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The study aims to evaluate and compare the onset of local anesthesia (LA) and pain perception during endodontic treatment in hemophilic and thalassemic patients. Methods: The study included 90 patients with symptomatic irreversible pulpitis of the mandibular molars. Three groups (n = 30 in each group) were included. Group 1: hemophilic patients; group 2: thalassemic patients; and group 3: individuals without any systemic diseases. Onset of LA and visual analogue scale (VAS) scores was recorded immediately after the administration of local anesthesia, during the pulp exposure procedure, and during canal instrumentation, and were compared between the three groups. Frequency distribution, ANOVA, and linear regression analysis (p < 0.05) were applied. Results: The mean onset time was 46 ± 34 s in the hemophilic group, 42 ± 23 s in the thalassemic group, and 38 ± 12 s in controls, but the differences were statistically insignificant. After LA administration (LA-VAS), all three groups experienced a statistically significant reduction in pain (p = 0.048). On pulp exposure (PE-VAS) (p = 0.82) and during canal instrumentation (CI-VAS) (p = 0.55), there was no statistically significant difference in pain perception between the groups. The coefficients indicate a positive correlation between the VAS and onset time, indicating a positive reduction in the VAS following the administration of LA. Conclusions: Hemophilic patients exhibited a clinically longer average onset time for LA. However, the difference among the three groups with regard to the overall pain perception after LA administration, during and after pulp exposure, and during canal instrumentation was statistically insignificant.

Objective: This study aimed to evaluate oral hygiene status, salivary fluoride concentration, and Streptococcus mutans and Lactobacillus levels in saliva of thalassemic, hemophilic and individuals without any other systemic disorders.Materials and Methods: A total 162 individuals (44 healthy individuals, 86 thalassemic and 32 hemophilic patients) were selected, and randomly (n=30 in each group), the patients were allocated to Group A: individuals without any systemic condition, Group B: thalassemic patients, and Group C: hemophilic patients. Detailed case history, DMFT/DMFS, and OHI-S index were recorded. An aliquot of 5 ml of saliva was collected from each patient to determine the salivary fluoride concentration and predominant microbial colony in saliva. The data were analyzed by chi-square test of independence and nonparametric Kruskal-Wallis H test.Results: The mean debris and calculus index among groups A, B, and C was 0.55 ± 0.43, 0.61 ± 0.46, 0.46 ± 0.47 and 0.33 ± 0.48, 0.18 ± 0.34, and 0.15 ± 0.34, respectively. The DMFT score for group A was high (1.93 ± 1.86, 1.67 ± 1.92) compared to groups B (0.40 ± 0.77, 0.67 ± 1.37) and C (0.47 ± 0.68, 0.30 ± 0.54). The fluoride concentrations among three groups (A, B, and C) were 0.06 ± 0.07, 0.12 ± 0.13, and 0.12 ± 0.13 ppm respectively. The number of colony-forming units was highest in the healthy individual>hemophilic>thalassemic and presence of predominant microorganisms showed insignificant association among the groups (p=0.323).Conclusion: Compared to healthy individuals, thalassemic and hemophilic patients had better oral hygiene.

Clinicians always face a challenge in selecting the appropriate material for clinical use. Presently, the term bioactive is being used judiciously and unquestionably in the field of dental materials. The introduction of nanotechnology brought about a revolution in material science leading to the development of bioactive materials for caries prevention and management. This review comprehensively evaluates the use of bioactive materials for modification of the oral biome, prevention of dental caries, and the management of dental caries as restorative materials. Six online database (PubMed, Scopus, Science Direct, Embase, Web of Science, and Cochrane library) were systematically searched using broad keywords. Published articles were scrutinized, analyzed and the full-text articles were selected. Data reveals relatively limited application of tissue engineering and regeneration for enamel and dentin due to their limited ability to remodel. However, many steps are being taken in biomimetic approach for the modification of dentin. The path to overcoming any challenges will require active collaboration among clinicians, a material scientist and pulp biologist.

This systematic review aimed to evaluate interventions individually and compare the clinical outcome of young, immature teeth treated with regenerative endodontic therapy (RET) and apexification procedure. The protocol was registered with PROSPERO (International Prospective Register of Systematic Reviews), bearing the registration number CRD42021230284. A bibliographic search in the biomedical databases was conducted in four databases—PubMed, CENTRAL, EMBASE and ProQuest—using searching keywords and was limited to studies published between January 2000 and April 2022 in English. The search was supplemented by manual searching, citation screening and scanning of all reference lists of selected paper. The study selection criteria were randomized clinical trial, prospective clinical studies and observational studies. The search found 32 eligible articles, which were included in the study. The quality assessment of the studies was performed using the Cochrane risk of bias tool for randomized control trials and non-randomized clinical studies. The meta-analysis was performed using Review Manager software (REVMAN, version 5). The results indicated that a clinicians’ MTA apexification procedure was more successful compared to calcium hydroxide. In RET, apical closure and overall success rate is statistically same for both apical platelet concentrates (APCs) and blood clots (BC). Both interventions have similar survival rates; however, RET should be preferred in cases where the root development is severely deficient, there is insufficient dentine and the tooth’s prognosis is hopeless even with an apexification procedure.

The present research study assessed the cell viability and cytotoxic effect of mineral tri-oxide aggregate (MTA), Tetric N-Bond Universal bonding agent, Theracal PT (pulpotomy treatment), and platelet-rich fibrin (PRF) as pulp capping agents on human dental pulp stem cells (hDPSCs). The cells were isolated from the pulp tissue of an extracted healthy permanent third molar. After four passages in Dulbecco’s Modified Eagle’s Medium, the primary cells were employed for the investigation. The test materials and untreated cells (negative control) were subjected to an Methylthiazol-diphenyl-tetrazolium (MTT) cytotoxicity assay and assessed at 24-, 48-, and 72-h intervals. The Wilcoxon matched-paired t-test and Kruskal–Wallis analysis of variance (ANOVA) test were applied (p < 0.05). PRF imparted the highest cell viability at 48 h (p < 0.001), followed by MTA, Theracal PT, and Tetric N-Bond. Similarly, PRF had the highest potential to enhance cell proliferation and differentiation (p < 0.001), followed by Theracal PT, MTA, and the bonding agent at the end of 24 h and 72 h, respectively. Finally, PRF sustained the viability of human primary dental pulp stem cells more effectively than Theracal PT and MTA; however, the application of a Tetric N-Bond as a pulp capping agent was ineffective.

Objectives This study aimed to investigate the efficacy of ionic and non-ionic-based contrast media (in vitro study) and the combinatorial effect of chitosan-based endo-radiopaque solution (CERS) (in vivo study) for visualization of the root canal anatomy. Materials and Methods In vitro study (120 teeth): The root canal of maxillary premolars and molars (in vitro group 1 and 2 respectively, n = 60 each) were analyzed using 4 different contrast media (subgroups: Omnipaque 350, Iopamidol, Xenetix 350, and Urografin 76; n = 15 each) in combination with 5.25% sodium hypochlorite (NaOCl). Based on the results of the in vitro study, in vivo study (80 teeth) was done to compare Xenetix 350 + 5.25% NaOCl with CERS (in vivo group 1 and 2 respectively, n = 40 each) on maxillary and mandibular premolars and molars. Two endodontists used radiovisiography to assess the depth of ingress and identify the aberrant root anatomy after access cavity preparation, and after initial cleaning and shaping of canals. Kruskal-Wallis test was used for in vitro comparison (p < 0.05), and Wilcoxon signed-rank test and Mann-Whitney U test for in vivo analysis (p < 0.01). Results In vitro study, Xenetix 350 + 5.25% NaOCl facilitated a significant higher visualization (p < 0.05). For in vivo study, CERS had a statistically significant depth of ingress (p < 0.01), and was efficient in identifying the aberrant root canal anatomy of premolars and molars. Conclusions CERS facilitates better visualization of the root canal anatomy of human premolars and molars.

ABSt rAc t Aim: A survey was conducted to analyze the prevalence and incidence of dental anomalies in relation to maxillary lateral incisors in the Odisha population. A multidisciplinary approach for aesthetic management of a geminated tooth is described. Material and Methods: A total of 1062 subject, aged between 1530 years (724 males and 338 Females) were randomly screened at Institute of Dental Sciences, Bhubaneswar, Odisha India. Each subject was examined clinically and radio visuographically for dental anomalies in relation to maxillary lateral incisors. In the related case described, endodontic management and aesthetic correction of geminated maxillary lateral incisors was done. results: Five dental anomalies i.e. gemination, fusion, missing lateral incisors (both unilateral and bilateral), peg shaped incisors (unilateral and bilateral), and dens in dente were observed. Anomalies found were Peg shaped; 2.82%, Missing;1.88%, Gemination;0.28%, Fusion;0.18% and Dens in Dente;0.18%. conclusion: Comparison of these results with that of other studies indicated that anomalies in lateral incisors occur at different frequencies among various countries and communities in the world. In the case since maxillary lateral incisors are in the aesthetic zone, recognizing these anomalies will facilitate a successful treatment.