Abhishek Parolia

A comparative histological analysis of human pulp following direct pulp capping with Propolis, mineral trioxide aggregate and Dycal

BACKGROUND Permanent teeth pulp exposures have traditionally been treated with calcium hydroxide pulp capping. The aim of this study was to investigate the response of human pulp tissue which were mechanically exposed to a new material, Propolis and compare it with two existing and commonly used pulp capping agents (mineral trioxide aggregate and Dycal). METHODS Thirty-six intact human premolars were mechanically exposed. Teeth were divided into six groups of 6 teeth each and were capped with Propolis, mineral trioxide aggregate and Dycal. Final restoration was done with posterior composite resin using light cured glass ionomer cement as a liner. The teeth were then extracted on the 15th or the 45th day and processed for histological evaluation. RESULTS Differences in inflammatory response and dentine bridge formation of the exposed pulp to the three different materials were statistically calculated using chi-square test and were found to be non-significant. There was more pulp inflammation in teeth treated with Dycal than with Propolis and MTA on the 15th as well as on the 45th day. Propolis and MTA showed bridge formation in more teeth, and the bridges were in closer proximity to pulp capping material than teeth treated with Dycal on the 45th day. CONCLUSIONS The response of pulps to Propolis as a pulp capping agent was comparable to MTA and Dycal.

Biofilm in endodontics: A review.

Endodontic disease is a biofilm-mediated infection, and primary aim in the management of endodontic disease is the elimination of bacterial biofilm from the root canal system. The most common endodontic infection is caused by the surface-associated growth of microorganisms. It is important to apply the biofilm concept to endodontic microbiology to understand the pathogenic potential of the root canal microbiota as well as to form the basis for new approaches for disinfection. It is foremost to understand how the biofilm formed by root canal bacteria resists endodontic treatment measures. Bacterial etiology has been confirmed for common oral diseases such as caries and periodontal and endodontic infections. Bacteria causing these diseases are organized in biofilm structures, which are complex microbial communities composed of a great variety of bacteria with different ecological requirements and pathogenic potential. The biofilm community not only gives bacteria effective protection against the host′s defense system but also makes them more resistant to a variety of disinfecting agents used as oral hygiene products or in the treatment of infections. Successful treatment of these diseases depends on biofilm removal as well as effective killing of biofilm bacteria. So, the fundamental to maintain oral health and prevent dental caries, gingivitis, and periodontitis is to control the oral biofilms. From these aspects, the formation of biofilms carries particular clinical significance because not only host defense mechanisms but also therapeutic efforts including chemical and mechanical antimicrobial treatment measures have the most difficult task of dealing with organisms that are gathered in a biofilm. The aim of this article was to review the mechanisms of biofilms′ formation, their roles in pulpal and periapical pathosis, the different types of biofilms, the factors influencing biofilm formation, the mechanisms of their antimicrobial resistance, techniques to identify biofilms.

Asthma and oral health: a review

Asthma is a chronic inflammatory condition that causes the airways to constrict and produce excess mucus, making breathing difficult. It is characterized by the obstruction of airflow which is variable over a short period of time. This condition is reversible, either spontaneously or can be controlled with the help of drugs. Asthma medication comprises bronchodilators, corticosteroids and anticholinergic drugs. Most of these drugs are inhaled using various forms of inhalers or nebulizers. The effect of these drugs on oral health is the subject of debate among dental practitioners. Patients taking asthma medication may be at risk of dental caries, dental erosion, periodontal diseases and oral candidiasis. Hence, patients with bronchial asthma on medication should receive special prophylactic attention. This article reviews the correlation between asthma and oral health, and suggests various measures to counter possible oral health problems related to asthma.

Management of supernumerary teeth

Supernumerary paramolars are the rare anomalies of the maxillofacial complex. These are more common in the maxilla than in the mandible. This article reviews the etiology, frequency, classification, complications, diagnosis and management of supernumerary teeth (bilateral maxillary paramolars)

Comparison of the shear bond strength of RMGIC to a resin composite using different adhesive systems- An in vitro study

Aim: This study evaluated and compared the role of newer dental adhesives to bond composite resin to the resin modified glass ionomer (RMGIC) liner. Materials and Methods: Thirty-six specimens were prepared on acrylic blocks, with wells prepared in it by drilling holes, to retain the RMGIC. The specimens were randomly divided into three groups of 12 specimens each. In group I, a thin layer of an adhesive, which was a Total-etch type (Adper Single bond-2), was applied between RMGIC and the composite resin. Ingroup II, a Self-Etch adhesive (Adper prompt-L pop) was applied, and in group III there was no application of any adhesive between RMGIC and the composite resin. After curing all the specimens, the shear bond strength was measured using an Instron universal testing machine. Results: The results were drawn and tabulated using ANOVA-fishers and Tukey’s statistical tests. The maximum shear bond strength values were recorded in group II specimens with the self-etch adhesive (Adper prompt-L pop), showing a mean value of 5.826 when compared to the group I adhesive-Total-etch type with a mean shear bond strength of 4.6380, while group III specimens, where no adhesive was used, showed a minimum mean shear bond strength of 2.8385. There was a great and significant difference between group I and group II (P value 0.003), whereas, both group I and group II showed a vast and significant difference from group III (P value 0 – 001). Conclusion: Hence, this present study concludes that application of Self-Etch adhesive (Adper prompt-L pop) in between RMGIC and composite resin increases the shear bond strength between RMGIC and the resin composites, as compared to the Total-etch type adhesives (Adper Single Bond 2), as well as, without application of the adhesive agent.

Comparative evaluation of the effectiveness of desensitizing agents in dentine tubule occlusion using scanning electron microscopy.

BACKGROUND Dentine hypersensitivity (DH) occurs on exposed dentine and is dependent on the patency of dentinal tubules. This study compared the effectiveness of red propolis extract (RPE), calcium sodium phosphosilicate (Novamin) and arginine-calcium carbonate (ACC) in occluding dentine tubules. METHODS Eighty dentine discs from extracted human molars were randomly divided into four groups (n=20): Group 1--RPE; Group 2--Novamin; Group 3--ACC; Group 4--saline. The discs were etched with 37.5% phosphoric acid and treated with the test agents. Ten treated discs from each group were then exposed to 6% citric acid challenge. The extent of tubule occlusion was assessed using scanning electron microscopy (SEM). Three blinded assessors scored each SEM image on the degree of tubule occlusion. Differences in occlusion were tested using ANOVA and Tukey adjustment. RESULTS Discs treated with ACC demonstrated more tubule occlusion, followed by RPE and Novamin, and were greater in statistical significance when compared to discs treated with saline. Following acid challenge, RPE treated discs maintained more occlusion, followed by ACC and Novamin. CONCLUSIONS All three agents demonstrated tubule occlusion. Although ACC showed more occlusion following treatment, RPE demonstrated a higher degree of occlusion following acid challenge.

Effects of saliva contamination and decontamination procedures on shear bond strength of self-etch dentine bonding systems: An in vitro study

Objective: This study aims to evaluate the effect of saliva contamination on the shear bond strength of two self-etch dentine bonding systems and also investigate the effect of decontamination procedure on the recovery of bond strength. Materials and Methods: Sixty premolars extracted for orthodontic reason were obtained and the buccal surfaces of teeth were reduced to create a flat dentine surface. The samples were randomly divided into three sub-groups for AdheSE (ASE) (Ivoclar – Vivadent, Schaan, Liechtenstein) and three sub-groups for Adper Prompt Self-Etch Adhesive (ADP) (3M ESPE, St Paul, MN, USA) of 10 each. For AdheSE (ASE); ASE-I was the control group (primer applied to fresh dentine surface), ASE-II was the contamination group (primer applied, followed by saliva contamination and then air dried) and ASE-III was the decontamination group (primer applied, followed by saliva contamination, air dried and then primer reapplied). For Adper Prompt (ADP); ADP-I was the control group (self-etch adhesive applied to fresh dentine surface), ADP-II was the contamination group (self-etch adhesive applied, followed by saliva contamination and then air dried) and ADP-III was the decontamination group (self-etch adhesive applied, followed by saliva contamination, air dried and then self-etch adhesive reapplied). Followed by the bonding procedure, a 5 mm composite resin block with Filtek P-60 (3M ESPE, St Paul, MN, USA) was built on the substrate. Shear bond strength (SBS) was tested with Instron Universal testing machine (Instron Corporation, Canton, MA, USA) with a cross head speed of 1 mm per minute. Data obtained was subjected to one way ANOVA test, while the inter group comparison was made using Tukey’s multiple comparison and Unpaired t-test. Results: In AdhSE group (ASE), the sub-group ASE-II (contamination group) [5.4 ± 2.2 MPa] showed lower SBS than ASE-I [11.8 ± 2.6 MPa] and ASE-III [8.9 ± 3.3 MPa], which was statistically significant. There was no significant difference in the bond strength between the ASE-I (control group) and ASE-III (decontamination group). In Adper Prompt group (ADP), there was a severe decrease of bond strength in ADP-II (contamination group) [4.6 ± 1.1 MPa] when compared to ADP-I (control group) [7.4 ± 1.4 MPa] and ADP-III (decontamination subgroup) [14.1 ± 2.2 MPa] which was statistically significant. The bond strength of ADP-III wherein Adper Prompt bonding agent was reapplied after salivary contamination was found to be statistically significant than ADP-I and ADP-II. Conclusion: Saliva contamination reduces the dentine bond strength of both the self-etch systems; AdheSE and Adper Prompt. Re-application of the primer for the AdheSE and re-application of the adhesive for the Adper Prompt after air drying the saliva off can recover the dentine bond strength. In the Adper Prompt group, the added application of adhesives to decontaminate saliva not only recovered the bond strength but also improved it significantly.

Use of a natural tooth crown as a pontic following cervical root fracture: a case report

The loss of anterior teeth can be psychologically and socially damaging to the patient. Despite a wide range of treatment options available, traumatised teeth may be inevitably lost on certain occasions. This paper describes the immediate replacement of a right central incisor using a fibre-composite resin with the natural tooth crown as a pontic. The abutment teeth can be conserved with minimal or no preparation, thus keeping the technique reversible, and can be completed at chair side thereby avoiding laboratory costs. It can be used as an interim measure or a definitive prosthesis.

Comparative radiopacity of six current adhesive systems.

Background: The radiopacity of contemporary adhesive systems has been mentioned as the indication for replacement of restorations due to misinterpretation of radiographic images. Aims: This study aimed to evaluate the radiopacity of contemporary bonding agents and to compare their radiodensities with those of enamel and dentin. Methods and Materials: To measure the radiopacity, eight specimens were fabricated from Clearfil SE Bond (CF), Xeno V (XE), Adper SE Bond (ASE), Magic Bond (MB), Single Bond 2 (SB), Scotchbond Multipurpose (SM), and gutta-percha (positive control). The optical densities of enamel, dentin, the bonding agents, gutta-percha, and an aluminium (Al) step wedge were obtained from radiographic images using image analysis software. Statistical Analysis: The radiographic density data were analyzed statistically by analysis of variance and Tukeys test (α =0.05). Results: Significant differences were found between ASE and all other groups tested and between XE and CF. No statistical difference was observed between the radiodensity of 1 mm of Al and 1 mm of dentin, between 2 mm of Al and enamel, and between 5 mm of Al and gutta-percha. Five of the six adhesive resins had radiopacity values that fell below the value for dentin, whereas the radiopacity of ASE adhesive was greater than that of dentin but below that of enamel. Conclusion: This investigation demonstrates that only ASE presented a radiopacity within the values of dentin and enamel. CF, XE, MB, SB, and SM adhesives are all radiolucent and require alterations to their composition to facilitate their detection by means of radiographic images.

Pharmacological Agents in Dentistry: A Review.

All clinicians should be fully aware of the recent trends in their speciality to enable them to provide effective and successful treatment to their patients. One vital aspect of the treatment is that the clinician should constantly update his knowledge on the drugs being administered during the course of treatment and their interactions. The purpose of this article is to review the current pharmacological agents being used in Prosthodontics along with their interactions and indications. The paper mainly focuses on Therapeutic drugs and drugs that aid in prosthodontics treatment. Therapeutic drugs include local anesthetics, antiseptics, steroids, analgesics, antimicrobials, antifungals, antianxity drugs, centrally acting muscle relaxants. Drugs that aid in prosthodontics treatment include astringents, vasoconstrictors, hemostatic agents, sialogogues, anti-sialogogues, denture cleansers, gum paints, denture cleansers, denture adhesives, ORAL protective agents and demulcents. An odontologist should have sound knowledge of the benefits and drawbacks of all these agents. This will enable the clinician to provide a safe and predictable treatment to the patients.