M Kundabala

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

BACKGROUNDnPermanent 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).nnnMETHODSnThirty-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.nnnRESULTSnDifferences 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.nnnCONCLUSIONSnThe response of pulps to Propolis as a pulp capping agent was comparable to MTA and Dycal.

A comparative in vitro evaluation of cytotoxic effects of EDTA and maleic acid: Root canal irrigants

OBJECTIVEnThe objective of this study was to compare aqueous solutions of ethylenediaminetetraacetic acid (EDTA) with that of maleic acid (MA) for their cytotoxic effect on Chinese hamster fibroblasts (V79) cells growing in vitro.nnnSTUDY DESIGNnExponentially growing V79 cells were treated with various concentrations of EDTA (0.05% to 1.0%) or MA (0.05% to 1.0%) alone for 30 minutes. After treatment, the media was removed, cells were trypsinized, and the cytotoxic effect of EDTA or MA was analyzed by Pratt Willis test and MTT assay. Similarly surviving fraction (clonogenic assay) was performed by treating the V79 cells with different concentrations of EDTA (0.0025% to 0.25%) or MA (0.025% to 0.25%) for 30 minutes. The statistical significance between the various groups was evaluated using the one-way analysis of variance (ANOVA) and Student t test (unpaired) for 2 group comparisons.nnnRESULTSnThere was a significant (P < .01) decrease in the cell viability in a dose-dependent manner indicating the cytotoxic effect of both EDTA and MA when compared with the control group. However, all the dilutions of EDTA were significantly (P < .01) more cytotoxic over that of MA in all 3 assays.nnnCONCLUSIONnThis study for the first time, clearly demonstrated the significantly less toxic effect of MA at a comparable dose of EDTA, suggesting its potential for use as root canal irrigant.

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.

A comparative evaluation of postobturation apical seal following intracanal irrigation with maleic acid and EDTA: a dye leakage under vacuum study.

OBJECTIVEnThe aim of the study was to evaluate the postobturation apical seal following irrigation with 7% maleic acid (MA) or 17% EDTA using dye leakage under vacuum method.nnnSTUDY DESIGNnSeventy single-rooted human anterior teeth were subjected to root canal instrumentation. Based on the final irrigating solution used, samples were divided into 3 groups: (1) 17% EDTA + 2.5% NaOCl, (2) 7% MA + 2.5% NaOCl, (3) 0.9% saline. Then samples were obturated and placed in 2% rhodamine B dye solution under vacuum pressure for 30 minutes and allowed to remain in the dye for 7 days. Samples were then longitudinally split and examined for dye leakage under stereomicroscope. Data were analyzed using the Kruskal-Wallis test.nnnRESULTSnMA showed the least apical leakage compared with EDTA and saline. Saline showed maximum leakage.nnnCONCLUSIONnFinal irrigation with 7% MA improved the postobturation apical seal compared with 17% EDTA.

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.

Antimicrobial efficacy of endodontic irrigants from Azadirachta indica: An in vitro study

Abstract Objective. This study analyzed the antimicrobial effect of five irrigants formulated from different parts of the tree Azadirachta indica (Neem) and compared with 2.5% sodium hypochlorite and 0.2% chlorhexidine gluconate through an agar diffusion test. Materials and methods. A clinical isolate of Candida albicans was innoculated on Sabourad Dextrose Agar and Enterococcus faecalis (ATCC 29212) on Sheep Blood Agar. Wells with 6 mm diameter were created in agar and 100 μL aliquiots of each irrigant were introduced to five different wells. After incubation, the largest uniform diameter of the inhibition zone was recorded. Results. The leaf extract of the tree and a mixture of the seed-bark powder dissolved in dimethyl sulfoxide were active against both organisms. The other neem-based irrigants, a leaf powder dissolved in dimethyl sulfoxide, aqueous bark decoction and neem oil, did not possess any antimicrobial efficacy. Sodium hypochlorite completely inhibited growth of C. albicans and the leaf extract had larger inhibition zones than chlorhexidine (p = 0.011) or the seed-bark irrigant (p = 0.008). Against E. faecalis, inhibition zones with chlorhexidine were the largest and differed significantly from sodium hypochlorite (p = 0.039), leaf extract (p = 0.008) and seed-bark irrigant (p = 0.011). Conclusions. Two neem irrigants displayed antimicrobial properties. The efficacy of the standard endodontic irrigants varied depending on the organisms tested. Clinical relevance: Neem-based endodontic irrigants may be formulated for clinical application.

Comparative anti-microbial efficacy of Azadirachta indica irrigant with standard endodontic irrigants: A preliminary study.

Objective: The anti-microbial efficacy of 2.5% sodium hypochlorite (SHC) and 0.2% chlorhexidine gluconate were compared with an experimental irrigant formulated from the Neem tree, Azadirachta indica A. Juss. Materials and Methods: A sample of 36 single rooted anterior teeth with periapical radiolucency and absence of response to vitality tests that required root canal treatment were selected for this study. The test irrigants and their combinations were assigned to five different groups and saline served as the control. Access cavities were prepared using an aseptic technique and samples collected for both anaerobic culture and Gram stained smears, followed by irrigation and sample collection again. The number of organisms were expressed in colony forming units/ml after 72 h of incubation; the smears were analyzed for their microbial loads and tissue clearance and assessed as per defined criteria. Results: Our results found the maximum reduction in microbial loads, when analyzed by culture method, with a combination of SHC and the experimental neem irrigant. Maximum tissue clearance on the Gram Stained smears was also found with the same combination. Conclusion: Neem irrigant has anti-microbial efficacy and can be considered for endodontic use.

Evaluation of tooth preparations for Class II cavities using magnification loupes among dental interns and final year BDS students in preclinical laboratory

Background: With the advances in optical technology, dentistry has been benefitted in varied ways over the ages. Aim: The aim of this study was to assess the effect of dental magnification loupes on psychomotor skill acquisition during preclinical operative exercise. Methods: 40 Typhodont teeth tooth no. 36 and 46 (Frasaco - U.S.A.) were mounted on the acrylic lower jaw base of Phantom Head. Teeth are prepared for class II (MO) cavity with conservative design using micromotor, mouth mirror and probe. Tooth no.36 was prepared using magnifying loupes while tooth no.46 was prepared without the loupes. Data collected was statistically analyzed using Chi square test. Results: The results revealed that tooth preparations were better under magnifying loupes as compared to those without it with statistically significant difference with Kappa value 0.64 for samples with loupes and 0.76 for without loupes. Moreover, the study samples expressed their difficulty for using the magnifying loupes during the tooth preparation since they were using it for the first time. Conclusions: Magnifying loupes help the dental students to have better vision, thus improved dexterity with hands while preparing the tooth for restoration. However, dental students have to get adapted to the loupes for the ease of using loupes. Using loupes frequently may help them to get adapted to the loupes.