Composite resin is presently used primarily as a direct esthetic restorative material. The esthetics of these tooth-coloured restorations is heavily dependent on surface finish Polishing of composite resin can produce potentially injurious temperature rise within the pulp chamber. This study was conducted to compare and evaluate the pulp chamber temperature rise associated with the polishing of light cured composite veneer restorations using 2 different polishing systems (Astropol, Shofu- Snap kit). 40 extracted maxillary central incisors were used in this study. They were randomly divided into 4 groups-Groups 1, II (Dry Continuous, Intermittent respectively) and Groups III, IV (Wet, Continuous, Intermittent respectively). Groups I, II were polished with the Shofu System and Groups Ill, IV were polished using Astropo System. The temperature rise was recorded within each group and the remaining dentin thickness (RDT) was measured after sectioning of the teeth. The results indicated:

1. There were significant differences in the temperature rise between the dry and the wet systems.
2. The correlation of the temperature rise and the remaining dentin thickness was significant for the dry, intermittent group and was dependent on application time of the disks.
3. Remaining dentin thickness is an important factor in regulating the magnitude of temperature rise during polishing of restorations.

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Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal. Of these three essential steps of root canal therapy, irrigation of the root canal is the most important determinant in the healing of the periapical tissues. The primary endodontic treatment goal must thus be to optimize root canal disinfection and to prevent reinfection. In this review of the literature, various irrigants and the interactions between irrigants are discussed. We performed a Medline search for English-language papers published untill July 2010. The keywords used were 'root canal irrigants' and 'endodontic irrigants.' The reference lists of each article were manually checked for additional articles of relevance.

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In the last few decades, there have been tremendous advances in the mechanical properties and methods of fabrication of ceramic materials. While porcelain-based materials are still a major component of the market, there have been moves to replace metal ceramics systems with all ceramic systems. Advances in bonding techniques have increased the range and scope for use of ceramics in dentistry. In this brief review, we will discuss advances in ceramic materials and fabrication techniques. Examples of the microstructure property relationships for these ceramic materials will also be addressed.

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Realization that dental caries is a reversible, dynamic biochemical event at a micron level has changed the way the profession recognizes the caries disease and the caries lesion. The diagnosis of dental caries poses challenges due to the complex interaction of multiple endogenous causal factors. The most appropriate diagnostic aid for this purpose is the risk model of caries risk assessment. The analyses of the biological determinants provide clues to the dominant causal factor. The detection of a carious lesion has undergone a rigorous revision and revolution in order to identify the earliest mineral change so that it can be controlled without resorting to invasive management options. Apart from detection, it became mandatory to assess the extent of the lesion (noncavitated/cavitated), assess the activity status of the lesion (active/arrested), monitor the lesion progress (progression/regression over a period of time), and finally to predict the prognosis of the lesion as well as the disease. The prognosis of the disease can be best assessed by analyzing the predictor factors in caries risk assessment. The ultimate objective of such a meticulous and methodical approach aids in devising a tailor-made treatment plan, using preventing measures precisely and restorative measures minimally. This ensures the best oral health outcome of the patient.

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The aim of this case series was to determine the clinical and radiographic success rate of pulpotomy, with new endodontic cement (NEC), in human mature permanent molar teeth. Twelve molars with established irreversible pulpitis were selected from patients 14 - 62 years old. The selection criteria included carious pulp exposure with a positive history of lingering pain. After isolation, caries removal, and pulp exposure, pulpotomy with NEC was performed and a permanent restoration was immediately placed. At the first recall (+1 day) no patients reported postoperative pain. One wisdom tooth had been extracted after two months because of failure in coronal restoration. Eleven patients were available for the second recall, with a mean time of 15.8 months. Clinical and radiographic examination revealed that all teeth were functional and free of signs and symptoms. Histological examination of the extracted teeth revealed complete dentin bridge formation and a normal pulp. Although the results favored the use of NEC, more studies with larger samples and a longer recall period were suggested, to justify the use of this novel material for treatment of irreversible pulpitis in human permanent molar teeth.

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Aims and Objectives : To compare the microleakage in class II nanocomposite restorations without liner, with resin-modified glass ionomer liner and flowable composite liner. Materials and Methods : Thirty-six sound premolars extracted for orthodontic reasons were selected and randomly assigned into three groups of 12 teeth each (Group I, II and III). Class II cavities of specified dimensions were prepared with margins located in the enamel. Cavities in group I were lined with resin modified glass ionomer (GC Fuji II LC-Improved), group II were lined with flowable composite (Filtex Z350 Flowable Restorative) and no liner was placed for cavities in group III. All the teeth were restored with nanocomposite (Z 350 Universal Restorative). The teeth were immersed in 0.5% methylene blue dye, sectioned mesiodistally and observed under stereomicroscope. Results : Group III showed maximum leakage compared to group I and II which was statistically significant. Microleakage was lesser in group lined with resin-modified glass ionomer as compared to flowable composite group but not statistically significant. Conclusions : Placement of liner beneath nanocomposite restoration results in significant reduction in microleakage. Both resin-modified and flowable composite liners under nanocomposite restorations result in comparable reduction of microleakage.

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While the regeneration of a lost tissue is known to mankind for several years, it is only in the recent past that research on regenerative medicine/dentistry has gained momentum and eluded the dramatic yet scientific advancements in the field of molecular biology. The growing understanding of biological concepts in the regeneration of oral/dental tissues coupled with experiments on stem cells is likely to result in a paradigm shift in the therapeutic armamentarium of dental and oral diseases culminating in an intense search for "biological solutions to biological problems." Stem cells have been successfully isolated from variety of human tissues including orofacial tissues. Initial evidence from pioneering studies has documented the likely breakthrough that stem cells offer for various life-threatening diseases that have so far defeated modern medical care. The evidence gathered so far has propelled many elegant studies exploring the role of stem cells and their manifold dental applications. This review takes you on a sojourn of the origin of stem cells, their properties, characteristics, current research, and their potential applications. It also focuses on the various challenges and barriers that we have to surmount before translating laboratory results to successful clinical applications heralding the dawn of regenerative dentistry.

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In spite of a knowledge explosion in cariology science, dental caries still remains a misunderstood phenomenon by the clinicians. In order to effectively use the wide range of preventive and management strategies, it is imperative to look beyond those black and white spots that manifest on the tooth surfaces.This paper focuses on the revised versions of the etiopathogenesis and definition of dental caries disease in the present century.

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Dentinal hypersensitivity (DH) is a common clinical condition usually associated with exposed dentinal surfaces. It can affect patients of any age group and most commonly affects the canines and premolars of both the arches. This article concisely reviews the patho-physiology, mechanism and clinical management of the DH. Treatment of DH should start with an accurate diagnosis. Differential diagnosis should be made and all other probable causes should be excluded. An often neglected phase of clinical management of DH is the identification and treatment of the causative factors of DH. By removing the etiological factors, the condition can be even prevented from occurring or recurring. There are various treatment modalities available which can be used at home or may be professionally applied. The "at home" desensitizing agents include toothpastes, mouthwashes or chewing gums and they act by either occluding the dentinal tubules or blocking the neural transmission. This article also discusses the recent treatment options like bioglass, Portland cement, lasers and casein phosphopeptide.

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Air abrasion dentistry has evolved over a period of time from a new concept of an alternative means of cavity preparation to an essential means of providing a truly conservative preparation for preservation of a maximal sound tooth structure. The development of bonded restorations in combination with air abrasion dentistry provides a truly minimal intervention dentistry. This article reviews the development of air abrasion, its clinical uses, and the essential accessories required for its use.

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An organized and systematic approach is required to evaluate, diagnose and resolve esthetic problems predictably. It is of prime importance that the final result is not dependent only on the looks alone. Our ultimate goal as clinicians is to achieve pleasing composition in the smile by creating an arrangement of various esthetic elements. This article reviews the various principles that govern the art of smile designing. The literature search was done using PubMed search and Medline. This article will provide a basic knowledge to the reader to bring out a functional stable smile.

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The choice of an impression material for a particular situation depends on the treatment being provided, operator preference, and so on. Even with the introduction of more advanced and more accurate rubber base impression materials, irreversible hydrocolloid impression materials have stood the test of time. This article gives a detailed perspective of how best to make alginate impressions.

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Introduction : The purpose of this study was to investigate root canal morphology of maxillary second premolars in an Indian population. Materials and Methods : Two hundred maxillary second premolars were collected, stained, decalcified, and cleared. Cleared teeth were examined in a steromicroscope under 7.5× magnification and the following observations were made: (1) length of the teeth, (2) number of root canals, (3) root canal configuration by Vertucci's classification, (4)number of isthmi between the canals, (5) frequency of apical deltas. Results : Of the two hundred maxillary second premolars, 64.1% had one root canal at the apex and 35.4 % had two root canals at the apex. The average length of the teeth was 21.5 mm. Concerning the canal morphology, 33.6% of the teeth exhibited Vertucci type II configuration followed by type IV pattern (31.1%); 29.2% of the teeth possessed type I pattern. An additional canal configuration type XIX was found in one tooth. Isthmi and apical deltas was found in 19% and 14% of the cases, respectively. Conclusion : The root canal morphology of Maxillary second premolars can be complex and requires careful evaluation prior to endodontic therapy.

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Mineral trioxide aggregate (MTA) is composed of Portland cement, with 4:1 addition of bismuth oxide added so that the material can be detected on a radiograph. The cement is made up of calcium, silicon and aluminium. The main constituent phases are tricalcium and dicalcium silicate and tricalcium aluminate. There are two commercial forms of MTA, namely the grey and the white. The difference between the grey and the white materials is the presence of iron in the grey material, which makes up the phase tetracalcium alumino-ferrite. This phase is absent in white MTA. Hydration of MTA occurs in two stages. The initial reaction between tricalcium aluminate and water in the presence of calcium sulphate results in the production of ettringite. Tricalcium and dicalcium silicate react with water to produce calcium silicate hydrate and calcium hydroxide, which is leached out of the cement with time.

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Electrosurgery has been used in dentistry for more than half a century. There is abundant literature on electrosurgery dating back more than a century. During the past three decades, a substantial increase in minimally invasive surgery and microvascular surgery prompted greater use of electrosurgery. Although this surge in utilization has resulted in new applications, equipment features, problems and solutions, the use of electrosurgery in the field of restorative dentistry has remained relatively unchanged. The presence of conflicting and sometimes confusing information on electrosurgical wound healing in the dental literature is the most likely reason. This article briefly explains the literature review of electrosurgery and clinical application of electrosurgery in aesthetic and restorative dentistry.

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The present in-vitro study was undertaken to evaluate the antimicrobial efficacy of a traditional zincoxide eugenol based scaler(Tubliseal) with a iodoform incorporated zincoxide eugenol based sealer (Endotas FS), a calcium hydroxide based sealer (Apexit) and the epoxy resin based sealers (AH PLUS and PC Seal), against the micro organisms Enterococcus faecalis and Candida albicans. The method employed to test the antimicrobial efficacy was the Kirby-Bauer method (Agar Disc Diffusion). The sealers were mixed according to the manufacturer's instructions and 0.1 ml of each sealer was placed on the sterile paper discs. The diameter of the zones of inhibition was measured in millimeters with the help of an inhibition zone measuring scale and the values were recorded. The antimicrobial efficacy of an iodoform incorporated zincoxide eugenol based sealer, Endoflas FS against Enterococcus faecalis and Candida albicans was statistically superior to the rest of the test groups._Endotlas FS performed far better than even the controls being employed (Amoxycillin and Nystatin) respectively._Tubliseal, a zincoxide eugenol based seater also showed significant antimicrobial properties, but was statistically inferior to Endoflas FS Apexit, a calcium hydroxide based sealer did not show significant antimicrobial efficacy against both Enterococcus faecalis and Candida albicans. AH PLUS and RC seal, epoxy resin based sealers showed no antimicrobial properties whatsoever.

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Periodontal therapy deals with many aspects of the supporting structures, including the prevention and repair of lesions of the gingival sulcus. Endodontics deals primarily with disease of the pulp and periapical tissues. The success of both periodontal and endodontic therapy depends on the elimination of both disease processes, whether they exist separately or as a combined lesion. The relationship between periodontal and endodontic disease has been a subject of speculation for many years. This paper aims at presenting a comprehensive review of several aspects of perio-endo lesions.

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Aesthetic dentistry continues to evolve through innovations in bonding agents, restorative materials, and conservative preparation techniques. The use of direct composite restoration in posterior teeth is limited to relatively small cavities due to polymerization stresses. Indirect composites offer an esthetic alternative to ceramics for posterior teeth. This review article focuses on the material aspect of the newer generation of composites. This review was based on a PubMed database search which we limited to peer-reviewed articles in English that were published between 1990 and 2010 in dental journals. The key words used were 'indirect resin composites,' composite inlays,' and 'fiber-reinforced composites.'

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Comprehensive management of dental caries should involve the management of disease as well as the lesion. Current decision making process in cariology is influenced by numerous factors such as the size/ depth/ activity of the carious lesion and age/ the caries risk status of the patient. Treatment decisions should involve planning the non-operative/ preventive treatment for non-cavitated or early cavitated lesions and also formulating operative treatment for cavitated lesions. Apart from these two responsibilities, a clinician should also be knowledgeable enough to decide when not to interfere in the caries dynamics and how frequently to recall the patient for follow-ups. The non-operative treatment prescriptions vary in dose, intensity and mode of delivery according to the caries risk status. Minimal invasion and maximal conservation of tooth structure has become the essence of current operative treatments. This part of the series elaborates on the paradigm shift in the management of dental caries.

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Aim: This in vitro study was conducted on enamel blocks of human premolars with the aim of evaluating the remineralization potential of fluoride and ACP-CPP and the combination of ACP-CPP and fluoride on early enamel lesions. Materials and Methods: Fifteen intact carious free human premolars were selected. The coronal part of each tooth was sectioned into four parts to make 4 enamel blocks. The baseline SMH (surface microhardness) was measured for all the enamel specimens using Vickers microhardness (VHN) testing machine. Artificial enamel carious lesions were created by inserting the specimens in demineralization solution for 3 consecutive days. The SMH of the demineralised specimens was evaluated. Then the four enamel sections of each tooth were subjected to various surface treatments , i.e. Group 1- Fluoride varnish, Group 2- ACP-CPP cream, Group 3- Fluoride + ACP-CPP & Group 4- Control (No surface treatment). A caries progression test (pH cycling) was carried out, which consisted of alternative demineralization (3hours) and remineralization with artificial saliva (21 hours) for five consecutive days. After pH cycling again SMH of each specimen was assessed to evaluate the remineralization potential of each surface treatment agent. Then, to asses the remineralization potential of various surface treatments at the subsurface level, each enamel specimen was longitudinally sectioned through the centre to expose the subsurface enamel area. Cross-sectional microhardness (CSMH) was evaluated to assess any subsurface remineralization Results: Statistical analysis using one-way ANOVA followed by multiple comparisons test was applied to detect significant differences at P ≤ 0.05 levels between various surface treatments at different phases. Conclusions: With in the limits, the present study concludes that; ACP-CPP cream is effective, but to a lesser extent than fluoride in remineralizing early enamel caries at surface level. Combination of fluoride and ACP-CPP does not provide any additive remineralization potential compared to fluoride alone. Fluoride, ACP-CPP and their combination are not effective in remineralizing the early enamel caries at the subsurface level.

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The longevity of dental restorations is dependent on many factors, including those related to materials, the dentist, and the patient. Dental amalgams have successfully served the profession for over a century. The main reasons for restoration failure are secondary caries, fracture of the bulk of the restoration or of the tooth, and marginal deficiencies and wear. The importance of direct-placement, aesthetic, tooth-colored restorative materials is still increasing. Amalgam restorations are being replaced because of alleged adverse health effects and inferior aesthetic appearance. All alternative restorative materials and procedures, however, have certain limitations. This article will attempt to critically analyse both amalgams and resin based composites, through an evaluation of scientific literature.

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A new emphasis on caries measurement and management is required for the dental community. The dental professionals need new approaches in caries detection, its assessment, and management. The future of research, practice, and education in Cariology requires the development of an integrated definition of dental caries, and uniform systems for measuring the caries process. Keeping this in view, the International Caries Detection and Assessment System (ICDAS) has presented a new paradigm for the measurement of dental caries, which was developed from the systematic reviews of literature on the clinical caries detection system and other sources. The ICDAS can serve as a basis and benchmark for clinical and epidemiological research and inform dental undergraduate and postgraduate teaching in Cariology. The ICDAS system was developed to bring forward the current understanding of the process of initiation and progression of dental caries to the fields of epidemiological and clinical research.

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Fluorosis has been reported way back in 1901. The treatment options for fluorosis are varied depending upon individual cases. This article comes from Madurai in India where its surrounding towns are fluorosis-prone zones. The purpose of this article is to report various treatment options available for dental fluorosis; this is the first time that complete full mouth rehabilitation for dental fluorosis is being reported. This article also dwells on the need for the dentists to be aware of their local indigenous pathologies to treat it in a better manner.

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Immature teeth with necrotic pulp and large periapical lesion are difficult to treat via conventional endodontic therapy. The role of materials such as calcium hydroxide and mineral trioxide aggregate in apexification is indispensable. This case report presents the successful healing and apexification with combined use of white mineral trioxide aggregate and demineralized freeze-dried bone allograft.

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Aim/Objective: To evaluate the in vitro effect of bonded restorations on the fracture resistance of root canal-treated teeth. Materials and Methods: One hundred twenty extracted, maxillary, permanent premolars were collected. After preparing the access cavity, the teeth were biomechanically prepared and obturated. Samples were divided into six groups based on the type of restorative material used to restore them. Teeth were embedded in acrylic resin and their fracture strength was measured using a Universal Testing Machine. Data were evaluated statistically using one-way ANOVA-F and unpaired t-test. Results: Teeth restored with bonded amalgam and composite resin showed higher fracture resistance than those restored with conventional amalgam. Fracture strengths of bonded restorations and intact teeth were not statistically different. The results suggested that the group restored with conventional amalgam had the lowest fracture resistance. No statistically significant differences were found between the bonded amalgam and composite resin groups. Conclusion: Conventional amalgam core showed the least fracture resistance whereas; composite resin and bonded amalgam core showed fracture resistance was similar to that of natural tooth.

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