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Large cavity designs and access cavities impair endodontically treated tooth fracture resistance. As the tooth's strength is known to reduce significantly after the root canal treatment, occlusal loading as a result of functions such as chewing, biting and certain parafunctional tendencies makes the endodontically treated tooth vulnerable to fracture. Hence, after endodontic treatment, it is vital to give adequate and appropriate restorative material to avoid tooth fractures. Accordingly, the choice for such restorative material should be dictated with the property of fracture resistance. The goal of this study was to conduct a systematic review and critical analysis of available data from in vitro studies examining the fracture resistance of endodontically treated teeth repaired with fiber-reinforced composites. A comprehensive literature search was performed using PubMed Central, Medline, Scopus, ScienceDirect, Google Scholar and LILACS. A manual search of the reference lists of the articles was also performed. Two reviewers scrutinized the papers for eligibility based on inclusion/exclusion criteria and extracted data. The studies were assessed for their potential risk of bias. A total of 15 studies met the inclusion criteria and were subsequently analyzed. Based on modified JBI & CRIS (checklist for reporting in vitro studies) guidelines, along with the methodology and treatment objective, we have formulated 13 parameters specifically to study the fracture resistance. The majority of the research had a moderate or high risk of bias. When compared to traditional hybrid composites, fiber-reinforced composites showed increased fracture resistance of endodontically treated teeth in the majority of investigations. On the other hand, limited evidence was found for the bulk fill composites. Moreover, moderate evidence was found for the fracture resistance of inlays and fiber posts with fiber-reinforced composites for core build up in endodontically treated teeth. No evidence could be found comparing the fracture resistance of crowns/endocrowns and fiber-reinforced composites in endodontically treated teeth. According to the research, using fiber-reinforced composites instead of conventional hybrid composites improves the fracture resistance of endodontically treated teeth. However, there was a high risk of bias in the research considered. No judgments could be reached about the superiority of one material over another based on comparisons between other core restorations.

Fluid dynamics is a majorly neglected aspect to be studied in root canal irrigation. The fundamental rule to understand mechanics is to observe patterns of flow during the process. Thus, this work is conducted to do a systemic assessment of the in-vitro and ex-vivo based studies to evaluate the effect of various parameters on the irrigant flow and apical pressure on using a manual syringe needle for root canal irrigation.The literature search was conducted through libraries such as PubMed (Medline), CINAHL, Embase, Scopus and other hand literature from Google Scholar, the British medical library etc. The systematic review was reported following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. As they include studies that were in-vitro and ex-vivo based, the risk of bias of the selected articles was assessed using a customized tool based on the previous literature and parameters evaluated in the studies included.The literature search resulted in 101 items of which 19 records were included in this review. Results reported that multiple factors and parameters were assessed to evaluate the flow and apical pressures on using manual syringe needle irrigation.Present systematic review gives insights in-depth about the irrigation dynamics of manual syringe needle irrigation. Besides, it is inconclusive to compile a single factor or a single parameter contributing to the enhanced irrigant flow and least apical pressures.

This systematic review assessed the clinical influence of centric and eccentric engine-driven instrument design for reduction in microbial load in infected root canal system. The literature search was conducted in electronic databases (PubMed, Cochrane Library, Scopus, Lilacs and Google Scholar) and grey literature till June 2022. The search strategy followed the PRISMA 2020 guidelines. Qualitative and quantitative synthesis was conducted based on the guidelines of the Cochrane Handbook. The risk of bias was assessed using the revised Cochrane criteria and quality of evidence was conducted using the Grading of Recommendation Assessment, Development and Evaluation tool. Out of 28 papers, only five papers met the inclusion criteria of this review. Studies showed reduction in microbial load after instrumentation using centric or eccentric instruments with no statistically significant difference in the meta-analysis. In conclusion, there is low-grade evidence suggesting that microbial reduction is similar using centric and eccentric instruments.

Background Over the past years, polysaccharide-based scaffolds have emerged as the most promising material for tissue engineering. In the present study, carrageenan, an injectable scaffold has been used owing to its advantage and superior property. Cissus quadrangularis, a natural agent was incorporated into the carrageenan scaffold. Therefore, the present study aimed to assess the antioxidant activity and biocompatibility of this novel material. Methods The present in vitro study comprised of four study groups each constituting a sample of 15 with a total sample size of sixty (n = 60). The carrageenan hydrogel devoid of Cissus quadrangularis acted as the control group (Group-I). Based on the concentration of aqueous extract of Cissus quadrangularis (10% w/v, 20% w/v and 30% w/v) in carrageenan hydrogel, respective study groups namely II, III and IV were considered. Antioxidant activity was assessed using a 1,1-diphenyl-2-picrylhydrazyl radical scavenging assay, whereas the biocompatibility test was performed using a brine shrimp lethality assay. The microstructure and surface morphology of the hydrogel samples containing different concentrations of Cissus quadrangularis aqueous extract was investigated using SEM. One-way ANOVA with the post hoc tukey test was performed using SPSS software v22. Results A significant difference (P P P Cissus quadrangularis. SEM analysis in group III showed even distribution throughout the hydrogel although the particles are close and densely arranged. Reduced antioxidant activity in group IV was probably due to clumping of the particles, thus reducing the active surface area. Conclusion Keeping the limitations of in vitro study, it can be assumed that a carrageenan based injectable hydrogel scaffold incorporated with 20% w/v Cissus quadrangularis can provide a favourable micro-environment as it is biocompatible and possess better antioxidant property.

Background: Over the past years, polysaccharide based scaffolds has been the most promising material for tissue engineering. In the present study, carrageenan, an injectable scaffold has been used owing to its advantage and superior property. Cissus quadrangularis, a natural agent was incorporated into the carrageenan scaffold which probably has the potential to make a favourable micro-environment for the dentin-pulp regeneration. Therefore, the present study aimed to assess the antioxidant activity and biocompatibility of the material. Methods: The present in vitro study comprised of four study group each constituting a sample of 15 (n=15). The carrageenan hydrogel without addition of Cissus quadrangularis acted as control group (Group-I). Based on the concentration of aqueous extract of Cissus quadrangularis (10% w/v, 20% w/v and 30% w/v) in carrageenan hydrogel, respective study groups namely II, III and IV were considered. Antioxidant activity was assed using 1,1-diphenyl-2-picrylhydrazyl radical scavenging assay and biocompatibility test was performed by using brine shrimp lethality assay. One-way ANOVA with the post hoc tukey test was performed using SPSS software v22. Results: Significant difference (PCissus quadrangularis hydrogel (group III) reported the highest and control group showed the least antioxidant activity. A significant (PPcissus quadrangularis, wherein group III showed even distribution throughout the hydrogel although the particles are close and densely arranged. Reduced antioxidant activity in group IV was probably due to clumping of the particles, thus reducing the active surface area.Conclusion: Keeping the limitations of the in vitro study, it can be assumed that carrageenan based injectable hydrogel scaffold, incorporated with 20% w/v Cissus quadrangularis can provide favourable micro-environment as it is biocompatible and possess better antioxidant property. Hence, this study lays ground for future studies to explore this scaffold incorporated with Cissus quadrangularis for dentin pulp regeneration.

The interest in the use of green-mediated synthesis of nanoparticles (NPs) is shown to have increased due to their biocompatibility and reduction of overall production costs. The current study aimed to evaluate a novel nanocomposite (NC) prepared by using a combination of zinc oxide, silver and chitosan with lemon extract as a cross-linking agent and assessed its antimicrobial effectiveness against

AIM: The aim of this study is to evaluate the efficacy of sodium bicarbonate as an additive alkalizing agent to local anesthetic solutions in inflamed and infected pulpal and periapical tissues. TYPE OF STUDY: A prospective, randomized crossover double-blinded study was carried out in a university-affiliated hospital in Chennai. MATERIALS AND METHODS: A randomized crossover double-blinded study was designed wherein ninety-six patients were enrolled for the study. 1.8 ml of 2% lignocaine with 1:200,000 adrenaline was administered. The latency time period was found to be 5–10 min and extraction was attempted. During extraction, if the patient experienced pain, 0.5 ml of 8.4% sodium bicarbonate was injected into the previously injected local anesthesia site. A time period of 3 min was allowed for the alkalinization to occur. Extraction was carried out only when the patient did not complain of pain. Pain score was assessed before and after administration of 8.4% sodium bicarbonate using visual analog scale. Pulse rate at the baseline, before and after administration of 8.4% sodium bicarbonate, was recorded and the pain scale values were correlated with pulse rate. RESULTS: It was found that there was a significant decrease in pain after injecting buffered local anesthetics (p

This systematic review aimed to compare the efficacy of herbal agents with ethylene diamine tetraacetic acid (EDTA) in removing the smear layer during root canal instrumentation. The research question in the present study was to assess: “Is there a significant difference in reducing smear layer comparing EDTA and herbal agents?” Electronic databases (PubMed, Scopus, and Web of Science) were searched from their start dates to April 2022 using strict inclusion and exclusion criteria, and reviewed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. Only in vitro studies comparing herbal agents with EDTA were included in the current systematic review. Two reviewers independently assessed the included articles. A total of 625 articles were obtained from an electronic database. Eighteen papers were included for review of the full text, out of which, ten papers were excluded because they did not meet the inclusion criteria. Finally, eight articles were included in the systematic review. The present systematic review considered only in vitro studies; hence, the result cannot be completely translated to strict clinical conditions. The results of the present systematic review have shown that quixabeira, morindacitrifolia, oregano extract, and neem show better smear layer removal compared to other herbal agents, whereas they showed reduced smear layer removal when compared with EDTA. Although, it was seen that most of the included studies did not report a high quality of evidence. Hence, the present systematic review concludes that herbal agents have reported to show inferior smear layer removal when compared to EDTA. Thus, as far as herbal based alternatives are concerned, there is no highest level of evidence to state its real benefit when used as a chelating root canal irrigant.

Oral disintegrating films (ODFs) are one of the forms of drug delivery system with better patient compliance. The advantage is that it disintegrates quickly when placed on the tongue and has better bioavailability.The aim of this study is to develop an ODF usingThisThe chemical composition of aqueous extracts ofData were analyzed statistically, one-way analysis of variance followed byMIC was 25 μg/ml for

The interest in the use of green-mediated synthesis of nanoparticles (NPs) is shown to have increased due to their biocompatibility and reduction of overall production costs. The current study aimed to evaluate a novel nanocomposite (NC) prepared by using a combination of zinc oxide, silver and chitosan with lemon extract as a cross-linking agent and assessed its antimicrobial effectiveness against Enterococcus faecalis (E. faecalis). The NPs and NC were prepared individually using a modification of previously established methods. Ananalys is of the physiochemical properties of the NC was conducted using ultraviolet-visible spectroscopy (UV-Vis) (Shimadzu Corporation, Kyoto, Japan). and transmission electron microscopy (TEM) imaging(HR-TEM; JEOL Ltd., Akishima-shi, Japan. The microbial reduction with this novel NC was evaluated by measuring the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) using a tube assay analytic technique. A time-kill assay analysis was conducted to evaluate the kinetic potential against E. faecalis at different time intervals. The novel NC showed a homogenous nanoparticle size under TEM imaging and under UV-Vis established an absorption range of 350–420 nm making it similar to its individual counterparts. The MIC and MIB were measured at 62.5 ± 20 mg/L (p < 0.05) and 250 ± 72 mg/L (p < 0.05), respectively. A time-kill assay analysis for the NC showed 5 h was required to eradicate E. faecalis. Based on the achieved results, it was seen that the novel NC using a combination of silver, zinc oxide and chitosan showed improved antimicrobial action against E. faecalis compared with its individual components under laboratory conditions. A complete eradication of 108 log units of E. faecalis at 250 mg/L occurred after a total of 5 h. These preliminary results establish the use of lemon extract-mediated silver, zinc and chitosan-based NC had an antibacterial effectiveness against E. faecalis similar to the individual counterparts used for its production under laboratory conditions.

The purpose of antimicrobial agents is to eliminate the microorganisms without causing toxicity to host cells. This study aimed to assess the cytotoxic effect of oregano essential oil on L929 fibroblast cells.L929 fibroblast cells were exposed to four different concentrations of oregano essential oil (25-200 μg/ml) and calcium hydroxide (1 mg/ml). Dose-response curve was evaluated using 3-(4,5 dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide assay. The toxicity of L929 fibroblast cells was determined by lactate dehydrogenase activity (LDH). The results were analyzed using one-way analysis of variance and turkey post hoc test.Oregano essential oil showed a higher percentage of cell viability than the calcium hydroxide group. At 50 μg/ml, fibroblast cells showed arbitrarily 80% of cell viability compared to calcium hydroxide. There was a statistically significant difference withWithin the limitation of the study, Oregano essential oil at 50 μg/ml reported to show reduced cytotoxicity compared to calcium hydroxide at 1 mg/ml. Therefore, perhaps after evaluating other properties, it might be considered an intracanal medicament.

Background: the efficiency of the diagnostic aids plays an important role in the treatment plan. This study aims to assess the diagnostic accuracy of dental pulse oximeter with a customized sensor holder, thermal test and electric pulp tester in assessing the actual pulp status and to evaluate the oxygen saturation level in control healthy teeth, non-vital and teeth with irreversible pulpitis. Material and methods: thirty-seven single canal teeth requiring endodontic therapy were included in the study. The selected teeth were tested with dental pulse oximeter, electric pulp test, cold spray, and heated gutta percha stick. Between each test a time lag of 2 minutes was allowed for the central sensitization to occur. Three blinded operators were involved in the study. The actual status of the pulp was evaluated after the initiation of endodontic treatment. To assess the actual pulp status direct visual examination of access cavity as performed. The data was statistically analysed using (ANOVA) Analysis of Variance and Post-hoc Tukey test. Results: sensitivity of pulse oximeter, heat test, cold and electric pulp test, was 100, 25, 50, and 12, respectively. The specificity of these tests was 100, 72 81, and 77, respectively. The ANOVA showed that there was statistical difference between all the groups (p=0.0005). Post-Hoc Tukey revealed that there was statistical difference among all the groups, nonvital group (p=0.0005), control group (p=0.01) and for irreversible pulpitis (p=0.01). The overall diagnostic accuracy of pulse oximeter was 100% followed by cold test 66%, heat test to be 49% and electric pulp test to be 45%. Conclusion: the custom-made holder used in the present study aided in providing accurate response for pulp vitality testing. In this study the diagnostic accuracy was high with dental pulse oximeter followed by cold, heat and the least was electric pulp tester in different pulpal conditions.KEYWORDS Cold test; Heat test; Oxygen saturation; Pulse oximeter; Vitality tests.

Esthetics, improved colour stability and ease of contour have made photo-activated resin based restorative materials being widely used in routine dental clinical practice. Perhaps improper and inadequate polymerization of resin based composite material might lead to elution of monomer. Thus, the aim of the current study was to quantify the monomer elution from three resin composites. The intended analysis was made using high performance liquid chromatography (HPLC) at two different time periods. Three different materials that were investigated in the current study included Swiss Tech resin composite (Group A), Ceram X (Group B) and Beautifil Injectable composite (Group C). Ten cylindrical samples were fabricated in each study group. In 75% wt of ethanol, the samples were ingressed immediately and stored at room temperature. A 0.5 mL of the samples was assessed at pre-defined time intervals at 24 h and 7th day. Later, assessment of the samples was performed with HPLC and the data was analyzed using statistical test. Bisphenol A-glycidyl methacrylate (Bis-GMA), Triethylene glycol dimethacrylate (TEGDMA), 2-hydroxyethyl methacrylate (HEMA) and Urethane dimethacrylate (UDMA) were quantified in the samples. When analyzing the release monomer, it was found that at the end of 24 h Bis-GMA was eluted more in the injectable resin composite whereas, TEGDMA was eluted from Swiss Tech and Ceram X resin composites. At the end of the 7th day it was evident that Bis-GMA was eluted maximum in all the three resin composites. Thus, monomer release was found to be evident among all three resin composites and it is of utmost important to be assessed in routine clinical practice.

Gram-negative, anaerobic bacterias are predominate in periapical infections. The bacterial lipopolysaccharide (LPS) initiates the process of inflammation and periapical bone resorption. Usage of various medicaments retards or inactivates the bacterial endotoxin (LPS). However, the results are not highly effective. In recent years, owing to antimicrobial resistance, the shift from conventional agents to herbal agents has been increased tremendously in research. Keeping this in mind, the present study was formulated to evaluate the efficacy of oregano essential oil in inhibiting bacterial LPS- induced osteoclastogenesis. Four different concentrations (0 ng/mL, 25 ng/mL, 50 ng/mL, and 100 ng/mL) of oregano essential oil extract were added into 96-well culture plate. Under light microscope, quantification of osteoclast cells was performed. One-way ANOVA with post-hoc Tukey test was carried out on SPSS v21. A significant reduction (p < 0.001) in the osteoclast was observed in the experimental groups compared to no oregano essential oil extract (control). A dose-dependent significant reduction (p < 0.001) in osteoclast formation was observed among the experimental groups, with lesser osteoclast seen in group IV with 100 ng/mL of oregano essential oil extract. Thus, it can be concluded that oregano essential oil extract can be utilized as a therapeutic agent that can target bacterial LPS-induced osteoclastogenesis. However, randomized controlled studies should be conducted to assess the potential use of this extract in the periapical bone resorption of endodontic origin.

Objective: The purpose of this study was to evaluate the comparative antibacterial efficacy of 0.2% oregano oil, 2% chlorhexidine (CHX), and 3% sodium hypochlorite (NaOCl) in disinfection of dentin tubules contaminated with Enterococcus faecalis. Materials and Method: One hundred and twenty human extracted anterior teeth were infected with E. faecalis for 21 days. They were assigned into three groups (n = 40) – Group 1: 3% NaOCl, Group 2: 2% CHX, and Group 3: 0.2% oregano oil. Disinfection protocol was followed using 31-gauge side-vented needle. After chemomechanical preparation, the apical 5 mm of the roots was removed frozen in liquid nitrogen and pulverized to expose E. faecalis in dentinal tubules. The number of colony-forming units of E. faecalis per mg dentin was determined. The data were analyzed statistically. Results: Zone of inhibition of oregano oil was found to be 15 mm, and the values were significant in Group III (P < 0.05) as compared to the other groups assessed. Conclusion: Within the study's limitation, 0.2% oregano oil showed better disinfection property against E. faecalis among tested irrigants. Therefore, it can be used as an effective alternative root canal irrigant.

Aim: The aim of the study was to evaluate the tissue inflammatory response of origanum vulgarae, omeprazole, triple antibiotic paste (TAP), and calcium hydroxide in an animal model. Materials and Methods: Seventy Five male Wistar rats were randomly divided into four experimental groups and one control group: Group 1: control (n = 15), Group 2: 0.25 mg origanum vulgarae/1 ml of cellulose (n = 15), Group 3: 2 mg omeprazole/1 ml of distilled water (n = 15), and Group 4: 1 mg TAP/1 ml of distilled water (n = 15), Group 5: 16 mg calcium hydroxide/1 ml of distilled water (n = 15). A trough was made in the periapical bone and the medicament of the respective groups was placed. After the 7th, 14th, 28th and days, the animals were euthanized and tissue specimen was prepared for histological examination. Results: The results were analyzed statistically. On the 7th and 14th days, all the experimental groups showed severe inflammatory response with no statistical significance, whereas on the 28th day, the inflammatory response was graded based on the mean value, in which omeprazole showed moderate inflammatory cells followed by TAP. Mild inflammatory response was seen in calcium hydroxide and origanum vulgarae, showing no statistical significance. Conclusion: Within the limitation of the study, severe inflammatory response was reported on the 7th and 14th days in all experimental groups, whereas on 28th day, there was a moderate inflammatory response seen in omeprazole, followed by TAP. Calcium hydroxide and origanum vulgarae showed a mild inflammatory response.

Aim: The purpose of this study was to determine the chemical composition of oregano essential oil, minimal inhibitory concentration (MIC) and to assess its antimicrobial efficiency against Enterococcus faecalis. Material and Methods: Gas Chromatography and Mass Spectrometry (GC-MS) was used to determine the chemical composition of essential oil from oreganum vulgare. Broth dilution and agar diffusion method was used to evaluate the MIC. For Broth dilution, 100 μL of different concentration of oil (6.25, 12.5, 25.0, 50.0, and 100 μg/ml) was tested. Agar diffusion method was utilized to evaluate the antimicrobial efficiency of different concentration of oil (25.0, 50.0, and 100 μg/mL) against E. faecalis. Results: GC-MS analysis revealed that oregano essential oil contained carvacrol (41.2%), γ-terpinene (12.68%), p-cymene (9.47%), α-terpinene (1.19%) as the major compounds and β–caryophyllene (0.83%), β-linalool (0.67%), β–bisabolene (0.601%), α-pinene (0.6%), β-pinene (0.5%), terpinen-4-ol (0.41%), borneol (0.4%), 3-thujene (0.4%), spathulenol (0.4%), myristicin (0.25%), and apiol (0.14%). The results of the present study reported Oregano essential oil possess antimicrobial activity against E. faecalis. The MIC was 25 μg/ml and the minimum bacterial concentration (MBC) was 50 μg/ml. Conclusion: Oregano essential oil was reported to be an effective antimicrobial agent against E. faecalis. The MIC was found to be 25 μg/ml and the MBC was found to be 50 μg/ml.