Shashirashmi Acharya

Comparison of the Efficacy of Maleic Acid and Ethylenediaminetetraacetic Acid in Smear Layer Removal from Instrumented Human Root Canal: A Scanning Electron Microscopic Study

INTRODUCTION The aim of this study was to assess, by scanning electron microscopic (SEM) analysis, the ability of 17% EDTA and 7% maleic acid in the removal of the smear layer from the human root canal system. METHODS Eighty single-rooted human anterior teeth were subjected to standardized root canal instrumentation (step-back technique) and were irrigated with 2.5% NaOCl after each instrument. Based on the final irrigating solution used, samples were divided randomly into three groups: (1) the EDTA group: 17% EDTA+ 2.5% NaOCl (n = 30), (2) the maleic acid group: 7% maleic acid + 2.5% NaOCl (n = 30), and (3) the control group: 0.9% saline (n = 20). After final irrigation, teeth were prepared for SEM analysis to evaluate the cleaning of the coronal, middle, and apical thirds of radicular dentin by determining the presence or absence of smear layer. The data was statistically analyzed using the Kruskall-Wallis test. RESULTS At the coronal and middle thirds, there was no significant difference between EDTA and maleic acid. Both were equally efficient in the removal of smear layer. In the apical third, maleic acid showed significantly better smear layer removing ability than EDTA. CONCLUSION Final irrigation with 7% maleic acid is more efficient than 17%EDTA in the removal of smear layer from the apical third of the root canal system, which is a crucial area for disinfection.

Effect of three indigenous food stains on resin-based, microhybrid-, and nanocomposites.

PURPOSE This study investigated the effects of three indigenous food stains (tea, tobacco, turmeric) on a nanocomposite (Ceram-X-Mono, Dentsply DeTery, Konstanz, Germany), a microhybrid posterior (P60, 3M ESPE, St. Paul, MN, USA), and a universal microhybrid (Z100, 3M ESPE) resin-based composite (RBC). MATERIALS AND METHODS Thirty-six disk-shaped specimens were fabricated (10 × 2 mm) for each type of RBC material, using a polytetraflouroethylene (PTFE) sheet. Specimens from each group were randomly distributed into three subgroups for each of the used stains. The baseline color values were measured using a spectrophotometer. The specimens were immersed in the staining solutions for a period of 3 hours per day for 15 days (3 hours/day × 15 days). Following this, the color change value (ΔE) was calculated. RESULTS AND CONCLUSION All the tested groups showed a clinically perceptible color change (ΔE values = 3.3 or >3.3), except for tea-stained P60 (ΔE = 3.15) and Z100 (ΔE = 1.63) groups. Turmeric caused the most significant color change for all the tested RBCs. The least amount of color change was observed with the Z100 (tea, ΔE = 1.63; tobacco, ΔE = 13.59; turmeric, ΔE = 38.77) group that was statistically significant from P60 (tea, ΔE = 3.15; tobacco, ΔE = 18.83; turmeric, ΔE = 57.72), and Ceram-X-Mono (tea, ΔE = 3.32; tobacco, ΔE = 18.83; turmeric, ΔE = 53.95) groups.

Esthetic Management of Fused Carious Teeth: A Case Report

UNLABELLED A rare case of a carious supernumerary tooth fused to the labial surface of a maxillary right central incisor is reported. Root canal therapy on the maxillary right central incisor was performed owing to the pulpal communication between the supernumerary tooth and the maxillary right central incisor after removing the carious supernumerary tooth structure. The defect was then restored with anterior resin composite and the esthetics reestablished. CLINICAL SIGNIFICANCE Clinical significance lies in identifying a rare case of fusion of supernumerary tooth to a permanent tooth and treating the anomaly in the most conservative way.

Evaluation of instant desensitization after a single topical application over 30 days: a randomized trial

BACKGROUND The aim of this study was to evaluate the efficacy of ProArgin(™) (8% arginine), Gluma(®) and NovaMin(®) (5% calcium phosphosilicate) in relieving dentinal hypersensitivity immediately and over 30 days following a single topical application. METHODS A three-cell, parallel group randomized trial was conducted among 56 patients exhibiting dentinal hypersensitivity with tooth as the unit of study. ProArgin(™) paste, Gluma(®) Desensitizer and NovaMin(®) paste were applied on randomly assigned teeth in each participant. Three stimuli were tested: tactile stimulated by running an explorer and measured using VAS (1-10 scale); air blast and cold water stimulated hypersensitivity measured using the Schiff Sensitivity Scale at baseline, immediately, 15 days and 30 days after application. Friedman test and Wilcoxon test were used for within group comparisons. Kruskal-Wallis test and Mann-Whitney U test were used for between group comparisons. RESULTS All three groups showed significant reductions in hypersensitivity from baseline at all time points (p < 0.05). ProArgin(™) paste elicited a significantly higher reduction in hypersensitivity (p < 0.016) compared to Gluma(®) and NovaMin(®) for all stimuli at the end of 30 days. CONCLUSIONS A single topical application of ProArgin(™) paste is significantly more effective than both a single topical application of Gluma(®) and NovaMin(®) paste in relieving dentinal hypersensitivity immediately and over 30 days.

Current Strategies and Applications of Tissue Engineering in Dentistry − A Review Part 1

UNLABELLED A new direction in the field of vital pulp therapy is given by the introduction of tissue engineering as an emerging science. It aims to regenerate a functional tooth-tissue structure by the interplay of three basic key elements: stem cells, morphogens and scaffolds. It is a multidisciplinary approach that combines the principles of biology, medicine, and engineering to repair and/or regenerate a damaged tissue and/or organ. This two part article reviews and discusses the basic concept and strategies so far studied and researched for the engineering of basic dental tissues, to restore a functional tooth anatomy. This first part focuses on a detailed description of key elements used in tissue engineering and their applied clinical applications in dentistry. The second part will deal with the strategies that are being used and/or developed to regenerate the tooth tissues with the help of this scientific principle. CLINICAL RELEVANCE The field of tissue engineering has recently shown promising results and a good prospect in dentistry for the development of the most ideal restorations to replace the lost tooth structure with a functional replacement.

Profilometric study to compare the effectiveness of various finishing and polishing techniques on different restorative glass ionomer cements

Objective: The aim of the present study was to evaluate the effect of various finishing and polishing techniques on the surface roughness of different types of glass ionomer (GI) restorative cements. Materials and Methods: Surface roughness of conventional, resin modified and nano-ionomer cements was evaluated after different polishing regimens. Totally 20 specimens of 12 mm thick and 10 mm diameter were prepared using Teflon mold. Prepared specimens were subjected to polishing (n = 5) by Sof-Lex discs, diamond finishing points and 30-fluted carbide burs. Control specimens did not receive any polishing treatment, but mylar trip was used as matrix. Average surface roughness (Ra) in micrometers was measured using Surtronic 3 + profilometer. Results were analyzed using Kruskal-Wallis and Mann-Whitney test. Results: Control specimens (mylar strip) showed least Ra values followed by Sof-Lex disc, carbide finishing burs and diamond finishing points with all types of glass ionomer cements used in the study. Among the GIs tested, Nano-ionomer showed least Ra followed by resin-modified GI and conventional GI. Conclusion: Mylar strip produced the smoothest surface on all the GIs tested. Nano-Ionomer showed the best polish ability with least Ra values. Clinical Relevance to Interdisciplinary Dentistry Glass ionomer cements (GIC) is one of the most commonly used direct restorative material used in non-stress bearing areas especially to restore cervical lesion at tooth gingival interface Polished GIC surface reduces plaque accumulation and thus decreases the incidence of gingival inflammation and thereby prevents periodontal problems Finishing and polishing of the GIC enhances the longevity and color stability of the restoration.

Interdisciplinary management of a two-rooted mandibular first premolar with furcation involvement: A 2-year follow-up

Consistent knowledge of developmental anomalies along with careful clinical and radiographic interpretation is essential pre-requisites for successful management. This case describes a 2-year follow-up of a case with carious mandibular right first premolar with two roots, three root canals and a deep periodontal probing depth along with an early Grade II furcation involvement. The tooth was endodontically treated followed by periodontal surgery, to eliminate the pocket and promote bone fill in the osseous and furcation defect. Hydroxyapatite graft composited with bioactive glass was utilized for enhancing bone formation. Clinical Relevance to Interdisciplinary Dentistry Detailed knowledge of root anomalies in mandibular premolars is a pre-requisite for successful management of combined endo-perio lesions. Periodontal regenerative procedure using hydroxyapatite graft can be performed to enhance bone formation. Use of radiographs and advanced diagnostic aids are recommended for clinical evaluation of tooth anomalies.