length till Protaper Gold F2. The samples were assigned to Groups 1, 2, and 3 and irrigated accordingly, and subjected to a confocal laser scanning Microscopy. Data were analyzed using one-way ANOVA and Tukey multiple comparison test. Karl Pearson's correlation test was performed to analyze the correlation between the two. Results: Group 3 had the lowest contact angle (12.82°) and the highest depth of penetration (222.74 μm) when compared to Group 1 and Group 2. Karl Pearson's correlation showed no correlation between the contact angle and the depth of penetration. Conclusion: Higher the concentration of CPC, lower is the contact angle formed with the dentin and higher is the depth of penetration into the dentinal tubule.

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Aim: The aim of this study was to investigate the diffusion of triamcinolone and demeclocycline from an endodontic paste when used unmodified, versus when combined in equal parts with a calcium hydroxide paste, in terms of diffusion through the dentinal tubules versus through the apical foramen. Methodology: Medicaments were placed in endodontically prepared roots that were kept in vials of Milli-Q water. The five experimental groups in the study were (1) control – no medicament, (2) medicament containing triamcinolone and demeclocycline (T&D) and occluded apex, (3) T&D paste and patent apex, (4) T&D + calcium hydroxide (Ca(OH)₂) occluded apex, and (5) T&D + Ca(OH)₂ and patent apex. The triamcinolone and demeclocycline concentrations were measured with solid-phase extraction and ultra-high performance liquid chromatography–mass spectrometry, after 1, 3, 8, and 24 h, and after 1 week. Results: Most of the triamcinolone and demeclocycline diffused through the apical foramen, with sparse diffusion through the dentinal tubules. The T&D paste mixed with Ca(OH)₂ in equal amounts showed greater than the expected 50% reduction in the diffusion of triamcinolone and demeclocycline from mass dilution alone (89% and 80%, respectively). Conclusions: These results stress the importance of maintaining apical patency, for allowing diffusion of active components of the drugs to target tissues in the periapical environment.

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Purpose: This study aimed to evaluate the effect of triple antibiotic paste (TAP) as an endodontic intracanal medicament on the bond strength of epoxy and methacrylate resin-based sealers to root canal dentin. Materials and Methods: In this in vitro study, 80 single-rooted human mandibular premolars were prepared using ProTaper rotary system. The specimens were randomly divided into a control group (without intracanal dressing) and an experimental group receiving TAP (n = 40). The intracanal dressing was removed after 3 weeks. Then, samples of each group were randomly divided into four subgroups (n = 10) and obturated with gutta-percha and different resin-based sealers. G1: AH Plus, G2: Syntex, G3: EndoREZ, and G4: MetaSEAL. After 1 week, 16 slices of 1 ± 0.1 mm thickness were obtained from the midroots of teeth in each subgroup, and a push-out test was used to measure the bond strength. Slices were examined using a stereomicroscope at 30 × to determine the mode of failure. The data were analyzed using two-way analysis of variance, one-way analysis of variance, and Tukey post hoc tests (α = 0.05). Results: Compared to control group, TAP significantly increased the bond strength of MetaSEAL and EndoREZ (P < 0.05). In the control group, epoxy resin-based sealers showed higher bond strength compared to methacrylate ones (P = 0.00). In TAP group, Syntex and EndoREZ showed significantly the greatest and the lowest bond strengths, respectively, (P < 0.05). The analysis of failure modes revealed a predominance of mixed failures in all groups except for Syntex group in which most failures were cohesive. Conclusions: TAP significantly increased the bond strength of methacrylate resin-based sealers.

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Context: The exposure to gamma radiation affects the enamel and dentin in teeth restored with composite restoration, but a little has been done to protect from the detrimental effect. Aims: The aim of this in vitro study was to evaluate the effect of gamma radiation, with or without shielding (0.5 mm thickness of lead), in Class V cavities prepared on teeth exposed before and after restoration using the self-etch adhesive technique. Methods: A total of 75 intact teeth were selected. The samples were divided into five groups: Group I (15 teeth) not exposed to gamma radiation. Group II and III exposed to gamma radiation as per the standardized radiation protocol (2 Gy/day for 5 days/week = 10 Gy/week for 6 weeks = 60 Gy). Group III shielded, using a “0.5 mm thickness of lead” molded into a “C” shaped tube. Standardized Class V cavities were prepared on the buccal surface of all teeth and were restored by composite. Groups IV (not shielded) and V (shielded) were then exposed to standardized radiation protocol. All the samples were evaluated for the assessment of microleakage under stereomicroscope. Statistical Analysis Used: Statistics were tabulated using the Kruskal–Wallis ANOVA test. Results: Samples showed a significant difference in dye penetration scores. Conclusions: The samples restored before being exposed to gamma radiations performed better. Shielding with 0.5 mm of lead has shown increased efficacy of self-etch adhesive system irrespective of the stage of exposure.

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