Vineeta Nikhil

An in vitro study of antibacterial effect of calcium hydroxide and chlorhexidine on Enterococcus faecalis.

AIMnTo evaluate and compare the antibacterial effects of chlorhexidine and calcium hydroxide on Enterococcus faecalis.nnnMATERIALS AND METHODSnRoot canal treatment involves a number of steps. In spite of all the steps done thoroughly, root canal treatment might fail due to the remnant microbes. Of all such bacteria, E. faecalis is found in failed root canals. The study tests the antibacterial activity of various intracanal medicaments. Agar diffusion test was used to evaluate the antibacterial effects of the following antibacterial agents: i. hexidine:0.2% chlorhexidine gluconate; ii. periogard:0.12% chlorhexidine gluconate; iii. calcium hydroxide powder plus sterile water; iv. metapaste plus sterile water; v. calcium hydroxide plus hexidine; vi. calcium hydroxide plus periogard; vii. metapaste plus hexidine; viii. metapaste plus periogard. The size of zones of inhibition was measured.nnnRESULTSnThe average size of zones of inhibition after 72 hours were hexidine: 5 mm; periogard: 4.25 mm; calcium hydroxide plus sterile water: 0.5 mm; metapaste plus sterile water: 0.5 mm; calcium hydroxide plus hexidine: 4.7 mm; calcium hydroxide plus periogard: 4 mm; metapaste plus hexidine: 4.65 mm; metapaste plus periogard: 4 mm. Results were subjected to statistical analysis using one way analysis of variance and Tukey tests.nnnCONCLUSIONnChlorhexidine and its preparations are more potent antibacterial agents against E. faecalis in comparison to calcium hydroxide.

Multiple idiopathic external apical root resorption: A rare case report

Multiple idiopathic external apical root resorption (MIEARR) is a relatively rare condition affecting multiple teeth in a dentition. As the condition is nonsymptomatic, a case is usually detected as an incidental radiographic finding. However, it may cause pain and mobility in severe cases. It is sometimes self-limiting or sometimes may progress to tooth loss. This paper presents a case of external apical root resorption involving multiple teeth in which etiology was not identified, so idiopathic root resorption was considered as a diagnosis of exclusion.

Confocal laser scanning microscopic investigation of ultrasonic, sonic, and rotary sealer placement techniques

Background: Sealers are used to attain an impervious seal between the core material and root canal walls. Aim: To compare the depth and percentage of sealer penetration with three different placement techniques using confocal laser scanning microscopy as the evaluative tool. Materials and Methods: Root canals of 30 single-rooted teeth were prepared to a size of F3 and AH plus sealer with Rhodamine B was applied with Ultlrasonic file (Gr-1), lentulospiral (Gr-2), and Endoactivator (Gr-3). Canals were obturated with gutta-percha. The roots were sectioned at the 3 and 6-mm levels from the apical foramen and were examined on a confocal microscope. Results: A statistical significant differences among Gr-1, Gr-2, and Gr-3 were found at the 3 and 6-mm level (P < 0.05; ANOVA-Tukey tests) for the depth and percentage of sealer penetration except for Gr-1 and Gr-2 at 3-mm level. Gr-1 showed maximum mean depth of penetration (810 μm) and maximum mean percentage of sealer penetration (64.5) while Gr-3 showed minimum mean depth of penetration (112.7 μm) and minimum mean percentage of sealer penetration (26.7). Conclusion: Depth and percentage of penetration of sealer is influenced by the type of placement technique and by the root canal level with penetration decreasing apically.

Effect of occlusal restoration on stresses around class V restoration interface: a finite-element study.

BACKGROUNDnCauses of failures in class V restorations have always been controversial until now, since the biomechanical aspects of these restorations have been understood.nnnAIMS AND OBJECTIVEnThis study was aimed to verify the hypothesis that eccentric forces are the cause of cuspal flexure, which lead to excessive stresses at the periphery of a class V restoration, further it identifies the amount of the stress and the flexure increase in the presence of an occlusal restoration using different restorative materials to restore (both cervical and occlusal) along with their comparison with respect to amount of stresses around the cervical restorations.nnnMATERIALS AND METHODSnThe study was done by modeling a mandibular first premolar which was sectioned bucco-lingually, in the NISA, EMRC II finite element software. A 100N eccentric load was applied on the tooth structure and stresses were observed at the peripheries of the class V restoration when it was restored with composite and with glass ionomer cement. The stresses were further analyzed in the presence of occlusal restorations with different materials and configurations.nnnRESULTSnIt was seen that the stresses at the gingival wall interface in case of class V glass ionomer cement was more than that for composite. In the presence of an occlusal amalgam restoration, the cuspal flexure was more than that of occlusal composite and the stresses at the class V peripheries were also statistically significant.nnnCONCLUSIONnIt was suggested that lower modulus composites can flex with the tooth structure decreasing the bond failure and that the stresses are much lesser when there is absence of an occlusal restoration. Occlusal composite restorations reinforce the tooth structure and reduce the cuspal flexure as compared to silver amalgam.

Comparative evaluation of bond strength of three contemporary self-etch adhesives: An ex vivo study

Aim: This study evaluated the effect of 2-hydroxymethyl methacrylate (HEMA) and the type of solvent on the tensile bond strength of the following three self-etch adhesives: Adper easy one (HEMA-rich adhesive) which contained ethanol, G-Bond (HEMA-free adhesive) which contained acetone, and Xeno V (HEMA-free adhesive) which contained butanol as a solvent. Material and Methods: Intact mandibular molars were mounted in self-cured resin and the occlusal surfaces were ground with # 600 SiC paper. Adhesives were applied on the prepared dentinal surfaces and the resin composite was condensed in the split brass mold (5 × 3 mm) placed over the adhesive surface. The specimens were stored in normal saline and placed in incubator at 37°C. After 24 hours, the specimens were tested in tensile mode at a crosshead speed of 1 mm/min. Statistical analysis was done using One way ANOVA and Tukeys HSD test. Results: The mean bond strengths of Adper easy one, G-Bond, and Xeno V were 12.41 MPa, 10.09 MPa, and 8.67 MPa, respectively. Conclusions: Comparison of contemporary adhesives in this ex vivo study revealed that the ethanol-based HEMA-rich self-etch adhesive is better than HEMA-free self-etch adhesive that contained acetone and butanol as the solvents, when compared in terms of bond strength.

An in vivo comparative evaluation to determine the accuracy of working length between radiographic and electronic apex locators.

BACKGROUNDnAn in vivo comparative evaluation to determine the accuracy of working length between radiographic and electronic apex locators.nnnAIMnThe study was aimed at evaluating the accuracy of electronic apex locator, to determine the working length of root canal, and to compare it with the radiographic method of working length determination.nnnMATERIALS AND METHODSnA total of 20 teeth selected for the study had to go for extraction because of periodontal or orthodontic reasons. Access cavity was prepared and the clinical estimated working length (CEWL) was determined with 10-25 no. K-file. A radiograph was then taken for determining the radiographic estimated working length (REWL). For electronic measurement of root canal, a 10 no. K-file was advanced toward the apex until it reached a 0.5 mm short of apex as shown by the apex locator. After fixing the file with a light cured composite, the tooth was extracted, the tooth surface was then longitudinally grounded using straight fissure diamond bur until the root canal and the tip of the file were visible. The distance of file from the minor constriction was measured with help of stereomicroscope.nnnSTATISTICAL ANALYSISnThe chi-square test was used for statistical analysis for this study.nnnRESULTSnThe chi-square test where χ² = 21.034 with P = 0.000 indicated that a significant difference exists among the groups. The electronic method showed highest number of cases with the working length at the minor constrictor.nnnCONCLUSIONnThe electronic method for determining the working length of root canal was found to be more accurate than the radiographic method.

An in vitro study to determine the sealing ability of sealers with and without smear layer removal.

Aims/Objectives: The objective of this in vitro study is to compare the sealing ability of Ketac-Endo and Acroseal. Materials and Methods: Seventy teeth were selected and sectioned at the cementoenamel junction. The teeth were cleaned and shaped, and they were divided into five different groups. Group1: 20 teeth in which the smear layer was left intact using sodium hypochlorite. Group 2: 20 teeth in which the smear layer was removed using 17% EDTA. Group 3: 20 teeth in which the smear layer was removed using 17% EGTA. These groups (1, 2, and 3) were further subdivided into two subgroups (a and b) by obturation utilizing lateral condensation with Gutta-percha and Acroseal (subgroup “a”) or Ketac-Endo (subgroup “b”). The subgroups contained 10 teeth each. Group 4: 5 teeth that were instrumented but not obturated. Group 5:5 teeth that were neither instrumented nor obturated. The specimens were immersed in methylene blue dye, and microleakage was assessed using a stereomicroscope. Results: The data was analyzed using one way analysis of variance and students t-test. Conclusion: 17% EGTA is a better and potent alternative to 17% EDTA for smear layer removal. Acroseal sealer has less microleakage as compared with Ketac-Endo. Sealing ability of Acroseal sealer is better when it is used in conjunction with 17% EGTA.

Effect of addition of 2% chlorhexidine or 10% doxycycline on antimicrobial activity of biodentine

Aim: The purpose of this in vitro study was to determine whether the addition of 2% chlorhexidine gluconate or 10% doxycycline would enhance the antimicrobial activity of Biodentine against Staphylococcus aureus (ATCC-25923), Enterococcus faecalis (ATCC-29212), Candida albicans (ATCC-90028), and Streptococcus mutans (MTCC-497). Materials and Methods: Three wells of 4 mm diameter and 4 mm depth on each plate were prepared on the agar medium with standardized suspensions of each microorganism. Biodentine powder mixed with 2% chlorhexidine (0.06 g) or 10% doxycycline (0.30 g) in its liquid or liquid alone was placed to fill each well. Plates were incubated at 37°C as required for microbial growth. A blinded, independent observer measured zones of inhibition. The data were analyzed using independent “t” test to compare the differences among the three cement preparations for different micro-organisms. Results: All Biodentine samples inhibited microbial growth. The highest mean diameters of zone of inhibition for all the micro-organisms were found around Biodentine/chlorhexidine (13.417) followed by Biodentine alone (12.236) and Biodentine/doxycycline (11.25). Conclusion: In conclusion, adding 2% chlorhexidine gluconate in liquid of Biodentine enhanced the antimicrobial activity of Biodentine against all the tested micro-organisms except Candida albicans, while addition of 10% doxycycline decreased the antimicrobial activity of Biodentine. The differences were significant statistically (P < 0.05).

Relationship between sealing ability of Activ GP and Gutta Flow and methods of calcium hydroxide removal

Aim: To evaluate the effect of method of calcium hydroxide intracanal dressing removal, on sealing ability of Gutta Flow and Activ GP. Materials and Methods: Seventy extracted mandibular premolars were sectioned at CEJ and canals were prepared with profile 4% rotary file till #40. Canals were filled with calcium hydroxide, coronally sealed with Cavit G and stored at 37°C. After 7 days, samples were divided on the basis of calcium hydroxide removal method (Master apical file, Navi Tip FX, and F File) and obturating material (Activ GP and Gutta Flow). Three coats of nail polish were applied except 2 mm around apical foramen and samples were immersed in India ink dye, sectioned, and observed under stereomicroscope for microleakage. Results: The results were statistically analyzed with one way ANOVA-F with Tukey HSD test with the null hypothesis set as 5%. Conclusions: The seal of the canal system was adversely impacted by residual calcium hydroxide when Activ GP and Gutta Flow were used as obturating material and the sealing ability of Activ GP and Gutta Flow was better when MAF was used for removal of calcium hydroxide than F file or Navi tip FX.

Effect of sealers on fracture resistance of endodontically treated teeth with and without smear layer removal: An in vitro study

Aim: The present study involved the in vitro comparison of root reinforcing abilities of two sealers, i.e., Ketac-Endo and Acroseal, in endodontically treated teeth in the presence and absence of smear layer. Materials and Methods: Fifty teeth were taken and sectioned at the cementoenamel junction. The teeth with faults were discarded and a total of 36 teeth were used for study. The samples were biomechanically prepared using step-back technique. In 10 teeth, the smear layer was preserved using sodium hypochlorite. Smear layers were removed from 10 teeth using 17% EDTA, and in another 10 samples, the smear layers were eliminated using 17% EGTA. The remaining samples served as controls. Samples were obturated with sealers using the lateral condensation technique. Ketac-Endo (3M) is a glass ionomer based root canal sealer, and Acroseal (Septodont) sealers were used. The teeth were then tested by using an Instron testing machine. Results: Ketac-Endo shows higher fracture resistance values in comparison to Acroseal. Other factors as the amount of tooth structure remaining, the agents used for the removal of smear layer and instrumentation techniques may alter the tooth resistance to fracture. Conclusion: Ketac-Endo shows higher fracture resistance values in comparison to Acroseal.