Journal of Conservative Dentistry最新文献

Aims: The aim of this study was to evaluate the effect on the degree of conversion of Tetric N-Ceram Bulk Fill Composite subjected to preheat treatment, postcure heat treatment, and combined heat treatment.

Materials and methods: A total of 90 samples were prepared from Tetric N-Ceram Bulk Fill using customized stainless steel molds and divided into six groups of 15 samples each based on the heat treatment. Group I (control group): no heat treatment, Group II: preheat treatment at 60°C, Group III: postcure heat treatment at 100°C, Group IV: postcure heat treatment at 200°C, Group V: combined preheat treatment at 60°C and postcure heat treatment at 100°C, and Group VI: combined preheat treatment at 60°C and postcure heat treatment at 200°C. The degree of conversion was analyzed using Raman spectrometer.

Statistical analysis used: Data were analyzed using analysis of variance followed by the Scheffé test using Statistical Package for the Social Sciences 20.0 version.

Results: The order of values of degree of conversion from maximum to minimum for the groups are as follows: Group VI (98.77 ± 0.52) > Group V (97.11 ± 0.78) > Group IV (95.00 ± 0.86) > Group III (93.00 ± 1.22) > Group II (86.88 ± 1.36) > Group I (76.55 ± 1.42). The statistical analysis revealed a statistically significant difference between the groups (P < 0.05).

Conclusions: Combined heat treatment samples showed better values of degree of conversion.

Background: Nanocurcumin has antimicrobial properties and it is to be tested as a coating on gutta-percha against Enterococcusi faecalis.

Aim: To evaluate the antimicrobial efficacy of nanocurcumin-coated gutta-percha against E. faecalis in comparison with conventional gutta-percha.

Materials and methods: The broth dilution method and colony-forming unit count assay were chosen for the evaluation of the minimum inhibitory concentration (MIC) and minimum bactericidal concentration of nanocurcumin against E. faecalis. ISO size 30, 4% taper gutta-percha cones were manually coated with nanocurcumin. All the coated and noncoated gutta-percha cones were examined under a scanning electron microscope to study the exterior surface. Antibacterial efficacy of nanocurcumin-coated gutta-percha and conventional gutta-percha was seen by agar diffusion method against E. faecalis.

Results: MIC of nanocurcumin was observed at 50 mg/ml for E. faecalis. Nanocurcumin-coated gutta-percha showed a larger zone of inhibition when compared to conventional gutta-percha which showed a smaller zone of inhibition (P < 0.0001). Nanocurcumin-coated gutta-percha showed moderate antimicrobial activity, while conventional gutta-percha showed weak activity.

Conclusion: The results of the study reveal that nanocurcumin has an antimicrobial activity against E. faecalis. The use of herbal alternatives in endodontics might prove to be advantageous.

Context: Biocompatibility is one of the major prerequisites for safe clinical application of materials. Resin composites release their components into oral environment following restoration which cause adverse reactions.

Aims: To evaluate and compare the genotoxicity and cytotoxicity of flowable, bulk-fill flowable, and nanohybrid composites with glass ionomer cement in human gingival cells using epithelial-based cytome assay.

Methodology: Sixty healthy patients with noncarious cervical lesions were selected and randomly assigned to four groups (n = 15): Group A, glass ionomer cement; Group B, flowable composite; Group C, bulk-fill flowable composite; and Group D, nanohybrid composite. Class V restorations were done in each group with the respective restorative materials. Samples of epithelial cells were collected from gingiva before (control) (T1) and after 10 and 30 days (T2 and T3) postrestoration and examined for the presence of micronuclei and other nuclear anomalies.

Statistical analysis used: The results were subjected to statistical analysis using Friedman's test and Kruskal-Wallis test.

Results: The highest level of cytotoxicity was noted at T2 time point with a significant decline at T3 time point. Least cytotoxic damage was exhibited by Group A followed by Group D. Highest cytotoxic effect was shown by Group B followed by Group C. There was no significant level of genotoxicity induced by any of the materials tested at different time points.

Conclusion: There is significant cytotoxicity induced by the tested composite materials which had no long-term effects and no genotoxicity was induced by any of the restorative materials tested.

Background: The development of early carious lesions can be prevented with the use of sealants. This study aimed to evaluate the retention and sealant quality of conventional and bioactive self-etching sealants by direct (clinical) and indirect (microscopical) assessment.

Materials and methods: Sixty newly erupted mandibular second molars (International Caries Detection and Assessment System ≤2) from adolescents were selected for the split-mouth trial study. The tooth was randomized and treated with conventional Fluoroshield (FS) and BeautiSealant (BS) bioactive self-etching sealants. Molds were taken and cast with epoxy resin after treatment. Indirect and direct assessments of retention degree and sealant remnant quality were performed after baseline, 1 month, and 1 year. The Chi-square test, ordinal regression, reasons of chance, and Fleiss' kappa statistical test were employed.

Results: After 1 month, greater total retention was observed for FS, but 1-year follow-up demonstrated no retention difference for FS and BS. The odds ratios showed an 86% greater chance of FS showing better marginal adaptation, after 1 month. At 1 year, the clinical assessment showed better anatomical shape and marginal adaptation scores for FS, but no microscopical difference was observed. A pour agreement between clinical and microscopical data was observed.

Conclusions: The 1-year follow-up showed no significant difference in the degree of retention, and in the microscopic evaluation of the conventional sealant (FS) and the bioactive self-etching sealant (BS), but in the clinical evaluation, better marginal and anatomical adaptation scores for FS were observed.

Context: In today's era, erosion is the most prevalent type of tooth wear. The prevention of demineralization with biomineralization is the most desired treatment.

Aim: The aim of this study is to evaluate and compare the surface remineralization potential of two remineralizing agents - self-assembling peptide P11-4 (SAP P11-4) and calcium silicate plus sodium phosphate (CSSP) salts on intact and demineralized enamel using laser-induced breakdown spectroscopy (LIBS).

Subjects and methods: Sixteen maxillary premolars were decoronated and split into buccal and palatal halves embedded in acrylic resin with a total sample size of 32 designated into Group 1 (intact teeth) and Group 2 (demineralized teeth). Further subdivision into Groups 1a and 2a (SAP P11-4 group [n = 8]); Groups 1b and 2b (CSSP group [n = 8]), Group 2 was first exposed to Coca-Cola. Then, all groups were subjected to experimental LIBS. Groups 1a and 2a were treated with SAP P11-4 based product, i.e., CURODONT™ PROTECT gel. Groups 1b and 2b were treated with CSSP-based products regimen, i.e., REGENERATE Enamel Science™ Advanced Toothpaste and Advanced Enamel Serum. The LIBS assessment was redone for all groups to attain a change in Ca and P values.

Statistical analysis used: Inferential statistics were done using Wilcoxon signed-rank test (Before-After product application) and Mann-Whitney U-test (between the groups).

Results: According to the statistical evaluation there was a statistically significant difference (P < 0.05), in Ca and P values in demineralized teeth when both SAP P11-4 and CSSP groups were evaluated. Although Ca values exhibited a significant difference in intact teeth, P did not exhibit a significant difference on the application of both remineralizing agents. The remineralizing potential between the two agents, SAP P11-4 and CSSP groups. There was no statistically significant difference ( P <0.05) observed between the two agent's remineralization potential for intact and demineralized teeth.

Conclusion: SAP P11-4 and CSSP have the potential to remineralize both intact and demineralized enamel. There was increased remineralization in demineralized samples subjected to erosion.

Aim: The aim of this study was to evaluate the effect upon postoperative pain in teeth of patients suffering from apical periodontitis or necrotic pulp when treated with calcium hydroxide and compare it with other intracanal medicaments.

Materials and methods: MEDLINE database, PubMed and Google Scholar databases were searched based on the filters and inclusion and exclusion criteria. The screening was done to finally acquire 9 articles from the mass of searched articles. The data extraction followed the screening process, and qualitative and quantitative data were recorded. The risk of bias was conducted with the Cochrane Collaboration tool, and meta-analysis was done using Review Manager version 5.3.

Results: A total of 9 studies over the past five decades met the inclusion criteria for full-text reading, and all 9 of them were included for further analysis. When we assessed for pain outcome, in comparison with CHX and Ca(OH), the cumulative mean difference was -4.57 (confidence interval: -16.25, 7.11). The heterogeneity was significant I² = 95%, hence we applied the random effects model. The mean difference showed that the mean pain outcome was more in the control (Ca(OH)) group, as compared to the intervention group.

Conclusion: Calcium hydroxide is effective in reducing posttreatment pain when it is used alone, but its effectiveness can be increased when used in combination with other medicaments such as chlorhexidine.

Objectives: The purpose of this systematic review was to analyze the effect of commercially available calcium silicate-based bioactive endodontic cement (BEC) on treatment outcome when used as root repair material in human permanent teeth and to compare it with traditional materials.

Methods: PubMed, Embase, and Cochrane Library were searched until June 2020. Randomized clinical studies and observational studies with a minimum 1-year follow-up and sample size of at least 20 were included. Risk of bias (ROB) was assessed using Cochrane's ROB tool and the National Institutes of Health Quality Assessment Tool.

Results: Thirty-nine studies were included in the systematic review. Majority of the studies used mineral trioxide aggregate. The pooled success rate for BEC was estimated by a random-effects method as 90.49% (95% confidence interval [CI]: 88.4992.34, I² = 54%). Eleven studies comparing BEC with traditional materials were included in the meta-analysis. The use of BEC significantly improved the treatment outcome when compared to traditional materials with odds ratio (OR) = 2.15 (95% CI: 1.57-2.96, I² = 0.8%, P = 0.433).

Conclusion: Very low-to-moderate-quality evidence suggests that the use of BEC as root repair material enhanced the treatment outcome. High-quality studies are required for the newer BEC to establish their clinical performance. Registration: PROSPERO CRD42020211502.

Endodontic treatment is associated with the risk of instrument separation due to multiple factors that create complications not only in further completion of the procedure but also on the final outcome and long-term prognosis of the treatment at times. Separated instrument retrieval is definitely challenging and technique sensitive, requiring a lot of clinical expertise for a successful therapy. All these hurdles make such cases a nightmare to the clinician. This case report presents two clinical cases in which cone-beam computed tomography (CBCT)-guided surgery was used for retrieval of separated instruments extending beyond the confines of root canals in a mandibular molar and maxillary premolar. This novel approach utilizes a customized 3D printed surgical guide fabricated with the help of CBCT, which is stabilized intraorally, helping in predefining the osteotomy site, angulation and depth required for retrieval of separated instruments without performing apicoectomy or root end filling. CBCT also plays an important role in these cases as the actual size, location, and depth of the separated instrument can be appreciated preoperatively. In the present cases, 3D surgical guides helped clinicians to selectively retrieve the separated instruments more conservatively and predictably. Furthermore, complete healing was seen within 3 months in both cases.

Aim: The present investigation aimed at assessing the diagnostic accuracy of DIAGNOdent compared to the International Caries Detection and Assessment System-II (ICDAS-II) in the detection of facial, smooth surface noncavitated carious lesions.

Settings and design: Sixty patients were enrolled in the current study according to the eligibility criteria. There were 161 teeth with noncavitated, white spot carious lesions and 32 sound teeth.

Materials and methods: Before examination, teeth were cleaned and polished and all patients were assessed under standardized operating conditions: preset dental unit position, operating light, and prolonged air drying (approximately 5 s). All teeth were assessed by two calibrated examiners individually without any contact using ICDAS-II and DIAGNOdent.

Statistical analysis: The diagnostic accuracy of DIAGNOdent device was determined, including sensitivity, specificity, overall accuracy, positive and negative predictive values, and receiver operating characteristic curve analysis. Chi-square test was conducted to compare the distribution of ICDAS-II and DIAGNOdent scores. Inter-observer agreement between assessors was evaluated using Cohen's kappa test.

Results: In the current study, DIAGNOdent had an overall accuracy of 84.45% with sensitivity and specificity of 87.58% and 96.87%, respectively, and +PV and -PV of 97.7% and 83.9%, respectively, when score 0 represented sound tooth surface, while scores 1 and 2 were considered clinically noncavitated carious lesions. Moreover, when only ICDAS score 1 was considered representing first visual change in enamel, DIAGNOdent had an accuracy of 74.15% with sensitivity and specificity of 83.53% and 90.62%, respectively, and +PV and -PV of 93% and 78.6%, respectively. In the present study, when only ICDAS score 2 was considered representing distinct visual change in enamel, DIAGNOdent had an accuracy of 100% with sensitivity and specificity of 100% and 100%, respectively, and +PV and -PV of 100% and 100%, respectively.

Conclusions: The overall performance of DIAGNOdent was equivalent to the visual inspection using ICDAS-II. DIAGNOdent might be considered a useful adjunctive device for detection and monitoring development of noncavitated carious lesions on facial smooth surfaces.