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Parkar A, Banga KS, Pawar AM, Luke AM. Extrusion of Sodium Hypochlorite in Oval-Shaped Canals: A Comparative Study of the Potential of Four Final Agitation Approaches Employing Agarose-Embedded Mandibular First Premolars. J Clin Med 2024; 13:2748. [PMID: 38792290 PMCID: PMC11121930 DOI: 10.3390/jcm13102748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/26/2024] [Accepted: 05/02/2024] [Indexed: 05/26/2024] Open
Abstract
Background: The aim of this investigation was to assess the apical extrusion potential of sodium hypochlorite (NaOCl) in agarose-embedded mandibular first premolars employing four final agitation procedures. Methods: Based on CBCT confirmation of single oval-shaped canals, one hundred extracted mandibular first premolars were chosen. Using 5.25% NaOCl, the teeth were prepared using the XP Endo Shaper and divided into experimental and control groups. The following were the experimental groups: Group 1 comprised the XP-Endo Finisher, Group 2 the Ultrasonic Activation, Group 3 the Gentle File Finisher Brush, and Group 4 the 27-gauge side-vented needle. To test extrusion, the teeth were placed in a 0.2% agarose gel that contained the pH-sensitive dye m-cresol purple, allowing pixel quantification via ImageJ software (version 1.54i). Results: The XP Endo Finisher featured the most pixels, depicting higher apical extrusion (p < 0.01), followed by the side-vented needle, Gentle File Finisher Brush, and PUI, while the Control Group endured no extrusion. Conclusions: The effective irrigation method for root canal therapy is critical, especially in situations of open apices, resorption, or perforation. According to in vitro experiments, the XP-Endo Finisher has the maximum sodium hypochlorite extrusion, which is determined by parameters such as apical preparation size and irrigation system.
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Affiliation(s)
- Aalisha Parkar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, India; (A.P.); (K.S.B.)
| | - Kulvinder Singh Banga
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, India; (A.P.); (K.S.B.)
| | - Ajinkya M. Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, India; (A.P.); (K.S.B.)
| | - Alexander Maniangat Luke
- Department of Clinical Sciences, College of Dentistry, Ajman University, Al-Jruf, Ajman P.O. Box 346, United Arab Emirates;
- Centre of Medical and Bio-Allied Health Science Research (CMBHSR), Ajman University, Al-Jruf, Ajman P.O. Box 346, United Arab Emirates
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Zeng Y, Hu X, Cai Z, Qiu D, Ran Y, Ding Y, Shi J, Cai X, Pan Y. Photodynamic and nitric oxide therapy-based synergistic antimicrobial nanoplatform: an advanced root canal irrigation system for endodontic bacterial infections. J Nanobiotechnology 2024; 22:213. [PMID: 38689259 PMCID: PMC11059741 DOI: 10.1186/s12951-024-02483-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND The main issues faced during the treatment of apical periodontitis are the management of bacterial infection and the facilitation of the repair of alveolar bone defects to shorten disease duration. Conventional root canal irrigants are limited in their efficacy and are associated with several side effects. This study introduces a synergistic therapy based on nitric oxide (NO) and antimicrobial photodynamic therapy (aPDT) for the treatment of apical periodontitis. RESULTS This research developed a multifunctional nanoparticle, CGP, utilizing guanidinylated poly (ethylene glycol)-poly (ε-Caprolactone) polymer as a carrier, internally loaded with the photosensitizer chlorin e6. During root canal irrigation, the guanidino groups on the surface of CGP enabled effective biofilm penetration. These groups undergo oxidation by hydrogen peroxide in the aPDT process, triggering the release of NO without hindering the production of singlet oxygen. The generated NO significantly enhanced the antimicrobial capability and biofilm eradication efficacy of aPDT. Furthermore, CGP not only outperforms conventional aPDT in eradicating biofilms but also effectively promotes the repair of alveolar bone defects post-eradication. Importantly, our findings reveal that CGP exhibits significantly higher biosafety compared to sodium hypochlorite, alongside superior therapeutic efficacy in a rat model of apical periodontitis. CONCLUSIONS This study demonstrates that CGP, an effective root irrigation system based on aPDT and NO, has a promising application in root canal therapy.
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Affiliation(s)
- Youyun Zeng
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
| | - Xiangyu Hu
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
| | - Zhibin Cai
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
| | - Dongchao Qiu
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
| | - Ying Ran
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
| | - Yiqin Ding
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
| | - Jiayi Shi
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
| | - Xiaojun Cai
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China.
| | - Yihuai Pan
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China.
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Gasparelli CHC, Marceliano-Alves MFV, Bastos LF, Lopes RT, Limoeiro AGDS, Nascimento WM, Dos Santos LMH, Boukpessi T, Soares ADJ, Frozoni M. Analysis of the penetration of NaOCl 5.25% into dentinal tubules using different irrigation protocols: An ex vivo study. AUST ENDOD J 2024; 50:140-147. [PMID: 38152976 DOI: 10.1111/aej.12824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/05/2023] [Accepted: 12/08/2023] [Indexed: 12/29/2023]
Abstract
The objective of the study was to investigate the 5.25% sodium hypochlorite (NaOCl) penetration into the dentinal tubules after different irrigation methods. Seventy canines were stained with 1% crystal violet and divided into groups (n = 20): GEC-EasyClean; GPUI-E1 Irrisonic ultrasonic insert; GXP-XP-Endo finisher; GPC-conventional irrigation and GNC-stained tooth without irrigation. Axial sections (16×) were assessed and irrigant penetration was quantified as a bleaching halo on the surface of the apical, middle and coronal third. In the apical third, GPUI promoted greater NaOCl penetration (p < 0.05). GXP was better than GEC (p < 0.05), as was GPC (p > 0.05). The GPUI and GXP groups were similar in the middle and coronal third (p > 0.05). GPUI and GXP showed better results than GEC (p < 0.05). GPUI was more effective in the apical third and like GXP in the cervical and middle third.
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Affiliation(s)
| | - Marília Fagury Videira Marceliano-Alves
- Department of Dental Research and Endodontics, Iguaçu University, Nova Iguaçu, Brazil
- Laboratory of Orofacial Pathologies, Imaging and Biotherapies, School of Dentistry, Laboratoire d'Excellence INFLAMEX, Université Paris Cité, URP 2496, Montrouge, France
- Department of Oral Health Sciences, BIOMAT - Biomaterials Research group & UZ Leuven (University Hospitals Leuven), KU Leuven (University of Leuven), Leuven, Belgium
| | - Luan Ferreira Bastos
- Nuclear Instrumentation Department, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Ricardo Tadeu Lopes
- Nuclear Instrumentation Department, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | | | - Wayne Martins Nascimento
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, São Paulo, Brazil
| | | | - Tchilalo Boukpessi
- Laboratory of Orofacial Pathologies, Imaging and Biotherapies, School of Dentistry, Laboratoire d'Excellence INFLAMEX, Université Paris Cité, URP 2496, Montrouge, France
- Pitié Salpétrière Hospital Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Adriana de Jesus Soares
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| | - Marcos Frozoni
- Department of Endodontics, São Leopoldo Mandic Dental Research Center, Campinas, São Paulo, Brazil
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Zhang N, Kang Q, Cheng Y. Pulpotomy for teeth with irreversible pulpitis in immature permanent teeth: a retrospective case series study. Sci Rep 2024; 14:6395. [PMID: 38493190 PMCID: PMC10944512 DOI: 10.1038/s41598-024-56975-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 03/13/2024] [Indexed: 03/18/2024] Open
Abstract
To evaluate the success of pulpotomy in treating immature permanent teeth with irreversible pulpitis. This case series included patients with irreversible pulpitis admitted to the Department of Oral Medicine at the author's Hospital between 2015 and 2020. The pulpotomies were carried out by clinicians with > 5 years of working experience. The follow-up findings and radiographic images were reviewed by two attending dentists. This study included 49 teeth from 48 children (25 boys and 23 girls). The follow-up was 23.3 ± 6.8 months (from 12 to 40 months). The success rate of pulpotomy was 85.7% (42/49). Pulpotomy failed in seven teeth (14.3%). The treatment success rate for traumatic crown fracture was lower than for dental caries and dens evaginatus (P < 0.001). There were no significant differences in the success rate of the pulp-capping agent, tooth root developmental phase, and pulpotomy method (all P > 0.05). Pulpotomy might be successfully used to treat immature permanent teeth with irreversible pulpitis in young patients mainly caused by caries and a fractured tubercle of dens evaginatus.
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Affiliation(s)
- Na Zhang
- Department of Oral Medicine, Shanxi Provincial People's Hospital, Taiyuan, 030012, China.
| | - Qian Kang
- Department of Oral Medicine, Shanxi Provincial People's Hospital, Taiyuan, 030012, China
| | - Yuzhao Cheng
- Department of Oral Medicine, Shanxi Provincial People's Hospital, Taiyuan, 030012, China
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Wang Y, Lei L, Huang J, Cai Z, Huang X. Sonic-assisted antibacterial photodynamic therapy: a strategy for enhancing lateral canal disinfection. BMC Oral Health 2024; 24:5. [PMID: 38166876 PMCID: PMC10762957 DOI: 10.1186/s12903-023-03801-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Bacterial infections in lateral canals pose challenges for root canal treatment. This in vitro study aims to evaluate the antibacterial efficacy of sonic-assisted methylene blue mediated antimicrobial photodynamic therapy (MB-aPDT) against Enterococcus faecalis (E. faecalis) in infected lateral canals. METHODS Sixty-five premolars infected with E. faecalis in lateral canals were randomly divided into five groups (n = 13) and treated with : (1) 5.25% NaOCl (positive control); (2) Saline (negative control); (3) Sonic-assisted MB-aPDT; (4) 3% NaOCl + MB-aPDT; (5) 3% NaOCl + sonic-assisted MB-aPDT, respectively. The antibacterial efficacy was evaluated by the colony- counting method (CCM) and scanning electronic microscope (SEM). RESULTS Both 5.25% NaOCl and the 3% NaOCl + sonic-assisted MB-aPDT exhibited the most effective while comparable antibacterial effects without significant statistical difference (P > 0.05). Furthermore, the antibacterial effect of the 3% NaOCl + MB-aPDT group was significantly higher compared to that of the sonic-assisted MB-aPDT group (P < 0.05). The SEM results demonstrated notable morphological alterations in E. faecalis across all experimental groups, except for the negative control group. CONCLUSION The concentration of NaOCl can be reduced to a safe level while preserving its antibacterial efficacy through the synergism with the sonic-assisted MB-aPDT in this study.
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Affiliation(s)
- Yanhuang Wang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, PR China
| | - Lishan Lei
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, PR China
| | - Jing Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, PR China
| | - Zhiyu Cai
- Department of Stomatology, Fujian Medical University Union Hospital, Fuzhou, 350002, PR China.
| | - Xiaojing Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, PR China.
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Zeng C, Hu P, Egan CP, Bergeron BE, Tay F, Ma J. Bacteria debridement efficacy of two sonic root canal irrigant activation systems. J Dent 2024; 140:104770. [PMID: 37923053 DOI: 10.1016/j.jdent.2023.104770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/07/2023] Open
Abstract
OBJECTIVE To evaluate the bacteria debridement efficacy of two generations of sonic root canal irrigant activation systems: EndoActivator (Dentsply Sirona), the first generation, and SmartLite Pro EndoActivator, the second generation. METHODS Instrumented, autoclaved, single-rooted human premolars were inoculated with Enterococcus faecalis (ATCC-29212) for 21 days. The bacteria biofilm-containing teeth were randomly divided into 5 groups (N=8): Group 1: Syringe-side-vented needle (S-N) delivery of saline for 1 min; Group 2: S-N delivery of 2% NaOCl for 1 min; Group 3: S-N delivery of 2% NaOCl for 5 min; Group 4: EndoActivator activation of 2% NaOCl for 1 min; Group 5: SmartLite Pro EndoActivator activation of 2% NaOCl for 1 min. The teeth were evaluated for bacterial reduction using CFU counts, and the percentages of dead bacteria within the dentinal tubules using confocal laser scanning microscopy. RESULTS Activation of NaOCl with EndoActivator or SmartLite Pro EndoActivator significantly reduced the overall intracanal bacterial load, compared with S-N irrigant delivery (P<0.05), with no significant difference between the two agitation devices (P>0.05). Nevertheless, S-N delivery of 2% NaOCl for 5 min produced better bacteria debridement than either sonic agitation system. Different degrees of bacteria kill were identified in the coronal-middle portions and apical portion of the canal space. CONCLUSION Delivery time of NaOCl affects the efficacy of bacteria disinfection. Activation for 1 min with the EndoActivator or SmartLite Pro EndoActivator demonstrated comparable canal wall biofilm and intracanal bacteria reduction efficacy when 2% NaOCl was used as irrigant for disinfecting E. faecalis in single-rooted teeth. CLINICAL SIGNIFICANCE Although the sonic root canal irrigant activation devices investigated do not completely eliminate live bacteria biofilms from the canal space, they help reduce bacteria load during irrigant activation.
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Affiliation(s)
- Chang Zeng
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Pei Hu
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Colin P Egan
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Brian E Bergeron
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Franklin Tay
- The Dental College of Georgia, Augusta University, Augusta, GA, USA.
| | - Jingzhi Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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Elmallah S, Abdou A, Rizk A, Kusumasari C, Ashraf R. Effect of silver diamine fluoride activation on bond strength to root dentin. BMC Oral Health 2023; 23:733. [PMID: 37814251 PMCID: PMC10561427 DOI: 10.1186/s12903-023-03457-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 09/26/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND To investigate the effect of silver diamine fluoride (SDF) application and activation on the bond strength of gutta-percha to dentin and resin bonded post to dentin. METHODS Thirty-six human premolar teeth were used. The coronal part tooth was removed, and endodontic mechanical preparation was performed for all the teeth. The teeth were divided according to final rinse protocol (n = 9) as follows: Control group; no SDF application, SDF/NA; 38% SDF as a final rinse with no activation, SDF/MDA; 38% SDF as a final rinse with manual dynamic activation and SDF/US; 38% SDF as a final rinse with ultrasonic activation. Root canal obturation using lateral condensation technique followed by fiber post insertion after 48 h in the root canal after corresponding preparations. The roots were cut with a low-speed precision saw creating 2 mm thickness sections. A total of 4 sections were obtained from each tooth, 2 coronal specimens (with post) and 2 apical specimens (with Gutta percha). Each specimen was subjected to push-out bond strength test with a universal testing machine. Data were analyzed using two-way ANOVA. RESULTS The Push-out bond strength at the apical root section was significantly higher in SDF/MDA and SDF/US groups compared to control group. While for the coronal part, all SDF treated specimen showed reduced Push-out bond strength. CONCLUSION SDF application as final rinse may reduce the bonding performance between fiber post and dentine. Activation with manual and ultrasonic methods improved the bond strength at the apical root section.
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Affiliation(s)
- Sara Elmallah
- Department of Endodontics, Faculty of Dentistry, Fayoum University, Fayoum, Egypt.
| | - Ahmed Abdou
- Department of Prosthetic Dentistry, Biomaterials Division, Faculty of Dentistry, King Salman International University, El Tur, South Sinai, Egypt.
- Faculty of Dentistry, Al-Ayen University, Thi-Qar, Iraq.
| | - Amr Rizk
- Department of Prosthetic Dentistry, Fixed Prosthodontics Division, Faculty of Dentistry, King Salman International University, El Tur, South Sinai, Egypt
| | - Citra Kusumasari
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Reem Ashraf
- Department of Prosthetic Dentistry, Biomaterials Division, Faculty of Dentistry, King Salman International University, El Tur, South Sinai, Egypt
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Kotecha N, Shah NC, Doshi RJ, Kishan KV, Luke AM, Shetty KP, Mustafa M, Pawar AM. Microbiological Effectiveness of Sodium Hypochlorite Gel and Aqueous Solution When Implemented for Root Canal Disinfection in Multirooted Teeth: A Randomized Clinical Study. J Funct Biomater 2023; 14:jfb14050240. [PMID: 37233350 DOI: 10.3390/jfb14050240] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/07/2023] [Accepted: 04/20/2023] [Indexed: 05/27/2023] Open
Abstract
The aim of endodontic therapy is to use various antimicrobial medications for proper cleaning and shaping to create an environment free of microorganisms by eradicating as many as possible from the root canal space. Even although it is a gold standard irrigant, sodium hypochlorite (NaOCl) is known for its cytotoxic effects on vital periapical tissues, making its higher concentrations inappropriate for use in conditions such as wide, underdeveloped, or damaged apices and in cases of perforations. Consequently, if it is ascertained that a gel form of sodium hypochlorite has equivalent antibacterial activity to the aqueous solution form, it could be employed in such situations. The aim of this study was the microbiologic evaluation of 5.25% sodium hypochlorite gel and aqueous solution as root canal disinfectants in multirooted teeth with primary endodontic lesions. Following ethical approval and CTRI registration, 42 patients who gave their consent and had multirooted teeth with pulpal necrosis and asymptomatic apical periodontitis were considered for the study. Following the opening of the access, pre-endodontic build up in case of class-II cavities and working length determination, a pre-operative sample (S1), which was regarded as the pre-operative microbial load of that canal, was acquired from the largest canal using a sterile paper point while maintaining strict isolation and disinfection. The computer randomization approach was used to divide the teeth into two groups at random just before beginning of chemo-mechanical preparation: Group A (n = 21)-canal disinfection with 5.25% sodium hypochlorite gel; Group B (n = 21)-canal disinfection with 5.25% sodium hypochlorite aqueous solution. Following the canal disinfection, a post-operative (S2) sample which was regarded as the postoperative microbial load of that canal was collected from the same canal using a sterile paper point. The Colony-Forming Units (CFUs) for the S1 and S2 samples were determined after 48 h aerobic incubation on Brain Heart Infusion (BHI) agar plates. The patients and the microbiologist were blinded throughout the procedure. Using SPSS 20.0 software (USA), the Shapiro-Wilk test and the Lilliefors Significance Correction were used for normality, followed by the Mann-Whitney U test which was used to compare the CFU difference (×105) between the two groups. A p value of <0.05 was perceived as statistically significant. The mean colony-forming units count difference between the 5.25% sodium hypochlorite gel and aqueous solution groups did not differ in a manner that was statistically significant (p = 0.744). In multirooted teeth with primary endodontic lesions, the 5.25% sodium hypochlorite gel and the aqueous solution demonstrated comparable antimicrobial effectiveness when implemented as root canal disinfectants.
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Affiliation(s)
- Niral Kotecha
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital Sumandeep Vidyapeeth, Pipariya, Waghodia, Vadodara 391760, Gujarat, India
| | - Nimisha Chinmay Shah
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital Sumandeep Vidyapeeth, Pipariya, Waghodia, Vadodara 391760, Gujarat, India
| | - Rohan Jiteshkumar Doshi
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital Sumandeep Vidyapeeth, Pipariya, Waghodia, Vadodara 391760, Gujarat, India
| | - Karkala Venkappa Kishan
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital Sumandeep Vidyapeeth, Pipariya, Waghodia, Vadodara 391760, Gujarat, India
| | - Alexander Maniangat Luke
- Department of Clinical Science, College of Dentistry, Ajman University, Al-Jurf, Ajman 346, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Al-Jurf, Ajman 346, United Arab Emirates
| | - Krishna Prasad Shetty
- Department of Clinical Science, College of Dentistry, Ajman University, Al-Jurf, Ajman 346, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Al-Jurf, Ajman 346, United Arab Emirates
| | - Mohammed Mustafa
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, P.O. Box 173, Al-Kharj 11942, Saudi Arabia
- Centre for Transdisciplinary Research, Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha University, Chennai 600077, Tamil Nadu, India
| | - Ajinkya M Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai 400008, Maharashtra, India
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