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ABSTRACT: Background: The continuous evolution in orthodontics introduces innovative materials and methods to enhance treatment efficacy. Among these advancements, orthodontic anchorage screws, particularly miniscrews, have revolutionized treatments by offering diverse nonsurgical solutions for managing space discrepancies and certain skeletal malocclusions. The success of miniscrews is influenced by various factors including patient-related factors (age, sex, skeletal pattern, and oral hygiene), miniscrew-related factors (diameter, length, shape), and treatment-related factors (technique, applied forces, and insertion site). Materials and Methods: This study used Cone Beam Computed Tomography (CBCT) to evaluate the mandibular buccal shelf area for miniscrew placement across different sagittal and vertical skeletal patterns in 63 subjects, categorized based on the ANB angle and Jarabak ratio into Class I, II, III, and horizontal, average, and vertical growth patterns, respectively. Measurements were taken at specific sites related to the mandibular first and second molars, focusing on angulation, buccal bone depth (4mm and 6mm from the cementoenamel junction), and buccal bone thickness (6mm and 11mm from the cementoenamel junction). Results: There were no significant statistical differences in any measurement between the right and left hemiarches. The values for the bone around the distal root of the mandibular second molar were significantly greater than the other values. With regard to Sagittal Skeletal Pattern, Class I cases showed greater values as compared to Class II and Class III with a significant difference in the angulation, bone depth, and thickness at 11 mm from CEJ. Although values tended to be greater in patients with horizontal growth pattern, the difference was not statistically significant. Conclusion: Mandibular buccal shelf provides an optimal bone site for miniscrew insertion with better osseous characteristics at the distal root of the mandibular second molar. Subjects with skeletal Class I and horizontal growth pattern exhibit the most favorable osseous characteristics in the MBS area. However, in terms of bone thickness at 6 mm from CEJ Class III cases showed significant difference compared to Class I and Class II. [ABSTRACT FROM AUTHOR]

Background: Silver diamine fluoride (SDF) has gained popularity for its caries-arresting properties, yet its tendency to cause esthetic concerns due to black-staining limits its widespread acceptance. Aim: The aim of the study was to evaluate and compare the shear bond strength of Activa BioActive and Giomer restorative material with different protocols of SDF pretreatment on carious dentin. Materials and Methods: Ninety-two extracted teeth were decoronated at the cementoenamel junction, sectioned 1 mm into dentin, mounted in acrylic resin and randomly divided into four (n = 8) control and six (n = 10) experimental groups. Seventy-six samples underwent demineralization process for a period of 14 days for artificial carious dentin (ACD) formation. The samples categorized based on the dentin substrate (sound or ACD) were subjected to various SDF pretreatment protocols, i.e., only SDF, SDF with potassium iodide (KI), and SDF with glutathione (GSH). Further, bioactive restorative materials, i.e., Activa BioActive and Giomer (Beautifil II), were placed on it, and the samples were subjected to shear bond strength testing. Statistical Analysis: Independent t -test was run to analyze the values obtained. Results: Giomer exhibited better mean bond strength with SDF, SDF + KI, and SDF + GSH (6.56, 4.67, and 3.34 mega-pascals [MPa], respectively) compared to Activa BioActive (3.42, 3.27, and 2.96 MPa, respectively). Conclusion: This study contributes to understanding the interplay between SDF application protocols, esthetic concerns, and the adhesive properties of bioactive restorative materials. Giomer exhibited enhanced bond strength after SDF application, unlike Activa BioActive. In addition, incorporation of KI or GSH adversely affected the bond strength of both the restorative materials, underscoring the critical need for cautious clinical application. Clinical Relevance: This study highlights the importance of selecting appropriate dentin pretreatment agents to maximize the bond strength of bioactive restorative materials with carious dentin. SDF application significantly enhanced the bond strength of Giomer with carious dentin compared to Activa BioActive, thus, making it a good choice for restoring nonesthetic areas. In addition, the application of KI or GSH to mitigate discoloration of carious dentin negatively affected the bond strength of both, Activa BioActive and Giomer. Thus, the clinicians should weigh the benefits of SDF against potential bond strength reductions when using KI or GSH, especially for esthetic restorations. [ABSTRACT FROM AUTHOR]

Aim: This study aims to compare and evaluate the fracture resistance of endodontically treated maxillary anterior teeth restored using new postplacement techniques. Methodology: Forty-five single-rooted maxillary anterior teeth (n = 15) were selected and decoronated at the cementoenamel junction. The working length was determined using a 15K file. Biomechanical preparation was done up to size 70 and the teeth were obturated. After 1 week, the root-filling material, gutta-percha, was removed, and postspace was prepared using a size 3 and 4 peeso reamer. The samples were divided into three groups (n = 15). Group I: Coltene Tenax fiber Post-reinforced with composite (anatomical post). Group II: Coltene Tenax fiber postreinforced with a leno-woven polyethylene; Ribbond fibers. Group III: Coltene Tenax fiber Post-luted with a dual cure cement. After postcementation, core buildup was done. Fracture resistance was measured using a universal testing machine. Results: Statistical analysis was done using one-way analysis of variance and Tukey's post hoc tests. A statistically significant difference was seen in the mean maximum load (N) between the groups. Group I showed the highest mean maximum load (N), followed by Group II and Group III. A significant P value (P = 0.025) was noted. Conclusion: Coltene Tenax fiber postreinforced with composite (anatomical post) showed the highest fracture resistance in endodontically treated maxillary anteriors. [ABSTRACT FROM AUTHOR]

Aim: To evaluate efficacy of three root canal irrigation protocols (2.5% NaOCl followed by 17% EDTA, 0.5% BioAKT, and Dual Rinse HEDP) on canal debridement using scanning electron microscope. Materials and methods: Forty-five single rooted human mandibular premolars with nearly straight single canals were selected, the crowns of all teeth were removed near the level of cementoenamel junction to obtain approximately 14±1 mm uniform root lengths. After instrumentation with ProTaper Universal rotary files up to F4 (40/06), roots were randomly divided into three equal groups (n = 15) according to the final irrigation protocol. Group I: samples were finally rinsed with 5 ml of 2.5% NaOCl for 2 min, followed by distilled water, then 5 ml of 17% EDTA for 1 min. Group II: samples were finally rinsed with 5 ml of 0.5% BioAKT for 3 min. Group III: 5 ml of dual rinse HEDP was used for 3 min. Canal cleanliness was evaluated using scanning electron microscope with magnification of ×1000. Results: Group III and group II had the best cleanliness of the root canal while group I had the worst result. There were statistical significant differences between group I versus group II and group III (P ≤ 0.05) while there was no significant difference between group II versus group III. Regardless the final irrigation method, the coronal and middle thirds showed less amount of smear layer and remaining debris than the apical third. Conclusion: None of the tested final irrigating protocols resulted in completely clean canal wall. BioAKT and Dual Rinse HEDP showed significant reduction in smear layer and remaining debris compared to NaOCl followed by EDTA irrigation protocol. [ABSTRACT FROM AUTHOR]

The article discusses the color change of Omnichroma composite resin restoration when exposed to different stains. Omnichroma is a composite resin that uses Smart Chromatic Technology to match any tooth shade, reducing the need for shade selection processes. The study compared Omnichroma with Tetric Evoceram composite resin and found that Omnichroma maintained color match with teeth after exposure to staining solutions, while Tetric Evoceram showed significant color mismatch. The results suggest that Omnichroma's chameleon effect allows it to adapt to the surrounding tooth color, providing a natural appearance. [Extracted from the article]

Aim: The present study aims to evaluate the irrigant penetration in extracted single-rooted teeth using various irrigant activation systems in different tapered preparations. Methods: One hundred and twenty-four single-rooted teeth were selected for the present study. They were standardized at the level of cementoenamel junction and shaped to 30 size using 4% and 6% taper rotary instruments under a standard irrigation regimen. Once the complete root canal preparations were done based on activation protocols, they were divided into four groups as Group 1: Four percent preparation sonic activation (n = 31), Group 2: Six percent preparation sonic activation (n = 31), Group 3: Four percent preparation ultrasonic activation (n = 31), and Group 4: Six percent preparation ultrasonic activation (n = 31). A radiopaque solution in conjunction with radiography was utilized to evaluate the penetration of irrigants into the canal. Radiographs were taken after dye injection to measure the length of irrigant penetration in each technique. Results were statistically analyzed using SPSS software. One-way ANOVA and Post hoc Tukey tests were performed. Results: The results of the study revealed that ultrasonic activation after 6% taper instrumentation was better followed by ultrasonic activation after 4% taper instrumentation (P < 0.05). The results revealed a statistically significant difference (P < 0.05) between the irrigation techniques. Conclusion: Ultrasonic irrigant activation proved to be a better and an effective technique for cleaning the root canal. [ABSTRACT FROM AUTHOR]

Aim: The adhesion ability of filling materials to the root canal wall can be affected by the intracanal medicaments. The present study investigated the effect of pretreatment with nano-calcium hydroxide and calcium hydroxide on the bond strength of Endoseal mineral trioxide aggregate (MTA) to root canal dentin. Methods: Fifty maxillary incisor teeth were randomly divided into two experimental groups (n = 20) and a control group (n = 10) after decoronation near the cementoenamel junction and root canal instrumentation according to the type of intracanal medicament (calcium hydroxide and nano-calcium hydroxide). Each experimental group was divided into two subgroups based on manual and ultrasonic drug removal methods. After removing intracanal medicaments and irrigating them, all the groups were obturated with gutta-percha and Endoseal MTA sealer. Then, the samples were sectioned into cross-sections with a thickness of 2 mm using a diamond disc, and the push-out bond strength test was performed on them. Results: The results showed no significant difference in the mean Endoseal MTA bond strength in terms of the type of intracanal medicament and the method used to remove it from the canal (P > 0.05). Conclusion: Using the ultrasonic method compared to the manual method in removing intracanal medicament resulted in no significant difference in the strength of the Endoseal MTA bond. Furthermore, the effect of nanoparticle calcium hydroxide on Endoseal MTA bond strength was not different compared to the conventional type of this medication. [ABSTRACT FROM AUTHOR]

Aim: This in vitro study was designed to compare the effect of blood contamination on the push-out bond strength of mineral trioxide aggregate (MTA), Biodentine, and bone cement. Methods: Seventy-eight human mandibular molars with furcation were selected and decoronated at the cementoenamel junction. The samples were mounted 3 mm below the furcation area into the acrylic resin. A perforation in the center of the furcation was made using a round carbide bur size 3 with a diameter of 1.2 mm. Then, the perforation was enlarged up to a standardized diameter of 1.3 mm using a size 5 Gates-Glidden drill. The samples were randomly divided into three groups. Based on blood contamination status, each group (n = 26) was further subdivided into two subgroups (n = 13). Whole fresh human blood was obtained from the principal investigator of the research group. A 27-gauge syringe was used to inject blood into the perforated furcal area. A piece of gelatin was packed under the furcal area using a condenser. MTA, Biodentine, and bone cement were mixed according to the manufacturer's recommendations and compacted into the perforation. A universal testing machine was used to evaluate the push-out bond strength. The results were analyzed using one-way analysis of variance followed by Tukey's post hoc test (P < 0.05). Results: In the experimental groups with blood contamination, Group 2A exhibited statistically significant push-out bond strength values compared with Group 1A and Group 3A. In the groups without blood contamination, Group 2B showed statistically significant push-out bond strength values compared with Group 1B and Group 3B. Irrespective of the blood contamination status, Group 3 exhibited higher push-out bond strength values than Group 1, with no statistically significant difference between the groups. No significant difference was observed within the groups. Conclusion: Biodentine showed promising results as a better perforation repair material irrespective of the status of blood contamination. Bone cement can be a viable alternative material for furcation perforation repair compared with MTA. [ABSTRACT FROM AUTHOR]

Introduction: Clinical practice demands understanding the complexity of the root canal system to achieve desired treatment goals. The statistically detailed morphology of the tooth and root canal morphology is very important to know. Therefore, the present study aims to investigate the statistical analysis of root canal morphology and morphological variations of maxillary and mandibular incisor teeth using cone‑beam computed tomography (CBCT) in Saudi patients attending King Saud University Dental Hospital. Materials and Methods: CBCT images of 480 patients were selected. Number of roots and root canal configuration were identified and categorized according to Vertucci’s classification. Tooth length, distance from cementoenamel junction (CEJ) to the area of canal division, and width of the canal at the area of division were also evaluated. Bilateral symmetry and association between gender and age with the different variables were investigated. Data were analyzed using Chi‑square, multiple linear regression, and McNemar’s tests. Results: A total of 3412 teeth were evaluated. All maxillary teeth had one root with Type I canal configuration. For mandibular teeth, all exhibited one root with the majority having Type I canal configuration in central (71.2%) and lateral (75%) incisor teeth. There was a statistically significant association between number of canals and age in mandibular incisor teeth observed only in females (P < 0.001), while no association was observed between canal configuration and gender (P = 0.900 and P = 0.721, respectively). Multiple regression analyses showed that age and gender significantly explain the difference of the variance in tooth length (P < 0.001). Moreover, bilateral symmetry was observed in 98.1% of mandibular central and 97.6% of lateral incisor teeth with no statistically significant association (P = 1 and P = 0.058, respectively). Conclusion: All maxillary and most mandibular incisor teeth present with one root and Type I canal configuration. In general, males have longer teeth than females, with a significant decrease in length with each year increase in age. Mandibular lateral incisor teeth exhibited the highest mean distance from CEJ to point of canal separation and highest mean width in the area of canal division. [ABSTRACT FROM AUTHOR]

Context: Effective endodontic treatment relies heavily on proper instrumentation, thorough disinfection, and precise three-dimensional obturation of the root canal system. Aims: This study aims to evaluate and compare continuous chelation (etidronic acid and sodium hypochlorite [NaOCl]) and sequential chelation (citric acid and NaOCl) on the dentinal tubule penetration of bioceramic-based sealer (Bio-C)-A confocal laser scanning microscopic study. Settings and Design: In vitro experimental study. Subjects and Methods: Sixty extracted permanent single-rooted teeth were selected and decoronated below cementoenamel junction to get a standardized length of 12 mm across all samples followed by enlargement of root canals till rotary ProTaper F3. The samples were randomly divided into three groups: Group I (control): Canals were irrigated with 3 mL 17% ethylenediaminetetraacetic acid/3 mL 3% NaOCl; Group II: Canals were irrigated with 10 mL etidronic acid + NaOCl solution; and Group III: Canals were irrigated with 3 mL 10% citric acid followed by 3 mL 3% NaOCl. 0.1% rhodamine B dye was mixed with Bio-C sealer followed by obturation. All the samples were subjected to confocal laser scanning microscopy evaluation. Statistical Analysis Used: One-way analysis of variance with the Bonferroni post hoc test was used for the statistical analysis. The level of significance was set at P < 0.05. Results: The pairwise comparison of depth of penetration showed statistically significant results in all the coronal, middle, and apical thirds. Group II showed better depth of penetration than Groups I and III. Conclusions: Continuous chelation protocol using etidronic acid and NaOCl showed greater and statistically significant sealer penetration depth when compared to the sequential chelation protocol, i.e., citric acid at all three levels. [ABSTRACT FROM AUTHOR]

Context: Endodontic success hinges on a multifactorial interplay, with meticulous canal shaping, proper disinfection, and three-dimensional obturation being paramount. Among these factors, the amount of dentin remaining after instrumentation directly influences the biomechanical resilience and longevity of the tooth. Aims: This study aims to evaluate the impact of various rotary instrumentation systems, including single-file, two-file, and multiple-file configurations, on the remaining dentin thickness (RDT) following canal preparation. Settings and Design: This was an in vitro study, original research article. Materials and Methods: Sixty mandibular premolar human extracted teeth were decoronated at the cementoenamel junction with a diamond disc. Samples were randomly assigned to three groups using a simple random sampling technique (n = 60). Group I - Single-file system (One Curve, MicroMega) (n = 20), Group II - Two-file systems (2Shape, MicroMega) (n = 20), and Group III - Multiple-file system (Hero Gold, MicroMega) (n = 20). Preoperative cone-beam computed tomography (CBCT) scans were obtained after the sample was mounted on a modeling wax sheet. The biomechanical preparation of canals followed the manufacturer's protocols for every system. Postoperative CBCT scans were obtained. Pre- and postoperative scans were compared at standardized depths (4 mm, 7 mm, and 11 mm) within the canals (coronal, middle, and apical thirds), allowing for a comprehensive assessment of RDT throughout the canal. Statistical Analysis and Results: According to one-way ANOVA, the highest mean was seen in Group I, followed by Group II and Group III. Hence, a statistically significant difference was found between all the groups. Post hoc Tukey's test was done for intergroup comparison. Conclusions: A single-file system preserved more dentin with less aggressive cutting compared to two-file and multiple-file systems. [ABSTRACT FROM AUTHOR]

Aim: The objective of the present research was to assess and compare the residual dentin thickness after biomechanical preparation of teeth using three distinct rotary nickel-titanium (Ni-Ti) file systems. Materials and Methods: In the current experimental study, a total of 45 single-rooted teeth were selected for the analysis. The cementoenamel junction of each tooth was decoronated using a diamond disc. The teeth were randomly allocated to three groups, with each group representing a different rotary file system: Group 1: Hero GOLD (Micro Mega), Group 2: One Curve (Micro Mega), and Group 3: HyFlex electro-discharge machining (EDM) (Coltene-Whaledent, Altstatten, Switzerland). To evaluate the initial condition of the teeth, cone-beam computed tomography (CBCT) scans were conducted before the biomechanical preparation. The teeth were positioned on a modeling wax sheet, and the CBCT scans provided baseline measurements. The biomechanical preparation of the root canals followed the manufacturer's recommended guidelines for each file system. After the completion of the canal preparation, follow-up CBCT scans were conducted. The postprocedure CBCT scans were then compared with the initial scans to assess any changes in the residual thickness of dentin in the teeth. Statistical Analysis: Post hoc Tukey analysis of variance tests was utilized to examine differences between the groups. A statistically significant result was defined as P = 0.05 or less for every test. Results: The comparison of preinstrumentation and postinstrumentation CBCT images showed that the HyFlex EDM group removed less dentin clinically compared to the other two groups, i.e., Hero GOLD and One Curve. No significant statistical difference was found between Hero GOLD versus One Curve, One Curve versus HyFlex EDM, and Hero GOLD versus HyFlex EDM. Conclusion: Based on the results of this study, the HyFlex EDM file system exhibited superior cutting efficiency at various levels. Nonetheless, additional investigations are required to comprehensively assess the influence of Ni-Ti rotary file systems on the remaining dentin thickness. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to know the clinical and radiographic outcomes of regenerative endodontic procedures of immature versus mature in young permanent incisors with apical periodontitis. Methods: Twenty non-vital, young permanent incisors with traumatic exposure between the age of 7 and 13 years were taken. Patients were divided into two groups: Group I – immature (number of teeth included = 10) and Group II – mature (number of teeth included = 10). The procedure was performed by the blood clot method as a scaffold. Biodentine (about 2–3 mm) was placed as a capping material at the cementoenamel junction. Evaluation was based on the clinical (pain, sinus, tender on percussion, swelling, mobility, intact restoration) and radiographical (Nolla stage, thickening of walls, lamina dura continuity, calcification of pulp chamber and canal, periapical healing, PAI score) parameters. Results: All 19 teeth were clinically asymptomatic after the 12-month follow-up. Radiographically, the percentage of continuous root development (in the immature group) was 100% at 12 months (P = 0.000**). Radiography revealed a reduction in the PAI scores at 12 months in the immature and mature groups. None of the treated teeth responded to the cold test after a 12-month follow-up. One patient did not come for intervention in the mature group. All the statistical tests (Chi-square, Mann–Whitney U-test, and Fisher's exact test) were performed at a 5% significance level. Conclusion: Outcomes did not differ significantly between immature and mature groups. [ABSTRACT FROM AUTHOR]

Aim: This study aims to evaluate the microleakage between the gingival seat and base material and to assess the interface integrity between the base material and overlying composite in class II cavities restored using deep margin elevation. Materials and Methods: Thirty maxillary molars (n = 30) were taken, and class II cavities were prepared with a gingival seat extending below the cementoenamel junction. These teeth were divided into three groups for subgingival margin elevation using different materials: Group A (n = 10) - flowable composite, Group B (n = 10) - glass ionomer cement (GIC), and Group C (n = 10) - GIC with nanohydroxyapatite (GIC n-HAp). The remaining cavities were restored with bulk-fill composite. After undergoing 1000 thermocycling cycles, half of the samples were examined for microleakage using confocal laser microscopy, and the other half were assessed for interface integrity using scanning electron microscopy. Microleakage was statistically analyzed by one-way ANOVA, and interface integrity was analyzed by Kruskal-Wallis tests. Results: The study found that GIC n-HAp exhibited significantly lower microleakage between the base material and gingival seat than flowable composite and GIC. However, regarding interface integrity between the base material and bulk-fill composite, flowable composite, and GIC outperformed GIC n-HAp. Conclusions: Incorporating n-HAp into GIC effectively reduced microleakage at the dentin-base material interface. However, the interface integrity between GIC n-HAp and the composite poses a challenge. [ABSTRACT FROM AUTHOR]

Background: Composites with 0.2% chitosan nanoparticles (CSN) are used recently; however, this combination needs to be studied in different cavity designs. Aims: The aim of the study was to compare the fracture resistance of maxillary premolars with different cavity geometries restored with different types of composite resins incorporated with 0.2% CSN. Methods: About 130 extracted human single-rooted maxillary premolars were embedded in acrylic molds 2 mm below cementoenamel junction, divided into five groups for cavity preparations of standardized dimensions. Group 1: (control) intact teeth (n = 10), Group 2: Class I cavities (n = 40), Group 3: Class II mesio-occlusal (MO) (n = 40), Group 4: Class II mesio-occluso-distal (MOD) (n = 40). Groups 2, 3, and 4 were subdivided into four subgroups for composite restoration; A: Neo spectra ST-Universal (NST); B: Tetric N-Ceram Bulk-fill (TNC); C: NST + CSN; and D: TNC + CSN and tested for fracture resistance using universal testing machine. Statistical Analysis: One-way analysis of variance and post hoc Tukey's tests were used for data analysis (P ≤ 0.05). Results: In all groups, the highest fracture resistance was found in MOD cavities, followed by MO and least in Class I cavities. Subgroup D (TNC with CSN) showed the highest fracture resistance in all groups (P ≤ 0.05). Conclusion: Tetric N-Ceramic bulk fill with 0.25% CSN showed high fracture resistance in cavities with different geometries. [ABSTRACT FROM AUTHOR]

Introduction: Long-term success of any indirect restorations such as pediatric crowns depends on the accuracy of the crown margins, because an acceptable fit at the margins will promote gingival health and protects the tooth from physical, chemical, bacterial, and thermal injury. Taking this into consideration, the present study was designed to assess the marginal fit of two tooth colored preformed pediatric crowns in primary teeth. Materials and methods: A total of twenty-eight extracted human primary molars were selected and divided into two groups: (n = 14) Group I (Zirconia crowns) and Group II (Fiberglass crowns). Tooth preparation was done to receive their respective crown, which was cemented using resin-modified glass ionomer luting cement. Following cementation, the teeth were sectioned 1 mm below the cementoenamel junction, thermocycled, and viewed under stereomicroscope at 100× magnification. The marginal gap was measured on the four sides of the crown (buccal, lingual/palatal, mesial, distal) from stereomicroscopic photographs using MICAPS image analyzer software. Results: Statistical analysis was done using Mann–Whitney U -test. It was observed that Group I samples showed better marginal fit values when compared to Group II samples on all the aspects. Conclusion: Both zirconia and fiberglass crowns are good options for full coronal restorations in primary teeth. However, zirconia crowns were found to be more acceptable in terms of its adaptability and esthetics. [ABSTRACT FROM AUTHOR]

Background: Antioxidant application soon after bleaching process increases the shear bond strength (SBS) of composite resin to enamel. Aims: The aim of the study was to evaluate the antioxidant effects of selenium alone and in combination with alpha-tocopherol (αT) and green tea (GT) on SBS of composite resin to enamel following in-office bleaching with 38% hydrogen peroxide (HP). Methods: Sixty extracted human single -rooted premolar teeth were cleaned and embedded in acrylic resin blocks at the level of cementoenamel junction(CEJ) followed by bleaching with 38% hydrogen peroxide (HP) and arbitrarily divided into seven groups (n=10) for antioxidant application: Group I (negative control): intact teeth, Group II (positive control): only bleaching, Group III: 10% selenium (Se), Group IV: 10% alpha tocopherol (αT), Group V: 10% αT +10% Se, Group VI: 10% Green tea (GT), Group VII: 10%GT+10% Se. In all groups, self-etch adhesive was applied and composite restoration was done, and specimens were stored in distilled water for 24h followed by SBS evaluation. Statistical Analysis: One-way analysis of variance and post hoc Tukey's tests were used (P < 0.05). Results: The highest SBS was found in negative control Group I (intact teeth) and least in positive control Group II (bleached teeth), whereas in experimental groups, Group VII (GT + Se) showed highest followed by Groups V (αT + Se), III (Se), and VI (GT) and least in Group IV (αT). Conclusion: Combination of selenium with green tea and alpha tocopherol enhanced the SBS of composite resin following in-office bleaching. [ABSTRACT FROM AUTHOR]

Background: An endodontic treatment is considered a success after thorough chemomechanical debridement coupled with obturating root canals in a concrete way thereby providing hermetic seal. Gutta-percha being nonadherent necessitates use of a sealer to achieve hermetic seal. Adequate adhesion of root canal sealer with gutta-percha core and radicular dentin ensures lack of apical leakage. Materials and Methods: Sixty extracted mandibular premolars with single root canal decoronated at cementoenamel junction were selected and randomly allocated to two groups (n = 30). Samples in Group 1 were prepared with BT Race file, while Group 2 samples were prepared with BT Race alongwith XP Endo file. Absorbent paper points were used for canal drying and samples were randomly divided into six subgroups. In Subgroup I, obturation was done with bio-ceramic (BC) sealer (Endosequence BC) and BC gutta-percha. In Subgroup II, resin-based (AH plus) sealer and gutta-percha were used. In Subgroup III, calcium hydroxide-based (Sealapex) sealer and gutta-percha were used. Sectioning of root samples was done perpendicularly into coronal, middle, and apical segments of 3 mm each. A universal testing machine was used for sample testing, in which push-out bond strength corresponded to the highest value obtained. Stereomicroscopic (×20) study of the samples determined the failure mode at dentin/sealer/main cone interface. Statistical Analysis: Analysis of variance and post hoc Tukey's tests were used for data analysis. Results: Endosequence BC with XP-Endo files showed the highest mean push-out bond strength (16.31 MPa), whereas Sealapex without XP-Endo file had the lowest values (12.76 MPa). Mixed failure of adhesive and cohesive mode was observed for most samples. Conclusion: Adjunctive irrigation agitation technique utilizing XP-Endo Finisher facilitates biofilm eradication from difficult niches in root canals, thereby improving adhesion of sealer and subsequently the sealer bond strength. [ABSTRACT FROM AUTHOR]

Objective: This study was designed to assess the effect of multiple coronal postendodontic restoration techniques on the ability to resist fracture and failure pattern of endodontically treated maxillary premolars having mesioocclusodistal (MOD) cavities. Materials and Methods: A total of 65 two-rooted maxillary premolars were taken and randomly divided into five groups (n = 13). In all teeth except the control group, MOD cavities were prepared, and endodontic treatment was carried out. Each tooth was embedded in a cold cure acrylic resin cylinder 2.0 mm below the cementoenamel junction. Groups were classified as follows; Group 1: Intact teeth (control), Group 2: Resin-restored group (CR), Group 3: Post and resin group (HFP + CR), Group 4: Resin and post group (CR + HFP), and Group 5: Polyethylene fiber (Ribbond) and post group (PEF + HFP + CR). Tooth samples with resin were loaded in a universal testing machine until fracture occurred. Loads at which fracture occurred were recorded, fracture patterns were analyzed, and statistical analysis was done (α = 0.05). Results: In Groups 1 and 5, maximum fracture resistance was observed, without any significant difference between these two groups (P > 0.05). No statistically noteworthy difference was detected between Groups 2 and 4 ( P > 0.05). The fracture resistance of Groups 1 and 5 was significantly greater than Groups 2, 3, and 4 ( P < 0.05). Group 3 had the least fracture resistance ( P < 0.05). In all the groups except Group 3, a maximum number of fractures were favorable. Conclusion: Utilization of horizontal fiber post along with polyethylene fibers significantly increases the fracture resistance of endodontically treated premolars with MOD cavities. Placement of horizontal fiber post before restoration of tooth leads to a greater number of unfavorable fractures. [ABSTRACT FROM AUTHOR]

Background: Gingival recession is defined as the apical migration of gingival margin to the cementoenamel junction. Recently, amnion membrane, the third-generation membrane which is a placental-derived tissue, has been introduced. Materials and Methods: Study included 45 subjects with age group of 20--60 years of both genders. Patients with Miller's Class I and Class II gingival recession were selected for the study. The progress was assessed at baseline one, three, and six months observation interval through clinical parameters RD, RW, PD, and CAL at the end of six months. Results: Recession depths in the first, third, and sixth month were 1.82 ± 0.442, 1.31 ± 0.47 mm, and 0.91 ± 0.29, respectively, which showed a significant reduction from the baseline. Recession widths in the first, second, and third weeks were 3.04 ± 0.442 mm, 1.31 ± 0.47 mm, and 1.49 ± 0.59 mm, respectively. There was a statistically significant reduction (P > 0.005) when compared to the baseline. Pocket depths in the first, third, and sixth month were 0.93 ± 0.447, 0.42 ± 0.50, and 0.24 ± 0.43 (P > 0.005) which is significant when compared to baseline. Clinical attachment levels in the first, third, and sixth month were 2.73 ± 0.751, 1.78 ± 0.70, and 1.18 ± 0.53 (P > 0.005) which is significant compared to six months. Conclusion: Within the limitations of the present study, the data obtained by periodic assessment of the clinical parameters indicate the use of amnion membrane and hyaluronic acid, and proper technique may thus be the panacea for root coverage procedure. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to evaluate and compare the pericervical dentin preservation and fracture resistance of root canal-treated teeth with rotary endodontic file systems of different types of taper. Subjects and Methods: Thirty-two single-rooted human-extracted premolars were used. They were mounted in wax, and preoperative cone-beam computed tomography (CBCT) scans were taken with 11 × 8 Field of view (FOV). The evaluation of the pericervical dentin thickness was done at the cementoenamel junction level. After pre-CBCT, the 32 samples were divided into four groups (n = 8) – Group A: fixed tapered hand files, Group B: variable regressive tapered TruNatomy, Group C: progressive tapered ProTaper Gold, and Group D: fixed tapered HyFlex EDM. Following instrumentation, postoperative CBCT scans were taken to evaluate pericervical dentin thickness. Obturation was done and access cavity was restored with composite. Fracture strength was checked for all the samples using "universal testing machine" until fracture, and calculated in newtons (N). Statistical Analysis Used: Student's t -test and ANOVA test, along with Tukey's post hoc analysis, were used for comparing mean values between the groups, and P < 0.05 was considered statistically significant. Results: The results of this study showed that there is no statistically significant difference in preserving pericervical dentin with file system of different types of taper and fracture resistance between the groups. Conclusions: Within the limitations of the study, it was concluded that different types of file taper systems used for root canal preparation have no significant effect on the preservation of pericervical dentin and fracture resistance of teeth. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the effectiveness of ultrasonic activation of ethylenediaminetetraacetic acid (EDTA), maleic acid (MA), and fumaric acid (FA) in combination with sodium hypochlorite (NaOCl) on postendodontic treatment root fracture toughness. Materials and Methods: Forty single-rooted mandibular premolars were sectioned below the cementoenamel junction and were kept on average 14 mm long. With the exception of eight randomly selected teeth acting as a negative control group (Group I/nonprepared), the rest were prepared till F3. Thirty-two specimens were randomly placed into four groups equally and then irrigated using the final irrigation protocols. Saline and NaOCl were used to irrigate Group II, 17% EDTA and NaOCl were used to irrigate Group III, 7% MA and NaOCl were used to irrigate Group IV, and 0.7% FA and NaOCl were used to irrigate Group V. The irrigants were ultrasonically activated in every group. The root canals were obturated with gutta-percha and AH Plus sealer. The roots were embedded along the long axis in the self-curing acrylic blocks along with polyvinyl siloxane, leaving the coronal 2 mm of the root exposed. The specimens were tested using a universal testing machine. Statistical Analysis: The Post hoc Tamhane's and one-way ANOVA tests were applied to examine the data. Results: The result of the study revealed that 0.7% FA (598.09 N) provided better root fracture resistance than EDTA (428.07 N) and MA (511.87 N). Conclusion: The conclusion derived from the study was that 0.7% FA provided better fracture resistance of endodontically treated teeth when compared to 17% EDTA and 7% MA. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate and compare the effect of 17% liquid ethylenediaminetetraacetate (EDTA), 10% citric acid, and 9% 1-hydroxy ethylidene-1,1-bisphosphonate (HEBP) on the microhardness of root canal dentin. Materials and Methods: Eighteen mandibular premolars which were freshly extracted were selected and randomly assigned to one of the three groups (n = 6). After decoronating, the teeth at the cementoenamel junction, specimens were prepared up to F3 (ProTaper Universal). After each instrument, irrigation was done with 3% sodium hypochlorite. Specimens were sectioned longitudinally to expose dentin surface and mounted on acrylic resin blocks. One half served as the test group and the other served as its control. The dentin was covered with test solutions throughout its length for 5 min. Group 1: 17% liquid EDTA, Group 2: 10% citric acid, and Group 3: 9% HEBP. Measurement of microhardness was done using Vickers indenter at 1000 μm, 1200 μm, 1400 μm from orifice of root canal and 100 μm from pulp-dentin junction, a load of 50 g for 15 s dwell time was applied. A mean of the three readings was used to calculate microhardness. Statistical analysis was performed using one-way ANOVA and post-hoc Tukey test at P ≤ 0.05. Results: The mean microhardness of EDTA reduced from 52.28 VHN to 39.00 VHN, and that of citric acid reduced from 52.50 VHN to 47.30 VHN, whereas, HEBP showed least reduction, from 52.46 VHN to 50.52 VHN. Conclusion: A reduction in microhardness was evident on using all three chelating agents. However, HEBP caused the least reduction in microhardness and can be a potential chelating agent for use in endodontics. [ABSTRACT FROM AUTHOR]

Introduction: The study evaluated the influence of coronal restoration after pulpotomy on the strength of electrical stimulus reaching the radicular pulp using an electric pulp test (EPT). Materials and Methods: The pulp tissue from ten freshly extracted mandibular premolar teeth was removed and replaced with an electroconductive gel. The cathode probe of Powerlab was inserted into the pulp space and the anode probe was attached to the EPT handpiece. The EPT probe coated with electro-conducting material was positioned in the middle third of the buccal crown surface. The EPT stimulus reaching the pulp space of an intact tooth at 40 numerical readings was recorded. The tooth was removed from model and endodontic access was made. The 2-mm thick mineral trioxide aggregate was placed at the cementoenamel junction followed by composite resin restoration. The experimental setup was re-established and postpulpotomy EPT stimulus data were recorded. The data collected were compared using the Wilcoxon signed-rank test. Results: There was a statistically significant difference (P = 0.038) between observed between the strength of EPT stimulus reaching the pulp space in prepulpotomy (mean 91.18 ± 101.02 V and median 25.79 V) and postpulpotomy (mean 58.49 ± 77.13 V and median 13.75 V) tooth samples. Conclusion: The placement of the restoration and pulp capping agent after pulpotomy dampens the strength of EPT stimulus reaching the pulp canal space. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to compare the root reinforcement potential of different light cured intraorifice barriers (TheraCal, lime-lite, lonoseal and resin-modified glass-ionomer [RMGI] [Fuji II LC]) with or without bonding agent placed in the orifice of endodontically treated and bleached teeth. Materials and Methods: In this experimental in vitro study, single-rooted bovine teeth were instrumented and obturated with gutta-percha. Except the control group, in other specimens, gutta-percha was removed 3 mm under cementoenamel junction.Then, the specimens were divided into seven groups according to the bases was applied: TheraCal LC, TheraCal LC with bonding agent, Lime-Lite, Lime-Lite with bonding agent, lonoseal, lonoseal with bonding agent, and RMGI (Fuji II LC). After internal bleaching, the teeth were decoronated. Then, all the groups were subjected to fracture resistance testing using Universal Testing Machine. For evaluating fracture resistance, analysis of variance and Tukey's test were used and for comparing the mode of fracture fisher test was applied in SPSS software. The significance was determined at (α = 0.05) confidence interval. Results: The group of TheraCal LC with bonding agent showed better fracture resistance as compared to the control group (P = 0.004). Although there was no statistically significant difference in the pairwise comparison between the other groups. Conclusion: TheraCal LC with bonding agent can be used as intraorifice barriers with good fracture resistance in endodontically treated and bleached teeth. [ABSTRACT FROM AUTHOR]

Aim: This in vitro study aimed to compare the fracture resistance of simulated immature permanent teeth restored with apical plugs of mineral trioxide aggregate (MTA), Biodentine, and bone cement. Methods: Forty-eight single-rooted human maxillary central incisors were selected and decoronated 6 mm above and 9 mm below the cementoenamel junction to simulate the immature teeth. Based on weight and homogeneity, the samples were distributed into three experimental groups (n = 12) and one control group (n = 12). In all the experimental group samples, a peeso reamer size 5 was stepped out 1 mm beyond the apex to enlarge the apices to a diameter of 1.5 mm. Apical plugs of MTA Plus (Prevest DenPro Limited, India), Biodentine (Septodont, France), and Bone cement (Surgical Simplex P, Stryker, Australia) were placed to 4 mm, and obturation was done using gutta-percha and AH Plus® sealer (Dentsply DeTrey, Konstanz, Germany). The force was applied at 45° angulation until fracture, using the universal testing machine. The results were analyzed using a one-way analysis of variance followed by Tukey's post hoc test at a 95% confidence level. Results: The Biodentine group showed a statistically higher fracture resistance value than the MTA Plus and bone cement group (P = 0.014 and P = 0.016, respectively). No statistically significant difference was reported between MTA Plus and the bone cement group. Conclusion: Within the limitations of this study, using Biodentine as an apical plug increases the fracture resistance of immature teeth. Bone cement can be used as a viable alternative to MTA. [ABSTRACT FROM AUTHOR]

Aim: The quality of obturation with recent capillary condensation technique and hybrid technique in teeth with artificial internal resorption cavity needs to be evaluated. Methods: Calculation of sample size was done with G*Power software (version 3.1.9.4) (effect size d = 1.46). Eighteen single-canal mandibular premolars were decoronated at the cementoenamel junction for standardization of specimen length as 12 mm. Biomechanical preparation was done with ProTaper Universal rotary file up to F4. Internal resorption cavity was prepared with #08 size round bur 6 mm from the apex. Samples were distributed randomly into two groups. Group I: teeth with bioceramic sealer (EndoSequence BC Sealer, Brasseler, USA) application using conventional technique and hybrid technique of obturation. Group II: capillary condensation technique of bioceramic sealer (EndoSequence BC Sealer, Brasseler USA) using single-cone gutta-percha obturation. The voids in three segments of the root canal were measured with cone-beam computed tomography using "OnDemand3D App" software. Data were statistically analyzed by one-way analysis of variance (ANOVA) and multiple comparisons of Tukey honestly significant difference tests with P < 0.05. Results: The mean area of the void was 0.3963 ± 0.3299 mm2 for Group I and 0.4022 ± 0.4101 mm2 for Group II. There was a difference in the number of voids present in different sections of the root within a group with significance but not between the groups. Conclusion: Capillary condensation technique with single-cone obturation is comparable to conventional sealer application and hybrid technique of obturation for filling internal resorption cavity. [ABSTRACT FROM AUTHOR]

Background: Rotary and ultrasonic instruments are not appreciable in the complete removal of Biodentine from root canals. Therefore, organic solvents can be used as an adjunct for its retrieval. Aim: The aim of this study was to compare the efficacy of 10% citric acid, 2% acetic acid, and 20% tartaric acid on the microhardness of Biodentine and radicular dentin. Materials and Methods: Forty single-rooted extracted teeth were decoronated at the cementoenamel junction and root canals were prepared with peeso reamers. Two-millimeter sections were obtained and restored with Biodentine. All samples were subjected to Vicker's microhardness test to record the microhardness of Biodentine and radicular dentin. Samples were randomly divided into four experimental groups and treated with (n = 20) – distilled water, 10% citric acid, 2% acetic acid, and 20% tartaric acid groups for 10 min, after which specimens were again subjected to the same microhardness test. Statistical Analysis: The data were subjected to Kruskal–Wallis ANOVA test, followed by Wilcoxon signed-rank test with a level of significance set at P ≤ 0.05. Results: 10% citric acid followed by 2% acetic acid exhibited the lowest mean microhardness values after immersing in respective solutions, whereas 20% tartaric acid exhibited the highest mean microhardness values on Biodentine and radicular dentin. Conclusion: 10% citric acid can be used for retrieving Biodentine from root canals for a limited time without adversely affecting the physical and chemical composition of radicular dentin. [ABSTRACT FROM AUTHOR]

Context: Nano-calcium hydroxide (NCH) has been proven to have several advantages over normal calcium hydroxide, supporting in its possible use as an intracanal medicament. Aim: The aim is to evaluate and compare calcium ion release and pH change using NCH with different vehicles as intracanal medicament. Subjects and Methods: Sixty freshly extracted premolars were decoronated at the cementoenamel junction level and the length was standardized. Canals were enlarged to F3 size using protaper rotary system. The samples were divided into three groups (n = 20), namely NCH + distilled water (Group 1), NCH + propylene glycol (Group 2), and NCH + chitosan (CT) (Group 3). Each sample was suspended in 6 ml of distilled water using silicone putty with only the apical third of the roots immersed. The pH and calcium ions were assessed at 24 h, 7 days, 15 days, and 30 days using a pH meter and ultraviolet spectrophotometer, respectively. Statistical Analysis: Comparison of mean calcium release and pH change was made using Kruskal–Wallis ANOVA with post-hoc Dunn's test. The level of significance was set at 5%. Results: A significant difference was seen in the calcium ion release and pH change among the three groups at 24 h, 7 days, 15 days, and 30 days. Conclusions: NCH mixed with propylene glycol showed alkaline pH and adequate release of calcium ions till 30 days. NCH mixed with CT exhibited a high pH at the end of 30 days. Both combinations proved their efficacy as intracanal medicaments. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to evaluate the push‑out bonding strength of class II cavities of maxillary molars restored with different concentrations of chitosan nanoparticles (CSN) incorporated in universal composite resin and eighth‑generation dentin bonding agent (DBA). Materials and Methods: Seventy extracted human maxillary first molar teeth were cleaned and mounted in acrylic mold up to 2 mm below cementoenamel junction and mesio‑occlusal Class II cavities with standard measurements were prepared. CSN 2% and 0.25% powder were added to the DBA and composite resin. The samples then arbitrarily divided into three groups for restoration: Group 1: composite restoration without CSN (control group) (n = 10), Group 2: 2% CSN (n = 30), and Group 3: 0.25% CSN (n = 30). Groups 2 and 3 were further subdivided into three subgroups (n = 10 each) subgroup A. CSN incorporated in composite resin. B. CSN incorporated in DBA and C. CSN incorporated in composite and DBA. After restoration, push‑out bond strength was evaluated in each sample using a universal testing machine, and data collected were statistically analyzed by one‑way analysis of variance and Post hoc Tukey tests (P ≤ 0.05). Results: Subgroup 3A (0.25% CSN + composite) has shown an increase in bond strength among all experimental groups with no significant difference between group 1 (control group). Conclusion: CSN 0.25% incorporated in composite or DBA exhibits no harmful effect on the bond strength of class II restorations. Hence, it can be used to improve the antibacterial action and longevity of composite resin. [ABSTRACT FROM AUTHOR]

Background: The depletion of bond strength after the bleaching procedure has resulted in the usage of several antioxidants to get rid of discharging oxygen from residual peroxides before any adhesive restorations. Aim: The in vitro study aimed to compare and evaluate the shear bond strength of composite after application of three over-the-counter natural antioxidants on bleached enamel. Materials and Methods: Thirty-six extracted human anterior teeth were decoronated at the level of cementoenamel junction and implanted into self-cure acrylic resin exposing the labial surface alone. The embedded specimens were categorized into six groups of six teeth each, and the groups were as follows: Group I: unbleached + composite bonding, Group II: bleaching + delayed composite bonding, Groups III, IV, and V: bleaching + antioxidants - olive oil/Vitamin E oil/propolis + immediate composite bonding, and Group VI: bleaching + immediate composite bonding. The shear bond strength analysis was performed with the help of the universal testing machine, and the values obtained were statistically analyzed using IBM SPSS for Windows, v. 21.0. Results: The results obtained from the study reveal that all the three experimental groups showed an increase in the shear bond strength in comparison to Group VI (positive control) and the difference in the bond strength between the experimental groups and positive control is also statistically significant. Conclusion: Within the limitations of this study, although the bond strength of composite resin after application of the three natural over-the-counter antioxidants falls very closely, the usage of oil-based antioxidants had been found to perform less effectively in improving the shear bond strength. [ABSTRACT FROM AUTHOR]

Aim: The study aims to compare and evaluate the fracture resistance of endodontically treated bicuspids instrumented with Hand Files, TruNatomy (TRN), ProTaper Next (PTN), ProTaper Gold (PTG), and WaveOne (WO). Materials and Methods: In total, 45 extracted single-rooted human premolar teeth were selected and sectioned at or below the cementoenamel junction to obtain roots 15 mm long. The samples were divided into four experimental groups and one control group (n = 9): instrumentation with nickel-titanium (NiTi) Hand Files (control group), instrumentation with TRN files, instrumentation with PTN files, instrumentation with PTG files, and instrumentation with WO files. The samples were obturated by lateral compaction technique using gutta-percha points and AH Plus sealer. A vertical load was applied to the tooth using the universal testing machine (Tecsol-TSI-BDS-2Kn-Sr No. 170710) for the fracture resistance test. Statistical analysis was performed. Results: The study reported that teeth instrumented with NiTi hand files exhibited the highest fracture resistance when compared to all the rotary and reciprocating file systems. Among rotary and reciprocating instruments, root prepared with TRN files showed the most significant resistance to fracture compared with PTN, PTG, and WO files. Conclusion: Within the limitations of this study, it can be concluded that minimally invasive instrumentation of the system preserves more pericervical dentin, which may increase the resistance to fracture. Results of this study and other studies support the use of minimally tapered instruments to improve the fracture resistance of endodontically treated teeth. [ABSTRACT FROM AUTHOR]

Context: The efficiency of the luting system to adhere with tooth and restoration is an important determinant factor in the success of indirect restoration. Aims: The aim of this study is to evaluate and compare the sealing ability of a new resin cement which was undergoing trial with other three luting cements. Settings and Design: In vitro study. Subjects and Methods: Forty extracted intact human premolars were selected and standardized class 5 preparations for inlays were done at cementoenamel junction of buccal surfaces and direct composite inlay was fabricated. The samples were randomly grouped into 4: Group I luted with Rely X ARC resin cement, Group II with DCRC-10, a new indigenously developed resin cement, Group III with FujiCEM, and Group IV with zinc phosphate. After 24 h storage, samples were thermocycled and immersed in basic fuchsine dye. The longitudinal sections were assessed under a stereomicroscope for microleakage using graded criteria. Statistical Analysis Used: To analyze leakage scores among four groups and between enamel and dentin/cementum margins, Kruskal-Wallis nonparametric test and the Mann-Whitney test at P < 0.05 were used. Results: The dye penetration at cementum/dentin margins showed a statistically significant difference among four groups (P < 0.001). Adhesive luting cements produced lesser leakage scores at both margins than those cemented with zinc phosphate. Conclusions: The indigenously developed resin cement (DCRC-10, Group II) is comparable to that of Group I (RelyX ARC) in terms of its luting efficiency. [ABSTRACT FROM AUTHOR]

Aim: The aim of the current study was to evaluate the radicular dentin defect during retreatment employed diverse NiTi hand and rotary retreatment file systems. Materials and Methods: Eighty mandibular premolars with a single root and root canal that were recently extracted were gathered and stored. The premolars were subject to decoronation at cementoenamel junction (CEJ) beneath irrigation with water to attain a uniform radicular length of 16 mm. Gutta-percha cones were covered with sealer and introduced into the root canal up to the working length. Eighty teeth were allocated at random into four groups with each group consisting of 20 samples. Group I: Control, Group II: EdgeFile XR retreatment rotary files, Group III: ProTaper Universal retreatment files, and Group IV: MTwo retreatment files. Under constant water cooling, the roots were cut flat with a diamond disc at apical third (3 mm), middle third (6 mm), and cervical third (9 mm) points. Stereomicroscope was employed to visualize the sections below × 20 magnification. Results: A statistically significant difference was noted among the groups with respect to the formation of radicular dentinal defects at 3 mm (P < 0.01) and 6 mm (P < 0.001), while the sections at 9 mm did not exhibit any statistically significant difference (P > 0.598). Conclusion: Despite the limitations in this study, it was concluded that all the evaluated file systems efficiently eliminated root canal filling during the retreatment. In addition, it was noted that the EdgeFile XR group exhibited fewer root dentin defects in comparison with the MTwo and ProTaper Universal group of files. [ABSTRACT FROM AUTHOR]

A palatogingival groove (PGG) is a developmental deformity that may cause a severe periodontal breakdown or combined endodontic and periodontal defect. In the present case, a 24-year-old patient reported a complaint of pain in the upper left front tooth region for 3 months. Clinical and radiological examination revealed a PGG in the permanent maxillary left lateral incisor. Cone-beam computed tomography showed multiple shallow grooves on the root surface and a deep palatal groove extending to the apex. Interdisciplinary management comprising endodontic therapy and intentional replantation was formulated. After endodontic procedure, tooth #22 was gently extracted. The shallow grooves were removed by odontoplasty. A Class II cavity was made in the deep palatal groove and was connected with the root-end preparation. The cavity was sealed with biodentin up to the cementoenamel junction and the coronal portion was sealed with light-cured glass-ionomer cement. The tooth was replanted in socket and splinted for 7 days. Follow-up visits revealed the functional status of tooth and complete bony healing. Tooth discoloration was successfully managed with intracoronal bleaching with sodium perborate. A 12-month radiographic follow-up revealed no evidence of root resorption or ankylosis. [ABSTRACT FROM AUTHOR]

Aims: The goal of this study was to analyze the bacterial microleakage following two methods (heat vs. rotary) of postspace preparation after two-time intervals (immediate vs. 1 week later). Setting and Design: In vitro-comparative study. Materials and Methods: Eighty-two single-rooted teeth were decoronated at the cementoenamel junction. Root canals were prepared using rotary files. After root canal obturation, specimens were randomly allocated to 4 experimental groups based on the method of postspace preparation (heat or peeso reamer) and time interval (immediate or 1 week later) (n = 18). Group 1: Peeso reamer-immediate, Group 2: Heat-immediate, Group 3: Peeso reamer-1 week later, Group 4: Heat-1 week later. 10 specimens were considered as positive and negative controls (n = 5 each). Custom-made dual-chamber devices were used to appraise the bacterial microleakage for 60 days. Statistical Analysis Used: Data were analyzed with Chi-Square and Log-Rank tests and Cox regression. Results: All through the experimental period, there was no significant difference (P = 0.41) between the studied groups. Groups 2 and 4 had the highest microleakage and the lowest survival rate (55.56% ± 11.71%). Group 1 showed the lowest microleakage and the highest survival rate (77.8% ± 9.80%). Conclusions: The applied techniques for postspace preparation and the time intervals (neither independently nor simultaneously) showed no significant difference in the field of bacterial leakage. [ABSTRACT FROM AUTHOR]

Background: Despite constant advances in science, obscurity remains in the efficient removal of pulp stones to aid in successful root canal treatment. In this context, chemical means of dissolving pulp stones were explored. Aim: The aim of this study is to evaluate and to compare the efficacy of decalcifying agents on the dissolution of pulp stones. Materials and Methods: The study was divided into two groups for pulp stone analysis (21 samples) and dentin analysis (54 samples). Twenty-one pulp stones from patients aged 18–70 who underwent root canal treatment were collected and divided into three subgroups (n = 7) randomly. They were subjected to chemical treatment in a labeled glass container with 5 ml of the respective chemical agents, such as 17% ethylenediaminetetraacetic acid solution (positive control), no treatment (negative control), and newly developed Physiological Simulated Decalcifying Agent (PSDA). At the end of the study period (24 h), the samples were removed, rinsed with deionized water, and subjected to physical analysis, scanning electron microscopy (SEM), and Energy –dispersive X-ray spectroscopy (EDS) analysis. Under dentin analysis, 54 maxillary premolars scheduled for orthodontic extraction without caries or extensive restorations were selected, following which 2-mm thick transverse dentinal sections at the cementoenamel junction level were obtained and randomly divided into two groups for SEM (n = 21) and microhardness analysis (n = 33). The samples were subjected to respective chemical treatment groups similar to pulp stones for 24 h and analyzed using SEM, EDS, and microhardness analysis. Results: Postchemical treatment with the newly developed decalcifying solution, the pulp stones showed the absence of nodular crystallites and surface softening under SEM and a decrease in the calcium level under EDS analysis. Concerning the microhardness of dentin, no significant changes could be observed. Conclusion: The newly explored PSDA was found to be efficacious in the decalcification of pulp stones at a clinically relevant time of 24 h, without significantly affecting the structural integrity and the hardness values of dentin. [ABSTRACT FROM AUTHOR]

Background: Peri-cervical dentin (PCD) and its reinforcement play a crucial role in the fracture resistance of root canal-treated teeth. Aims: The aim of this study was to compare the fracture resistance of dual-cure, nano-hybrid, and short-fiber reinforced composite resins restored PCD with conventional hybrid composite (CHC) resin restored endodontically treated mandibular premolars. Settings and Design: Academic, in vitro study. Materials and Methods: The prepared mandibular premolar samples were randomly divided into five groups of 10 each. In Group 1, teeth were left intact. The remaining 40 teeth were endodontically treated and obturated as follows: In Group 2, teeth were obturated with gutta-percha till cementoenamel junction and restored with CHC. Teeth in Groups 3, 4, and 5 were obturated to a depth of 5 mm from the cervical line and restored with dual-cure, nano-hybrid, and short-fiber reinforced composite resins, respectively. Fracture resistance was tested using a universal testing machine. Statistical Analysis Used: One-way analysis of variance and post hoc Tukey's test. Results: Short-fiber reinforced composite resin showed a significantly higher mean fracture resistance value compared with other experimental groups. The mean fracture resistance values were obtained as Group 1 > Group 5 > Group 4 > Group 3 > Group 2. Conclusions: Reinforcement with short-fiber reinforced composite showed significantly higher fracture resistance compared with nano-hybrid and dual-cure composite resins. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study is to compare and evaluate the remaining dentin thickness following biomechanical preparation of teeth using different rotary file systems. Materials and Methodology: Sixty noncarious mandibular premolar teeth were collected and decoronated at the level of cementoenamel junction with a diamond disc. All specimens were randomly divided into 5 experimental groups - ProTaper Next (Dentsply Mallifer), Mtwo (VDW, Antaeus, Munich, Germany), RaCe (FKG, La Chaux-de-Fonds, Switzerland), Hyflex electro-discharge machining (EDM) (Coltene-Whaledent, Allstetten, Switzerland), NeoNiTi (Neolix, France) and 1 control group of 10 teeth each. After mounting the samples on a modeling wax sheet, preoperative cone-beam computed tomography (CBCT) scans were taken. Biomechanical preparation of canals was done following the assigned protocol of manufacturers. Postoperative CBCT scans were taken and comparison was carried out with preoperative scans. Statistical Analysis Used: Difference among the groups was analyzed by post hoc Turkey and analysis of variance tests. A P < 0.05 was considered statistically significant for all tests. Results: A comparison of preinstrumentation and postinstrumentation CBCT images revealed ProTaper Next group to remove more dentin at 7 mm as opposed to other groups in mesiodistal direction. However, no statistical difference was evident between ProTaper Next, MTwo, Race, Hyflex EDM, NeoNiTi file systems at 3 mm, 5 mm, and 7 mm in buccolingual direction. A statistically nonsignificant difference was evident between MTwo, Race, Hyflex EDM, NeoNiTi file systems at 3 mm, 5 mm, and 7 mm in both mesiodistal and buccolingual direction. Conclusion: Race file system performed better and removed lesser dentin in both buccolingual and mesiodistal directions. More dentin was removed at the coronal in mesiodistal direction with the use of ProTaper Next, and significant difference was seen between Protaper Next group and other groups in the study. [ABSTRACT FROM AUTHOR]

Introduction: After orthodontic treatment, some teeth undergo external root resorption due to different factors, such as the root shape, oral habits, biological and genetic factor, gender, and age. Furthermore, extraction cases, long treatment duration, and the amount of force applied during the treatment might be related to root resorption. Materials and Methods: Panoramic radiographs for 226 patients treated in the orthodontic department were screened. The lower first permanent molars, lower second premolars, and lower first premolars were measured in centimeters on a ruler using ImageJ System. Teeth were measured from the cusp tip to the cementoenamel junction (CEJ) and from the CEJ to the root apex, and then, the tooth was measured as a whole before and after the treatment. Results: Multiple analysis of variance showed that there were no interactions between the root lengths of all teeth tested and either gender, treatment type, or treatment duration (P > 0.05). Conclusion: Based on the results of this study, no statistically significance relationship between external apical root resorption and gender, type of treatment, and treatment duration was found. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study is to evaluate of debris and smear layer formation after using rotary ProTaper Universal, Twisted File, and XP Endo file systems under scanning electron microscope. Materials and Methods: Forty freshly extracted mandibular second premolar teeth were taken to decoronate at the cementoenamel junction to make the remaining root length 15 mm. Specimens were divided into four groups of 10 teeth each, Group I (control) – no instrumentation. Group II – ProTaper Universal rotary file (F2), Group III – twisted file (ISO size 0.25 and 6% taper), Group IV – XP Endo file (ISO size 0.25). During instrumentation, 5 ml normal saline was used as irrigating agent. Grooves parallel to the longitudinal axis of the root were made on the mesial and distal surface of each specimen to split it into two halves and examined under scanning electron microscope at ×1500 and ×5000 magnification. Photomicrographs were taken to evaluate debris and smear layer. Evaluation of photomicrographs was done using a score index. Results: One-way analysis of variance (ANOVA) was used to compare more than one means at a time. Tukey's critical difference followed by ANOVA was used to compare the mean values pair wise. P <0.05 was considered to be statistically significant. Among all the file systems, Group II showed maximum amount of debris (3.50 ± 1.109) followed by Group III (2.83 ± 1.238) and least amount was showed by Group IV (2.65 ± 1.122) at all levels (cervical, middle, and apical third). Among all the experimental groups, Group II showed maximum amount of smear layer (2.75 ± 1.149) followed by Group III (2.40 ± 0.982) and least amount of smear layer shown by Group IV (2.10 ± 0.841) at all levels (cervical, middle and apical third), the result was statistically significant (P < 0.05). Conclusions: At all the levels (cervical third, middle third, and apical third), among all the experimental groups, highest amount of debris and smear layer was formed by ProTaper Universal rotary file followed by Twisted file and least amount showed by XP Endo file system. In all the levels, control group showed highest amount of debris but least amount of smear layer. [ABSTRACT FROM AUTHOR]

Context: Accuracy of fit of cast metal posts fabricated with direct and indirect techniques.Aims: To evaluate the accuracy of fit of cast metal posts fabricated with direct and indirect techniques using micro-CT.Materials and Methods: Sixty extracted human maxillary central incisors were used. The teeth were decoronated leaving 2 mm at the cementoenamel junction. Four patterns for each tooth were made including one direct and indirect wax pattern and one direct and indirect resin pattern. In total, 240 patterns and castings were made. Each tooth was scanned using microcomputed tomography (μCT) system with a resolution of 14.5 μm. μCT analyzer Sky scanner software was used to calculate the volume of space between the post and the canals. Statistical analysis used: The student paired t-test and unpaired t-test were used to determine the significant differences between groups.Results: The overall space between the canal walls and posts made with the direct wax and resin technique had an average mean value of 1.10 mm3, whereas with the indirect technique resin and wax pattern, the average mean was 1.30 mm3 which was significant.Conclusion: Within the limitations of the study, it was found that the accuracy of fit is better in direct technique using wax pattern. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The present study was undertaken for evaluating various hand instrumentation techniques with different instruments in the formation of smear layer. Materials and Methods: One hundred and seventy-five extracted mandibular molars were collected and were cut at cementoenamel junction. Afterward, the distal roots were separated. Working length was determined, and roots were divided into five equal groups with 35 roots in each group as follows: Group A: K-type files with conventional step-back technique, Group B: Canal Master U instrument with clockwise-counterclockwise rotation, Group C: Flex-R® files with clockwise-counterclockwise rotation, Group D: FlexoFiles® with conventional step-back technique, and Group E: Nickel titanium files with conventional step-back technique. Biomechanical preparation was done according to their respective groups. The teeth in various groups were scanned under scanning electron microscope and scoring was done. All the results were analyzed by SPSS software version 17.0. Results: Scanning electron microscopic results indicated that apparently there seems to be a significant difference in the scoring of the smear layer between each group at all the three levels, but the difference was statistically nonsignificant. Microleakage was present in all the samples. Nonsignificant results were obtained while comparing the microleakage in between different the groups. However, microleakage was highest in Group D. Conclusion: The amount of smear layer is maximum at the apical third and lesser in the middle third followed by the coronal third in all the groups. All the samples showed microleakage to a varying extent. [ABSTRACT FROM AUTHOR]

Context: Three-dimensional seal of the root canal space has always been challenging. The incorporation of gutta-percha and sealer prevents microleakage by bacteria, ensuring a shielded root canal space. However, the penetration of sealer to various depths within the root canal has always been looked with curiosity. Aims: Thus, the present in vitro study was undertaken to evaluate the percentage and average depth of penetration of Endoflas F. S., AH Plus, and Epiphany sealers into dentinal tubules among the coronal, middle, and apical thirds of the roots following obturation with a lateral compaction technique using Confocal Laser Scanning Microscopy. Settings and Design: The study is an in vitro randomized control trial. Subjects and Methods: Thirty sound central incisors were decoronated at the level of the cementoenamel junction. Working length determination was done followed by a meticulous cleaning, shaping, and under copious irrigation. The teeth were then randomly divided into three groups: Endoflas FS sealer, AH Plus sealer, and Epiphany sealer. On fluorescence treatment, the teeth were sectioned at the midpoint of coronal, middle, and apical third of each root and viewed under confocal laser scanning microscope. Statistical Analysis Used: The results were analyzed using one-way ANOVA, and the significant difference between groups was analyzed with post hoc Tukey test. Results: Epiphany sealer provided with better percentage and depth penetration in comparison to Endoflas FS and AH Plus sealers. Furthermore, the coronal third of the root had better percentage and sealer penetration than the middle and apical thirds. Conclusions: Sealers tend to provide a firm bond between the tooth and the gutta-percha. They bind, lubricate, and seal the gutta-percha cones to fill the accessory canals. Within the limitations of this study, the superior flow and enhanced setting time Epihany sealers provide better percentage and depth of penetration than AH Plus and Endoflas FS. [ABSTRACT FROM AUTHOR]

Background: Sealer penetration into dentinal tubules eliminates the pathways for bacterial leakage and entombs intratubular bacteria. Aim: The aim of this study was to evaluate and compare the depth of radicular dentinal tubule penetration of five root canal sealers using confocal laser scanning microscopy. Methods: Fifty freshly extracted single-rooted maxillary anterior teeth were used. After decoronation at the cementoenamel junction, they were prepared to ProTaper size F3. After irrigation with 5 mL smear clear, 5 mL 5% sodium hypochlorite and 5 mL distilled water alternatively, the samples were randomly divided into five groups (n = 10) and obturated by lateral compaction technique using the test sealers labeled by fluorescent rhodamine B dye (Mayor Diagnostics, Mumbai, India). Zinc oxide eugenol (ZOE) (Prime Dental Products), EndoREZ (Ultradent), Sealapex (SybronEndo), AH Plus (Dentsply Maillefer), and MTA-Fillapex (Angelus) formed the test groups. Teeth were then positioned in blocks of orthodontic resin. Three horizontal sections of 1-mm representing coronal middle and apical thirds were made and examined with Zeiss (laser scanning microscope [LSM] 780) confocal LSM. Images were analyzed using ZEN 2.1 software. Statistical Analysis: Data were recorded and subjected to statistical analysis using one-way ANOVA test. Results: Maximum penetration depth was demonstrated by AH Plus in the coronal and apical thirds, MTA-Fillapex in the middle thirds, while minimum penetration depth was seen in ZOE in the coronal and middle thirds and Sealapex in the apical thirds. None of the root canal sealers were able to penetrate the complete depth of radicular dentinal tubules. Conclusion: While AH Plus and MTA-Fillapex showed the highest penetration into radicular dentinal tubules, ZOE and Sealapex demonstrated the least penetration. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to evaluate the prevalence of root canal isthmus (RCI) and measure the interorifice distance (IOD) between the root canals. Additionally to correlate IOD with the RCI in human permanent teeth using cone-beam computed tomography (CBCT) in an Indian sub-population (Chennai). Materials and Methods: A total of 5881 teeth from 280 CBCT full mouth scans were analyzed. The presence or absence of complete and incomplete RCI of each tooth was identified using the map-reading strategy. IOD was calculated by measuring the distance between the center of each root canal orifice to that of the center of the adjacent orifice at the level of the cementoenamel junction using the axial and sagittal sections. Chi-square analysis and correlation statistics using Spearman's rank-order test was done (P < 0.05). Results: High prevalence of RCI was found in maxillary first premolars, mesial root of mandibular molars, and mesiobuccal root of maxillary first molars, while its prevalence was low in maxillary canines and mandibular premolars and absent in maxillary incisors. RCI was predominantly seen in the cervical and middle third of the root canal in all the teeth evaluated. A weak negative correlation was established between the IOD and RCI for maxillary premolars, whereas a weak positive correlation was seen in maxillary first molars and mandibular second molars. Conclusion: The prevalence of RCI was high in the posterior teeth in comparison to the anterior teeth in the present study. There was no strong correlation between IOD and RCI in all the teeth evaluated. [ABSTRACT FROM AUTHOR]

Background: Factors that influence anchorage of the orthodontic miniscrew implants are interradicular areas and cortical bone thickness. Aims and Objectives: The aim of this study was to evaluate the three-dimensional interradicular areas and the buccal cortical bone thickness in Indian patients using cone beam computed tomography (CBCT) images, and to find the suitable and safe sites for orthodontic miniscrew implant placement. Materials and Methods: CBCT images of 20 patients were divided into three planes as axial, coronal, and sagittal. Measurements, that is, mesiodistal distance and buccal cortical bone thickness were taken at five different heights from the cementoenamel junction (CEJ) toward apical region. Results: In the maxilla, the safe sites for placing miniscrew implant were between the second premolar and first molar at 10-mm height, whereas in the mandible, the safe sites for placing miniscrew implant were between the first and second premolar at 6-, 8-, and 10-mm height, between the second premolar and first molar at 10-mm height, and between the first and second molar at 8- and 10-mm height. Conclusion: CBCT can be effectively used to evaluate interradicular areas and cortical bone thickness in predicting the safe and suitable sites for placing orthodontic miniscrew implants. [ABSTRACT FROM AUTHOR]

Background: The complex structure and irregularities of root canal walls are liable for infection by several bacterial species. Thus, the use of irrigants and auxiliary chemical solutions associated with instrumentation is necessary for effective eradication of the biofilm as well as complete removal of the smear layer.Aim: To evaluate the effects of calcium hypochlorite and chitosan oligosaccharide (COS) in disinfecting Enterococcus faecalis root canal biofilm and smear layer removal with minimal erosion.Materials and Methods: A total of 70 mandibular premolars were decoronated at the cementoenamel junction. The samples were biomechanically prepared, sterilized in an autoclave, and incubated with E. faecalis (ATCC-29212) bacteria for 21 days. Cleaning and shaping were done till maximum apical file size of #45 K. Specimens were randomly divided into 4 groups: GROUP I: Control Group, GROUP II: 5% Sodium Hypochlorite (NaOCl) solution followed by 17% EDTA solution, GROUP III: 5% Calcium Hypochlorite [Ca(OCl)2] solution followed by 17% EDTA solution and GROUP IV: 5% Ca(OCl)2 solution followed by 1% COS. The samples were subjected to microbial count followed by smear layer removal under scanning electron microscope (SEM) at coronal, middle and apical third.Statistical Analysis Used: Kruskal-Wallis Test and post-hoc Scheffe's test.Results: It was observed that Group IV showed the lowest amount of CFU count/mL and the highest amount of smear layer removal with a statistically significant difference (P < 0.05) when compared with the other three Groups.Conclusion: 5% Ca(OCl)2 solution with 1% COS solution effectively removed the Enterococcus faecalis biofilm and smear layer from the root canals with minimal erosion. [ABSTRACT FROM AUTHOR]

AIM: This study evaluated the effect of preheated irrigants (EDTA, QMix), then use of various activation techniques such as ultrasonic system and laser on push-out bond strength (POBS) of fiber posts to root dentin. Methodology: One hundred and twenty extracted human teeth were decoronated below the cementoenamel junction. All the root canals were instrumented, irrigated using sodium hypochlorite and normal saline, dried with paper points, and filled with gutta-percha and AH Plus sealer. Post spaces were prepared. The irrigating solutions QMix and EDTA were heated to 60°C. Normal QMix and EDTA served as control. The irrigants were activated with Laser and Ultrasonic system. Then, the fiber posts were cemented, roots were sliced to thickness of 2 mm and mounted for measurement of POBS. Results: Preheated irrigants group showed maximum POBS as compared to Normal irrigants. QMix group showed better results as compared to EDTA. Irrigants when activated with laser and ultrasonics showed comparable results. Conclusion: Within the limitations of the study, it can be concluded that preheated irrigants(QMix, EDTA) increase the POBS of fiber post to root dentin. Both laser and ultrasonic are equally effective for increasing the POBS. [ABSTRACT FROM AUTHOR]

Background: Abfraction is a loss of tooth structure along the gingival margin and manifests with different clinical appearances. It has multifactorial etiology and may occur due to normal and abnormal tooth function and may also be accompanied by pathological wear, such as abrasion and erosion. The theory behind the abfraction is that the tooth flexure in the cervical area is caused due to occlusal compressive forces and tensile stresses. This results in the fractures in the hydroxyapatite (HA) crystals. It is also caused by the low packing density of the Hunter-Schreger band (HSB) at the cervical area. Unfortunately, there is a lack of evidence regarding the outcome of abfraction with or without intervention. The aim of this review is to collect clinical information from the literature and discuss the etiology, pathogenesis, clinical representation, and management. Also, search databases for clinical studies that describe the role of sclerotic dentine in non-carious cervical lesions (NCCLs) are becoming a clinical challenge.Methods: The literature was searched that described the etiology, pathogenesis, clinical representation, and management of the abfraction lesions. Also, a specific question regarding the formation of sclerotic dentin in the NCCL lesion was described and searched for evidence that challenges etching, bonding, and successfully restoring NCCLs. The databases PUBMED, SCOPUS, MEDLINE, WEB of SCIENCE, and EMBASE were searched using the key terms. The inclusion criteria were the randomized controlled clinical trial, cohort studies, and cross-sectional studies that aimed at determining the role of sclerotic dentine in NCCLs and its effect on etching, bonding.Results: One clinical study was retrieved according to the PRISMA flowchart and PICO format. The longer etching time, total-etch adhesive system, and EDTA pre-treatment of the sclerotic dentin of cervical wedge-shaped defects could improve the bonding strength in lesions like NCCL's.Conclusion: In conclusion, clinical challenges that occur due to NCCLs are better managed by a proper understanding of factors like etiopathogenesis, ultra-structure of enamel, and dentine and their effect on the bonding of restorations of the tooth. [ABSTRACT FROM AUTHOR]