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Vertical root fractures, or VRFs, usually are characterized by an incomplete or complete fracture line that extends through the long axis of the root toward the apex. The cause of VRFs is mainly trauma and iatrogenic reasons. Complete or incomplete VRFs constitute an ongoing problem in dentistry because they are difficult to be diagnosed in the early stages. In most cases, tooth extraction is the only reasonable treatment when the VRF is finally diagnosed. Other options have been put forward such as bonding the two fractured segments and reimplanting the tooth. A similar case has been described here. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the study is to assess and compare compressive strength of newer nanocomposites (FiltekZ350, Ceram X Mono, Ceram X Duo) with microhybrid (Tetric Ceram) and to compare difference in compressive strength of newer nanocomposites. Materials and Methods: Forty eight specimens of composite were fabricated using customized biparpite brass mold measuring 5mm x 5mm and were grouped with twelve specimens in each Group I : Tetric Ceram, Group II: Filtek Z 350, Group III : Ceram X Mono, Group IV : Ceram X Duo. Composite resins are placed in cylindrical recesses and covered withmylar strip and are cured using QHL light curing unit. Compressive strength is evaluated using Instron machine. Results are statistically analyzed using One way Anova and Student t test. Analysis demonstrated that nanocomposites have better compressive strength than micro hybrid (P<0.001). Results: Within the limitations of the study, it can be concluded that nanocomposites have better compressive strength than microhybrid composite and nanocomposite showed optimal compressive strength of 312 - 417 Mpa. [ABSTRACT FROM AUTHOR]

Aims/Objectives: The aim of this in vitro study is to study, measure and compare the microleakage in three different newer direct composite resins using a self-etch adhesive bonding system in class V cavities by fluorescent dye penetration technique. Materials and Methods: Class V cavities were prepared on 45 human maxillary premolar teeth. On all specimens, one coat of G-Bond (GC Japan) applied and light cured. Teeth are then equally divided into 3 groups of 15 samples each. Filtek Z350 (3M ESPE), Ceram X duo (Dentsply Asia) and Synergy D6 (Coltene/Whaledent) resin composites were placed on samples of Groups I, II and III, respectively, in increments and light cured. After polishing the restorations, the specimens were suspended in Rhodamine 6G fluorescent dye for 48 h. The teeth were then sectioned longitudinally and observed for the extent of microleakage under the florescent microscope. Statistical Analysis Used: The results were subjected to statistical analysis using Kruskal Wallis and Mann-Whitney U Test. Results: Results showed no statistically significant difference among three groups tested. Conclusions: None of the materials tested was able to completely eliminate the microleakage in class V cavities. [ABSTRACT FROM AUTHOR]

Aim: To evaluate and compare the antibacterial activity of polymerized, two-step, self-etching and one-step, self-etching adhesive systems by using the direct contact test after one, seven, and fourteen days. Materials and Methods: The direct contact test was used to evaluate the antibacterial activity of Clearfil Protect Bond, Adper SE Plus, Clearfil SE Bond, and Adper Easy One on Streptococcus mutans after aging the samples in phosphate-buffered saline for one, seven, and fourteen days. Statistical analysis included the one-way Anova and Tukey's multiple comparison tests. Results: Among the tested materials, Clearfil Protect Bond exhibited an antibacterial effect for seven days when in contact with S. mutans. None of the adhesive systems exhibited any antibacterial effect after 14 days. Conclusion: The incorporation of antibacterial agents into dentine-bonding agents may become an essential factor in inhibiting residual bacteria in the cavity following a cavity disinfection procedure, and it could be recommended in situations where total disinfection of cavity is not accomplished due to lack of accessibility. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The objective of this in vitro study was to investigate whether weight gain in three different composites occurs due to water absorption, when stored in water. Materials and Methods: The composite restorative materials selected for this study included a micro-fine hybrid (Synergy) and two nano-filled composites (CERAM X duo and FILTEK Z 350). Twenty specimens of each material were fabricated with each composite material.-- Group A: Filtek Z 350, Group B: Synergy, and Group C: CERAM X Duo. Then all the specimens were stored in 10 ml distilled water in test tubes, and then placed in an incubator at 37oC for six weeks. The weight changes of these specimens were measured daily for the first week, and, later, once a week, for the next five weeks, by using an electrical analytical balance. Results: The data were analyzed using one-way analysis of variance and Student 't' test. There was a tendency for the weight of the specimens to increase with the passage of time, when stored in water. All the groups showed maximum amount of water absorption in the first week; then there was a gradual decrease in the water absorption, from the second to the sixth week. Synergy showed the maximum amount of water absorption in the first week, as compared to FILTEK Z 350 and Ceram X Duo. However, FILTEK Z 350 showed the maximum amount of water absorption from the second week to the sixth week, as compared to Ceram X Duo and Synergy. Conclusion: All composite restorative materials absorb some amount of water. The water absorption of the composite may decrease the physical and mechanical properties of the composites; hence, it is necessary to consider the type of the material before starting treatment. [ABSTRACT FROM AUTHOR]

The study aimed at evaluating the depth of cure and knoop hardness of a microfine-hybrid composite resin that was photoactivated using different methods. A bipartite brass mold was filled with composite resin and photo-activation was performed using four methods: (1) Intermittent method using quartz tungsten halogen (QTH) light curing unit (LCU) (2) Continuous method (QTH) (3) Exponential method (QTH) (4) Continuous method using light-emitting diode (LED). Depth of cure was measured at the unexposed bottom surface of the specimen using microtester as a penetrometer. The surfaces exposed to light were subjected to knoop hardness testing, using a digital microhardness tester. Knoop hardness measurements were obtained at the top surface and at depths of 1, 2, 3, 4 and 5 mm. The data was analyzed using anova and Tukey's test (5%). Results showed that the depth of cure was higher with the intermittent method (QTH), followed by the continuous method (QTH), the exponential method and the continuous method (LED). At the top surface and up to 1 mm, continuous method (LED) demonstrated the highest knoop hardness number (KHN). At 2 mm and up to 5 mm, intermittent method (QTH) presented the highest KHN and continuous method (LED) showed the lowest KHN. At all depths, continuous method (QTH) showed higher KHN, as compared to the exponential method (QTH), except at 2 mm where both showed no significant difference. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the shear bond strength of Total etch Prime and Bond NT and self etch newer dentin bonding agents Clearfil S3, Xeno III Bond, Clearfil Protect Bond and G Bond used to bond composite resin to dentin, and to compare the difference in the shear bond strengths of the self etch newer dentin bonding agents. Hundred freshly extracted noncarious human maxillary premolar teeth were selected. The occlusal surfaces of each tooth were ground to prepare flat dentin surfaces at a depth of 1.5 mm and were randomly grouped, with twenty specimens in each: Group I - Prime and Bond NT, Group II - Clearfil Protect Bond, Group III - Xeno III Bond, Group IV - Clearfil S3 Bond, Group V - G Bond. Each group was treated with its respective bonding agents, as per the manufacturers' instructions Clearfill -- Kuraray , Japan, G bond -- GC Tokyo, Japan, Xeno- De Trey Densply, Germany. Blocks or Cylinders of composite resin were built up using Teflon mold and cured. Shear bond strengths were tested using Instron Universal testing machine and recorded in Mpa. The results were statistically analyzed using One-way anova and Tukeys HSD test. The total etch adhesive showed higher shear bond strength than self etching adhesives (P<0.001). Within the limitations of this in vitro study, it can be concluded that all the adhesive agents evaluated showed optimal shear bond strength 17-20 Mpa, except G bond. However, shear bond strength of composite resin to dentin is better with one bottle total etch adhesive than with the newer self etching bonding agents. [ABSTRACT FROM AUTHOR]

Aims: a) To evaluate the bond strength of eugenol- and non-eugenol--based endodontic sealers to gutta-percha and dentin and b) To make a comparative evaluation of the bond strength of sealers to gutta-percha and dentin. Material and Methods: Seventy-two specimens were used in this study, which was divided into two groups -- group I consisting of 36 freshly extracted human molars with 2 mm coronal cut surface; and group II consisting of gutta-percha disks of 10 mm diameter and 2 mm thickness embedded in 36 plaster of Paris specimens. Group I was further divided into three subgroups: subgroup 1, subgroup 2, and subgroup 3, consisting of 12 teeth each; and group II was further divided into three subgroups: subgroup 1, subgroup 2, and subgroup 3, consisting of 12 plaster specimens each. Each subgroup consisted of two materials each, which were placed in 5 mm long sections of polyethylene tubing and were then placed on coronal 2 mm cut surface of human molars; likewise subgroup 1, subgroup 2, and subgroup 3 of group II consisted of two materials each, which were also placed in 5 mm long sections of polyethylene tubing and then placed on gutta-percha disks 10 mm in diameter and 2 mm in thickness, which were embedded in the plaster specimens. After the materials were set, the specimens were subjected to test for shearing bond strength using a universal testing machine (Instron). Statistical Analysis: Mann-Whitney U test. Results: Group I, i.e., zinc oxide eugenol sealers, showed more bond to gutta-percha than to dentin, in which subgroup 2b, endomethasone, showed the maximum bond. Group II, i.e., non.zinc oxide eugenol sealers, showed more bond to dentin than to gutta-percha, where the maximum bond was shown by subgroup 3b, EndoRez. Conclusion: Under the circumstances of this in vitro study, all the six endodontic sealers had significant differences in terms of shear bond strength to gutta-percha and dentin. [ABSTRACT FROM AUTHOR]

Background: Conventional radiographic techniques being two dimensional, has its restrictions and is confined to limited diagnostic value. However, the incorporation of Cone Beam Computed Tomography (CBCT) gives a three dimensional insight to the tooth morphology and leads to better evaluation and treatment management. Aim: The aim of this study was to evaluate and assess the root canal morphology of mandibular pre-molars in South Indian Population using CBCT radiographic technique. Materials and Methods: One thousand and eighty six and 814 fully erupted mandibular first and second premolars respectively were scanned using CBCT to evaluate the canal morphology according to Vertucci and Gulabiwala's classification. Results: The most common configuration in mandibular first and second premolars was Vertucci's Type I(83.81% and 93.48% respectively) followed by Type V (11.97% and 3.5% respectively). Conclusion: South Indian population presented Type IV ertucci's canal morphology as the most common in mandibular first and second pre-molars followed by Type V. CBCT scanning poses a greater advantage in assessing the complexity of root canal morphology and planning an appropriate endodontic treatment for the same. [ABSTRACT FROM AUTHOR]

Mandibular first molar commonly has two roots, the mesial and the distal root. Surprisingly in some mandibular first molar has an unusual extra third root in between mesial and distal root. This extra root is the most commonly seen in lingual side and is called as radix entomolaris. If this extra root is seen on the buccal side, it is termed as radix paramolaris (RP), which is a very rare phenomenon. Recently, various case report studies has shown the presence of third canal in the mesial and distal roots of mandibular molars. They are named as middle mesial and middle distal canal, respectively. Here, we present a case report of mandibular second molar showing three canals in the mesial root and a RP. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the incidence of loss of anterior teeth due to caries in 2000 patients randomly selected from the South Indian population in 2009. Material and Methods: 2000 patients were examined for incidence of loss of anterior teeth due to caries and the recorded data was statistically analysed using Pearson Chi-Square test. Results: Incidence of loss of anterior teeth due to caries in the population of South Canara district was found to be 16.3%. It was observed incidence of loss of anterior teeth that there was increased in age group above 65 years. No difference in incidence of anterior tooth loss was observed between urban and rural patients and also between males and females. There was high rate of replacement for the missing lost anterior teeth. Conclusion: This study showed that less than one fourth population of South Canara district had missing anterior tooth due to caries. Since anterior teeth occupies a strategic position in the dental arch, it is necessary to know the caries prevalence in this tooth and take adequate measures to prevent its progression and/or development of new carious lesions. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to evaluate the the physical, cytoxic and genotoxic properties before and after electron beam irradiation of comercially available type II glass ionomer (3M ESPE). Materials and Method: Samples were prepared according to ISO standards and divided into two groups- Non radiated and radiated groups. The set material was placed in polypropylene vials and exposed to 10KGy of electron beam irradiation. The extraction was done for a duration of 24 hours, 7days and 14 days. Blood sample was collected. Erythrocytes were separated. Hemolysis assay was performed as per the method described by Black et.al., 2003, with slight modification. Percentage of Cell viability was analysed by MTT assay. The cytotoxicity was rated based on cell viability relative to control as Dahl et al, 2006. Lymphocyte was separated and used for genotoxicity study. The alkaline comet assay was performed as described by Tice et al. 1991. DNA diffusion assay was performed as described by Singh et.al., 2004. Statistical analysis was performed using SPSS. Result and Discussion: Technical properties showed noticeable changes in color, setting time, viscosity and flow. Physical properties mainly flexural strength increased and compressive strength decreased in irradiated samples. Hemolytic effect of radiated samples was less in samples incubated for 7 days, when compared to irradiated. In glass ionomer type-II, non-radiated samples had a higher cell viability than irradiated at 10 KGy. In the present study, irradiation of Glass Ionomer type II with 10 KGy dose of electron beam irradiation showed increase in the frequency of DNA damage when compared to that of the non-radiated group. Conclusion: From the study it can be concluded that the reduction in hemolysis after electron beam irradiation of samples may be due to cross linking of unbound acids and increase in hemolysis of non radiated samples may be due to the presence of unbound acids. Increase in the frequency of DNA damage after electron beam irradiation may be due to the release of unbound acids because of chain breakage and due to the release of fluoride ions. [ABSTRACT FROM AUTHOR]

These proteins are produced in response to stress in cells. It is scientifically shown that heat shock proteins are expressed during change in temperature and damage due to increased cell stress. These chaperon's stabilize new protein during various type of cell stress. The present study gives an insight into salivary heat shock protein levels in individuals undergoing radiotherapy. The variation in heat shock protein 70 is evaluated. [ABSTRACT FROM AUTHOR]

Introduction: Radiotherapy is a frequently used treatment for oral cancer. Although radiation therapy may promote healing, head and neck-irradiated patients are susceptible to oral complications. Radiation caries is one of the highest indirect and late effects of radiation in the head and neck region damaging the structural and mechanical properties of tooth Enamel & Dentin. The weakened Enamel and Dentin are more susceptible to caries formation. So far, very little is known about the influence of irradiation on the tribological properties of enamel. Therefore, this study is aimed investigate the effect of electron beam radiation on the endodontically treated tooth. Material & Methods: A total number of 20 Intact teeth samples were selected for the study. The samples were endodontically treated and further used for the analysis. Microhardness test, scanning electron microscope (SEM) analysis were used to evaluate the structural and Morphological properties of enamel and dentin before and after irradiation treatment. X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR) were performed to analyse the changes in crystallography and chemical composition induced by irradiation. Results: The results showed that irradiation resulted in decreased micrhardness values and loss of prism orientation in both the tissue layers. Also, the variations in mechanical and morphological properties were closely related to changes in the crystallography and chemical composition of the dental tissues. Conclusion: Altogether, the test measurements indicated that irradiation had a direct deleterious effect on the mechanical and morphological properties of human tooth enamel along with the resultant variation in the tissue composition. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to study the effect of medicated toothpaste on oral health, a 6-month follow-up., Methods: Four hundred and twenty-seven participants were screened and followed up for 6 months. The intraoral examination was performed to record caries, gingival bleeding, and plaque index. Saliva collected was evaluated for pH, total antioxidant capacity (TAC), malondialdehyde (MDA), and Vitamin C level for 6 months, and data were analyzed., Results: On the usage of medicated toothpaste with herbal extract for 6 months, the salivary pH levels were increased, the interquartile range for plaque, and the gingival bleeding index decreased. The percentage change in salivary TAC, MDA, and Vitamin C levels in the caries-free group of subgroup I was 174.8, 58.06, and 59.98, respectively, in subgroup II was 133.3, 52.08, and 58.51, and in subgroup III was 63.77, 45.11, and 47.77. The percentage change in salivary TAC, MDA, and Vitamin C levels in the caries-active group of subgroup I was 136.62, 57.27, and 72.83, subgroup II was 108.59, 37.50, and 61.55, and in subgroup III was 35.62, 30.82, and 54.10, respectively., Conclusion: The salivary pH levels increased on the usage of medicated toothpaste with herbal extract; plaque and the gingival bleeding index scores were decreased. The salivary antioxidant defense was increased in individuals using medicated toothpaste with herbal extracts which signifies an improvement in overall oral health in the 6-month follow-up., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Conservative Dentistry.)

Aim To evaluate the efficacy of ozonated water as an irrigant in disinfection of the root canal system.Materials and methods This systematic review was conducted according to PRISMA guidelines and methodological studies were assessed through the Cochrane Risk of Bias tool. All studies on extracted human teeth using ozonated water were considered for the study, whereas ex vivo studies, studies on animal dentition and studies which were published in languages other than English were excluded from the study. The search was carried out on various databases such as PubMed, Google Scholar and ScienceDirect within the last 15 years. The assessment of quality of the studies was performed under the following: 1) size of sample; 2) control group; 3) standardisation of procedure; 4) statistical analysis performed; 5) risk of bias.Results There were a total of 154 study results, out of which duplicates and full-text analysis were excluded. A total of seven studies were included in the systematic review. The results in one study by Cardoso et al. showed ozonated water was better at reducing microbial counts, while two other studies demonstrated the difference in reducing microbial counts when comparing ozonated water against other irrigants. The remaining four studies concluded that ozonated water did not perform better as compared to the other irrigants such as sodium hypochlorite and chlorhexidine.Discussion It could be concluded that ozonated water is not a better disinfecting irrigant than sodium hypochlorite and chlorhexidine in the disinfection of the root canal system; however, it had an almost comparable level of disinfection., (© 2022. The Author(s), under exclusive licence to the British Dental Association.)

Introduction: Irrigants play an important role in the eradication of microorganisms in the complex root canal system. Sodium hypochlorite (NaOCl), chlorhexidine (CHX), and iodine potassium iodide (IKI) have certain limitations despite their routine clinical use. Surfactant irrigants with antimicrobial properties can be a milestone in endodontics to overcome the drawbacks of conventional irrigants. The aim of this study was to evaluate the antimicrobial efficacy of surfactants in comparison with routine endodontic irrigants on Enterococcus faecalis ., Materials and Methods: Primary irrigants NaOCl, CHX, IKI were prepared at concentrations of 5%, 2.5%, 2%, and 1%; while mixture of tetracycline acid and detergent (MTAD) (100%) served as control group. Surfactants such as cetrimide (CTR) and sodium dodecyl sulfate (SDS) were prepared at concentrations of 0.5%, 1%, and 2%. The direct contact assay was used to evaluate the antimicrobial efficacy after 5 min. Statistical analysis was performed using one-way ANOVA and Mann-Whitney U -test., Results: In the primary group, only 5% CHX was significant over MTAD ( P < 0.05). In the surfactant group, all concentrations of CTR and SDS (except 0.5%) were significant ( P < 0.05) in killing E. faecalis over MTAD. Two percent CHX in combination with 0.5% CTR and 1% SDS had an effective kill percentage over 2% CHX and MTAD alone., Conclusion: Surfactant irrigant regimens can be used as adjuncts with CHX to overcome its clinical limitations and potentiate its substantivity, thereby enhancing clinical success in endodontics., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Contemporary Clinical Dentistry.)

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., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Conservative Dentistry.)

Objective: The research for analyzing the smile characteristics in the Indian population has been limited with contradictory outcomes. This consensus statement aims to critically review the literature and provide basic practice guidelines on dental aesthetics related to the Indian population., Clinical Considerations: 9 clinicians and 6 resource persons from dental colleges in India collaborated in this consensus statement which covered 6 topics along with 6 introductory and 6 conclusive remarks. The statement was developed through a colloquium conducted on topics; global aesthetics: different smile design proportions and guidelines, patient perspective towards aesthetic dentistry in India, a literature survey of aesthetic dentistry for the Indian population, macro and micro-aesthetics, multidisciplinary approach in aesthetic dentistry, inclusion of high-end technologies in Indian modern-day practice, followed by a panel discussion to devise and establish the practice guidelines of aesthetic dentistry in India. The Consensus Statement has been formulated according to AGREE Reporting checklist., Conclusion: The experts and panelists reached a Consensus on protocols to institute clinical practice guidelines of aesthetic dentistry for Indians. However, based on all available literature from India, further research is required to investigate many questions that have not been previously considered., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Conservative Dentistry.)

The role of inflammatory mediators in dental pulp is unique. The local environment of pulp responds to any changes in the physiology that are highly fundamental, like odontoblast cell differentiation and other secretory activity. The aim of this review is to assess the role of cathelicidins based on their capacity to heal wounds, their immunomodulatory potential, and their ability to stimulate cytokine production and stimulate immune-inflammatory response in pulp and periapex. Accessible electronic databases were searched to find studies reporting the role of cathelicidins in pulpal inflammation and regeneration published between September 2010 and September 2020. The search was performed using the following databases: Medline, Scopus, Web of Science, SciELO and PubMed. The electronic search was performed using the combination of keywords "cathelicidins" and "dental pulp inflammation". On the basis of previous studies, it can be inferred that LL-37 plays an important role in odontoblastic cell differentiation and stimulation of antimicrobial peptides. Furthermore, based on these outcomes, it can be concluded that LL-37 plays an important role in reparative dentin formation and provides signaling for defense by activating the innate immune system.

Introduction: The butterfly effect is an optical phenomenon and is related to the presence of sclerotic dentin in the roots. The unique pattern of sclerotic dentin formation produces a characteristic butterfly shape in transverse sections of the roots. The objective of this study was to evaluate the direction of the fracture line in roots that exhibit the butterfly effect., Methods: Thirty single-rooted premolars with oval-shaped roots were decoronated and embedded in acrylic blocks and subjected to vertical force under a universal testing machine (HPBSD; Tec-Sol India, Chennai, India). Fractured roots were examined under a stereomicroscope (Model no. 080772; Lawrence and Mayo, Mumbai, India) at ×10 magnification to determine the location and direction of the fracture line. To evaluate the correlation between the direction of sclerotic dentin and the direction of the fracture line, teeth were sectioned and observed under a stereomicroscope at ×20 and ×40 magnification. The correlation was analyzed using the Fisher exact test (P < .05 for the coronal and apical thirds and P > .05 for the middle third)., Results: Sclerotic dentin was observed more in the apical area and less in the coronal third of the root. The correlation between the direction of sclerotic dentin and the direction of the fracture line was statistically significant in the coronal and apical thirds of the root., Conclusions: The vertical root fracture that runs buccolingually is correlated to the harder sclerotic dentin present in the mesiodistal direction., (Copyright © 2021 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Aims: This study aims to evaluate the bond strength (BS) and microleakage (ML) of the newer bonding agents to enamel and dentin., Objective: (1) To analyze the BS between self-etch and total-etch adhesives. (2) To analyze the depth of ML between self-etch and total-etch adhesives., Materials and Methods: Sixty mandibular premolars were fabricated and randomly divided into three groups: Group I ( n = 20)-bonded with self-etch adhesive + nanohybrid, Group II ( n = 20) with total-etch adhesive + micro hybrid and Group III ( n = 20) with total-etch adhesive + nanocomposite. Teflon ring molds were used to make composite resin cylinders bonded to the buccal surface. Class II box cavity was prepared on the samples' proximal surface and condensed with composite resin with each group's specific bonding protocol. Shear BS and ML testing were conducted, and data analyzed., Statistical Analysis: Kruskal-Wallis analysis was done to statistically differentiate the BS and ML between the three experimental groups; the P < 0.05, it showed a statistically significant difference. Intergroup comparison was made using the Mann-Whitney U test., Conclusions: Within this study's limitation, resin bonded with self-etch G-Premio Bond used in selective etch technique showed the highest BS and resistance to ML., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Conservative Dentistry.)

Aim: To compare the stress distribution of four modalities of reinforcing the radicular space of a pulpless central incisor exhibiting stage 4 root development., Materials and Methods: The model of a pulpless immature central incisor with a stage 4 of root development supporting periodontium was generated based on the properties. The longitudinal growth of the root was completed. Four such models were developed. Then, the radicular space was rehabilitated as follows: Model 1: Ceramicrete; Model 2: Biomimetic Mineralization; Model 3: Biodentine; Model 4: Bioaggregate. They were subjected to three different loading conditions. One was to mimic the mastication by applying a load of 70 N applied at 45° angle. Second loading condition was a vertical load of 100 N to mimic bruxism. The third loading condition was to mirror the impact of a frontal trauma. A load of 100 N was applied labially., Results: It was observed that during mastication, Model 2 has exhibited the lowest concentration of von Mises stresses, followed by Model 3 and then Model 4 followed by Model 1; this could be because the modulus of elasticity of Model 2 is comparable to that of Dentin. During bruxism and horizontal impact, the maximal stress concentration was found in Model 4, Model 3, Model 2, followed by Model 1., Conclusion: The closer the elasticity of modulus of the primary endodontic replacement monoblock was to that of dentin, the lower were the stresses generated. However, as the increase in stress values was minimal between groups, these obturating materials can be viable reinforcement materials for the rehabilitation of cases of stage 4 developing root. Biomimetic mineralization strategies can be a viable treatment option for managing cases of the open apex., Clinical Relevance: Biomimetic mineralization strategies and bioceramics can be used for obturation of root canals with open apex, instead of utilizing these bioceramics as apical plugs.

Background. Bioceramics need to interact chemically with dentin to exhibit adequate bioactivity. Proper bonding of bioceramics with dentin is of considerable importance. This study aimed to evaluate the wettability and marginal adaptation of bioceramics after the use of surface-active agents on dentin: %0.5 cetrimide and %1 alkylbenzene sulfonate. Methods. Of ninety maxillary central incisors, 45 teeth were sectioned longitudinally with 45 root halves randomly assigned to three groups (n=15): group I: no pre-treatment; group II: %0.5 cetrimide; group III: %1 alkylbenzene sulfonate. Then, the samples were subdivided into three subgroups (n=5): subgroup I: MTA; subgroup II: Biodentine, and subgroup III: BioRoot. A controlled-volume droplet of bioceramic material was placed on each root half, which was positioned in a dynamic contact angle analyzer to record the static contact angle for wettability. The remaining 45 samples were decoronated; the root canals were prepared and randomly categorized, as mentioned above. The root canal surfaces were treated, filled with the bioceramic material, transversely sectioned, and then each middle section was analyzed microscopically for marginal adaptation. Statistical tests used included post hoc Tukey tests and one-way ANOVA. The level of statistical significance set at %95 (P<0.05). Results. The contact angle values and interfacial gap width values after surface pre-treatment were significantly lower when compared to no pre-treatment group (P<0.05). The values were significant for %0.5 cetrimide in the case of Biodentine and %1 alkylbenzene sulfonate in the case of BioRoot (P<0.05). Conclusion. The two surfactants yielded promising results for enhancing the wettability and marginal adaptation of materials to the root dentin, which is required for obtaining an adequate seal, penetration, and bond strength of bioceramics., (© 2020 The Authors.)

Introduction: Failures of root canal treatments are mainly attributed to missed canals and ignorance about the complex anatomy of the root canal system. One such example of anatomic variation is the middle mesial canal (MMC) in mandibular molars which is often missed, and literature on methods for identifying them is limited., Aim: This in vitro study aimed to assess the occurrence of MMCs with cone-beam computed tomography (CBCT) and then under magnification in the mandibular first and second molars., Materials and Methodology: A total of 120 extracted intact human permanent mandibular first and second molars were selected. These were subjected to CBCT imaging and magnification for the detection of MMCs. The percentage of incidence in the detection of MMC was compared between these two methods., Results: The incidence of MMC detected in mandibular molars using CBCT was 13.33% (16 of 120 teeth), while using a dental operating microscope, the incidence was 18.33% (22 of 120 teeth) and the comparison between the two methods was statistically not significant. The MMCs were classified based on the Pomeranz Classification. The most prevalent canal configuration was a confluent type which was found to be in 72% cases (16 of 22), followed by fin type which was 22.7% (5 of 22) and independent type was only 4.54% (1 of 22). The incidence of the location of MMC orifice was studied. In 50% of the cases, orifice was located closer to the mesiolingual canal, whereas in 27% of the cases, it was closer to the mesiobuccal canal and in 4.95% of the cases, it was detected midway., Conclusions: Since the incidence of MMC was higher with the use of a microscope, it is preferred to use simpler, chairside aids like magnification and ultrasonic troughing. On the other hand, one should be judicious while subjecting a case to preoperative CBCT evaluation owing to its ionizing radiation., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Conservative Dentistry.)

The COVID-19 pandemic, still on the growth curve, has had a devastating effect on the dental health sector for the past 3 months. This has become an area of enormous concern for the dentists professionally and the patients in terms of dental health. Dentistry at this point needs a complete structural change to prevent cross-infection among the patients and dentists owing to the unique characteristic of a dental health-care setting as well as to offer a sense of safety and security to the patients. This article highlights the salient points to be considered for the post-COVID phase in dentistry., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Conservative Dentistry.)

Introduction: Irradiation is known to cause oxidation process among the tissue-altering the properties of teeth leading to tissue necrosis and caries formation. Hence protection of the oral cavity is a major concern to deal with therapy side effects., Aim: Evaluation of wear resistance property of Enamel against electron beam radiation and analysing the radio protective effects of natural organic compounds., Materials and Methods: Total of 36 healthy extracted human molar teeth were collected, four samples were used as control, and remaining 32 were divided into four groups ( N  = 8 each): radiation control group and three groups treated with organic compounds during radiation treatment. The enamel samples were tested for FTIR spectroscopy, XRD analysis, SEM and EDAX analysis before and after 70 Gy radiation treatment., Results and Discussion: The particle size of radiation control samples had increased showing decrease in its crystallinity index. Calcium to Phosphorous ratio had also decreased along with structural changes as observed by SEM analysis. But groups treated with organic compounds has maintained tooth integrity in comparable to control groups after radiation treatment., Conclusion: Virgin coconut oil, vitamin E oil and curcumin has potential radioprotective action against radiation in protecting tissue properties. Hence, with further advanced research, these natural substances should emerge as a topical applicator during radiotherapy to oral cancer patients., Competing Interests: Competing interestsThe authors declare no competing interests.

Aim: The aim of the present review article is to establish a systematic review to describe the role of various salivary components such as pH, buffering capacity, proteins, electrolyte, antioxidant, enzymes, and minerals in occurrence and initiation of dental caries in participants with and without dental caries., Methodology: An electronic search was conducted in the PubMed, Scopus, Web of Science, and Google Scholar databases. The MESH terms (Medical Subject Headings) were "dental caries susceptibility," "caries risk assessment, "Salivary Biomarker," "saliva," "Proteins," "electrolytes," "biomarker," "Anti-oxidant's." The database search was limited to the studies published between 2008 and 2018 and only human studies were included. Furthermore, the STROBE criteria checklist was used to analyze the studies which had to be included in the systematic review., Results: A total of 150 articles were retrieved through electronic database. After evaluating the title, abstract, and full text of these articles, only 11 were selected for the present systematic review. However, two articles were excluded because they were classified as high risk of bias according to the STROBE criteria. Out of 9 studies selected, 5 were classified as low-risk bias and 4 were classified as moderate-risk bias., Conclusion: Based on the results of the systematic review, out of 11 studies, 7 found to have a statistically significant difference between individuals with and without caries experience. Hence, it can be concluded that there is an association between various components of saliva and dental caries., Competing Interests: There are no conflicts of interest.

Background: Vancomycin-resistant enterococci (VRE) are on the rise globally in primary intraradicular infections and resistant to most intracanal irrigants and medicaments. The aim of this study was to evaluate the efficacy of irrigants and identify a cost-effective regimen to eradicate VRE., Materials and Methods: In this in vitro study irrigants were categorized as primary and surfactant groups with individual concentrations consisting of 10 samples each. Primary irrigants; sodium hypochlorite (NaOCl), chlorhexidine (CHX), and iodine potassium iodide (IKI) were prepared in concentrations of 5%, 2.5%, 2%, and 1%. Surfactants cetrimide (CTR) and sodium dodecyl sulfate (SDS) were prepared in concentrations of 0.25%, 0.5%, 1%, and 2%. Biopure MTAD was chosen as the control group. ATCC 51299 (VRE) was evaluated for antimicrobial susceptibility to the above irrigants by direct contact test for 5 min. The effect of each test irrigant was determined by calculating the percentage kill of viable bacteria by spectrophotometer. Statistical analysis was done by means of a one-way ANOVA and Mann-Whitney U-test ( P < 0.05 consider significant)., Results: About 2.5% and 5% CHX were significant over mixture of tetracycline, acid and detergent (MTAD) ( P < 0.05). 5% CHX could achieve 100% elimination while 2.5% CHX and 5% IKI had 99.90%. 2% CHX and 2.5% IKI had 99% effective kill percentage. All concentrations of NaOCl were ineffective (90%) as compared to MTAD (95%). CTR (0.5%, 1% and 2%) and SDS (2%) were significant ( P < 0.05) over MTAD. Combination surfactant regimens of 2% CHX +0.5% CTR and 2% CHX +1% SDS achieved 99.90% eradication potential and were significant ( P < 0.05) over MTAD., Conclusion: Surfactant regimens were highly effective and superior to MTAD. CTR and SDS by their organic solvent property enhanced the antibacterial action of CHX., Competing Interests: The authors of this manuscript declare that they have no conflicts of interest, real or perceived, financial or nonfinancial in this article.

Background: Renal failure is a process that expresses a loss of functional capacity of the nephrons, independently of its etiology. The most widely used technique to combat renal failure is hemodialysis. Renal failure causes various systemic alterations including oral complications such as variations in the flow and composition of the saliva. Caries is a multifactorial disease and impaired stimulated salivary flow rate and buffering capacity are the best-known risk factors. The present study aims to evaluate the salivary pH, buffering capacity and the flow rate of saliva to the DMFT status in adult hemodialysis patients among the Indian population., Material and Methods: Twenty healthy individuals and sixty patients undergoing hemodialysis were divided into four groups based on the following criteria: Group 1: Control group; healthy individuals,Group 2: Patients before undergoing dialysis or undergoing dialysis<3 months, Group 3: Patients undergoing dialysis since 6 months-2 years, Group 4: Patients undergoing dialysis>2 years. Dental examinations were performed according to the modified WHO oral health survey 2013 criteria and DMFT index. Saliva was collected after pre-stimulation to measuring the flow rate, buffering capacity and pH., Results: The results exhibited a decrease in the salivary flow rate and buffering capacity with the increase in the time interval of hemodialysis, but salivary pH was found to be increasing with time. A direct relationship was seen between the DMFT scores with the increasing time interval. There was a significant correlation between DMFT index, stimulated salivary flow rate, and buffering capacity in the patients., Conclusions: Oral health impairment can beacon to grave problems in infection-prone hemodialysis patients. Hence, the patients on hemodialysis should have regular dental examinations and treatment. Regular dental examination and instruction in patients awaiting a renal transplantation is of vital importance to ensure optimal oral health. Key words: Saliva, pH, Buffering Capacity, Flow Rate, Hemodialysis, DMFT., Competing Interests: Conflict of interest statement: The authors have declared that no conflict of interest exist.

Aim: The study evaluated the antibacterial effects of dental restorations such as nano-hybrid composite (Empress), a glass ionomer cement (GIC Gold label Type 9) and silver amalgam against Streptococcus mutans ., Materials and Methods: A modified bacterial suspension within the material assay was used to study the antibacterial effects. A volume of 20 μl of bacterial suspensions were placed in a narrow conical cavity within the materials. They were incubated for 0, 3, 6, 12, 24, and 48 h at 37°C. After the incubation period, the number of viable cells in the suspension was evaluated. In liquid culture assay, growth inhibition was measured at A600 nm up to 6 h in bacterial suspensions treated with the eluates of the restorative materials., Statistical Analysis: Kruskal-Wallis test and Mann-Whitney's test were performed to determine the significant differences between the control and restorative materials for given incubation periods at 5% level of significance ( P < 0.05)., Results and Conclusion: After 6 h of incubation, all restorative materials showed an inhibitory effect when compared to the controls. Silver amalgam showed the highest inhibition, followed by GIC Type 9 and composite. Silver amalgam showed marked inhibition after 2 h in comparison to the other material groups. These techniques employed to study the antibacterial effects showed that the silver amalgam had the pronounced inhibitory effect followed by GIC and composite. Further research on these aspects is necessary to determine whether the material can prevent secondary caries formation., Competing Interests: There are no conflicts of interest.

Aim: The aim of this study is to evaluate the protective effect of the salivary proteins on the demineralization of enamel., Materials and Methods: Twenty freshly extracted human molar teeth were used in this study. Enamel samples (2 mm thickness) were prepared from the buccal and lingual surfaces of the teeth selected. An acid-resistant nail varnish was used to cover every aspect of the sample, except an area of 5 * 5 mm limited by an adhesive tape. After drying, the adhesive tape was removed, exhibiting a rectangular area on the enamel surface. Samples were divided into two groups: Group I (10 samples): Each sample was coated by 100 μg of albumin for 2 hours at 37°C. Group II (10samples): Each sample was exposed to 100 μL of deionized water.Samples were washed by dipping once in deionized water. They were then disposed into individual tubes containing demineralization solution for 1, 2, 3, and 4 minutes at 37°C with gentle agitation. The demineralization solution was utilized to determine the calcium loss from specimens at 1, 2, 3, 4 minutes using an ultraviolet-visible spectrophotometer., Results: Calcium loss was less from the albumin-coated samples than control group at all times and was statistically significant (p < 0.05). Also, calcium loss was maximum at the end of 1 minute, and it decreased as time interval increased and was statistically significant (p < 0.001)., Conclusion: Albumin has provided a strong protection against enamel demineralization at all times compared to the one without it., How to Cite This Article: Hegde MN, Sajnani AR. Salivary Proteins-A Barrier on Enamel Demineralization: An in vitro Study. Int J Clin Pediatr Dent 2017;10(1):10-13., Competing Interests: Source of support: Nil Conflict of interest: None

This study compared the tensile bond strengths of different adhesive systems to different dentinal substrate conditions. The adhesive systems used were Adper Single Bond 2 total etch, XP Bond total etch, and two all-in-one adhesives, Adper Easy One and Xeno V. Ninety-six intact human premolars extracted on periodontal or orthodontic grounds were collected and stored in 0.9% physiologic saline for less than four weeks. Teeth were carefully cleaned to remove the soft tissue remnants. The occlusal surfaces were ground until the level of the dentinoenamel junction, exposing superficial dentin using a low-speed diamond disc. A standard smear layer was produced by wet sanding the dentin surface with 600-grit silicon carbide sandpaper for 40 seconds. The 96 specimens were embedded in autopolymerizing acrylic resin and divided into four groups of 24 each based on the dentin bonding agents used. Each group consisted of 24 specimens, which were further divided into two subgroups of 12 specimens each, moist dentin and dentin air-dried for 10 seconds. The regions of interest for adhesion were demarcated in each sample using adhesive tape, with a 4-mm–diameter hole isolating the peripheral region, and each adhesive system was employed. Four adhesive systems, two total etch and two self-etching adhesive, were applied to different dentinal substrates as per the manufacturers' instructions. Following the adhesive application, the specimens were restored with composite material using a metallic mold measuring 5 mm in diameter and 5 mm in height to keep the material in cylindrical form and were light cured per manufacturers' instructions. After being stored for 24 hours in distilled water at room temperature, the specimens were thermocycled for 550 cycles at temperatures ranging from 5°C to 60°C with a dwell time of 15 seconds in each bath and a transfer time of five seconds. The tensile bond strengths were determined using a Universal loading machine (Lloyd Universal Testing Machine) at a cross-head speed of 1 mm/min. On moist dentin, total-etch adhesives showed higher bond strength than did the all-in-one adhesives. Under the dry dentin condition, XP Bond exhibited significantly higher bond strength than did the Adper Single Bond 2 and two all-in-one adhesives, Adper Easy One and Xeno V.

Background and Objectives: To investigate whether salivary contamination during various stages of the bonding procedures of Xeno III and Clearfil SE Bond influences shear bond strength., Materials and Methods: THE OCCLUSAL SURFACES OF THIRTY SIX MAXILLARY PREMOLAR TEETH WERE GROUND AND DIVIDED INTO TWO GROUPS CONTAINING EIGHTEEN SPECIMENS EACH, WHICH WAS SUBDIVIDED INTO THREE SUB GROUPS: Group I - Xeno III, Group II - Clearfil SE Bond, Subgroup A - Uncontaminated (control), Subgroup B - Contaminated with saliva before application and light curing, Subgroup C - Contaminated with saliva after light curing. Composite resin Filtek Z350 was packed using Teflon mold cured and subjected to shear bond strength analysis using universal Instron machine., Results: Statistical analysis was made using One-way ANOVA and Tukeys HSD test. Clearfil SE Bond showed very high statistically significant reduction in the bond strength, when salivary contamination took place after light curing; whereas, Xeno III showed very high statistically significant reduction when salivary contamination took place before application and light curing., Conclusion: Clearfil SE Bond showed more tolerance to salivary contamination of dentin and higher shear bond strength value, when compared to Xeno III.