Mithra N Hegde

Internal and external root resorption management: a report of two cases.

ABSTRACT The response of the dentoalveolar apparatus to infection is characterized by inflammation which may result in tooth resorption. Depending upon the type of resorption and etiology, different treatment regimens have been proposed. The following two cases demonstrate internal and external inflammatory root resorption arrest by conventional nonsurgical endodontic therapy combined with calcium hydroxide-iodoform dressing, mineral trioxide aggregate (MTA) and flowable gutta-percha system.The patient has been regularly recalled every 6 months and radiographically the apical lesion showed signs of healing and arrest of root resorption after 1 year and 6 months. How to cite this article: Hegde N, Hegde MN. Internal and External Root Resorption Management: A Report of Two Cases. Int J Clin Pediatr Dent 2013;6(1):44-47.

Correlation between dental caries and salivary immunoglobulin in adult Indian population: An in vivo study

Aim: To evaluate the relationship between dental caries and salivary immunoglobulins (S-Igs) in unstimulated saliva of young adults between the age group of 20 and 30 years from South Canara district, Karnataka with varying caries experience as determined by their Decayed Missing Filled Teeth (DMFT) scores. Materials and Methods: The study was conducted on 80 healthy adult subjects with age group between 20 and 30 years. The healthy subjects without any chronic diseases were selected. The patients were divided into four groups according to DMFT status (WHO, 1997) as G-I, DMFT 0; G-II, DMFT 1-5; G-III, DMFT 6-10; and G-IV, as DMFT above 10. Unstimulated saliva samples were collected from each subjects and checked for S-IgA and IgG. The obtained data was statistically analyzed using one-way ANOVA and Tukey`s Honestly Significant Difference test. Results: Correlation of DMFT with S-IgA showed that as the S-IgA levels decreased in the saliva, there was increase in the DMFT levels. With intergroup comparison of S-IgA, there is no significant difference between group I and group II. There was no significant correlation seen between the S-IgG G levels and dental caries experience. Conclusion: The S-IgA increases with decrease in caries activity and S-IgG does not show any correlation with dental caries.

Leaching of monomers from bulk-fill composites: An in vitro study

Aim and Objectives : To evaluate the elution of bisphenol A-glycidyl methacrylate (BisGMA) and triethylene glycol dimethacrylate (TEGDMA) from two bulk-fill composites at different polymerization times, for different storage periods when cured with quartz-tungsten-halogen (QTH) curing unit. Materials and Methods : Tetric N-Ceram bulk fill and EverX Posterior were analyzed using high-performance liquid chromatography unit. Totally, 68 samples were prepared, two groups (n = 17) from both the composites, one for each tested polymerization time. Each sample was cured with a QTH curing unit, using soft-start curing technique and stored in 2 ml of ethanol for 24 h. Storage medium was renewed and then stored again for 1 week. Data acquired were statistically analyzed. Results : The elution of BisGMA was significantly higher from Tetric N-Ceram bulk fill and BisGMA and TEGDMA from EverX Posterior composite at the end of 24 h, irrespective of the curing time. In EverX Posterior, a higher amount of TEGDMA was eluted at the end of 24 h, while at the end of 1 week, significantly higher amount of BisGMA was released. Conclusion : A significant amount of the release of BisGMA as well as TEGDMA was seen from both the composites when stored for different time intervals.

Vertical root fractures: Review and case report

Vertical root fractures, or VRFs, usually are characterized by an incomplete or complete fracture line that extends through the long axis of the root toward the apex. The cause of VRFs is mainly trauma and iatrogenic reasons. Complete or incomplete VRFs constitute an ongoing problem in dentistry because they are difficult to be diagnosed in the early stages. In most cases, tooth extraction is the only reasonable treatment when the VRF is finally diagnosed. Other options have been put forward such as bonding the two fractured segments and reimplanting the tooth. A similar case has been described here.

Evaluation of Enterococcus faecalis adhesion, penetration, and method to prevent the penetration of Enterococcus faecalis into root cementum: Confocal laser scanning microscope and scanning electron microscope analysis.

Aim: To ascertain the role of Enterococcus faecalis in persistent infection and a possible method to prevent the penetration of E. faecalis into root cementum. Methodology: One hundred and twenty human single-rooted extracted teeth divided into five groups. Group I (control): intact teeth, Group II: no apical treatment done, Group III divided into two subgroups. In Groups IIIa and IIIb, root apex treated with lactic acid of acidic and neutral pH, respectively. Group IV: apical root cementum exposed to lactic acid and roughened to mimic the apical resorption. Group V: apical treatment done same as Group IV and root-end filling done using mineral trioxide aggregate (MTA). Apical one-third of all samples immersed in E. faecalis broth for 8 weeks followed by bone morphogenetic protein and obturation and again immersed into broth for 8 weeks. Teeth split into two halves and observed under confocal laser scanning microscope and scanning electron microscope, organism identified by culture and polymerase chain reaction techniques. Results: Adhesion and penetration was observed in Group IIIa and Group IV. Only adhesion in Group II and IIIB and no adhesion and penetration in Group I and V. Conclusion: Adhesion and penetration of E. faecalis into root cementum providing a long-term nidus for subsequent infection are the possible reason for persistent infection and root-end filling with MTA prevents the adhesion and penetration.

Analysis of marginal seal of ProRoot MTA, MTA Angelus biodentine, and glass ionomer cement as root-end filling materials: An in vitro study

Background: Search for a root-end filling material fulfilling all the ideal characteristics is an ongoing process. The present study aimed to evaluate the marginal seal of the following materials when used as root-end filling materials, MTA Angelus, White ProRoot MTA, Biodentine and Glass ionomer cement (GIC). Materials and Methods: Sixty single-rooted maxillary central incisors were included in the study. The crowns were resected followed by cleaning and shaping with hand files and protaper rotary files followed by obturation of the roots. The root ends were resected at 3 mm level. Then, root-end cavity preparation of 3 mm depth was done using ultrasonic tips. The samples were randomly divided into four groups of 15 each and cavities restored with, such as (1) Group 1: MTA Angelus, (2) Group 2: ProRoot MTA, (3) Group 3: Biodentine, and (4) Group 4: GIC. The root samples were coated with two coats of nail varnish and immersed in methylene blue dye 2% for 48 h. Longitudinal root resection was done. The depth of dye penetration was evaluated under the stereomicroscope to examine the extent of microleakage. The amount of dye penetration was measured in millimeters. The results were then statistically analyzed using one-way analysis of variance and post-hoc Tukey′s test. Conclusion: Microleakage was present in all the samples. Least amount of apical dye microleakage was seen in biodentine with mean value of 0.16 mm followed by ProRoot MTA 0.68 mm, MTA Angelus 0.74 mm, and GIC 1.53 mm. The best sealing ability was seen in biodentine, and this difference was statistically significant.

Prevalence of permanent anterior tooth fracture due to trauma in South Indian population

Aim: The aim of the study is to determine the prevalence of permanent anterior teeth fracture due to trauma in South Indian population. Materials and Methods: After formal consent, study was conducted on 2000 patients reporting for treatment in A B Shetty Memorial Institute of Dental Sciences and Rural Satellite Centers from June to December 2013. They were examined under good illumination using sterilized mouth mirror, explorer and cotton rolls. Results were evaluated using Pearson Chi-square test. Results: Of 2000 patients, overall prevalence of anterior teeth fracture due to trauma was 14.85%, 53.9% cases were noticed in the age group of 15-30 years, 20.2% cases in an age group of 12-15 years. Of 14.85% (297) cases, 53.9% males and 46.1% females had anterior teeth fracture, 88.67% cases were with respect to maxillary arch and 11.33% cases were with respect to mandibular arch. 43.9% patients had enamel and dentin fracture, only enamel fracture was seen in 31.6% patients and the least was 6.01% which showed displacement of tooth without crown or root fracture, 67% were because of falls and rest of the 33% of patients had anterior tooth fracture because of violence, sports and traffic accidents, 71.42% cases had fracture with maxillary central incisor. Furthermore, 59.6% cases were seen with Class II Division I malocclusion. Conclusions: In the present study we noticed that fall was the most frequent cause and are seen more in males with an increased prevalence in 15-30 years of age. Furthermore, fracture of maxillary central incisor was most common and among all, fractures involving enamel and dentin were most common.

Laser induced biostimulation: A possible healing prospect in endo-perio lesion

The health of the tooth is governed by both endodontic tissue and periodontal apparatus. Endo-perio lesion is the term used to describe the lesions in which inflammatory products involves both pulpal and periodontal tissues in varying degrees. The disease of endodontium may lead to the involvement of the periodontium and vice versa. Endo-perio lesions are the clinical conditions that are often difficult to diagnose and persistent if not treated appropriately. Lasers have been used successfully in endodontic as well as periodontal procedures. With endodontic treatment alone, only part of the lesion will heal to the level of the secondary periodontal lesion. Overall prognosis depends upon the severity of periodontal damage and the efficacy of the periodontal treatment. Laser can be considered as an efficacious tool and an adjunct to conventional periodontal therapy both for its decontaminating and biostimulating effects.

Nanoleakage phenomenon on deproteinized human dentin—an in vitro study

Abstract Aim The purpose of this study is to evaluate the influence of sodium hypochlorite (NaOCl) on the nanoleakage phenomenon at resin-dentin interface using two different bonding systems. Materials and Method Class V cavities were prepared in 40 human premolars on buccal surfaces with cervical margins located in dentin. The cavities were assigned to two major groups: Group I—teeth not treated with NaOCl; and Group II—teeth treated with NaOCl. Groups were further divided into two sub-groups: Sub-group A—teeth bonded with total-etch adhesive system; and Sub-group B—teeth bonded with self-etch adhesive system. In all the groups, dentin was treated following manufacturers instructions. Group II was treated according to manufacturers instructions +5% NaOCl. Dentin bonding systems used were XP Bond (total-etch system) and Xeno V (self-etch system). The cavities were restored with composite resin. The specimens were immersed in AgNO 3 (50%) for 24 hours, rinsed under running water for 5 minutes, immersed in a photo developing solution, and exposed to a fluorescent light for 8 hours. The teeth were sectioned buccolingually through the center of the restorations, and nanoleakage pattern was evaluated by scanning electron microscope (SEM). Results The SEM analysis showed that irrespective of the dentin treatments, both the dentin bonding systems showed nanoleakage. Self-etch bonding system which was not treated with NaOCl showed the least nanoleakage. Conclusion The influence of dentin deproteinization on the nanoleakage phenomenon was dependent on the dentin bonding system formulation and bonding strategies.

Salivary Proteins—A Barrier on Enamel Demineralization: An in vitro Study

Aim The aim of this study is to evaluate the protective effect of the salivary proteins on the demineralization of enamel. Materials and methods Twenty freshly extracted human molar teeth were used in this study. Enamel samples (2 mm thickness) were prepared from the buccal and lingual surfaces of the teeth selected. An acid-resistant nail varnish was used to cover every aspect of the sample, except an area of 5 * 5 mm limited by an adhesive tape. After drying, the adhesive tape was removed, exhibiting a rectangular area on the enamel surface. Samples were divided into two groups: Group I (10 samples): Each sample was coated by 100 μg of albumin for 2 hours at 37°C. Group II (10samples): Each sample was exposed to 100 μL of deionized water. Samples were washed by dipping once in deionized water. They were then disposed into individual tubes containing demineralization solution for 1, 2, 3, and 4 minutes at 37°C with gentle agitation. The demineralization solution was utilized to determine the calcium loss from specimens at 1, 2, 3, 4 minutes using an ultraviolet-visible spectrophotometer. Results Calcium loss was less from the albumin-coated samples than control group at all times and was statistically significant (p < 0.05). Also, calcium loss was maximum at the end of 1 minute, and it decreased as time interval increased and was statistically significant (p < 0.001). Conclusion Albumin has provided a strong protection against enamel demineralization at all times compared to the one without it. How to cite this article Hegde MN, Sajnani AR. Salivary Proteins—A Barrier on Enamel Demineralization: An in vitro Study. Int J Clin Pediatr Dent 2017;10(1):10-13.