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Background: The long-term success of root canal therapy depends on the effective debridement and removal of smear layer and debris from the canal. Root canals with difficult anatomy and complex systems pose great challenge to achieve this. Mechanical therapy alone cannot achieve this goal, various intracanal chemicals also have their own limitations along with the difficulty in reaching the farfetched and difficult areas, and hence, introduction of ultrasonic bypass system has been a boon for the endodontic therapy. Objectives: The aim of this study is to compare the various root canal medicaments along with ultrasonic bypass system in effectively cleaning the debris and smear layer from the various parts of the root canal system. Materials and Methods: Forty single-rooted anterior maxillary and mandibular human teeth were collected for this study, after disinfection, they were sectioned into three equal parts coronal, middle, and apical and these parts were later studies under SEM (Scanning Electron Microscope) and scoring as per the scoring criteria set before the study was done and results were then compared statistically. Results: Group with both ethylenediaminetetraacetic acid (EDTA) and NaOCl with ultrasonic bypass system was the most effective one, when compared with sterile water, NaOCl + ultrasonic bypass system, EDTA + ultrasonic bypass system. NaOCl + ultrasonic bypass system was more effective as compared with the EDTA + ultrasonic bypass system. Conclusion: Ultrasonic bypass system is a useful tool for debris and smear layer removal from a root canal system, but its effectiveness increases when both EDTA and NaOCl are used along with it.

RATIONALE: Addiction is characterized by intermittent drug seeking despite rising costs. This behavior is heavily influenced by environmental stimuli that signal drug availability and reinforce drug seeking. OBJECTIVE: To establish the relationship between three key aspects of human drug use in rats: the intermittent, binge nature of drug intake, the motivational conflict of drug seeking in the face of escalating negative costs, and the ability of different drug cues to interact to modulate relapse. METHODS: Male and female rats were trained to self-administer cocaine on an intermittent access schedule, where brief drug-availability states were signaled by a shift in the ambient lighting of the environment and cocaine infusions were signaled by a separate proximal discrete cue. Rats then went through a conflict procedure, where foot shock intensity associated with cocaine seeking was escalated until intake was suppressed. We then completed relapse tests where the drug-delivery cue was non contingently presented alone, or in the context of dynamic drug-availability state transitions. RESULTS: Intermittent access spurred psychomotor sensitization and binge-like cocaine intake. The intensity of binge-like drug taking during training was predictive of later drug seeking despite escalating costs during conflict. In relapse tests, the ability of a proximal discrete drug cue to trigger relapse was gated by the presence of a global cue signaling drug-availability state transitions. CONCLUSIONS: Our results suggest that the pattern of drug intake plays a role in many features of addiction, including modifying an individual’s willingness to endure high costs associated with drug seeking. Further, our studies indicate that drug-related sensory information can be hierarchically organized to exert a dynamic modulating influence on drug-seeking motivation.

Background: Increased C-reactive protein (CRP) levels are associated with various diseases such as cardiovascular diseases (CVDs), periodontal diseases, and other inflammatory diseases and can be an effective biomarker for predicting future risks of periodontal diseases. Aims: The present trial was carried out to evaluate if CRP levels are lower in healthy and young individuals as compared to individuals with high body mass index (BMI), gingival index, and CVDs by assessing CRP levels in young and old individuals (more than 45 years). Materials and Methods: A total of 174 participants were recruited for the study and were divided into three following groups: Less than 45 years healthy participants (n = 124), more than 45 years healthy participants, and more 45-year-old participants with CVDs (n = 25). The collected data were subjected to the statistical analysis. Results: In Group I, females had a CRP level of 8476 ± 6.86 pg, females of Group II had a CRP value of 13,262 ± 3.76, and in females of Group III CRP value was 22,761 ± 6.24 pg. These values, respectively, for males were 8494 ± 7.68, 13,840 ± 4.82, and 13,839 ± 3.8. In smokers, the CRP values for Group I, II, and III were 29,012 ± 14.66, 12,568 ± 4.16, and 16,826 ± 3.42, respectively. Conclusion: CRP levels were higher in males as compared to females. Higher BMI was associated with higher values of CRP. The participants with higher BMI presented higher CRP values irrespective of age.

The association between cardiovascular diseases and periodontitis had different pathophysiological mechanisms involved. These mechanisms are both inflammatory and microbial. Furthermore, the possible association between two diseases can be explained by common risk factors.The present trial was carried out to establish a relation between coronary artery disease and periodontitis.One hundred and twenty-six participants advised for the angiography were included. Periodontists determined the presence of periodontitis in all participants followed by lipid profile, C-reactive protein (CRP) levels, and blood coronary angiography was then performed. The collected data were subjected to the statistical analysis, and the results were formulated.The level of CRP in participants with and without coronary artery disease was 0.66 ± 1.52 and 0.53 ± 1.01, respectively, which was nonsignificant with aThe present study establishes an association between poor oral health, periodontitis, and coronary artery disease. This study demonstrates that tooth loss which is an important feature of periodontitis is significantly associated with coronary artery disease.

Background: Recently, the caries management had shifted from extension for prevention to early detection and remineralization of remaining tooth structure using noninvasive techniques. Aim: The present trial was carried out to assess the effect of adding mono-n-Dodecyl phosphate as a surfactant to ceramic on remineralization of dentin. Materials and Methods: The 32 teeth were divided into the following four groups randomly (n = 8 each group) – Group I: cavities not restored, Group II: Restored with ceramic, Group III: restored with ceramic and 2% mono-n-Dodecyl phosphate, and Group IV: restored with ceramic and 5% mono-n-Dodecyl phosphate. Knoop indenter microhardness tests were done at 10, 20, and 40 days. The surface was evaluated under scanning electron microscope. The collected data were subjected to statistical evaluation, and the results were formulated. Results: In ceramic restored (Group II), an increase in Knoop microhardness (KHN) values was seen at 10-, 20-, and 40-day assessment with the respective values of 102.2 ± 20.3, 118.7 ± 19.4, and 127 ± 15.1. Similarly, a constant increase at different assessments was observed for Groups III and IV with 2% and 5% of mono-n-Dodecyl phosphate with ceramic with a 40-day KHN value of 128.2 ± 21.4 for Group III and 113.5 ± 17.3 for Group IV. A statistically significant difference was seen between ceramic and 5% mono-n-Dodecyl phosphate (Group IV) with hardness values of 30.31%, 29.8%, and 21.78% for Groups II, III, and IV, respectively, at 20 days. Conclusion: The present study concludes that ceramic restorations are effective in promoting dentin remineralization. However, the addition of only 2% mono-n-Dodecyl phosphate was beneficial, whereas 5% mono-n-Dodecyl phosphate reduced the efficacy of ceramic on dentin remineralization.

Background: The COVID-19 pandemic is badly affecting more than 2 million population of 213 countries and has caused 1,952,976 deaths till January 12, 2020. India has also suffered a great loss in terms of economy and people. Furthermore, owing to the complete lockdown enforced in India, restricting humanitarian movement also affected day-to-day life of Indians with a huge impact. Objectives: The present clinical trial was carried out to evaluate the impact of the COVID-19 pandemic on private practitioners. Furthermore, changes in their practice pattern were evaluated along with the perspective of their health, role, and response to the pandemic. Materials and Methods: The study includes a total of 120 health-care professionals of either gender. The stress and mental health of the participants was assessed using Depression Anxiety Stress Scale-21 in English format, also included the questions related to the demographic characteristics, use of technologies for providing virtual health care, changes in the working during the pandemic, and an opinion of their experiences during that period. The data collected were subjected to the analysis and were kept confidential and anonymous. Results: 16.6% of participants preferred virtual consultation before the pandemic in contrast to 83.3% during the pandemic. The most preferred method remained the phone call by 15.8% (n = 19) patients. Depression was seen severely in 35% of study participants (n = 42) and 13.3% of participants extremely severe depression was seen (n = 16). Severe and extremely severe anxiety was noticed in 31.66% (=38) and 15% (18) study participants respectively, whereas severe and extremely severe stress was found in 30% (n = 36), and 12.5% (n = 15) private practitioners. The most common factor that can be considered responsible for compromised mental health in private practitioners was the possibility of infecting the society seen in 59.1% (n = 71) participants. Conclusion: During the pandemic breakout, private practitioners suffered a great challenge both financially and mentally, especially during the lockdown. Furthermore, a significant increase was seen in the virtual consultation methods during the pandemic breakout.

Background: Prevention of the debris from extruding to the periapical region is an important aspect to be taken care of as its extrusion can result in pain, periapical inflammation, and delayed healing owing to the presence of highly infective components in the debris. Aim: The present trial was aimed to compare and assess the amount of debris extruded apically using the single-file reciprocating system - WaveOne GOLD and single file rotary system - OneShape in root canal preparations in vitro. Materials and Methods: Thirty mandibular premolars were divided into two groups (15 samples each) prepared with a single-file reciprocating system - WaveOne GOLD and single-file rotary system - OneShape. Debris extruded was collected and then stored in an incubator. The final weight was calculated after obtaining the mean of three consecutive weights obtained for each tooth. The data were compared using the ANOVA and Turkey's post hoc analysis. Results: Debris extrusions were recorded in both groups and analysis revealed statistical differences in weight before and after the instrumentation procedures in both groups. When compared, reciprocating single file – WaveOne GOLD extruded more debris than rotary single file system – OneShape with a P < 0.001. Conclusions: The rotary instrumentation systems extrude lesser debris apically than the reciprocating instrumentation system. The difference found was statistically significant.

Aim To evaluate and compare the antimicrobial properties of propolis and calcium hydroxide alone and in combination with ciprofloxacin and moxifloxacin against Enterococcus faecalis (E. Faecalis). Materials and methods The laboratory study was carried out to test the effectiveness of propolis and calcium hydroxidealone as well as in combination with the established endodontic medicaments (moxifloxacin and ciprofloxacin). The various combinations were—group 1: propolis, group 2: calcium hydroxide, group 3: moxifloxacin, group 4: ciprofloxacin, group 5: propolis + moxifloxacin, group 6: propolis + Ciprofloxacin, group 7: calcium hydroxide + ciprofloxacin, group 8: calcium hydroxide + moxifloxacin. The efficacy of these medicaments was tested by checking for the zone of inhibition for the specific strain (ATCC 29212) of E. faecalis at different time intervals, i.e. 24, 48 and 72 hours. Results Mean zone of inhibition was maximum in group V (21.94 ± 4.26) followed by group VI (18.80 ± 1.93), g roup I (18.71 ± 4.26), group VIII (15.88 ± 2.59), group III (14.91 ± 1.00), group VII (14.57 ± 2.17), group IV (13.91 ± 1.00) and minimum in group II (12.89 ± 2.14). Mean zone of inhibition was found to be maximum at 72 hours and minimum at 24 hours. At all time intervals, the combination of Propalis with Moxiflocacin showed the maximum antimicrobial efficacy. Conclusion On the basis of the results of the present study, it can be concluded that propolis and calcium hydroxide show synergistic effect with moxifloxacin and ciprofloxacin against E. Faecalis. Propolis in combination with antibiotics and alone is more effective than calcium hydroxide. Clinical significance Since propolis alone and in combination with antibiotics was observed to be more effective than calcium hydroxide, propolis can be considered as an intracanal medicament when compared to traditional calcium hydroxide How to cite this article Shrivastava R, Rai VK, Kumar A, Sinha S, Tripathi P, Gupta K, Sabharwal S. An in vitro Comparison of Endodontic Medicaments Propolis and Calcium Hydroxide alone and in Combination with Ciprofloxacin and Moxifloxacin against Enterococcus Faecalis. J Contemp Dent Pract 2015;16(5):394-399.

Aim: This study was carried out to evaluate the combined effect of taper and different irrigating agents on the cleanliness of root canal. Materials & Methods: 45 extracted mandibular premolars were divided into three groups, according to the taper produced, 2%, 4% and 6% with Hero Shaper files respectively, which were further divided into subgroups, according to the irrigation regime followed. The teeth were split and subjected to SEM analysis. Results: The results showed that the canals prepared to a taper of 6% and irrigated with 5.2% NaOCl and 25% Citric acid had less debris and smear layer, which was statistically significant. Conclusion: It was concluded that a taper of 6% facilitates irrigant delivery in the canal and 25% Citric acid is more potent demineralising agent than 17% EDTA.

Accidents are unpleasant incidences that happen when we are careless or when we do not follow the safety rules. In the dental office, foreign body ingestion or aspiration is a rare but serious mishappening. Ingestion of blunt foreign objects is less life-threatening and the object is generally egested through the gastrointestinal tract uneventfully, but sharp objects like endodontic files may sometimes cause intestinal perforation. Aspiration, on the other hand, is a more serious, but fortunately, less prevalent hazard and often leads to hospitalization of the patient. From a legal aspect also, such incidence is counted as negligence on the part of the operator and the dentist should be well aware of the legal liabilities and should take the appropriate preventive measures to prevent or intercept any untoward circumstance.