Journal of Operative Dentistry & Endodontics

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2018 | June | Volume 3 | Issue 1

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Disha Mehta, Pallav Choksi, Rupal Vaidya, Kunjal Mistry, Zarna Sanghvi, Pruthvi Patel

Comparative Evaluation of Antibacterial Efficacy of 5% Sodium Hypochlorite, 940 nm Diode Laser, and Gaseous Ozone against Enterococcus faecalis Biofilm formed on Tooth Substrate: A Scanning Electron Microscope Study

[Year:2018] [Month:] [Volume:3] [Number:1] [Pages:6] [Pages No:1 - 6]

Keywords: Biofilm, Diode laser, Enterococcus faecalis, Ozone, Root canal disinfection.

   DOI: 10.5005/jp-journals-10047-0047  |  Open Access |  How to cite  | 


Aim: To comparatively assess the antibacterial effectiveness of 5% sodium hypochlorite, 940 nm diode laser, and gaseous ozone against Enterococcus faecalis biofilm produced on the substrate. Materials and methods: Freshly extracted maxillary central incisor teeth of human source were decoronated and vertically sectioned after biomechanical preparation. The samples were then, after sterilization, placed in Eppendorf tubes filled with 1 mL of bacterial solution containing 1.5 × 105 colony-forming units (CFUs)/mL of E. faecalis. Then, these adulterated samples were divided into four groups (n = 8) depending upon the method of disinfection used: group I, 5% sodium hypochlorite (positive control); group II, normal saline (negative control); group III, gaseous ozone; and group IV, 940 nm diode laser. At the conclusion of 3 weeks, all the samples were disinfected according to their groups and were analyzed qualitatively and quantitatively. Results: The positive control group (5% sodium hypochlorite) showed statistically significant results in comparison with the other three groups (p < 0.05). Statistically, there was no significant difference found between the experimental groups, i.e., ozone group and diode laser group (p > 0.05). Conclusion: A 5% sodium hypochlorite showed the highest antibacterial effect against E. faecalis biofilm formed on substrate, i.e., tooth. Both diode laser and gaseous ozone groups have a statistically significant antibacterial action on the infected root canals.



Amrita V Sali

Effect of Post Space Irrigation using Novel Irrigant: SmearOFF (containing Chlorhexidine and EDTA) on the Push-out Bond Strength of Fiber Posts luted with Self-adhesive Resin Cement

[Year:2018] [Month:] [Volume:3] [Number:1] [Pages:5] [Pages No:7 - 11]

Keywords: Ethanol, Fiber post, Irrigation, Push-out, SmearOFF.

   DOI: 10.5005/jp-journals-10047-0048  |  Open Access |  How to cite  | 


Aim: To make a comparative evaluation of the effect of different post space irrigation procedures on the push-out bond strength of prefabricated fiber posts luted with self-adhesive resin cement in different root thirds (coronal, middle, and apical). Materials and methods: Sixty freshly extracted single-rooted teeth were selected, and after root canal preparation and obturation, standardized post spaces were prepared. Teeth were then randomly divided into four groups (n = 15), according to the different post space irrigants used: group I—distilled water (control); group II—17% ethylenediaminetetracetic acid (EDTA) + 2.5% sodium hypochlorite (NaOCl); group III—99% ethanol; group IV—SmearOFF. All solutions were maintained in the root canals for 60 seconds and dried with paper points. Prefabricated fiber posts were luted using the self-adhesive resin cement. The push-out test was carried out by applying a load using Instron Universal Testing Machine. Results: The results of the analysis of variance (ANOVA) and the post hoc Bonferroni tests revealed that the push-out bond strength was significantly affected by the different post space irrigants (p < 0.001). However, no significant difference in push-out bond strength was attained with reference to the different locations inside the canal (i.e., coronal, middle, and apical) (p > 0.05). Conclusion: Pretreatment of the post space using 99% ethanol resulted in highest bond strength with respect to prefabricated fiber posts luted with self-adhesive resin cement. The push-out bond strengths exhibited by both, the newly launched irrigant: SmearOFF and the combination of EDTA + NaOCl, were comparable. Clinical significance: Irrigation of post space after mechanical post space preparation is the central key to remove smear layer, open dentinal tubules along with achieving superior bond strength of fiber posts cemented with a self-adhesive resin cement to root dentin.



In vitro Evaluation of Fracture Resistance of Endodontically treated Teeth restored with Bulk-fill, Bulk-fill Flowable, Fiber-reinforced, and Conventional Resin Composite

[Year:2018] [Month:] [Volume:3] [Number:1] [Pages:6] [Pages No:12 - 17]

Keywords: Bulk-fill composites, Endodontically treated, Fracture resistance, Resin-based composites.

   DOI: 10.5005/jp-journals-10047-0049  |  Open Access |  How to cite  | 


Aim: This original research was carried out to assess the susceptibility to fracture of root canal treated teeth with composite postendodontic restorations. Materials and methods: Seventy-two sound human mandibular premolar teeth, extracted for various reasons, were selected. For experimental purposes, they were then divided into six groups (n = 12). Groups I and II were designated the negative control (no preparation done) and positive control (cavity preparation was done but left unrestored) respectively. In all other teeth, mesio-occluso-distal (MOD) cavities were prepared, and they were then root canal treated. The other groups were also restored with the respective resins: group III: condensable bulk-fill composite, group IV: bulk-fill flowable resin composite, group V: fiber-reinforced composite, and group VI: conventional resin-based composite. Manufacturerrecommended adhesive systems for respective restorative resins were used. To avoid desiccation of the specimens, they were kept in distilled water for 24 hours at body temperature. The specimens were then subjected to compressive loads until they fractured. Statistical analysis was performed using analysis of variance (ANOVA) and post hoc Tukey tests. Results: Statistically significant results were observed among all groups. The highest and lowest values were noted with groups I and II respectively (p = 0.05). Conclusion: The resistance to fracture in root canal-treated teeth with everX Posterior, fiber-reinforced bulk-fill composite was the highest.



Sneha Jeetendra, Anithakumari Rangappa, Meena Naganathan

Influence of Dentin Desensitizers on the Bond Strength of Self-etch Adhesive to Dentin: An in vitro Study

[Year:2018] [Month:] [Volume:3] [Number:1] [Pages:4] [Pages No:18 - 21]

Keywords: Desensitizing agents, Self-etch adhesive, Tensile bond strength.

   DOI: 10.5005/jp-journals-10047-0050  |  Open Access |  How to cite  | 


Aims and objectives: Hypersensitivity is a multietiological clinical problem. Many desensitizing treatments have been advocated to reduce the hypersensitivity. The aim of this study is to evaluate the effect of few in-office desensitizing agents on the bond strength of composite restoration. Materials and methods: Forty-eight sound human premolars were used for the study. The occlusal surface of each teeth was grounded with a diamond disk to expose the flat dentin surface, polished with 120 and 320 silicon grit sand paper. The specimens were then divided into four groups (n = 12) based on the type of dentin desensitizing agent given. Group I was treated with Vivasens, group II was treated with MS Coat F, group III was treated with Solo Eze, and group IV served as a control where no desensitizing agent was used. The specimens were treated with one-step self-etch and restored with composites according to the manufacturer's instructions. The specimens were then stored in distilled water for 24 hours and subjected to Universal Testing Machine to check the tensile bond strength. Results: Statistical analysis of the data obtained revealed the mean values for the tensile bond strengths were 92.53, 71.07, 95.07, 160.28 N for groups I to IV respectively. These values were statistically significantly different between groups pretreated with desensitizing agents as compared with control group. Conclusion: Dentin pretreated with desensitizing agents has lower tensile bond strength with resin composites as compared with dentin that is untreated. Among the experimental groups, hydroxyethyl methacrylate (HEMA)-containing desensitizing agents had better bond strength compared with the fluoridecontaining agents.



Carounanidy Usha

Caries Risk Assessment: A Critical Look

[Year:2018] [Month:] [Volume:3] [Number:1] [Pages:6] [Pages No:22 - 27]

Keywords: Caries risk assessment, Cariogram, Cariology.

   DOI: 10.5005/jp-journals-10047-0051  |  Open Access |  How to cite  | 


Caries risk assessment (CRA) is a concept that is firmly grounded on the well-known fact that dental caries is a disease. Steady accumulation of evidence under cariology has placed this concept as the pivotal point in management of caries disease. Although existent for decades, the CRA concept has not yet become the mainstream practice or training in India. Whatever is being practiced or taught does not seem to be proportionate enough to match its paramount importance in patient service. The reasons may be that it is still being overshadowed by the robust technical and technological growth of restorative dentistry that focuses only on restoring a carious lesion; or it does not possess enough evidence to be emphatic; or it does not provide the expected outcome reliably. The following review attempts to dissect various aspects of CRA in the realm of current evidence and propose certain future directions toward its effective adoption.



Allu Baby, T Prasanth Dhanapal, Shabeer Ummer TK, Helma George

Endodontic Management of Mandibular Premolars with Three Roots and Three Canals

[Year:2018] [Month:] [Volume:3] [Number:1] [Pages:5] [Pages No:28 - 32]

Keywords: Anatomical variations of teeth, Endodontic management, Mandibular premolar, Root canal anatomy.

   DOI: 10.5005/jp-journals-10047-0052  |  Open Access |  How to cite  | 


Proper knowledge of the internal anatomy of tooth is essential for the long-term success of endodontic treatment. Mandibular premolars exhibit a greater variation in their internal morphology due to the occurrence of additional roots and root canals. This article showcases two case reports of successful endodontic management of mandibular premolars with three roots and three canals. A detailed diagnosis of symptomatic irreversible pulpitis with apical periodontitis was made through clinical and radiographic examinations. Endodontic management was carried out successfully and the patient was evaluated.



S Vidhya Shankari, R Vinoo Subramaniam, K Karpagavinayagam

Smile Design using Recurring Esthetic Dental Proportion

[Year:2018] [Month:] [Volume:3] [Number:1] [Pages:5] [Pages No:33 - 37]

Keywords: Composite restoration, Diastema, Esthetics, Facial image view analysis values, Recurring esthetic dental proportion.

   DOI: 10.5005/jp-journals-10047-0053  |  Open Access |  How to cite  | 


Beautiful confident smile has a positive impact on the psychosocial well-being of patients. Spacing present in the anterior region makes a patient feel dissatisfied with their smile. Over the years, a number of innovative techniques have been described in the treatment of diastema. However, a less invasive and short-time treatment procedure with satisfactory result is preferred by the patient. This case report describes the technique of anterior diastema closure by applying Recurring Esthetic Dental (RED) proportion for smile designing using direct composite resin. The RED proportion has been stated to be an essential tool for achieving esthetics and harmony in smile.



Shekar Shobana, K Girija

Management of Internal Resorption with Perforation

[Year:2018] [Month:] [Volume:3] [Number:1] [Pages:5] [Pages No:38 - 42]

Keywords: Biodentine, Internal resorption, Mineral trioxide aggregate, Osteoclastic activity, Perforation, Thermoplasticized obturation.

   DOI: 10.5005/jp-journals-10047-0054  |  Open Access |  How to cite  | 


Internal root resorption is a pathologic intraradicular process in which there is loss of dental hard tissue due to osteoclastic activity inside the root canal space. It is a rare lesion of permanent teeth, which might be caused due to caries, trauma, restorative procedures, etc. Because of its insidious pathology, it can extend to significant dimensions before being diagnosed and may lead to perforation to external root surface due to progressive odontoclastic activity. This article describes two case reports of surgical management of a perforating internal resorption in maxillary central incisors, managed by routine root canal treatment, followed by repair with Biodentine and mineral trioxide aggregate (MTA). About 12 to 24 months of follow-up demonstrated clinically asymptomatic and adequately functional tooth, with radiographic signs of healing. Care was taken to conserve the tooth structure and avoid further weakening of the alreadycompromised tooth. A tooth deemed to have a questionable prognosis was conserved and found to demonstrate satisfactory healing with no radiographic evidence of progressive resorption.



Ashwini Prasad, Jaya Purewal

Management of the Open Apex using New Biomaterials

[Year:2018] [Month:] [Volume:3] [Number:1] [Pages:5] [Pages No:43 - 47]

Keywords: Apexification, Biodentine, Biomaterials, Blunderbuss canal, Immature root apices, Mineral trioxide aggregate, Retrograde filling.

   DOI: 10.5005/jp-journals-10047-0055  |  Open Access |  How to cite  | 


At the time of root development, trauma or caries results in tooth with immature and open root apices. The single most important factor that affects the success of endodontics is achievement of perfect apical seal. Apexification is done to achieve an apical barrier against which the obturating material can be condensed. Nowadays due to new advancements in materials and methods, single-visit apexification as compared with long and multiple visits (calcium hydroxide apexification) has gained popularity. With the new bioceramic materials like mineral trioxide aggregate (MTA) and Biodentine, perfect seal can be achieved much more easily and effectively. Various treatment modalities are present to treat immature open root apices. Retrograde root end filling by surgical intervention provides faster healing of the associated lesions. Both MTA and Biodentine promise to be quite reliable retrograde filling materials. In the following case reports, apexification using different treatment modalities— newer biomaterials—is explained.



Nagarajan Geethapriya, Suresh Mitthra, Paramasivam Vivekanandhan

Management of Cracked Teeth: A Report of Two Cases

[Year:2018] [Month:] [Volume:3] [Number:1] [Pages:4] [Pages No:48 - 51]

Keywords: Cracked tooth, Hypersensitivity, Masticatory force, Root canal treatment.

   DOI: 10.5005/jp-journals-10047-0056  |  Open Access |  How to cite  | 


Cracked tooth is an incomplete crack running in the crown of the tooth starting from the cervical portion. The crack may be initiated by excessive masticatory force or unintentional bruxism. Initially, they do not present with any symptoms, but later, these cracked teeth develop pain and sensitivity, which requires treatment. Here, we have presented two case reports diagnosed as cracked teeth, which were managed successfully by root canal treatment. The cases were followed up and the patients are asymptomatic. This proves that root canal treatment is a viable choice of treatment for cracked teeth.


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