B Nandlal

Efficacy of various root canal irrigants on removal of smear layer in the primary root canals after hand instrumentation: A scanning electron microscopy study

AIM The purpose of this in-vitro study is to determine the efficacy of various irrigants in removing the smear layer in primary teeth root canals after hand instrumentation. MATERIALS AND METHODS The present study consisted of 30 human primary incisors which were sectioned at the cementoenamel junction horizontally. The specimens were divided randomly into four experimental and one control group having six teeth each and each group was treated with the specific irrigant. 5.25% NaOCl, 5.25% NaOCl + 10% EDTA, 6% citric acid, 2% chlorhexidine, saline (control) were the irrigants evaluated for efficacy in removal of smear layer. The specimens were split along the longitudinal axis using a chisel after placing superficial grooves in cementum not extending to the root canal. The exposed surface was subjected to scanning electron microscopic analysis to reveal the efficacy of irrigants in removal of smear layer. The representative areas were evaluated twice at 15 days interval by a single evaluator. The scale for the smear layer removal by Rome et al was modified and used in the present study. RESULTS The pictures from the scanning electron microscopy showed that among the tested irrigants, citric acid has the best efficacy to remove the smear layer without altering the normal dentinal structures, which was supported by the lowest mean smear scores. The pictures from the 10%EDTA + 5.25% sodium hypochlorite group showed that even though it removed the smear layer, it adversely affected the dentine structure. SEM pictures of the other groups like sodium hypochlorite, chlorhexidine revealed that these irrigants does not have the capacity to remove the smear layer in primary teeth. CONCLUSIONS The results of the present study clearly indicate the superior efficacy of 6% citric acid than the other tested irrigants on removing the smear layer in primary teeth root canals.

Comparative evaluation of fluoride release from PRG-composites and compomer on application of topical fluoride: An in-vitro study

AIMS AND OBJECTIVE To determine the fluoride release from Giomer and Compomer, using different topical fluoride regimes, and to compare the amount of fluoride release from giomer with that of compomer. MATERIALS AND METHOD Forty-eight specimens of each giomer and compomer were divided into four treatment groups, namely, control group, fluoridated dentifrice (500 ppm) once daily group, fluoridated dentifrice (500 ppm) twice daily group, fluoridated dentifrice (500 ppm) once daily + fluoridated mouthwash (225 ppm) group. Each specimen was suspended in demineralizing solution for six hours and remineralizing solution for 18 hours. Fluoride release was measured in both the demineralizing solution and remineralizing solution daily for seven days. Total daily fluoride release for each specimen was calculated by adding the amount released in the demineralizing solution to that released in remineralizing solution. RESULTS AND CONCLUSION The fluoride release (ppm) was found to be more in Giomer when compared to Compomer. The fluoride released from Giomer and Compomer was significantly greater in the acidic demineralizing solution than in the neutral remineralizing solution. It was found that increasing fluoride exposure significantly increased fluoride release from the giomer and compomer. It was found that the fluoride release from the subgroups of giomer and compomer was in the following order: fluoridated dentifrice twice daily > fluoridated dentifrice once daily + fluoridated mouthwash > fluoridated dentifrice once daily > control group. It was found that the giomer showed a greater fluoride uptake than the compomer.

Effect of low-concentration daily topical fluoride application on fluoride release of giomer and compomer: an in vitro study.

AIMS AND OBJECTIVE To determine the effect of low-concentration daily topical fluoride application on fluoride release of Giomer and Compomer and to compare the amount of fluoride release from Giomer to that of Compomer. MATERIALS AND METHODS Forty-eight specimens of each Giomer and Compomer were divided into four treatment groups, namely, control group, fluoridated dentifrice (500 ppm) once-daily group, fluoridated dentifrice (500 ppm) twice-daily group and fluoridated dentifrice (500 ppm) once-daily + fluoridated mouthwash (225 ppm) group. Each specimen was suspended in demineralising solution for 6 h and remineralising solution for 18 h. Fluoride release was measured in both the demineralising solution and the remineralising solution daily for 21 days. Total daily fluoride release for each specimen was calculated by adding the amount released in the demineralising solution to that released in the remineralising solution. RESULTS AND CONCLUSION The fluoride release (ppm) was found to be higher in Giomer when compared with Compomer. The fluoride released from Giomer and Compomer was significantly higher in the acidic demineralising solution than in the neutral remineralising solution. It was found that increasing fluoride exposure significantly increased fluoride release from Giomer and Compomer. It was found that the fluoride release from the subgroups of Giomer and Compomer was in the following order: fluoridated dentifrice twice-daily > fluoridated dentifrice once-daily + fluoridated mouthwash > fluoridated dentifrice once-daily > control group. It was found that Giomer showed a greater fluoride uptake Compomer.

Effects of asthma and inhalation corticosteroids on the dental arch morphology in children.

BACKGROUND Hereditary, environmental and developmental factors play an important role in dentofacial development, as well as the initiation of malocclusion disorder. Allergic phenomenon such as asthma that induces an alternative mode of breathing in patients is a contributing factor in development of the dental arch. AIM Our aim in this study was to evaluate the dentoalveolar morphology in asthmatic children and to analyze the effects of asthmatic medications on the dental arch. SETTING AND DESIGN This study is centered on 44 asthmatic children aged between 6-12 years from J.S.S Hospital, Mysore. Selected variables from model analysis of the casts of the asthmatic group were subjected to comparison with those of the non-asthmatic group, which comprised of 44 non-asthmatic children. Selected parameters were arch width, arch length and palatal depth. MATERIALS AND METHODS Impressions of upper and lower arches were made with rubber based impression material. A sliding digital caliper was used to measure the casts for arch width and arch length. A palatal depth gauge was used to measure the palatal depth. STATISTICAL ANALYSIS Differences in arch widths, arch lengths and palatal depths between asthmatics and non-asthmatics groups were evaluated by independent sample t-tests. Chi-square test was applied to assess the frequency of occurrence of malocclusion in the asthmatic children. RESULT The results obtained revealed that the arch length and palatal depth of asthmatic group had higher values compared to that of non-asthmatic groups for both age groups (6 to 8-year-old males and females, 10 to 12-year-old males and females). Inter molar width showed a significant lower value in asthmatics in the maxillary arches of 10 to 12-year-old females. Fifty percent of the asthmatic children aged 10 to 12-years had open-bite. Children under regular medication showed significant deviation in the dentoalveolar morphology as compared to those under irregular medication. CONCLUSION The present study proves a strong relation between asthma and dentoalveolar morphology.

Comparative evaluation of fluoride release from hydroxyapatite incorporated and conventional glass ionomer cement: An in vitro study

BACKGROUND Glass ionomers are most commonly used esthetic restorative material, but has inferior mechanical properties. The search to improve its mechanical properties led to the use of hydroxyapatite (HA) whiskers as strengthening material for glass ionomer cement but its effect on fluoride release is still not clear. AIMS To evaluate and compare the fluoride release from HA incorporated glass ionomer and conventional glass ionomer cement (CGIC). SETTINGS AND DESIGN This in vitro study comprised of total forty sample. Twenty Specimens of each HA incorporated glass ionomer and conventional glass ionomer were fabricated. MATERIALS AND METHODS Specimens were suspended individually in 25 mL of distilled water in a 50 mL plastic container and stored at 37°C. Distilled water was renewed every 24 h for 21 days. Fluoride release of sample was measured every 24 h for 7 days and weekly from 7 th day to 21 st day using Sension4 pH/ion selective electrode/mV meter. STATISTICAL ANALYSIS USED Descriptive statistics, Repeated Measure analysis of variance, Paired Sample t-test, Independent Sample t-test, scheffe post hoc test. RESULTS AND CONCLUSION There was a significant decrease in the mean fluoride release from day 1 to day 21 for both the groups hydroxyapatite glass ionomer cement and conventional glass ionomer cement ([HA-GIC] and CGIC). Though, the mean values of HA-GIC were slightly lower than C GIC, there was no statistically significant difference in the mean fluoride release between HA-GIC and CGIC throughout the experimental period. Within the limitations of this experimental design, definitive conclusions cannot be drawn and further investigations at a molecular level are needed to evaluate the trend of fluoride release from this material.

Comparative evaluation of shear bond strength of nano-hydroxyapatite incorporated glass ionomer cement and conventional glass ionomer cement on dense synthetic hydroxyapatite disk: An in vitro study

AIM The aim was to evaluate and compare the shear bond strength of nano-hydroxyapatite (Nano-HAp) incorporated and conventional glass ionomer cement (GIC). MATERIALS AND METHODS Nano-HAp GIC was prepared by replacing 8 wt% of GIC powder with nano-HAp powder. Twenty-six HAp disks were used as substrate for bonding and divided into two equal groups. Before bonding the HAp disk was prepared by silicon carbide (no. 2500) followed by 10% polyacrylic acid conditioning. The standardized samples were prepared using split teflon mold on customized bonding jig so as to adhere testing materials to pretreated HAp disk. These samples were stored in distilled water for 24 h at 37°C before bond strength testing. RESULTS The descriptive statistical analysis and independent samples t-test were used. The nano-HAp incorporated and conventional GIC had the mean shear bond strength of 3.28 ± 0.89 MPa and 5.25 ± 0.88 MPa, respectively. Nano-HAp incorporated GIC had lower shear bond strength with very high level of significance (P < 0.001). The nano-HAp incorporated GIC showed mainly mixed type of failure whereas conventional GIC showed mainly a cohesive failure. CONCLUSION The lower shear bond strength of nano-HAp incorporate GIC revealed that the addition of nano-HAp interfered with the bonding ability of GIC to the substrate interface, but the mixed type of failure in nano-HAp incorporated GIC suggests that it increases the strength of the matrix. However, the role of nano-size particles on the micro-size particles of GIC for the bonding mechanism and the ratio and proportions of nano-HAp to the GIC needs further elucidation.

Correlation of oral health status of socially handicapped children with their oral heath knowledge, attitude, and practices from India.

Background: Information on oral health knowledge and practice in orphanage house children is essential for healthcare policy makers to promote oral health resources and address oral health needs of this unprivileged group of society. Objectives: To assess the source of information, level of knowledge, attitude, and practice toward oral hygiene and oral health among socially handicapped children from city of Mysore, Karnataka state, India. Materials and Methods: A cross-sectional survey was conducted among 488 children of 12-14 years of age living in five different orphanage houses of Mysore district. Data regarding knowledge and practice were collected through structured questionnaire and oral health status by type III clinical oral examinations by two trained examiners. Decayed, Missing, Filled, Teeth (DMFT) and OH I-S was then correlated with the above information. Spearmans correlation test was used to measure the correlation. Results: The final data analysis included 488 children, of which 216 (44.26%) were boys and 272 (55.74%) were girls. A total of 88.5% children showed one or more decayed teeth in their oral cavity, with an overall mean DMFT of 3.55. Among DMF, component D showed maximum value with mean 3.42, followed by components F and M. Correlation between source of information, knowledge, and attitude for oral health to oral hygiene index (OHI-S; P < 0.05) and gingival index (P < 0.001) showed highly significant negative values. Correlation between oral hygiene practice to OHI-S, DMFT, and gingival index (P < 0.001) showed highly significant (P < 0.001) negative values. Conclusions: Although children of orphanage have positive attitude toward oral health, knowledge and practice among children are still below the satisfactory level. The children did not receive appropriate information or, if informed, were not re-evaluated or reinforced for its practical application by the concerned authority. The findings of this study suggest that awareness on the importance of oral health needs to be enhanced among the orphanage children of Mysore.

Effect of nano-filled surface coating agent on fluoride release from conventional glass ionomer cement: An in vitro trial

CONTEXT To overcome the drawbacks of glass ionomer cement of sensitivity to initial desiccation and moisture contamination the use of surface coating agent is recommended. The search in this area led to invent of use of nanofillers in surface coating agent, but its effect on fluoride release is not clear. AIM The aim of this study is to evaluate and compare the fluoride release from conventional glass ionomer cement with and without surface coating agent. SETTINGS AND DESIGN This in vitro study comprised of total 80 samples (40 samples of each with and without surface coating). MATERIALS AND METHODS Specimens were prepared, G coat plus was applied and light cured. Fluoride release of the sample was measured every 24 h for 7 days and weekly from 7th to 21 st day using Sension4 pH/ISE/MV Meter. STATISTICAL ANALYSIS USED Descriptive Statistics, Repeated Measure ANOVA, Paired Sample t-test, Independent Sample t-test, Scheffe post hoc test. RESULTS Mean values clearly reveal a significant decrease in the fluoride release from day 1 to day 21 for both groups. Non-coated group released significantly more fluoride than surface coated group (P<0.001). CONCLUSIONS It can be concluded that nanofilled surface coating agent will reduce the amount of fluoride released into oral environment as compared to non-coated group and at the same time releasing fluoride into surrounding cavity walls to create zones of inhibition into the cavity floor to help internal remineralization.

Management of recurrent fracture of central incisor with internal resorption using light transmitting (luminex) post.

The normal root canal anatomy may be altered in various pathological processes and making it very difficult and at times impossible to achieve ideal obturation by normal methods. Internal resorption is one among them. There are several treatment protocols advised for this pathological condition. A crown-root fracture is defined as a fracture involving enamel, dentin and cementum and accounts for 5% of all traumatic injuries to the permanent dentition. In anterior teeth, these fractures are usually caused by direct trauma and often complicated in fully erupted teeth. In cases where the fracture line extends down along the long axis of the root, extraction of the tooth is indicated. The purpose of this report is to present the use of light transmitting post system to reinforce the crown root fractured maxillary central incisor due to trauma and internal resorption.

Comparative evaluation of the effect of cavity disinfectants on the fracture resistance of primary molars restored with indirect composite inlays: An in vitro study

A study was conducted to evaluate and compare the effect of cavity disinfectants on the fracture resistance of primary molars restored with indirect composite inlays. Thirty-six non-carious primary second molars were selected and divided randomly into three groups (n = 12): control group (no disinfectant), chlorhexidine group (disinfected with 2% chlorhexidine for 40 seconds) and sodium hypochlorite group crowns (disinfected with 2% chlorhexidine for 40 seconds). The inlays were fabricated by indirect method using Ceram X nanocomposite on plaster die. All the groups were submitted to compression mechanic test in a Hounsfield universal testing machine at 1 mm/min cross-head speed and the results were calculated in Newtons. Descriptive statistics, independent t test, and one way analysis of variance (ANOVA) test revealed the mean fracture resistance of three groups, i.e., control group, chlorhexidine group and sodium hypochlorite group to be 2260.66, 1858.08 and 1310.66, respectively. When intragroup comparisons were made, a significant difference was observed in all the groups (P<0.001). Scheffes post hoc test revealed that control group had the highest fracture resistance, followed by chlorhexidine group, and sodium hypochlorite group had the least fracture resistance. Each value differed significantly from the other (P<0.05). Cavity disinfectants used in the present study had detrimental effect on the fracture resistance of primary molars. Among the disinfectants employed in the present study, chlorhexidine showed a better resistance to fracture than sodium hypochlorite.