Vasudev Ballal

Assessment of the wetting behavior of three different root canal sealers on root canal dentin

Aim: The objective of the present study was to evaluate and compare the wetting behavior of three different root canal sealers on the root canal dentin surface treated with irrigants and their combination. Materials and Methods: Decoronation and apical third resections of 27 extracted single-rooted human mandibular premolars were done. The roots were then split longitudinally into two halves, and randomly assigned into three treatment groups (n=18). The root dentin surfaces in Group1, Group 2 and Group 3 were treated with 17% ethylene diamine tetra acetic acid (EDTA), 3% sodium hypochlorite (NaOCl) and combination of 17% EDTA and 3% NaOCl, respectively. Each group was subdivided into three subgroups of 6 specimens each, depending on the the sealer used, i.e. sub group A. zinc oxide (ZnOE), sub group B. AH plus, subgroup C. Guttaflow sealer, respectively. The contact angle was measured using First Ten Angstroms (FTA) 200 dynamic contact angle analyzer. Results: The contact angle values for AH Plus sealer were significantly lower when compared to the other two sealer groups. Conclusion: The wettability of AH Plus sealer on the root surface dentin was found to be better than Gutta-Flow and ZnOE sealer.

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.

Comparative evaluation of microleakage in Class V cavities using various glass ionomer cements: An in vitro study

Aim: The study aimed to evaluate the microleakage of nano-filled resin-modified glass ionomer restorative (nano-filled RMGI) in comparison with that of conventional glass ionomer cement (CGIC), and resin-modified glass ionomer cement (RMGIC). Materials and Methods: Forty-five standardized Class V cavity preparations were prepared on sound extracted human molar teeth. Teeth were randomly assigned to three experimental groups of 15 teeth each and restored as follows: Group 1, CGIC; Group 2, RMGIC; and Group 3, nano-filled RMGI. The specimens were placed in a solution of 2% Rhodamine-B dye for 24 h at room temperature under vacuum. Staining along the tooth restoration interface was recorded. Results were analyzed using Kruskal-Wallis and Wilcoxon tests. Results: There were no statistically significant differences in dye leakage between all the three restorative materials for occlusal margins (P = 0.464). Group 3 showed significantly less microleakage compared to Group 1 (P = 0.007) and Group 2 (P = 0.040) at the gingival margins. The degree of microleakage in the gingival margins of each group was more than that found in occlusal margins. Conclusions: No material was able to completely eliminate microleakage at enamel, dentin, or cementum margin. Nano-filled RMGI showed least microleakage compared to other two cements at gingival margins. Clinical Relevance to Interdisciplinary Dentistry Cervical lesions have been a restorative challenge for dentists for many years. An interdisciplinary treatment approach is the appropriate choice in cases where there is gingival recession and cervical lesions. Glass ionomer cements have been commonly used for restoration of cervical lesions. Nano-filled resin-modified glass ionomer cement can be used for the restoration of cervical lesions, as it has a better marginal sealing ability compared to conventional glass ionomer and resin-modified glass ionomer cements.

Comparative evaluation of the accuracy of two electronic apex locators in determining the working length in teeth with simulated apical root resorption: An in vitro study

Introduction: Accurate determination of working length (WL) is a critical factor for endodontic success. This is commonly achieved using an apex locator which is influenced by the presence or absence of the apical constriction. Hence, this study was done to compare the accuracy of two generations of apex locators in teeth with simulated apical root resorption. Materials and Methods: Forty maxillary central incisors were selected and after access preparation, were embedded in an alginate mold. On achieving partial set, teeth were removed, and a 45° oblique cut was made at the apex. The teeth were replanted and stabilized in the mold, and WL was determined using two generations of apex locators (Raypex 5 and Apex NRG XFR). Actual length of teeth (control) was determined by visual method. Statistical Analysis: Results were subjected to statistical analysis using the paired t-test. Results: Raypex 5 and Apex NRG was accurate for only 33.75% and 23.75% of samples, respectively. However, with ±0.5 mm acceptance limit, they showed an average accuracy of 56.2% and 57.5%, respectively. There was no significant difference in the accuracy between the two apex locators. Conclusion: Neither of the two apex locators were 100% accurate in determining the WL.

Effects of chelating agent and acids on Biodentine

BACKGROUND To evaluate the effect of distilled water, ethylenediaminetetraacetic acid (EDTA), phosphoric acid and maleic acid on Biodentine regarding surface topography, microhardness and push-out bond strength (POBS). METHODS Fifty-two cylindrical shaped Biodentine specimens were divided into groups: control (distilled water); EDTA (17% EDTA); PA (37% phosphoric acid); and MA (7% maleic acid). Surfaces were evaluated by topographic analysis and Vickers microhardness test. Topographic changes were evaluated qualitatively and microhardness was statistically analyzed by Kruskal-Wallis test. Forty mandibular molars were used to simulate clinical conditions. The crowns were removed and a perforation was created at the furcal floor. The Biodentine was packed into the root perforations and the roots were divided into four groups (DW, EDTA, PA, MA). Samples were stored and subjected to interfacial analysis. POBS data were analyzed by Kruskal-Wallis and Dunn tests. RESULTS Ethylenediaminetetraacetic acid, MA and PA changed the morphology of the Biodentine surface. PA showed microhardness similar to distilled water (P > 0.05), while MA and EDTA demonstrated reduced values when compared with PA (P < 0.05). PA improved the POBS of Biodentine in comparison with the control. CONCLUSIONS Changes in the topography, microhardness and POBS of Biodentine are associated with irrigant agent used.

Comparative evaluation of ethylenediaminetetraacetic acid, maleic acid, and peracetic acid in smear layer removal from instrumented root canal system: A scanning electron microscopic analysis study

Introduction: The aim of this study was to assess the ability of 7% maleic acid, 0.5% peracetic acid (PAA), and 17% ethylenediaminetetraacetic acid (EDTA) in removing smear layer from root canal system of human teeth using scanning electron microscopic analysis (SEM). Materials and Methods: Thirty-five non-carious human anterior teeth with single roots were selected for the study. Chemo-mechanical preparation was done using crown down technique with irrigation of 2.5% NaOCl after every instrument use. Depending on the final irrigation solution, the samples were divided randomly into three experimental groups and one control group: (1) The maleic acid group: 07% (n = 10), (2) the PAA group: 0.5% (n = 10), (3) the EDTA group: 17% (n = 10), and (4) the control group: 0.9% saline (n = 5). These teeth were then evaluated using SEM analysis for the absence or presence of smear layer, thereby analyzing their cleaning effectiveness in the coronal, middle, and apical thirds of the root canal system. The inter examiners reliability was verified with the use of Kappa test. The data of the score for intragroup comparison and intergroup comparison for evaluation of the presence or absence of smear layer were statistically analyzed by Pearson Chi-square test. The level of statistical significance was set at P < 0.05. Results: In the coronal thirds of the root canal, there was no statistically significant difference between the EDTA and the maleic acid groups when evaluated for their efficacy at smear layer removal. Whereas, maleic acid performed significantly better than PAA and EDTA in removing smear layer from middle and apical thirds of the root canal system. Conclusion: A final irrigation with 7% maleic acid is more efficacious than 17% EDTA and 0.5% PAA when used as a smear layer removal agent in the apical third of the root canal system.

MMP-9 in Dentinal Fluid Correlates with Caries Lesion Depth

The analysis of molecular cues in dentinal fluid from an excavated cavity could improve diagnostics in the context of minimally invasive caries treatment. In the current clinical trial we assessed whether the dentinal fluid levels of MMP-9 (matrix metalloproteinase-9; neutrophil gelatinase) would increase with the progression of carious lesions. MMP-9 is associated with neutrophil-related tissue breakdown in the pulp. Absolute MMP-9 levels were contrasted against the levels of MMP-2, an enzyme related to normal tissue turnover. Dentinal fluid was collected below deep and shallow caries from molars and premolars within the same patients aged 18 years and older (n = 30, 1 tooth per group/patient). Experimental teeth were isolated under a rubber dam prior to excavation. Dentinal fluid was collected from the bottom of the cavity using a size 25 paper point. MMP levels were assessed using an enzyme-linked immunosorbent assay. Nonparametric methods were applied to test for differences between groups. Significantly more (p < 0.05, Wilcoxon test) MMP-9 was collected from the deep carious lesions than from the shallow counterparts. Pairwise comparison of MMP-9 values within patients revealed that there was more MMP-9 collected from deep lesions than from shallow counterparts in 27 of the 30 individuals under investigation (pairwise Wilcoxon test, p < 0.001). In contrast, no such difference existed for MMP-2. There was a high correlation between MMP-9 from deep and shallow lesions (Spearmans ρ = 0.72, p < 0.001), indicating that patients with more MMP-9 in the deep carious lesion also tended to have more MMP-9 in the shallow lesion.

Web Yourself to Cease Bleeding

The presence of dust or cob webs, instigate us to quickly pick up the broom and sweep it off. But, hidden amid the grime may be substances of profound value. The ancient Greeks applied cobwebs directly to wounds. Sounds spooky rite? Spider-web silk has attracted the interest of several researchers in recent years because it displays a unique combination of high tensile strength, high breaking strain and ultra low weight. All spider species spin their silk and uses them for a variety of purposes like dragline for safety, web building to trap their prey and also thick cocoon is used by female spiders for protecting their eggs.

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.

A self-designed instrument to evaluate cavosurface angle for class I amalgam cavity preparation: A learning aid.

Fighting the controversies, amalgam, as a posterior restorative material has survived till date. The fate of amalgam restoration is determined by geometry of the cavity preparation and cavosurface angle is one integral part of the cavity, which decides the marginal characteristics of the restoration and health of the tooth. Low edge strength of amalgam highlights the importance of cavosurface angle. However, at the same time conservation of the tooth also should be considered. This article presents a self-designed instrument to evaluate and obtain a cavosurface angle close to 110°. The design of the instrument also helps in evaluating parameters, such as depth of the cavity, undercut angle, and allows finishing of the buccal or lingual walls.