Comparative Evaluation of the Efficacy of TheraCal LC, Mineral Trioxide Aggregate, and Biodentine As Direct Pulp Capping Materials in Patients With Pulpal Exposure in Posterior Teeth: A Triple-Blinded Randomized Parallel Group Clinical Trial

Background The aim was to evaluate and compare the efficacy of TheraCal LC, mineral trioxide aggregate (MTA), and Biodentine as direct pulp capping (DPC) materials in patients with pulpal exposure in the posterior teeth. Methodology A total of 54 samples were assessed for eligibility. Out of this, 12 teeth samples failed to meet the inclusion criteria. Finally, 42 teeth samples were selected which were randomly distributed into three groups (n = 14). Groups A, B, and C received the intervention of MTA, Biodentine, and TheraCal LC, respectively. The assessment was performed clinically to check for postoperative pain, tenderness, and neural sensibility, and the radiographs were used to check the presence of periodontal ligament (PDL) space widening, calcified barrier, and periapical radiolucency at the follow-up of 21 days, three months, and 12 months. The outcomes depended on the clinical and radiographic success rates recorded at 12 months of recall. Results Overall successful outcome of DPC clinically at different periods was 97.61% at three months and 88.09% at 12 months. A Chi-square test was used which showed that the difference was statistically nonsignificant. For groups A, B, and C, the success rate at follow-up came out to be 85.71%, 100%, and 78.57% at 12 months, respectively. The overall radiographic success rate of DPC at different time periods was 83.33% at three months and 88.09% at 12 months. A Chi-square test was used which showed that the difference was statistically nonsignificant. For groups A, B, and C, the success rate at follow-up came out to be 85.71%, 100%, and 78.57% at 12 months, respectively. Conclusion Resin-based calcium-silicate agent (TheraCal LC) showed good efficacy and can be used in practice with the predictability of a good success rate both clinically and radiographically. Thus, TheraCal LC can be utilized as an alternative to MTA or Biodentine in clinical practice, with the predictability of similar successful outcomes in patients with pulpal exposure in the posterior teeth.

Role of Fluoride in Dentistry: A Narrative Review

Fluoride has performed a central role in the growth over the last fifty years. This report examines the present state of knowledge about fluoride's involvement in preventing dental caries. In recent years, our knowledge of the development of dental caries and the manner of operation of fluoride has been shifted. Dental caries is a constant procedure for enamel demineralization and remineralization, and fluoride plays an important part in this action by acting at the plaque-enamel contact. Fluoride's major method of action is now recognized as posteruptive. Fluoride's post-eruptive activity has led to the development of novel fluoride delivery systems. The importance of various fluoride delivery techniques on a population and societal level is discussed, along with suggestions.

Navigating Separated Instrument Retrieval: A Case Report

Instrument separation during endodontic therapy is a complication occurring in 2% to 6% of cases. Focusing on the Masserann technique, the study presents a success rate of 55% in retrieving separated instruments. The technique's effectiveness is demonstrated through a case involving retrieving an instrument from the mandibular first premolar. The technique utilizes various tools, including trephine burs and an extractor, providing a reliable means to dislodge tightly wedged fragments. Despite limitations in specific tooth types and the necessity for frequent radiographic monitoring, the Masserann kit proves effective and underscores the importance of attempting retrieval before considering surgical interventions. The presented case exemplifies the technique's clinical applicability and positive outcomes in intricate scenarios, emphasizing its significance in endodontic practice.

Understanding the Complexities of Cast Post Retention: A Comprehensive Review of Influential Factors

This comprehensive review delves into the intricate landscape of cast post retention in restorative dentistry, encompassing historical perspectives, contemporary techniques, and future directions. Examining factors ranging from tooth-related considerations to prosthesis-related dynamics, the review provides a detailed analysis of clinical techniques, including step-by-step procedures, common challenges, and innovative advancements. Technological breakthroughs, such as digital impressions, computer-aided design and computer-aided manufacturing (CAD/CAM) technology, three-dimensional (3D) printing, and finite element analysis, are explored for their transformative impact on precision and customization. The discussion extends to the promising future of cast post retention, emphasising emerging materials, the integration of artificial intelligence in treatment planning, and patient-specific approaches. Implications for clinical practice underscore the importance of individualised treatment planning and the adoption of advanced technologies. Recommendations for future research advocate for comprehensive long-term clinical studies, investigations into AI-driven treatment planning, and a focus on patient outcomes and satisfaction. This review consolidates existing knowledge and anticipates a future marked by enhanced precision, individualised care, and improved long-term success in cast post-retained restorations.

Application of Low-Level Laser Therapy in Endodontics: A Narrative Review

Low-level laser therapy (LLLT) stands out in the realm of dentistry for its unique attributes that set it apart from traditional therapeutic approaches. This non-invasive and painless modality harnesses the power of low-intensity lasers, offering a distinct advantage in terms of safety and patient comfort. Unlike many conventional methods, LLLT does not rely on pharmaceutical interventions or invasive procedures, making it a gentle yet effective option for various dental applications. Its non-thermal, photobiomodulatory effects on cellular and tissue functions mark a notable departure from the more aggressive treatment modalities commonly associated with dentistry. This article provides an extensive exploration of LLLT's applications in dentistry, focusing on its mechanisms of action and biological effects, and emphasizes the uniqueness of LLLT as a transformative tool in modern dental care.

Beyond Tradition: Non-surgical Endodontics and Vital Pulp Therapy as a Dynamic Combination

Symptomatic irreversible pulpitis and apical periodontitis in mature permanent teeth present challenges in their management. Traditional treatment approaches, such as root canal therapy or tooth extraction, may compromise tooth structure and oral function. This review article explores the combination of non-surgical endodontic treatment and vital pulp therapy as an alternative approach for these conditions. The purpose is to examine this combined approach's effectiveness, benefits, challenges, and limitations. The objectives include reviewing the literature, evaluating clinical outcomes, discussing potential benefits, and providing recommendations for clinical practice. The combination approach aims to preserve tooth structure, promote healing, and reduce postoperative complications. The article discusses the rationale for combining the two techniques, presents evidence supporting their efficacy, and outlines the techniques and protocols involved. Clinical outcomes, case studies, potential challenges, and comparative analysis with traditional approaches are also explored. Future directions and research recommendations highlight areas for further investigation, innovations, and the development of clinical guidelines. In conclusion, the combination of non-surgical endodontic treatment and vital pulp therapy offers a valuable strategy for managing mature permanent mandibular molars with symptomatic irreversible pulpitis and apical periodontitis. Further research and advancements are needed to refine the treatment protocol and expand the evidence base, and clinicians should stay updated to provide optimal care and improve patient outcomes.

Anterior Matrix Systems for Composite Restorations: A Review

In the field of restorative dentistry, composite resins have emerged as the most utilized materials. They revolutionized the cosmetic approach to anterior tooth treatment since their introduction to dental practice. In cases where one or more of the tooth's walls are absent, matrices are employed to assist in the creation of the proper anatomic contour and proximal contacts without the occurrence of gingival overhangs. Matrices come in a variety of designs suitable for various therapeutic conditions. Depending on the level of tooth destruction, they might range from a simple metal or plastic strip to a circumferential ring of metal surrounding the entire crown. Although the handling characteristics of modern composites have significantly improved, dentists still encounter challenges with the development of good interproximal contact and proper anatomical contour. The utilization of an anterior matrix system can be paramount in achieving these objectives.

Bromelain: A Potent Phytomedicine

The commercially available protein-digesting enzyme bromelain is derived from the pineapple fruit or stem. Bromelain from fruit and stems are produced in different ways and has varied enzyme compositions. “Bromelain” often refers to the "stem bromelain". Bromelain is a combination of several thiol endopeptidases and others including various protease inhibitors, glucosidase, cellulase, phosphatase, peroxidase, and escharase. Studies conducted in both the lab and on animals show that bromelain has a variety of fibrinolytic, anti-edematous, antithrombotic, and anti-inflammatory effects. The body can absorb bromelain to a significant extent without it ceasing its proteolytic activity or having any negative side effects. Numerous therapeutic advantages of bromelain include wound debridement, improved drug absorption, and the management of sinusitis, bronchitis, angina pectoris, surgical trauma, and thrombophlebitis. Additionally, it treats numerous cardiovascular conditions, diarrhoea, and osteoarthritis. Bromelain also encourages apoptotic cell death and exhibits some anti-cancerous properties. This review compiles the crucial traits, medical and dental uses of bromelain as well as its potential mechanism of action.

Composite Pre-heating: A Novel Approach in Restorative Dentistry

Resin composite pre-heating is a novel approach that might improve handling and marginal adaptation of the unset material paste in clinical application. The goal of this review article is to compile all laboratory experiments on resin composite preheating and see how it impacts the mechanical properties of the material. Results have shown that preheating composite resins improves the degree of conversion, stiffness, marginal adaptability, and microhardness. While flexural strength is unbothered, polymerization shrinkage is hindered, and the microleakage results are unknown.

Clinical Efficacy of Two Different Desensitizers in Reducing Postoperative Sensitivity Following Composite Restorations

Objective: The objective is to evaluate the efficacy of different desensitizing agents in the reduction of postoperative sensitivity after composite restoration.

Materials and methods: Class I cavities were prepared in 39 patients by the same operator. The patients included in the study were between 20 and 45 years with vital pulp and a remaining dentin thickness of 1mm. Previously restored, nonvital and tooth with periodical changes were excluded. Patients were randomly assigned into three groups of 13 each - Group I (Control); Group II (Gluma desensitizer) and Group III (shield active desensitizer [SAD]). After the surface treatment, the teeth were restored with composite. The patients were assessed for postoperative sensitivity at 24 hours and one week with a visual analog scale (VAS).

Statistical Analysis: Data were analyzed using SPSS v23 software. Data were analyzed using one-way ANOVA and post-hoc Tukey test.

Results: Gluma and SAD on comparison with control group i.e. composite group showed statistical significance difference at day 1 (P-value 0.003), but on comparing the sensitivity after one week, there is no significant difference in sensitivity score between all three groups (P-value 0.073). There was no statistically significant difference between day 1 and one week when comparing Gluma desensitizer and SAD.

Conclusion: The application of the desensitizer led to a statistically significant reduction in postoperative sensitivity on day 1 and a clinically significant reduction was observed at one week.

Conservative Management of Complicated Crown-Root Fracture: An Immediate Esthetic Rehabilitation

Among the various types of dental trauma, crown-root fractures are one of the most challenging to treat and require a multidisciplinary approach. This paper reports a case of a complicated crown-root fracture of maxillary left central incisor with esthetic, functional complications. An 18-year-old male patient presented to the department immediately after suffering trauma with a complicated crown-root fracture on tooth 21. As per the treatment, the patient had undergone endodontic therapy followed by flap reflection. Post flap reflection, a glass fiber post was luted, and the fractured fragment was reattached. By this approach, in the same appointment, the cervical margin can be exposed with appropriate isolation followed by a reattachment procedure. Reattaching the fragment is a viable option as it can be done immediately, provides better esthetics, restores function, and is less complicated than the conventional approach. A good prognosis is dependent on patient cooperation with the understanding of the treatment limitations. The article discusses a successful case of complicated crown-root fracture treated with the reattachment of a tooth fragment.

Eighteen months of clinical and radiographic evaluation revealed that the clinical protocol was effective, as the tooth was functional, asymptomatic, and esthetic.

Comparative Evaluation of Apical Debris Extrusion during Root Canal Preparation using Three Different Rotary File Systems: A Study Protocol

Background: Apical extrusion of debris leads to postoperative inflammation and endodontic failure. Objectives: To comparatively evaluate debris extrusion by using Trunatomy rotary files, 2 shape, ProTaper next rotary files. Methodology: Sixty Extracted single rooted human premolar teeth will be included in the study. After access opening, canal patency will be established by 15 K-file till the apical foramen followed by determination of working length by visual method. Now the samples will be divided into 3 groups: Group1: Trunatomy, Group 2: 2 shape file, Group 3: ProTaper Next files. Following this the manufacturer's instructions will be followed for the instrumentation. During instrumentation, extruded debris and irrigants will be collected into the preweighed test tubes. Following this, these tubes will be stored in an incubator at the temperature of 70°C for next 5 days. To evaluate the resultant weight of extruded debris, these test tubes will be weighed. Expected Results: Trunatomy rotary file system is expected to produce less debris than 2 shape, ProTaper Next file system. Conclusion: This study would be helpful for clinicians to choose better and efficient file system for instrumentation which produce comparatively less debris extrusion further reducing the chances of endodontic flareup.