A comparative evaluation of the effect of alcoholic and non alcoholic beverages on tooth enamel surface pretreated with β-tricalcium phosphate, bioactive glass and amine fluoride: an in vitro study

Background and aims

The aim of this in vitro study is to quantitatively evaluate the effect of different alcoholic and non alcoholic beverages on the tooth enamel surface topography pretreated with various remineralizing agents using Atomic Force Microscopy.

Methods

120 tooth specimens were prepared from 60 freshly extracted intact human premolars by sectioning from mesial to distal surfaces using low speed diamond discs and were randomly assigned to study groups and control group. Specimens of Group I, Group II and Group III were pre-treated with β-Tri calcium phosphate, bioactive glass and amine fluoride respectively for 4 minutes for 28 days, followed by storage in artificial saliva. All the specimens were evaluated for surface roughness using Atomic Force Microscopy. The specimens were then placed in alcoholic and non-alcoholic beverages for 10 minutes for 4 days and were again analyzed by Atomic Force Microscopy.Descriptive statistics was performed by using the proportional or frequency distribution of the parameters. The respondents were then grouped according to the branch of specialty if any and the data was evaluated by the one-way ANOVA with post-hoc, with p value <0.005.

Results

In the present study, among the remineralizing agents tested, bioactive glass was found to be more effective than β-Tri Calcium Phosphate and Amine Fluoride. Among the demineralizing agents used in this study, the demineralization potential of Coca Cola was found to be highest, followed by wine and green tea pretreated with β-tricalcium phosphate, bioactive glass and amine fluoride.

Conclusions

The present study concluded that all the remineralizing agents tested were found to be effective in inhibiting the demineralization caused by various alcoholic and non alcoholic beverages. Among the remineralizing agents tested, bioactive glass was found to be more effective than β-tri calcium phosphate and amine fluoride.

Reinforcing an immature tooth model using three different restorative materials

Background

To compare and evaluate the strength rendering capacity of three restorative materials in tooth model simulated as immature teeth.

Materials and Methods

In this in vitro study, 80 human maxillary permanent central incisors scheduled for periodontal extraction were collected, and an immature tooth model was prepared using a 3 mm twist drill. To simulate single-visit apical barrier, all the teeth were prepared with peso number 1-6. The teeth were segregated into three experimental and a control group. The experimental groups (n = 20) comprised of fiber-reinforced composite (FRC), Biodentine, and glass ionomer cement. The fracture resistance of all the teeth was tested using universal testing machine. The final reading of the applied load to cause fracture was noted and later was subjected to statistical analysis, P ≤ 0.05 was considered statistically significant, and the level of significance was fixed at 5%. Student's t-test was applied to compare values among experimental groups.

Results

There was a significant difference in the values of peak load resulting in fracture among experimental groups which was observed statistically (P ≤ 0.001). FRC exhibited superior reinforcing capacity (mean: 1199.7 N) among the experimental materials followed by Biodentine and Bioglass R. The lowest value to fracture was observed in control group (mean: 236.7 N).

Conclusion

The results indicate that FRC could substantially contribute positively in reinforcing the simulated thin-walled immature roots.

Evaluation of titanium mesh and fibers in reinforcing endodontically treated molars: An in vitro study

Aim/Objective:

We aimed to evaluate the fracture resistance of titanium mesh and fibers that could aid as a substitute for crown coverage.

Materials and Methodology:

Forty extracted human mandibular molar teeth were selected for this study and were divided into four groups (n = 10). Access cavity preparation was done in all experimental teeth (Groups 2–4) maintaining 1.2–1.5 mm diameter of tooth structure around the circumference to mimic the structural loss of teeth due to the extent of dental caries. Group 1 consisted of intact teeth which were assigned as control. Group 2 was reinforced with titanium mesh. Group 3 was reinforced with glass fiber. Group 4 was reinforced with polyethylene fiber. The access cavities in all the experimental teeth were later filled with nanohybrid composite and were subjected to fracture resistance using a universal testing machine.

Results:

The results of the study were evaluated statistically using the Kruskal–Wallis test. There was no statistically significant difference among the experimental and control groups.

Conclusion:

Within the constraint of this in vitro study, an inference can be given that fiber-reinforced composite and titanium mesh could rule out the mandatory procedure of crown placement for endodontically treated molars.

Mechanical and antimicrobial property of different surface treated glass ionomer cements under desiccated condition

BACKGROUND

The purpose of this in vitro study was to evaluate the effect of five different surface treatments on the mechanical property and antimicrobial effect of three desiccated glass ionomer cements.

MATERIALS AND METHODS

In this in vitro experimental study, 300 rectangular blocks of three different restorative materials were fabricated using an aluminum mold, Group I (n = 100) Micron bioactive, Group II (n = 100) GC Fuji IX GP Extra, and Group III (n = 100) bioglass R. These blocks were stored in 100% humidity for 24 h and then placed in air to desiccate for another 24 h. These groups were further divided into two major groups (n = 50) for both mechanical (Flexural) and antimicrobial testing. The blocks of mechanical and antimicrobial groups were further divided into five subgroups (n = 10) based on the medias used for surface treatment (senquelNaF, MI varnish, chlorhex plus, kedodent mouthwash, and 100% humidity [control]). Flexural strength (FS) was measured using the universal testing machine. Fracture strength of groups was compared using the one-way analysis of variance and Tukey's post hoc test with P ≤ 0.05 considered statistically significant. Antimicrobial effect was carried out by covering the specimens in a suspension of Streptococcus mutans followed by incubation for 24 h. The blocks were later washed, vortex mixed, serially diluted, and plated. Ccolony-forming unit/ml was calculated after 3 days of incubation. Data were then analyzed using the Kruskal-Wallis and Mann-Whitney U nonparametric test, with P ≤ 0.05 considered statistically significant.

RESULTS

Micron bioactive with the surface treatment of MI varnish significantly exhibited highest FS. Surface treatment of desiccated restorative materials with chlorhex plus exhibited no growth of S. mutans. GC Fuji IX GP Extra with surface treatment of MI varnish exhibited highest reduction in S. mutans growth compared to other experimental group.

CONCLUSION

Surface treatment of restorative material with MI varnish improved their mechanical and antimicrobial property while among three restorative materials Micron bioactive showed better mechanical property, whereas GC Fuji IX GP Extra exhibited better antimicrobial property.

Evaluation of antibacterial activity of three different glass ionomer cements on streptococcus mutans: an in-vitro antimicrobial study

Aim

Purpose of this in-vitro study was to assess and compare the antimicrobial activity of three different glass ionomer cements (GIC) against streptococcus mutans (S. mutans) bacteria using agar plate diffusion test.

Methods

Thirty blood agar plates were prepared and three wells of 4mm diameter were made on each agar plate. Three different GIC (Micron bioactive, GC Fuji IX GP Extra, Bioglass r) were mixed and filled into the wells. These plates were inoculated with S. Mutans and incubated at 37°C for 24 hours. Bacterial growth inhibition zone around each well were recorded in millimeters using Hiantibiotic Zonescale-C.

Result

All the restorative material used in the study exhibited antimicrobial property against S. Mutans. GC Fuji IX GP Extra showed superior antimicrobial efficacy with 17.3±2.6 mm mean diameter of bacterial inhibition zone, followed by Micron bioactive 14.4±1.07 mm and Bioglass r 10.8 ± .91 mm inhibition zone respectively.

Conclusion

Within the limitation of this study, it can be concluded that all the GIC evaluated demonstrated antibacterial activity against S. mutans. The superior antimicrobial activity was demonstrated by GC Fuji IX GP Extra. Hence, it could be advantageous in patients with high caries risk.

Dentinal Adaptation of Warm Thermoplastic Obturating Material and Cold Thermoplastic Obturating Material: An In vitro Study

Introduction:

The objective of endodontic obturation is to provide a complete seal along the length of the root canal system, thereby ensuring the healing and sustained health of the periradicular tissue. Root canal obturation involves the three-dimensional filling of the entire root canal system and is a critical step in endodontic therapy. Gutta-percha has universally been accepted as the gold standard for root canal filling materials. However, it lacks bonding to the internal tooth structure resulting in the absence of complete seal.

Aim:

The aim of the present study is to compare the dentinal adaptation of warm thermoplastic obturating material and cold thermoplastic obturating materials.

Materials and Methods:

Thirty single-rooted, anterior noncarious human teeth extracted for periodontal or orthodontic reasons were used for the study. The samples were stored in distilled water until obturation. The specimens were then randomly divided into three groups of ten specimens each: Control group – Cold lateral condensation with AH Plus, Group I – Endosure with AH Plus^®, and Group II – GuttaFlow^® 2 with master cone. The obturation for each group was done following manufacturer's instructions. Under On-demand software, the area of voids at the level of 3 mm, 5 mm, and 8 mm from the apex was observed for all the samples. The obtained results were submitted for statistical analysis.

Results:

The result in the present study showed that Endosure provides a better consistent seal as compared to cold lateral condensation, or GuttaFlow 2 techniques.

Conclusion:

Mean void value was maximum for GuttaFlow 2 group, followed by cold lateral condensation, Endosure. Though there was a difference in the mean void values, it was not statistically significant except between Endosure and GuttaFlow 2. The result in the present study showed that Endosure provides a better seal as compared to cold lateral compaction, GuttaFlow 2 or Endosure technique.

Cutaneous dental sinus of submental region: an eight years follow-up

A 22-year-old female patient had a history of a 7-month recurrent pus discharge from her chin. She had been previously treated by physicians, dermatologist, and surgeons. The sinus kept re-occurring and she was referred to dental hospital for opinion.

The patient had cutaneous opening of size 5 mm × 6 mm with purulent discharge in submental region. Patient had undergone three surgical excisions and multiple antibiotic regimens. Patient had a history of trauma due to fall six years back. A 30 number standard gutta-percha was used to trace the sinus tract and dental origin was confirmed radiographically. The tract led to in-between the root canal apices of both mandibular incisors. Treatment included non-surgical endodontic treatment with both mandibular central incisors and antibiotic coverage following bacterial culture of discharge. The pus culture showed Streptococcus anginosus which was found to be sensitive to penicillin. Patient was kept on 1-week course of oral amoxicillin-clavulanate along with root canal therapy.

The cutaneous sinus healed following root canal treatment and antibiotic coverage. On an 8-year follow-up skin of sub-mental region appeared normal and peri-apical healing with both mandibular central incisors was evident radiographically. Cutaneous lesions on face may be of dental origin. A cross referral between dentists, physicians, surgeons, and dermatologists should be considered in such cases.

Internal tunneling resorption associated with invasive cervical resorption

Treating pathological defects that are caused by resorption in teeth can be challenging. The task is complicated further if the resorption extends beyond the restrains of the root. The aim of this report is to describe a case of extensive internal tunneling resorption (ITR) associated with invasive cervical resorption (ICR) in a maxillary right lateral incisor and its nonsurgical treatment. A 22-year-old male was referred to the department of endodontics with a chief complaint of discolored maxillary right lateral incisor or tooth 12 and a history of trauma. An extensive ITR associated with ICR accompanied by apical periodontitis was detected on a preoperative radiograph which was confirmed on a cone-beam computed tomography (CBCT) scan in a maxillary lateral incisor. After chemomechanical debridement and withdrawal of a separated file in the canal, calcium hydroxide was placed as an intracanal medicament for 2 weeks. Biodentine (BD) was used to obturate the defect as well as entire root canal system and to restore ICR. On a 5-year follow-up, the tooth was functional, and periapical healing was evident. Based on results of this case, successful repair of ITR associated with ICR with BD may lead to resolution of apical periodontitis. Trauma to teeth may lead to resorption which may be internal, external, and or a combination of both which may be asymptomatic in some patients. Preoperative assessment using CBCT imaging achieves visualization of location and extents of resorptive defects. Bioactive materials like BD may lead to favorable results in treating such extensive defects.

Evaluation of different fibers and biodentine as alternates to crown coverage for endodontically treated molars: An in vitro study

OBJECTIVE

The objective of this study is to evaluate the fracture resistance of newer restorative materials that could serve as an alternate to crown coverage.

MATERIALS AND METHODS

Forty extracted human mandibular molar teeth were selected for this study and were divided into four groups (n = 10). All the teeth in the experimental groups (Group 2-4) were subjected to access cavity preparation with roughly 1.5 mm of tooth structure remaining throughout the circumference. Group 1: Intact teeth used as control. Group 2: Access cavities reinforced with biodentine. Group 3: Inner circumference of access cavities reinforced with polyethylene fiber and nano-hybrid composite. Group 4: Access cavities were reinforced with fiber reinforced composite. All the teeth were subjected to fracture resistance using universal testing machine.

RESULTS

The results of the study were evaluated statistically using one-way ANOVA and Tukey post hoc test. Group 2 demonstrated the least mean values of fracture resistance and was significantly different from the control and other experimental groups. Statistically significant difference among Groups 1, 3, and 4 was not found.

CONCLUSION

Within the limitation of this in vitro study, it can be concluded that fiber reinforced composite and polyethylene fibers with nanohybrid composite could serve as an alternate to crown coverage.

Use of second-generation platelet concentrate (platelet-rich fibrin) and hydroxyapatite in the management of large periapical inflammatory lesion: a computed tomography scan analysis

Periapical surgery is required when periradicular pathosis associated with endodontically treated teeth cannot be resolved by nonsurgical root canal therapy (retreatment), or when retreatment was unsuccessful, not feasible or contraindicated. Endodontic failures can occur when irritants remain within the confines of the root canal, or when an extraradicular infection cannot be eradicated by orthograde root canal treatment. Foreign-body responses toward filling materials, toward cholesterol crystals or radicular cysts, might prevent complete periapical healing. We present here a case report wherein, combination of platelet-rich fibrin (PRF) and the hydroxyapatite graft was used to achieve faster healing of the large periapical lesion. Healing was observed within 8 months, which were confirmed by computed tomography, following improved bone density. PRF has many advantages over platelet-rich plasma. It provides a physiologic architecture that is very favorable to the healing process, which is obtained due to the slow polymerization process.

Accidental injection of 2% chlorhexidine gluconate instead of an anesthetic agent: A case report

We report a case where 2% chlorhexidine (CHX) gluconate was mistaken for an anesthetic solution and infiltrated into the buccal vestibule during routine root canal treatment. Accidentally, 2% CHX gluconate solution was injected in the right upper buccal vestibule (16) of a 23-year-old male during routine root canal treatment. The patient experienced pain and a burning sensation over the injected area shortly after injection. Swelling with mild extraoral redness over the right cheek area was observed clinically. The patient was immediately administered dexamethasone intramuscularly, and was prescribed antibiotics, analgesics, and antihistamines. The patient complained of a loss of sensation over the right cheek by the 15^th day. The swelling reduced gradually over a period of 15 days. Reversal of sensation was attained after 35 days.

Successful removal of a 16 mm long pulp stone using ultrasonic tips from maxillary left first molar and its endodontic management

To present a case report describing successful removal of a 16 mm long pulp stone in a single mass from a maxillary left first molar and its endodontic management. In the presented case, the conventional approach of dissecting the pulp stone was not considered, as radiographically the calcification was extending up to the apex of the palatal root canal and the separation of the coronal and radicular pulp stone would have risked the obliteration of its orifice. A new set of ultrasonic endodontic tips were used for the removal of significantly large pulp stone in single mass.

Use of ribbond and panavia F cement in reattaching fractured tooth fragments of vital maxillary anterior teeth

Coronal fractures of the anterior teeth are a common form of dental trauma that mainly affects children and adolescents. One of the options for managing coronal tooth fractures when the tooth fragment is available and there is no or minimal violation of the biological width is the reattachment of the fragment. This article presents a novel technique for reattachment of oblique fractured fragment of vital maxillary central and lateral incisor with pulp exposure. Pulp capping was done using mineral trioxide aggregate. Orthodontic extrusion was done to expose the sub gingival fractured site. Polyethylene fiber (ribbond) and panavia F cement were used to reattach the fractured fragment using an internal groove technique to provide high fracture strength to restored tooth. Ribbond fibers can be used to give additional strength to the reattached tooth fragment so that the tooth obtains fracture resistance equal to an intact tooth.

Single-step apical barrier placement in immature teeth using mineral trioxide aggregate and management of periapical inflammatory lesion using platelet-rich plasma and hydroxyapatite

We present here a case report of a tooth with an immature root with a large periapical lesion. The open apex was managed by placing an apical barrier using mineral trioxide aggregate, and the periapical lesion was treated surgically. A combination of platelet-rich plasma (PRP) and hydroxyapatite graft (HA) was used to achieve faster healing of the periapical lesion. The case was followed up for 11 months. The indications and advantages of apical barrier placement, periapical surgery, and the role of PRP and HA in postsurgical healing are discussed.

Invasive cervical resorption: a case report

Invasive cervical resorption (ICR) is a relatively uncommon form of external resorption, which may occur in any tooth in the permanent dentition. Characterized by its cervical location and invasive nature, this resorptive process leads to progressive and usually destructive loss of the tooth structure, the clinical features of which often resemble internal resorption ("pink tooth"). This article describes a case report of ICR and its management. The salient features were a large resorptive defect and localized fibrous in-growth located almost wholly on the cervicolabial aspect of the maxillary incisor crown involving the enamel and dentin.