Ex vivo study of bacterial coronal leakage in indirect pulp treatment

Chlorhexidine gluconate enhances the remineralization effect of high viscosity glass ionomer cement on dentin carious lesions in vitro

Background

To compare the mean mineral density (MMD) and examine the remineralization of carious dentin after cavity disinfection with chlorhexidine gluconate (CHX) and restoration with high viscosity glass ionomer cement (H-GIC) in vitro.

Methods

Selective caries removal to leathery dentin was performed in 40 extracted primary molars. The samples were scanned using micro-computed tomography (micro-CT) to determine the MMD baseline and randomly divided into 4 groups (n = 10): Equia™ group, applied dentin conditioner and restored with H-GIC (Equia Forte™), CHX-Equia™ group, disinfected the cavity with 2% CHX before applying dentin conditioner and restored with H-GIC (Equia Forte™), Ketac™ group, restored with H-GIC (Ketac Universal™) and CHX-Ketac™ group, disinfected the cavity with 2% CHX before restored with H-GIC (Ketac Universal™). The samples underwent micro-CT scanning post-restoration and post-pH-cycling to determine their respective MMDs. One sample from each group was randomly selected to analyze by scanning electron microscopy (SEM).

Results

The MMD gain in the 4 groups post-restoration was significantly different between the Equia™ and CHX-Ketac™ groups (oneway ANOVA with Post hoc (Tukey) test, P = 0.045). There was a significant difference in MMD gain post-restoration between the Equia™ and CHX-Equia™ groups (Independent t-test, P = 0.046). However, the Ketac™ and CHX-Ketac™ group’s MMD were similar. The SEM images revealed that the CHX-Ketac™ group had the smallest dentinal tubule orifices and the thickest intertubular dentin among the groups. However, the CHX-Equia™ group had thicker intertubular dentin than the Equia™ group.

Conclusion

Applying 2% CHX on demineralized dentin enhances the remineralization of the dentin beneath the restoration.

Comparison of fluid filtration and bacterial leakage techniques for evaluation of microleakage in endodontics

BACKGROUND

Apical leakage assessment is a way to compare the efficiency of a filling material to seal the apical region of the tooth. Many microleakage testing techniques have been introduced through the years, but there has been no agreement as to which technique gives the most accurate results. The aim of this study was to compare the accuracy of fluid filtration and bacterial leakage techniques in the assessment of the apical sealing ability of mineral trioxide aggregate (MTA) and calcium enriched mixture (CEM).

MATERIALS AND METHODS

A sample of 34 extracted single-rooted human teeth were selected and prepared. The samples were divided in to 2 experimental groups. The apical 3 mm of each root was resected at 90° to its long axis and root end preparation was done with ultrasonic tips to a depth of 3 mm and filled with MTA and CEM, respectively. Assessment of apical sealing ability was done with fluid filtration technique and bacterial leakage technique along 90 days with Enterococcus faecalis bacteria. Mann-Whitney U-test and Chi-square test were used to analyze the data using SPSS (SPSS Inc., Chicago, IL, USA). P less than 0.05 was considered as significant.

RESULTS

There was no significant difference in apical sealing ability between MTA and CEM in bacterial leakage and fluid filtration techniques. Samples which had bacterial leakage showed higher leakage values by fluid filtration technique.

CONCLUSION

Both techniques showed same results and there was no significant difference between fluid filtration and bacterial leakage techniques in assessment of apical microleakage.