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Objective: The aim was to compare the "reverse sandwich restoration" to resin composite restorations regarding marginal adaptation, fracture resistance, favourable/unfavourable fractures in the management of external cervical resorption. Methods: Forty-eight extracted maxillary central incisors were selected and endodontically treated. Cervical regions of the labial root surfaces received simulated resorptive defects and were restored as three randomly allocated groups: Reverse Sandwich Restoration (resin composite + resin-modified glass ionomer) (RSR); resin composite restoration (COMP), and no restoration (NR). Each group was further divided into two subgroups (n=8 each): Thermomechanical Aging (TA) (equivalent to one year) and No Aging (NA). Marginal adaptation was scored by scanning electron microscopy. Fracture resistance was tested using a universal testing machine. Favourable versus unfavourable fractures were classified based on fracture extent. Results: TA decreased the marginal adaptation for both RSR and COMP. Mean fracture resistance per groups were: RSR-NA 1522.4±94.9N, RSR-TA 939.6±72.9N, COMP-NA 1197.6±95.7N, COMP-TA 870.4±86.3N, NR-NA 1057.1±88.1N, and NR-TA 836.6±81.9N, respectively. Fracture resistance was the highest for RSRNA compared to all other groups (p<0.05). TA decreased the fracture resistance in all groups (p<0.05), there was no significant difference between RSR and COMP regarding fracture resistance and favourable/unfavourable fractures (p>0.05). Conclusion: RSR provided comparable results to resin composite fillings to restore artificial cervical defects pertaining to marginal adaptation, fracture resistance, and favourable versus unfavourable fractures. RSR is preferable due to its inherent biocompatibility to the periodontium. [ABSTRACT FROM AUTHOR]

The purpose of this systematic review was to critically evaluate the available clinical literature on the use of regenerative endodontic therapy (RET) for the treatment of root resorption. All case reports, case series and clinical studies documenting the management of root resorption in mature or immature permanent teeth using RET were included. Review articles, animal studies, and RET in teeth showing developmental anomalies were excluded. A literature search was conducted in electronic databases MEDLINE, Scopus, Cochrane, and Google Scholar from 2001 to January 2022. The JBI Critical Appraisal Checklist Quality was used to appraise the included case reports and case series. The Methodological item for non-randomised studies (MINORS) tool was used to appraise the clinical study critically. After applying the inclusion and exclusion criteria, the search resulted in 14 studies (12 case reports, 1 case series, and 1 clinical study) accounting for root resorption in 34 teeth from 29 patients treated with RET. Despite the wide variation in RET protocols, the arrest of root resorption and resolution of symptoms was seen in all teeth except one (failure after 27 months). The clinical study's cone beam computed tomography (CBCT) imaging evaluation documented a significant volumetric decrease in resorptive and periapical lesions after RET. The clinical study was deemed as good quality using the MINORS scale. The JBI critical appraisal tool showed that the case series was of poor quality; 11 of the case reports were of good quality, while 1 case report was of fair quality. This systematic review revealed a low-to-moderate level of evidence for the use of RET in resorption cases. However, further well-designed, long-term clinical studies are required to recommend it as an alternative treatment option for root resorption management. Funding: None. The systematic review was registered in PROSPERO (CRD42021274569). [ABSTRACT FROM AUTHOR]

Background: Dentinal hypersensitivity (DH) is a common dental problem and is treated non-invasively using topical application of various desensitizing agents. When there is loss of tooth structure or tooth preparation is to be followed by a bonded restoration, it requires application of dentin bonding agent. However, the effect of desensitizers on bond strength is still controversial. Aim and Objective: To evaluate the influence of different desensitizing agents on the bond strength of the dentin bonding agents. Methods and Materials: PICO strategy was used to formulate the research question. In-vitro studies conducted on human teeth to evaluate the bond strength of dentin bonding agent following the application of desensitizing agent were included. Electronic databases PubMed and Cochrane and google scholar were searched using search terms alone or in combination from the year 2010 till 2020. Search was conducted using the key words and MeSH terms (hypersensitivity, bond strength, dental adhesives, dentin bonding agents). The title and abstract were read to verify the inclusion and exclusion criteria and if further any details required, full article was accessed to check the criteria and then included or excluded. Data extraction was done using a customized data extraction form. The risk of bias was evaluated using modified Cochrane Collaboration Quality Assessment tool. Results: Total no of studies identified in the search were 146, after scrutiny 23 articles were eligible to be included in this study. Out of 23 articles, 17 articles were of medium bias and 6 articles were of high risk after risk of bias assessment. Conclusion: According to the various articles included in this study, GLUMA and 8.0%Arginine and CaCO3 when used as desensitizing agents along with different bonding agents, were found to be highly compatible without interfering with the bond strength of the dentin adhesives. [ABSTRACT FROM AUTHOR]

Introduction: The interaction between chlorhexidine (CHX) and sodium hypochlorite (NaOCl) yields a thick precipitate capable of occluding dentinal tubules. Previous studies are unclear as to the above-mentioned precipitate contains para-chloroaniline (PCA) or not. PCA is a known toxic and carcinogenic compound which may lead to methemoglobinemia in humans. Aim: This study aims to evaluate the precipitate formed on combination of different irrigants, weigh the amount of precipitate formed and to analyze the precipitate for PCA by using thin layer chromatography (TLC), high performance liquid chromatography (HPLC), column chromatography (CC), electron spray ionization mass spectrometry (ESI-MS), Ultraviolet (UV), and nuclear magnetic resonance (1H-NMR and C-13 NMR). Materials and Methods: Four different irrigants namely 2% CHX gluconate, 3% NaOCl, 5% neem and 5% tulsi were taken in different test tubes. Group 1, 2 and 3 included 1 ml 2% CHX combined with 1 ml each of 3% NaOCl, 5% neem and 5% tulsi. Group 4 and 5 comprised of 1 ml 3% NaOCl in combination with 1 ml 5% each of neem and tulsi. Finally, group 6 constituted 1 ml 5% neem mixed with 1 ml 5% tulsi. Each group was observed for 2 min for the formation of any precipitate, and the formed precipitate was weighed and analyzed using 1H-NMR and C-13 NMR, TLC, CC, HPLC, ESI-MS, and UV. Statistical Analysis: One-way ANOVA and Post hoc-Tukey test were used. Results: Presence of PCA was detected in group 1 (CHX + NaOCl), group 2 (CHX + neem) and group 3 (CHX + tusli) in all the sensitive methods employed. Conclusion: The presence of PCA in precipitate was confirmed by TLC, CC, HPLC, ESI-MS, and UV. Based on the results of the present study, we assume that components in CHX are responsible for precipitate formation which contains PCA as well. Extrusion of precipitate beyond the apex may cause periapical tissue damage and delay wound healing at the same time. [ABSTRACT FROM AUTHOR]