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In vitro comparative evaluation of apical leakage using a bioceramic sealer with three different obturating techniques: A glucose leakage model 使用生物陶瓷封闭剂和三种不同闭合技术对根尖渗漏进行体外比较评估:葡萄糖渗漏模型
Pub Date : 2024-01-01 DOI: 10.4103/jcd.jcd_303_23
Tanvi S Agrawal, Shishir Singh, Rajesh S. Podar, Gaurav P. Kulkarni, Anuprita Gadkari, Navin S Agarwal
Bioceramic sealers have improved sealing ability by forming an interfacial apatite layer that chemically bonds the sealer and radicular dentin thus decrease apical leakage. This study aims to evaluate and compare the apical leakage of Cerafill RCS bioceramic sealer and gutta percha when used with three different obturating techniques. Thirty-four extracted single-rooted premolars were decoronated and prepared up to size F3. Then, the specimens were randomly divided into 3 experimental groups (n = 10) cold lateral obturation technique, warm vertical obturation technique, single-cone obturation technique, positive and negative control groups (n = 2), according to the obturation technique used along with a bioceramic sealer. To evaluate apical leakage, all specimens were mounted in a glucose leakage model and assessed at 7 and 14 days using an ultraviolet-visible spectrophotometer. The results were subjected to ANOVA/Kruskal–Wallis ANOVA; followed by post hoc analysis using Bonferroni correction. Significant differences were found in the cumulative leakage of all the three experimental groups. Significantly higher leakage was found in groups obturated using single-cone obturation technique as compared to warm vertical compaction technique at both 7 and 14 days. Warm vertical compaction showed a better sealing result than single-cone obturation techniques at all observation periods.
生物陶瓷封闭剂通过形成界面磷灰石层,将封闭剂和根尖牙本质化学粘结在一起,从而提高了封闭能力,减少了根尖渗漏。 本研究旨在评估和比较 Cerafill RCS 生物陶瓷封闭剂和古塔胶在使用三种不同的闭合技术时的根尖渗漏情况。 我们对 34 颗拔出的单根前臼齿进行了装饰,并制备成 F3 尺寸。然后,根据与生物陶瓷封闭剂一起使用的封闭技术,将标本随机分为 3 个实验组(n = 10):冷侧封闭技术组、温垂直封闭技术组、单锥封闭技术组、阳性对照组和阴性对照组(n = 2)。为了评估根尖渗漏,将所有标本安装在葡萄糖渗漏模型中,并在 7 天和 14 天时使用紫外可见分光光度计进行评估。 对结果进行方差分析/Kruskal-Wallis 方差分析,然后使用 Bonferroni 校正进行事后分析。 所有三个实验组的累积渗漏量均存在显著差异。在 7 天和 14 天内,使用单锥套扎技术套扎的组比使用温热垂直压实技术套扎的组渗漏率明显更高。 在所有观察期内,温热垂直压合技术的密封效果均优于单锥体阻塞技术。
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引用次数: 0
Comparative assessment of nanosized intracanal medicaments on penetration and fracture resistance of root dentin – An in vitro study 纳米级根管内药物对牙根穿透性和抗折断性的比较评估 - 体外研究
Pub Date : 2024-01-01 DOI: 10.4103/jcde.jcde_138_23
BR Prashanth, Bhoomika Revankar, R. Karale, Prashant P Moogi, MG Mangala, A. Sahoo
The antimicrobial potential of conventional medicaments is reduced due to their limited permeability. The use of calcium hydroxide (CH) is known to reduce the root strength. Nano intracanal medicaments have the following advantages over conventional such as higher surface area and chemical reactivity, and due to its nanosize, have better penetrability, supporting its possible use as an intracanal medicament. Nano versions of CH, chitosan (CS), CS + CH, curcumin (T), and its conventional forms are used in our study. The aim of this study was to evaluate and compare the depth of penetration of nanosized intracanal medicaments and their effect on fracture resistance of root dentin. Eighty extracted single-rooted teeth were used after decoronation. Canals were enlarged up to size 30 (0.04° taper) using Neoendo instruments (Orikam, India). Teeth were randomly assigned to two broad groups based on the type of intracanal medicament used; Group A: control (conventional) (n = 40) and Group B: nanosized intracanal medicaments (n = 40). Each group was subdivided into four experimental groups (n = 10), Group A1: CH, Group A2: CS, Group A3: curcumin (T), Group A4: CS + CH, Group B1: nano calcium hydroxide (NCH), Group B2: nano CS (NCS), Group B3: nano curcumin (NT), and Group B4: NCS + nano calcium hydroxide (NCS + NCH). All the specimens were stored in a humidor at 37°C for 4 weeks. Out of 10 specimens from each group, five specimens were used for evaluating the depth of penetration using a confocal laser scanning electron microscope, and the remaining five specimens were used for evaluating fracture resistance in a universal testing machine at the end of 4 weeks. Data were analyzed using one-way ANOVA and intergroup comparison using Tukey’s post hoc multiple comparison test. The highest fracture resistance was seen with NCS and the maximum depth of penetration with nano calcium hydroxide (NCH). The fracture resistance and depth of penetration at a 4-week interval were higher in nano forms compared to their micro-sized counterparts with all groups. The coronal section presented the highest depth of penetration of intracanal medicaments followed by the middle and least in the apical section of root dentin with all groups.
传统药物的抗菌潜力因其有限的渗透性而降低。众所周知,氢氧化钙(CH)的使用会降低牙根的强度。与传统药物相比,纳米龋内药物具有以下优点,如更大的表面积和化学反应活性,而且由于其纳米尺寸,具有更好的渗透性,因此可以用作龋内药物。我们的研究使用了纳米级的壳聚糖(CS)、壳聚糖 + CH、姜黄素(T)及其传统形式。 本研究的目的是评估和比较纳米级根管内药物的渗透深度及其对根牙本质抗折性的影响。 我们使用了 80 颗拔出的单根牙齿,经过装饰处理。使用 Neoendo 仪器(印度 Orikam 公司)将牙槽扩大至 30 号(锥度为 0.04°)。根据所使用的根管内药物类型将牙齿随机分配到两大组:A 组:对照组(常规)(n = 40);B 组:纳米级根管内药物(n = 40)。每组又分为四个实验组(n = 10):A1 组:CH;A2 组:CS;A3 组:姜黄素(T);A4 组:CS + CH;B1 组:纳米氢氧化钙(NCH);B2 组:纳米 CS(NCS);B3 组:纳米姜黄素(NT);B4 组:NCS + 纳米氢氧化钙(NCS + NCH)。所有标本均在 37°C 的保湿盒中保存 4 周。每组 10 个试样中,5 个试样用激光共聚焦扫描电子显微镜评估穿透深度,其余 5 个试样在 4 周后用万能试验机评估抗断裂性。数据分析采用单因素方差分析,组间比较采用 Tukey 后多重比较检验。 NCS 的抗断裂强度最高,纳米氢氧化钙(NCH)的穿透深度最大。 在所有组别中,与微小尺寸的同类产品相比,纳米级产品在间隔 4 周后的断裂抗力和穿透深度都更高。在所有组别中,冠状切面的根牙本质内药物渗透深度最高,其次是中间切面,而根尖切面的渗透深度最小。
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引用次数: 0
Effect of prewarming and continuous warming on tissue dissolving ability of Triton™ versus Twin Kleen™: An in vitro study 预热和持续加热对 Triton™ 和 Twin Kleen™ 组织溶解能力的影响:体外研究
Pub Date : 2024-01-01 DOI: 10.4103/jcde.jcde_201_23
V. Deepa, Himasai Reddy Vanga, Naveena Kadali, Sravyasai Divve, Vemana Sravya, Roopa Sravya Kapa
TwinKleen™ and Triton™ are newer all-in-one irrigants that have simultaneous action on both organic and inorganic contents. Studies comparing their tissue dissolving ability (TDA) either at room temperature (RT) or on prewarming (PW) and continuous warming (CW) are not yet reported. To evaluate and compare the effect of 3% sodium hypochlorite (NaOCl), Twin Kleen™, and Triton™, on the bovine TDA. One hundred and twenty tissue specimens (size 4 mm × 4 mm × 2 mm and weight 37 ± 3 mg) were divided into Group 1, normal saline (negative control); Group 2, 3% NaOCl (positive control); Group 3, Twin Kleen™; and Group 4, Triton™ (n = 30) Each group is further divided into three subgroups with ten samples each as sub group a – at room temperature (RT), sub group b – on pre warming (PW) and sub group c– on continuous warming (CW), Tissue specimens were immersed in test tubes with 5 ml of respective irrigants replenished thrice every 15 min. The percentage difference in tissue weights was calculated after 5, 10, and 15 min. Multiple intergroup comparisons were done using Tukey’s multiple-comparison test, using SPSS software version 23.0. Both Triton™ and 3% NaOCl showed significantly higher dissolution than normal saline and Twin Kleen™ on CW followed by PW than at RT. Twin Kleen™ showed significantly less dissolution at all the tested temperatures. Heating enhances the TDA of Triton™ and 3% NaOCl but not Twin Kleen™. CW showed significantly higher dissolution than PW.
TwinKleen™ 和 Triton™ 是较新的多合一冲洗剂,可同时作用于有机物和无机物。目前还没有研究报告比较它们在室温(RT)或预热(PW)和持续加热(CW)下的组织溶解能力(TDA)。 评估和比较 3% 次氯酸钠 (NaOCl)、Twin Kleen™ 和 Triton™ 对牛组织溶解能力的影响。 将 120 份组织标本(大小为 4 mm × 4 mm × 2 mm,重量为 37 ± 3 mg)分为:第 1 组,正常生理盐水(阴性对照);第 2 组,3% NaOCl(阳性对照);第 3 组,Twin Kleen™;第 4 组,Triton™;每组又分为三个子组,每个子组 10 个样本,子组 a - 室温(RT);子组 b - 预热(PW);子组 c - 持续加热(CW),将组织样本浸入装有 5 毫升相应冲洗液的试管中,每 15 分钟补充三次。分别在 5 分钟、10 分钟和 15 分钟后计算组织重量的百分比差异。 使用 SPSS 软件 23.0 版的 Tukey's 多重比较检验进行多组间比较。 Triton™ 和 3% NaOCl 在 CW 和 PW 条件下的溶解度明显高于正常生理盐水和 Twin Kleen™。Twin Kleen™ 在所有测试温度下的溶解度都明显较低。 加热可提高 Triton™ 和 3% NaOCl 的 TDA,但不能提高 Twin Kleen™ 的 TDA。CW 的溶解度明显高于 PW。
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引用次数: 0
Stabilizing bony plate in guided endodontic surgery using an innovative approach 使用创新方法在引导式牙髓手术中稳定骨板
Pub Date : 2024-01-01 DOI: 10.4103/jcde.jcde_178_23
Maulee D. Sheth, Ankit Arora, Sonali V. Kapoor
Endodontic microsurgery in tandem with advanced radiographic techniques has led to the emergence of guided surgeries. Preservation of the cortical bone to enhance the healing and stabilization of tissues surrounding the tooth of concern can now be facilitated by bone cement used in the field of orthopedics. This case report details a guided endodontic surgery technique in 17 years old where a traumatic infliction leads to a phoenix abscess. The technique elaborated emphasizes on the three-dimensional printing of a surgical template with the help of cone-beam computed tomography, followed using a medical-grade bone cement in the most minimal manner to reposition the buccal cortical bone. A 12-month-old follow-up revealed the patient to be asymptomatic with a flawless periapical region radiographically. This case testifies that the optimum use of available biomedical material in surgical endodontics can assure a predictable prognosis.
牙髓显微手术与先进的放射成像技术相结合,导致了引导手术的出现。现在,骨科领域中使用的骨水泥可以促进皮质骨的保留,从而增强相关牙齿周围组织的愈合和稳定。本病例报告详细介绍了一种引导下的牙髓手术技术,该技术适用于 17 岁因外伤导致凤凰脓肿的患者。该技术强调在锥形束计算机断层扫描的帮助下三维打印手术模板,然后使用医用骨水泥以最简便的方式重新定位颊皮质骨。12 个月后的随访显示,患者无任何症状,根尖周的影像学表现完美无瑕。这个病例证明,在牙髓手术中充分利用现有的生物医学材料,可以确保预后的可预测性。
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引用次数: 0
In vitro comparison to study the antimicrobial effect of silver nanoparticles gel and its various combinants as an intracanal medicament against Enterococcus faecalis 体外比较研究纳米银颗粒凝胶及其各种组合物作为龋内药物对粪肠球菌的抗菌效果
Pub Date : 2024-01-01 DOI: 10.4103/jcde.jcde_180_23
S. Jhamb, R. Singla, Amandeep Kaur, Jyoti Sharma, J. Bhushan
Endodontic infections have been clearly described as biofilm-mediated infections. Bacteria and their by-products have been known to cause these infections. With the introduction of new drugs and the use of nanoparticles in recent times, there has been a significant reduction in the bacterial load in endodontic infections. The in vitro study focuses on checking the antibacterial efficacy of silver nanoparticles and its combination with other medicaments against the root canal pathogen – Enterococcus faecalis (E. faecalis). In the present study, 140 extracted human teeth were used. The teeth were sectioned, and biomechanical preparation was done. The root canals of the extracted teeth were inoculated with the culture of E. faecalis. The teeth were divided into six groups based on the intracanal medicament used: Group 1 – Silver nanocure gelGroup 2 – Silver nanocure gel + Cavisept gel (1:1)Group 3 - Silver nanocure gel + Aveu-Cal gel (1:1)Group 4 – Silver nanocure gel + Cavisept gel + Aveu-Cal gel (1:1:1)Group 5 - Positive control (specimens were inoculated with Enterococcus faecalis and left untreated to confirm the presence of infection)Group 6 - Negative control (no bacterial contamination of specimens). The colony-forming units were recorded after 48 h of incubation. The statistical analysis of the colony-forming units was done using the Kruskal–Wallis tests. Silver nanocure gel + Cavisept gel + Aveu-Cal gel (1:1:1) showed the least colony-forming units. The present study is an in vitro study, in which we concluded that the combination of all the intracanal medicaments is the best for the elimination of E. faecalis biofilm from the root canal. The above findings need to be tested in vivo also.
牙髓感染已被明确描述为生物膜介导的感染。众所周知,细菌及其副产品是造成这些感染的原因。近来,随着新药物的引入和纳米粒子的使用,牙髓感染中的细菌量已显著减少。 这项体外研究的重点是检查纳米银颗粒及其与其他药物的组合对根管病原体--粪肠球菌(E. faecalis)的抗菌效果。 本研究使用了 140 颗拔出的人类牙齿。对牙齿进行切片,并进行生物力学制备。将粪大肠杆菌培养物接种到拔出牙齿的根管中。根据根管内使用的药物将牙齿分为六组: 第 1 组--纳米银凝胶第 2 组--纳米银凝胶 + Cavisept 凝胶(1:1)第 3 组--纳米银凝胶 + Aveu-Cal 凝胶(1:1)第 4 组--纳米银凝胶 + Cavisept 凝胶 + Aveu-Cal 凝胶(1:1:1)第 5 组--阳性对照(标本接种了粪肠球菌,未经处理以确认是否存在感染)第 6 组--阴性对照(标本未受细菌污染)。 培养 48 小时后记录菌落形成单位。 菌落形成单位的统计分析采用 Kruskal-Wallis 检验。纳米银凝胶 + Cavisept 凝胶 + Aveu-Cal 凝胶(1:1:1)显示的菌落形成单位最少。 本研究是一项体外研究,我们得出的结论是,所有根管内药物的组合是消除根管内粪大肠杆菌生物膜的最佳方法。上述研究结果还需要进行体内试验。
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引用次数: 0
Comparative evaluation of remineralization potential of four different remineralization agents on human enamel: An in vitro study 四种不同再矿化剂对人体珐琅质再矿化潜力的比较评估:体外研究
Pub Date : 2024-01-01 DOI: 10.4103/jcde.jcde_113_23
Giftlin Denny Xavier, George Thomas, Sunil Jose, V. J. Vivek, Kanimozhi Selvam, Ashish Ramakrishnan
The study aimed to assess the remineralizing potential of four different commercially available agents using a Scanning Electron Microscope (SEM), energy dispersive X-ray (EDX) analysis, and Vickers Microhardness (VMH) Test. Forty-four specimens (n = 11 per group) were prepared from extracted teeth. A window of 6 mm × 4 mm was made on all the specimens that represented three zones, namely, sound enamel, demineralized enamel, and remineralized enamel. The zone for demineralized enamel was subjected to four different remineralizing agents; casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF), tricalcium phosphate fluoride (TCP-F), calcium sucrose phosphate (CSP), and self-assembling peptide (P11-4). Remineralization (REM) was assessed using VMH; the structural changes were assessed using SEM that was analyzed using EDX analysis. The specimens were subjected to a newer regimen of demineralization. One-way ANOVA followed by post hoc Tukey test was used with a level of significance at P ≤ 0.05. There were no significant differences in VMH between the groups for sound enamel (P = 0.472) and demineralized enamel (P = 0.116). VMH was statistically significantly more for P11-4 and the least for CPP-ACPF (P = 0.011). A post hoc analysis revealed higher VMH for P11-4 compared to CPP-ACPF (P = 0.014) and TCP-F (P = 0.035). SEM showed a homogeneous layer of minerals for all groups except CPP-ACPF. TCP-F reported a higher degree of REM, followed by P11-4 as assessed using EDX analysis. Self-assembling peptide (P11-4) exhibited a higher degree of REM than other remineralizing agents followed by CSP.
该研究旨在使用扫描电子显微镜(SEM)、能量色散 X 射线(EDX)分析和维氏硬度(VMH)测试评估四种不同市售制剂的再矿化潜力。 从拔出的牙齿上制备了 44 个标本(每组 11 个)。在所有试样上开出一个 6 mm × 4 mm 的窗口,代表三个区域,即健全釉质、脱矿釉质和再矿化釉质。脱矿釉质区使用了四种不同的再矿化剂:酪蛋白磷酸肽-无定形磷酸钙氟化物(CPP-ACPF)、磷酸三钙氟化物(TCP-F)、蔗糖磷酸钙(CSP)和自组装肽(P11-4)。使用 VMH 评估再矿化 (REM);使用扫描电镜评估结构变化,并使用 EDX 分析。对标本进行了较新的脱矿化处理。采用单因素方差分析和事后 Tukey 检验,显著性水平为 P ≤0.05。 健全釉质(P = 0.472)和脱矿釉质(P = 0.116)组间的 VMH 无明显差异。在统计学上,P11-4 的 VMH 明显更高,而 CPP-ACPF 的 VMH 最低(P = 0.011)。事后分析显示,P11-4 的 VMH 比 CPP-ACPF (P = 0.014)和 TCP-F (P = 0.035)高。扫描电子显微镜(SEM)显示,除 CPP-ACPF 外,所有组的矿物质层都很均匀。根据 EDX 分析,TCP-F 的 REM 程度更高,其次是 P11-4。 与其他再矿化剂相比,自组装肽(P11-4)的再矿化程度更高,其次是 CSP。
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引用次数: 0
Assessment of the impact of XP-Endo Finisher file on push-out bond strength of various endodontic sealers 评估 XP-Endo Finisher 锉刀对各种牙髓密封剂推出粘接强度的影响
Pub Date : 2024-01-01 DOI: 10.4103/jcde.jcde_189_23
P. Mohite, Divya Gupta, Ruchika Gupta, S. Kamat, Amar Kumar Shaw
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. 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. Analysis of variance and post hoc Tukey’s tests were used for data analysis. 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. 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.
在彻底的化学机械清创后,再以具体的方式将根管闭合,从而达到密封的效果,这样的根管治疗才算成功。由于根管胶不具有粘附性,因此需要使用封闭剂来实现密封。根管封闭剂与水门汀核心和根尖牙本质的充分粘合可确保根尖不渗漏。 我们选择了 60 颗拔出的下颌前磨牙,它们的单根根管在牙本质-牙釉质交界处装饰,并随机分配到两组(n = 30)。第一组使用 BT Race锉,第二组使用BT Race锉和XP Endo锉。使用吸水纸点干燥牙管,并将样本随机分为六个亚组。在子组 I 中,使用生物陶瓷(BC)封闭剂(Endosequence BC)和 BC 牙胶进行封闭。子组 II 使用树脂基(AH plus)封闭剂和牙胶。子组 III 使用氢氧化钙基(Sealapex)封闭剂和古塔波卡。将根部样本垂直切成冠状、中间和根尖段,每段 3 毫米。使用万能试验机对样本进行测试,其中推出粘接强度与获得的最高值相对应。样品的立体显微镜(×20)研究确定了牙本质/封闭器/主锥体界面的破坏模式。 数据分析采用方差分析和事后 Tukey 检验。 使用 XP-Endo 锉刀的 Endosequence BC 显示出最高的平均推出粘接强度(16.31 兆帕),而不使用 XP-Endo 锉刀的 Sealapex 的值最低(12.76 兆帕)。大多数样本都出现了粘合和内聚模式的混合失效。 利用 XP-Endo Finisher 的辅助灌洗搅拌技术有助于根管中难以清除的龛位中的生物膜,从而提高封闭剂的附着力,进而提高封闭剂的粘接强度。
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引用次数: 0
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Journal of Conservative Dentistry and Endodontics
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