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   2020| May-June  | Volume 23 | Issue 3  
    Online since December 4, 2020

 
 
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ORIGINAL ARTICLES
Evaluation of tissue inflammatory response of four intracanal medicament – An animal study
Krishnamachari Janani, Kavalipurapu Venkata Teja, P Ajitha, Raghu Sandhya
May-June 2020, 23(3):216-220
DOI:10.4103/JCD.JCD_243_20  
Aim: The aim of the study was to evaluate the tissue inflammatory response of origanum vulgarae, omeprazole, triple antibiotic paste (TAP), and calcium hydroxide in an animal model. Materials and Methods: Seventy Five male Wistar rats were randomly divided into four experimental groups and one control group: Group 1: control (n = 15), Group 2: 0.25 mg origanum vulgarae/1 ml of cellulose (n = 15), Group 3: 2 mg omeprazole/1 ml of distilled water (n = 15), and Group 4: 1 mg TAP/1 ml of distilled water (n = 15), Group 5: 16 mg calcium hydroxide/1 ml of distilled water (n = 15). A trough was made in the periapical bone and the medicament of the respective groups was placed. After the 7th, 14th, 28th and days, the animals were euthanized and tissue specimen was prepared for histological examination. Results: The results were analyzed statistically. On the 7th and 14th days, all the experimental groups showed severe inflammatory response with no statistical significance, whereas on the 28th day, the inflammatory response was graded based on the mean value, in which omeprazole showed moderate inflammatory cells followed by TAP. Mild inflammatory response was seen in calcium hydroxide and origanum vulgarae, showing no statistical significance. Conclusion: Within the limitation of the study, severe inflammatory response was reported on the 7th and 14th days in all experimental groups, whereas on 28th day, there was a moderate inflammatory response seen in omeprazole, followed by TAP. Calcium hydroxide and origanum vulgarae showed a mild inflammatory response.
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Oxygen inhibition layer: A dilemma to be solved
Aarti C Panchal, Geeta Asthana
May-June 2020, 23(3):254-258
DOI:10.4103/JCD.JCD_325_19  
Objective: This study aimed to evaluate the thickness of oxygen inhibition layer (OIL), produced on various composite materials, and to compare their interlayer shear bond strength (SBS), by treating the OIL with various agents. Materials and Methods: The thickness of OIL of three different composite materials (120 specimens divided into three groups) Group 1 – Ivoclar Tetric N-Ceram (nanohybrid composite), Group 2 – Ivoclar Te Econom Plus (microhybrid composite), and Group 3 – GC EverX Posterior (a short glass fiber-reinforced composite) was evaluated. Each group was divided into four subgroups (A, B, C, and D) depending on the surface treatment given – no surface treatment (control group), ethanol, water spray, and grinding with SiC paper. This was followed by interlayer SBS testing. Statistical Analysis: The data were statistically analyzed using ANOVA at a significance level of P < 0.05. Tukey’s post hoc analysis was performed following ANOVA to determine differences among the groups. Results: The control group showed higher SBS irrespective of the type of composite material. The group treated with SiC paper resulted in the lowest interlayer SBS among all groups. Glass fiber composite showed higher interlayer SBS compared to both nanohybrid and microhybrid composites, irrespective of the surface treatment given. Conclusion: The OIL, which acts as an intermediate layer, is retained on the surface of the composite even after treatment with ethanol and water spray. The presence of an OIL improved the interlayer SBS of two adjacent composite layers and led to more durable adhesion. Rather, the absence of an OIL adversely affected the bond strength and led to adhesive interfacial failures.
  1,801 115 -
To evaluate the fracture resistance of proclined endodontically treated teeth with different post and core systems: In vitro study
Aparajita Dutta, Roopa R Nadig, Yashwanth Gowda
May-June 2020, 23(3):233-239
DOI:10.4103/JCD.JCD_366_20  
Aim: This study was aimed to evaluate the fracture resistance of proclined endodontically treated teeth with different post and core systems. Settings and Design: Experimental in vitro study. Methodology: Eighty extracted maxillary central incisors were selected and decoronated keeping 2 mm of crown ferrule and were endodontically treated. Postspace was prepared retaining 5 mm apical gp using peeso 3. Samples were divided into two groups. In Group 1, Wax pattern fabricated to accommodate different core angulations to be casted with Ni-Cr alloy. In Group 2, ever stick posts were angulated and cemented followed by porcelain fused to metal crown cementation for both the groups. Samples were thermocycled and subjected to the universal testing machine. Statistical Analysis Used: One-way ANOVA and Tukey’s post hoc test were used to compare the mean fracture resistance between different angulations in cast post and ever stick posts. Student’s paired t-test was used to compare the mean fracture resistance between cast post and everstick posts for each angulations. P value was set at P < 0.05. Results: The fracture resistance was the highest at 20° and lowest at 30° core angulations in both the groups. Conclusions: Changing core angulation up to 20° can be carried out safely using any of the post systems tested in the study. Core angulations >20°, should be used with caution, especially in patients with abnormal parafunctional habits and occlusal trauma.
  1,604 127 -
Clinical efficacy of universal adhesives for the restoration of noncarious cervical lesions: A randomized clinical trial
GR Ranjitha, R Vikram, N Meena, L Vijayalakshmi, Chethana S Murthy
May-June 2020, 23(3):227-232
DOI:10.4103/JCD.JCD_51_20  
Introduction: The efficacy of an adhesive agent is an important aspect in restoring noncarious cervical lesion (NCCL) as studies have proved that compromise in adhesive agent results in reduced bond strength. The purpose of this prospective randomized double-blind clinical trial was to evaluate the efficacy of the newly formulated “universal” dental adhesive in the restoration of NCCLs in permanent dentition using either a self-etch or a selective-etch approach. Materials and Methods: The study was done following the consolidated standards of reporting trials. 100 NCCLs randomly divided into 2 groups were restored using G-Premio Bond adhesive and Genial flowable composite in selective etch mode and self-etch mode. Restorations were evaluated at 1 week, 6 months, and 12 months using modified US Public Health Service criteria for marginal staining, fracture, and postoperative sensitivity. Statistical analysis was performed using appropriate tests. Results: Recall rates were 100%, 98%, and 78% at the evaluation time. The result showed that neither the self-etch nor the selective etch mode had significant difference in ALPHA/BRAVO/CHARLIE scores (P > 0.05). Percentage-wise comparison showed less changes reported in the selective etch group compared to self-etch group. Conclusion: It was concluded that there was no statistical significance between the groups for the parameters evaluated, but selective etch performed better than self-etch group.
  1,390 102 -
Comparative evaluation of pulp tissue dissolution ability of sodium hypochlorite by various activation techniques: An in vitro study
Srividhya Srinivasan, Senthil Kumar Kumarappan, Anupama Ramachandran, Manjiri Nagesh Honap, Sadasiva Kadandale, Sreeram Rayar
May-June 2020, 23(3):304-308
DOI:10.4103/JCD.JCD_425_20  
Background: The success in endodontic therapy is dependent largely on the absolute elimination of pulp tissue remnants and the maximum reduction of pathologic microbial load present within the root canal system. Aim: The aim of this in vitro study was to compare and evaluate the ability of pulp tissue dissolution with and without activation of 5.25% sodium hypochlorite (NaOCl). Materials and Methods: Pulp tissue samples collected from intact, noncarious extracted third molars were standardized to 8 mg in each group. These samples were placed in conical Eppendorf tubes of 15 ml with 10 ml 5.25% NaOCl for 4 min and were activated suitably according to the group specifications. All the procedures in this study were carried out at room temperature. The preweighed pulp tissue samples were further weighed again after the dissolution phase, and residual weight loss in each group along with its percentage was obtained. The results were then statistically analyzed using one-way analysis of variance and Tukey post hoc test. Results: The maximum amount of pulp tissue dissolution was found in the laser-assisted irrigation group, i.e., NaOCl with Er, Cr: YSGG (P < 0.05) and showed a statistically significant result in comparison with other groups. Conclusion: Within the limitations of the study, laser-assisted irrigation with a radial firing tip (NaOCl activated by Er, Cr: YSGG) was the most effective in dissolving the pulp tissue in comparison with other groups. The ultrasonic activation also showed a considerable amount of pulp tissue dissolution comparable to laser-activated irrigation in this study.
  1,030 104 -
Evaluation and comparison on the wettability of three root canal sealers after three different irrigant activation techniques: An in vitro study
Beulah Mary Bejoy, Josey Mathew, Liza George, Dhanya John, Aleesha Joy, Sinju Paul
May-June 2020, 23(3):289-294
DOI:10.4103/JCD.JCD_72_20  
Background: Wettability of root canal sealers to the root canal wall plays a significant role in the attainment of a fluid-tight seal. Aims: This study aimed to evaluate and compare the wettability of three different root canal sealers on the root canal walls after three different irrigant activation techniques using the contact angle meter. Subjects and Methods: Thirty-six single-rooted mandibular premolars after decoronation and cleaning and shaping up to size #35 were randomly divided into three groups with 12 samples in each group (n = 12) based on the different activation techniques: Group I (passive irrigation with side-vented needle), Group II (manual dynamic agitation), and Group III (passive ultrasonic irrigation). Root segments were split longitudinally and were subdivided into three subgroups based on the root canal sealers tested with four samples in each subgroup (n = 4): Subgroup A (Tubliseal EWT), Subgroup B (AH Plus), and Subgroup C (Endosequence BC sealer). A controlled volume droplet of sealer was placed on each specimen and was subjected to the contact angle meter. Statistical Analysis: Data were statistically analyzed using the one-way ANOVA and Tukey’s post hoc test at a significance level of 0.05 (P < 0.05). Results: A statistically significant difference was seen among all the groups and subgroups with the highest contact angle value for Group III and Subgroup C and the least value for Group I and Subgroup A. Conclusions: Passive irrigation with side-vented needle and Tubli-Seal EWT showed better wettability on dentin.
  1,026 99 -
Effect of fiber reinforcement on color stability of composite resins
Ozcan Karatas, Nurcan Ozakar Ilday, Funda Bayindir, Neslihan Celik, Nilgun Seven
May-June 2020, 23(3):299-303
DOI:10.4103/JCD.JCD_344_19  
Aim: The aim of this in vitro study was to determine the effect of fiber reinforcement on the color changes of two different composite resins. Materials and Methods: A silorane-based composite (Filtek Silorane, A2 shade) and a methacrylate-based composite (Valux Plus, A2 shade) were used in this study. Three groups of samples (control group with no reinforcements, polyethylene fiber [Ribbond THM]-reinforced composite, and glass fiber [everStick® Net]-reinforced composite groups) were prepared from each composite (n = 8). The color change was calculated between baseline and 1 day (DE1) and between baseline, 7 days (DE2), and 21 days (DE3) with a spectrophotometer. The data were analyzed by ANOVA, Duncan’s multiple-range tests and independent sample t-test. Results: Statistical analysis of variance presented the statistically significance difference between composite, fiber, and time for DE (P < 0.05). The Ribbond reinforced composite showed a similar color change to the control group (ΔE = 3.69), while the everStick reinforced composite showed the largest total color change (ΔE = 4.13). It was determined that the time is an effective factor on the color stability of reinforced composites (P < 0.05). Conclusion: The addition of fiber may lead to color change in composite resins. The amount of change may differ depending on the structural properties of the composite resin or the fiber and time.
  1,046 77 -
Evaluation of the effect of natural versus synthetic matrix metalloproteinase silencers in preservation of dentin collagen and long-term bond strength of total etch adhesive
Megha Nagpal, Sonali Taneja, Mohit Kumar, Chetna Dudeja
May-June 2020, 23(3):221-226
DOI:10.4103/JCD.JCD_91_20  
Aim: This study investigated the effect of various synthetic (galardin [Gal] and benzalkonium chloride [BAC]) and natural agents (hesperidin [HES] and epigallocatechin gallate) on the stability of dentin collagen matrix to resist collagenase degradation and improve long-term microtensile bond strength. Materials and Methods: Ten sound-impacted third molars were collected and manual removal of pulp, periodontal ligament, cementum, and enamel was done. Remaining dentin fragments were pulverized under liquid nitrogen to obtain dentin powder. 2 mg aliquot of dentin powder was allocated to each of the test solutions and subjected to hydroxyproline assay. Another 60 sound human third molars were collected and occlusal enamel was ground flat to reach dentinoenamel junction. Class I cavities were prepared in dentin, followed by etching using 37% phosphoric acid for 15 s. Samples were then subjected to surface treatment with different agents for 60 s, followed by application of Optibond S and restoration with P 60 composite resin. Samples of all groups except control were subject to thermocycling. Samples were sectioned to 1 mm thick slabs which were subject to universal testing machine to determine ultimate tensile strength. One-way analysis of variance and Bonferroni post hoc test with a significance level of P < 0.05 were used to analyze data. Results: HES resulted in maximum resistance to collagen degradation, followed by epigallocatechin gallate (EGCG), Gal, and BAC with a significant difference among the groups. Samples of Gal group showed the highest microtensile bond strength values, followed by HES, EGCG, BAC with a significant difference between the groups except HES and EGCG where the difference was nonsignificant. Conclusion: The use of matrix metalloproteinase silencers could improve the mechanical properties of collagen and resist enzymatic degradation, leading to an improved long-term intimate restoration.
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Comparative evaluation of remineralization potential of nanohydroxyapatite crystals, bioactive glass, casein phosphopeptide-amorphous calcium phosphate, and fluoride on initial enamel lesion (scanning electron microscope analysis) – An in vitro study
RD Geeta, Saritha Vallabhaneni, Kainath Fatima
May-June 2020, 23(3):275-279
DOI:10.4103/JCD.JCD_62_20  
Aim: The aim of this in vitro study was to evaluate and compare the remineralization potential of four different remineralizing agents, i.e., nanohydroxyapatite crystals, bioactive glass, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and fluoride on initial enamel lesion. Materials and Methods: Sixty human maxillary central incisors were used in the present study. Samples were randomly divided into four groups (n = 15). Group 1: nanohydroxyapatite-containing dentifrice (Acclaim); Group 2: bioactive glass containing-dentifrice (SHY-NM); Group 3: CPP-ACP-containing dentifrice; and Group 4: fluoride-containing dentifrice. Baseline microhardness was checked, followed by immersion of teeth samples in demineralizing and remineralizing solution. This was followed by a pH cycle of 10 days. Data were analyzed using ANOVA and Bonferroni method. After this, scanning electron microscopic analysis was done to evaluate remineralization. Results: Statistical analysis of data was conducted using ANOVA, and multiple comparisons within groups were done using the Bonferroni method (post hoc tests). The decision criterion was to reject the null hypothesis if P < 0.05. If there was a significant difference between the groups, multiple comparisons (post hoc test) using the Bonferroni test were carried out. Conclusion: There is a significant difference in mean microhardness between the groups after remineralization. The mean value was found to be highest for nanohydroxyapatite, bioactive glass, CPP-ACP, and fluoride in descending order.
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Efficacy of hydroxyapatite and silica nanoparticles on erosive lesions remineralization
Srujana Karumuri, Jyothi Mandava, Sahithi Pamidimukkala, Lakshman Varma Uppalapati, Ravi Kumar Konagala, Lohita Dasari
May-June 2020, 23(3):265-269
DOI:10.4103/JCD.JCD_182_20  
Aim: The aim is to assess and compare the mineral gain and penetration depth of hydroxyapatite and silica nanoparticle infiltrates into artificially created erosive lesions of enamel and dentin. Materials and Methods: Sixty extracted human molars were sectioned to obtain enamel and dentin samples (n = 60 each). They were demineralized using citric and formic acid, respectively, to create erosive lesions on enamel and dentin surfaces. Samples were assigned into nanohydroxyapatite (nHA) or nanosilica groups (n = 30 each) according to the infiltrant used. Half of the enamel and dentin samples in each group (n = 15) were analyzed after erosive attack for mineral loss, after infiltrant application for mineral gain, using energy-dispersive X-ray spectroscopy. In another half of the enamel and dentin samples (n = 15), the penetration depth of the nanoinfiltrants was analyzed using confocal microscopy. Statistical Analysis: To compare the overall mineral gain between groups, a dependent t-test was applied. The intergroup comparisons were made using one-way ANOVA followed by Tukey post hoc test for pairwise comparisons for both penetration depth and mineral gain. The significance level was set to P ≤ 0.05. Results: The mineral gain in enamel was not statistically different between nHA and nanosilica infiltrants (P = 0.9950). nHA infiltrated dentin showed significantly more mineral gain (P = 0.0001) than nanosilica infiltrant. The depth of penetration of the nHA in enamel was statistically greater than that of nanosilica, but in dentin, the difference was not significant. Conclusion: nHA infiltrant performed better in mineral gain, and penetrated deeper into the demineralized erosive lesions, compared to nanosilica infiltrant in both enamel and dentin. The highest mineral precipitation and deeper penetration into both demineralized enamel and dentin was observed with nHA infiltrant compared to (as against) nanosilica infiltrant.
  892 83 -
Comparative evaluation of effect of chloroquick irrigating solution on push-out bond strength of endoseal mineral trioxide aggregate and endosequence root repair material when used as furcal perforation repair material: An in vitro study
Margi Parikh, Karkala Venkappa Kishan, Maitry Parikh
May-June 2020, 23(3):259-264
DOI:10.4103/JCD.JCD_346_19  
Aim: The purpose of this study was to comparatively evaluate the effect of Chloroquick irrigating solution on push-out bond strength of Endoseal mineral trioxide aggregate (MTA) and endosequence root repair material (ERRM) when used as furcal perforation repair materials. Materials and Methods: Forty human extracted mandibular molars were collected. A standardized endodontic access cavity was prepared in 40 samples, and intentional perforation of 1.32 mm in diameter was created on the pulpal floor. Teeth were randomly divided into four groups: Group A: EndoSeal MTA with irrigation, Group B: ERRM with irrigation, Group C: EndoSeal MTA without irrigation (Control group), and Group D: ERRM without irrigation (Control group). The samples were subjected to universal testing machine then examined under a stereomicroscope at × 40 to determine the nature of the bond failures. Results: EndoSeal MTA with Chloroquick irrigating solution irrigation showed the highest push-out bond strength (MPa) with a statistically significant difference among all the groups (P = 0.003). The majority of the samples exhibited cohesive and mixed types of failures. Conclusion: Chloroquick irrigating solution irrigation has no adverse effect on the push-out dentin bond strength of Endoseal MTA and ERRM.
  846 82 -
Evaluation of the correlation between dental caries and periodontitis - A clinico- immunological analysis
Janani Balachandran, N Gurucharan
May-June 2020, 23(3):280-283
DOI:10.4103/JCD.JCD_186_19  
Background: To study the correlation between dental caries and periodontitis. Aim: The aim of the study was to evaluate the correlation between dental caries and periodontitis based on the clinical and immunological analysis. The null hypothesis was that there is no clinical and immunological correlation between dental caries and periodontitis. Settings and Design: Fifty systemically healthy adults (mean age of 35 years) with decayed, missing, and filled teeth scores of more than 6 were assessed for periodontal health by recording their probing depth (PD) and bleeding on probing (BOP) values. Unstimulated whole saliva was collected, and enzyme-linked immunosorbent assay (ELISA) analysis was conducted for determining the immunoglobulin A (IgA) and immunoglobulin G (IgG) levels. The obtained clinical and immunological values were statistically analyzed. Results: The results of the clinical examination revealed low PD and BOP scores, whereas the ELISA analysis showed significantly higher salivary IgA levels as compared to salivary IgG. Conclusions: Based on the observations of this clinicoimmunological study, it was concluded that no correlation existed between dental caries and periodontal disease.
  800 67 -
Need for an alternative method to cement fiber-reinforced posts - A pushout bond strength analysis
Susan Dax, Dax Abraham
May-June 2020, 23(3):240-243
DOI:10.4103/JCD.JCD_345_20  
Background: The use of dissimilar materials used as posts, luting agents, and the core often makes the restorative procedure quite complicated, as each material demands its own technical process. Furthermore, it may not necessarily result in better collective physical properties. Aim: The aim of this study was to analyze the pushout bond strength of a zirconia-based core buildup material in cementing two fiber posts. Methods: Eighty single-rooted mandibular premolars were decoronated, endodontically treated, post space prepared, and randomly assigned to one of the following four groups: carbon fiber post luted with PermaCem 2.0, carbon fiber post luted with LuxaCore Z Dual, glass fiber post luted with PermaCem 2.0, and glass fiber post luted with LuxaCore Z Dual. Pushout bond strength was evaluated in a universal testing machine for each of the 2 ± 0.5 mm sections obtained from the samples (total 160 sections) Statistical Analysis: One-way ANOVA and post hoc tests were used for statistical analysis. Results: The glass fiber posts cemented with LuxaCore Z showed significantly higher pushout bond strength (P < 0.001). Conclusion: LuxaCore Z Dual-core build material was more effective as a luting agent for glass fiber post cementation.
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Effect of temperature and activation techniques of irrigating solutions on push-out bond strength of fiber post
Prasanti Kumari Pradhan, Sradhashree Dipallini, Kanhu Charan Sahoo, Gaurav Patri, S Lata
May-June 2020, 23(3):295-298
DOI:10.4103/JCD.JCD_384_20  
AIM: This study evaluated the effect of preheated irrigants (EDTA, QMix), then use of various activation techniques such as ultrasonic system and laser on push-out bond strength (POBS) of fiber posts to root dentin. Methodology: One hundred and twenty extracted human teeth were decoronated below the cementoenamel junction. All the root canals were instrumented, irrigated using sodium hypochlorite and normal saline, dried with paper points, and filled with gutta-percha and AH Plus sealer. Post spaces were prepared. The irrigating solutions QMix and EDTA were heated to 60°C. Normal QMix and EDTA served as control. The irrigants were activated with Laser and Ultrasonic system. Then, the fiber posts were cemented, roots were sliced to thickness of 2 mm and mounted for measurement of POBS. Results: Preheated irrigants group showed maximum POBS as compared to Normal irrigants. QMix group showed better results as compared to EDTA. Irrigants when activated with laser and ultrasonics showed comparable results. Conclusion: Within the limitations of the study, it can be concluded that preheated irrigants(QMix, EDTA) increase the POBS of fiber post to root dentin. Both laser and ultrasonic are equally effective for increasing the POBS.
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EDITORIAL
From the desk of the editor… Plagiarism: The biggest plague in research writing
Shishir Singh
May-June 2020, 23(3):215-215
DOI:10.4103/JCD.JCD_566_20  
  662 49 -
ORIGINAL ARTICLES
Microcomputed tomographic evaluation of shaping ability of two thermo mechanically treated single-file systems in severely curved roots
Swapnil J Kolhe, Priyanka S Kolhe, Meenal N Gulve, Gayatri B Aher, Chetan J Bhadage, Shailendra S Mashalkar
May-June 2020, 23(3):244-248
DOI:10.4103/JCD.JCD_349_20  
Context: Canal shaping abilities such as canal transportation, centering ability, and preparation time are important and have to be considered before using any Nickel–Titanium file system. Aim: This in vitro study aimed to evaluate and compare the amount of canal transportation, centering ability, and time required for the shaping of severely curved canals with WaveOne Gold (WOG) Primary Reciprocating file and One Curve (OC) Rotary file using the micro computed tomography (μCT). Materials and Methods: Thirty intact mesial roots of extracted human mandibular first molars having severe curvature (25°–35°) were selected. Samples were divided into two groups. Samples in Group I and II were shaped with WOG primary reciprocating files and OC rotary files, respectively, to the working length. Time required to prepare each canal was recorded. μCT pre- and post-instrumentation scans of all samples were taken. The cross-sectional images at 3, 6, and 9 mm from the radiographic apex were selected for analysis. Statistical analysis was performed using the Kruskal–Wallis and unpaired t-test. Results: At 3 mm, OC showed statistically lower canal transportation with mean value (0.17 ± 0.10) than WOG (0.55 ± 0.42). Furthermore, OC showed statistically significant better centering ability (0.59 ± 0.25) than WOG (0.39 ± 0.20) at 3 mm level. However, the differences between both instruments were not statistical significant at 6 and 9 mm level for canal transportation and centering ratio. WOG reciprocating file required less time for canal preparation than OC file. Conclusions: OC rotary file showed less canal transportation and better canal centring ability than WOG file, during the preparation of severely curved canals. However, WOG required less time for canal preparation.
  644 50 -
Comparative evaluation of apical extrusion of intracanal bacteria using ProTaper Next, Mtwo, and ProTaper rotary systems: An in vitro study
Swapnika Polineni, Bhargavi Damaraju, Nagesh Bolla, Sunil Ch, N Vamsee Krishna, K Sreeha
May-June 2020, 23(3):314-318
DOI:10.4103/JCD.JCD_283_19  
Aim: The aim of this study was to evaluate the number of intracanal bacteria extruded apically after instrumentation with three different nickel–titanium rotary instruments. Materials and Methodology: Forty freshly extracted mandibular premolars were selected, access cavities were prepared, and the teeth were mounted in the bacterial collection apparatus. Root canals were contaminated with a suspension of Enterococcus faecalis and incubated for 24 h at 37°C. The contaminated teeth were divided into four groups of 10 teeth each according to the rotary system used for instrumentation: Group 1: ProTaper universal files, Group 2: MTwo files, Group 3: ProTaper Next files, and Group 4: Control group (no instrumentation). Bacteria extruded after preparations were collected into vials. The number of colony-forming units (CFUs) was determined for each sample. Statistical Analysis: The data obtained were analyzed using the one-way analysis of variance followed by post hoc Tukey’s test with a P = 0.05 as the level for statistical significance. Results: The results suggested a statistically significant difference in the number of CFUs between four experimental groups (P < 0.001). Conclusion: Least amount of bacterial extrusion was seen in ProTaper Next Group while more bacterial extrusion was seen in MTwo Group.
  624 65 -
Assessment of various endodontic instrumentation systems on the amount of apically extruded bacteria - An in vitro study
Garima Sahni, Nisha Garg, Ajay Chhabra, Shabnam Negi, Sandeep Gupta, Vandana Chhabra
May-June 2020, 23(3):270-274
DOI:10.4103/JCD.JCD_298_20  
Aim: The objective of this in vitro study was to assess the effect of different endodontic instrumentation systems on the amount of apically extruded bacteria. Materials and Methods: One hundred and twenty freshly extracted human mandibular premolars with single canal were collected. Endodontic access cavities were prepared and then contaminated with an Enterococcus faecalis suspension (ATCC 29212). After incubation at 37°C for 24 h, the root canals were instrumented with K flare files, F360 Single file system, K3XF files, Heroshaper files, Protaper Next files, and Hyflex EDM Single file system. During instrumentation, apically extruded bacteria were collected in the vials containing 0.9% NaCl. Samples were taken from the vials and incubated in brain–heart infusion agar medium for 24 h. Statistical Analysis: The number of colony-forming units was determined, and data were statistically analyzed using one-way analysis of variance and post hoc Tukey test. Results: Significant difference was found between the rotary and hand instrumentation systems. Conclusions: Both rotary and hand instrumentation systems extruded intracanal bacteria through the apical foramen, Group 1 (Hand K Flare files) showed maximum, whereas, Group 5 (Protaper Next) and Group 6 (Hyflex EDM) showed the least extrusion.
  628 56 -
Root canal morphology of South Asian Indian mandibular first, second, and third molar: A dye penetration and clearing study
Shishir Singh, Mansing Pawar, Rajesh Podar, Gaurav Kulkarni, Nikhil Bhanushali
May-June 2020, 23(3):284-288
DOI:10.4103/JCD.JCD_379_20  
Context: Studying in detail the root canal morphology specific to the Indian mandibular molars will help discern whether the root canal anatomy patterns resemble those reported internationally or are different from it. Aim: The aim is to study the root canal anatomy of Indian permanent mandibular first, second, and third molar teeth using a tooth clearing technique. Methods: The root canals of a total of 300 extracted Indian mandibular molars consisting of 100 first, second, and third molars each were accessed and injected with India ink, after which they were subjected to the clearing technique. Statistical Analysis: Data was analyzed using descriptive statistics for the computation of percentages using SPSS version 21. Results: Of the hundred first molars, 90% of teeth were two rooted with three canals, 79% had two apical foramina. 70% mesial roots of the three-rooted type showed Type I, whereas 100% distal roots and distolingual roots showed Type I Vertucci’s anatomy. About 70% mesial roots of two roots showed Type II and 90% distal canals showed Type I configuration. Among the second molars, five (5%) were single-rooted, ninety-one (91%) teeth were two rooted and four (4%) had three roots. Among the mandibular third molars, fifteen (15%) teeth had one root, sixty-three (63%) teeth had two roots, eighteen (18%) teeth had three roots, and four (4%) teeth had four roots. Conclusions: The root canal anatomic features of mandibular molars showed differences in the frequency of particular anatomic types as compared to mandibular molars from other racial backgrounds. Further comparative studies on inter-racial anatomic characteristics from various geographic locations would be beneficial.
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Micro-computed tomographic evaluation of smear layer and accumulated hard tissue debris removal
Giovani Antonio Ortigara, Maíra Prado, Ricardo Tadeu Lopes, Bernardo Camargo dos Santos, Heloisa Gusman
May-June 2020, 23(3):249-253
DOI:10.4103/JCD.JCD_293_20  
Background: The isthmus and irregularities present in the root canal system are potential areas for debris accumulation areas and therefore the seach for devices and solutions to improve cleaning of these areas is of utmust importance. This study evaluated, by micro–computed tomography, the efficiency of 37% phosphoric acid solution with that of 17% EDTA in the removal of smear layer and accumulated hard tissue debris (AHTD) after canal preparation. Methods and Materials: Twenty-six mesial roots of mandibular molars were subjected to microtomographic scanning using the SkyScan 1173 X-ray microtomograph at a resolution of 14,97 µm. The canals were prepared using Reciproc R40 instruments, 6% NaOCl and EndoVac System® to irrigation/aspiration. After instrumentation, the specimens were divided into two groups: 37% phosphoric acid solution or 17% EDTA. Results: The results demonstrated that 37% phosphoric acid was significantly more effective in removing smear layer and AHTD than 17% EDTA (Mann-Whitney, p <0.05). It was shown that both 37% phosphoric acid and 17% EDTA are effective agents in the removal of smear layer and debris, but better results were obtained with the use of 37% phosphoric acid. Conclusion: The results suggest that this solution can be a potential alternative to remove smear layer after root canal preparation.
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Synchrotron radiation-based micro-computed tomographic analysis of dentinal microcracks using rotary and reciprocating file systems: An in vitro study
Harikumar Vemisetty, N Tulasi Priya, Balwant Singh, Pooja Yenubary, Ashish Kumar Agarwal, Jayaprada Reddy Surakanti
May-June 2020, 23(3):309-313
DOI:10.4103/JCD.JCD_465_20  
Background: Advances in both X-ray sources and X-ray optics have dramatically improved the feasibility of these techniques in various fields. Aims: We aimed to evaluate the frequency of dentinal microcracks observed after root canal preparation with ProTaper Gold (PTG), Hyflex electrodischarge machining (HEDM), Reciproc (RPC), and WaveOne Gold (WOG) using synchrotron radiation-based micro-computed tomographic (SR-μCT) analysis. Subjects and Methods: Forty mandibular molars were assigned to 4 experimental groups (n = 10) according to the file system used for the root canal preparation: Group 1: PTG (25/0.08), Group 2: HEDM (25/0.08), Group 3: RPC (25/0.08), and Group 4: WOG (25/0.07). The specimens were scanned on SR-μCT system before and after root canal preparation. The pre- and postoperative cross-sectional images (N = 183,200) of the mesial roots were screened to identify the presence of dentinal microcracks. The number of microcracks was determined as a percentage for each group. Statistical Analysis: There was no necessity of statistical analysis in the present study. The number of microcracks was determined as a percentage for each group. Results: Among the four file systems tested, HEDM (0.9%) has shown a fewer number of new dentinal microcracks. Conclusions: SR-μCT can be used as a reliable diagnostic tool for further implications.
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