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Elghandour IA. Use of Resin Solvent as a Facilitator for Removal of Resin Composite Restoratives by Influencing their Mechanical Properties: Is this Possible?. J Oper Dent Endod 2019; 4 (1):1-5.
Aim: The aim is to evaluate the influence of resin solvent on Vickers microhardness, flexural strength, and flexural modulus of a resin composite in order to test the ability of resin solvent to soften or weaken resin composite during replacement of failed restoration.
Materials and methods: Fifty specimens were prepared from Tetric N-Ceram; forty used for flexural strength and elastic modulus tests and ten used for microhardness test. For flexural strength; they were divided into four groups of ten specimens each; in first group; specimens were not subjected to resin solvent (control), in second, third and fourth groups; specimens were subjected to resin solvent for 1, 3, and 5 minutes respectively. For microhardness, specimens were examined before after application of resin solvent for 1, 3, and 5 minutes with a total of forty readings. Collected data were statistically analyzed.
Results: Resin solvent was found to reduce significantly the flexure strength of Tetric N-Ceram compared to the control group. Differences in flexure strength between 1, 3, and 5 minutes applications were statistically nonsignificant. For elastic modulus and microhardness, the influence of resin solvent on resin composite was statistically nonsignificant.
Conclusion: Resin solvent weakens the flexural strength of resin composite but did not affect its microhardness or elastic modulus. Increasing the time of application from 1, 3, and 5 minutes did not further reduce the flexural strength.
Clinical significance: Resin solvent had shown promising potentials to reduce the strength and hence facilitate removal of failed composite restoration during replacement.
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Chanian S, Sundar S, Suresh N, Natanasabapathy V. Cyclic Fatigue Life Assessment of a Newer Heat-treated Reciprocating NiTi File in a 90-degree Canal Curvature. J Oper Dent Endod 2019; 4 (1):6-9.
Aim: The purpose of this study was to compare the cyclic fatigue resistance WaveOne Gold and WaveOne files in a reciprocating motion.
Materials and methods: A total of 24 new rotary WaveOne Gold (ISO size = 25, taper = 0.07, length = 25 mm) and WaveOne files (ISO size = 25, taper = 0.08, length = 25 mm) were selected and divided into 2 groups (n = 12 each). A cyclic fatigue-testing device was fabricated with a 90-degree angle of curvature and a 5 mm radius. All instruments were reciprocated until fracture occurred. The time was taken for each instrument to fracture, and the length of the broken fragments was recorded. All the fractured files were analyzed under a scanning electron microscope to detect the mode of fracture. The Kolmogorov–Smirnov test was used to assess the normality of sample distribution, and statistical analysis was performed using the independent sample t test.
Results: The time taken for the instruments of WaveOne Gold group to fail under cyclic loading was significantly longer compared with the WaveOne group (p < 0.001). Scanning electron microscopic observations showed that the instruments of all groups had undergone a ductile mode of fracture. The length of the fractured segments was between 1.5 and 5 mm, which was statistically significant among the experimental groups.
Conclusion: WaveOne Gold instruments showed a significantly higher cyclic fatigue resistance compared to WaveOne in a reciprocating motion.
Aim: To compare and evaluate the fracture resistance of endodontically treated teeth restored with Rebilda post GT, EverStick post and prefabricated glass fiber post at 90-degree vertical load and 45-degree oblique load.
Materials and methods: Eighty freshly extracted single-rooted mandibular premolars were selected, and after root canal preparation and obturation, standardized post spaces were prepared. Samples were randomly divided into four groups (n = 20) depending on the type of restorative technique used: group I restored with Rebilda post GT system (bundled glass fiber reinforced composite post), group II restored with EverStick post (Individually formable glass fiber root canal post), group III restored with prefabricated glass fiber post, group IV restored with direct composite resin restoration without a post (control). Using a universal testing machine, 90-degree vertical and 45-degree oblique load was applied to the restored teeth with a crosshead speed of 0.5 mm/minute. Fracture loads and mode of fracture was recorded.
Results: The results of the analysis of variance (ANOVA) and post hoc Tukey HSD test revealed that the fracture resistance was significantly affected by different post systems (p < 0.001).
Conclusion: Rebilda post GT samples showed maximum fracture resistance followed by the EverStick fiber post group, prefabricated post, and least in the control group.
Aim: To evaluate the microcrack propagation after root canal instrumentation using instruments operating in rotary, reciprocating, translinear, and centrifugal motions.
Materials and methods: An estimated 80 mandibular molars were divided into three experimental groups (n = 20). Group I—rotary motion (ProTaper Universal Dentsply, Maillefer, Ballaigues, Switzerland, and F2 file). Group II—reciprocating motion (WaveOne Dentsply, Maillefer, Ballaigues, Switzerland, Primary Files ISO 25, and 8% taper). Group III—translinear motion (Self-Adjusting File, ReDent Nova, Ra\'anana, Israel). Standard access cavities were prepared and the canals were manually prepared up to a 15-K file to establish patency. Shaping and cleaning was performed according to manufacturer\'s instructions for each group, keeping the irrigation protocol constant. The samples were then scanned in a four-dimensional X-ray microscopy machine (ZEISS Xradia 510 Versa) and were virtually sectioned. The Z test was applied for statistical analysis.
Results: No significant difference was found between rotary (ProTaper Universal) and reciprocating groups (WaveOne) (p = 0.3112). Translinear motion (Self-Adjusting File) showed statistically significant least microcracks (p = 0.000).
Conclusion: (1) Self-adjusting file proved to be the most minimally invasive file system. (2) Reciprocation showed lesser samples with cracks than rotary motion. (3) Apical sections showed significantly higher cracks than the other sections. (4) Four-dimensional X-ray microscopy could be a promising tool for dental imaging.
Clinical significance: The stress induced by aggressive preparation procedures of certain file systems have led to microcrack propagation, reduction in the resistance form, and subsequently failure of endodontic therapy owing to vertical root fracture. Literature suggests that kinematics of the file influences crack propagation in a radicular dentin. Hence, this study has been undertaken to compare and evaluate the effect of four different kinematics of nickel–titanium file systems on microcrack propagation in a radicular dentin.
Aim: The aim of this study was to evaluate the pH of three different sealers—BioRoot RCS, Sealapex, and AH-plus at different time periods.
Materials and methods: The diluted sealer was transferred to a clean dry test tube. The pH of the root canal sealers was assessed using a digital pH meter. The measurement was carried out at 37°C fluid temperature for all the samples to simulate the oral temperature. The pH measurements were carried out at the end of mixing time (0 hours), 4 hours, 8 hours, and at 24 hours before renewal of the test liquids. Statistical analysis was done using t test—comparison of two independent means. The statistical analysis was done using the post hoc tests.
Results: The results of the study show that all the three sealers tested were alkaline in nature throughout the test periods. All the sealers showed a significant change during the time periods (p < 0.05). AH-plus showed a gradual reduction in pH within the range of 10–10.5. There was a statistically significant change at all time intervals between AH-plus and BioRoot RCS (p < 0.05), but no difference between Sealapex and BioRoot RCS or AH-plus (p > 0.05).
Conclusion: All the three sealers used in this study are alkaline in nature, with BioRoot RCS showing the highest pH and AH-plus displaying the lowest with a significant difference between the two. There was no significant difference between BioRoot RCS and Sealapex at all time periods.
Clinical significance: The antimicrobial activity of sealer is directly related to pH of sealer. The pH of three sealers—BioRoot RCS, Sealapex, and AH-plus are in the alkaline range up to 24 hours. Bioceramic sealer and Sealapex show the highest pH with no significant difference between them.
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Kangabam N, Subbiya A, Geethapriya N, Padmavathy K, Mahalakshmi K, Megha R. Efficacy of Herbal Extracts against Enterococcus faecalis on a Dentinal Biofilm. J Oper Dent Endod 2019; 4 (1):22-26.
Aim and objectives: Antibacterial activity of five different extracts of Cinnamomum zeylanicum was estimated and compared with the conventional root canal irrigant sodium hypochlorite on planktonic cells as well as on a 6-week biofilm.
Materials and methods: An estimated 10 g of the five different herbal extracts, namely methanol, ethanol, isopropyl alcohol, acetone, and chloroform were weighed and mixed with 20 mL of inert solvent. Zone of inhibition was assessed by the agar well diffusion assay and MIC (minimum inhibitory concentration) by the broth dilution assay. A total of 90 teeth samples were inoculated with E. faecalis (ATCC 29212) and were incubated for 6 weeks. The samples were assigned into six different groups, namely Cinnamomum zeylanicumm ethanolic extract, Cinnamomum zeylanicum ethanolic extract, Cinnamomum zeylanicum isopropyl alcohol extract, Cinnamomum zeylanicum acetone extract, Cinnamomum zeylanicum chloroform extract, and NaOCl. Time required to inhibit 6-week biofilm of E. faecalis was assessed using time kill curve with a time interval of 5, 10, 15, and 20 minutes. Statistical analysis was done using the Kruskal–Wallis test.
Results: The methanol, ethanol, isopropyl alcohol, acetone, and chloroform showed a complete eradication of Enterococcus faecalis—both planktonic organism and the 6-week biofilm.
Conclusion: According to the study conducted, methanol, ethanol, isopropyl alcohol, acetone, and chloroform extracts of Cinnamomum zeylanicum were found to be effective antibacterial agents against E. faecalis—both planktonic cells and 6 weeks biofilm formed on dentin substrate.
Clinical significance: Since cinnamon extract has a good antimicrobial activity almost at par with NaOCl, it could be a promising alternative to conventional irrigants.
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Majeti C, Veeramachineni C, Ravi R. Effect of Silanization on Push-out Bond Strength of H2O2-etched Fiber Posts Using Various Resin Cements: An In Vitro Study. J Oper Dent Endod 2019; 4 (1):27-32.
Background and objectives: Etching of a fiber post is necessary for enhancing its adhesion to both the core and the root canal dentin. Many surface treatments are recommended for this purpose. The purpose of the present study was to evaluate the efficacy of silanization on the push-out bond strength of H2O2-etched fiber posts to a root canal dentin using different luting agents.
Materials and methods: Sixty maxillary central incisors and fiber posts were taken and grouped, based on surface treatment posts received, as group I (control); group II and group III—etched with 24% H2O2, and sub-grouped (Ia Ib; IIa IIb; IIIa IIIb) based on the luting agent used. Group III received an additional treatment with silane before cementation and after etching. Each tooth was sectioned into three slices of 2 mm representing coronal, middle, and apical section of the tooth and subjected to a push-out test and the values obtained are statistically analyzed using two-way ANOVA and Tukey\'s post hoc tests.
Results: Among all the groups, group III irrespective of sub-groups showed the highest bond strength values followed by group II and then group I. Coronal region showed higher values than middle and apical.
Conclusion: Both the H2O2 etched groups (II and III) showed higher values than control group (group I). Silane treated groups (IIIa, IIIb) showed higher values than non-silanated group (IIa, IIb). There was no significant difference between the sub-groups (a, b) in all individual groups. In all groups, bond strengths were higher in coronal root region followed by middle and then apical.
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Kaboré WA, Avoaka-Boni M, Bane K, Gnagne-Koffi Y, Seck A, Leye-Benoïst F. Direct Coronal Restoration with Composite Resins: An Assessment of 44 Cases Performed by Students at Yalgado Ouédraogo University Hospital Center of Ouagadougou, Burkina Faso. J Oper Dent Endod 2019; 4 (1):33-36.
Introduction: Composite resins restoration requires a rigorous approach in its implementation, which should be integrated into the learning process. The objective of this study is to assess the immediate quality of filling carried out by students in the Department of Conservative Dentistry and Endodontics, Yalgado Ouédraogo University Hospital Center.
Materials and methods: This is an evaluative prospective study conducted from April 1, 2018 to May 31, 2018. Direct coronal restorations performed by 1st year PhD students were assessed using well-established clinical and radiographic criteria and data were gathered using a form.
Results: Restorations were performed in 44 patients. Most of them (56.8%) were performed on first maxillary incisors. The fillings contour was in line with the tooth morphology for 39 (88.6%) fillings. Eleven (25%) fillings have gap apparent on radiography. Of the 44 assessed fillings, seventeen (38.6%) received a final score of “Not good” and 27 (61.4%) were rated “Good”. All patients were satisfied with their restorations.
Conclusion: This study showed that students perform sufficient high quality restorations. However, the restoration emergence profile and the polishing still need to be improved.
Chakravarthy S Vineetha,
Arthanarieswaran A Sivakumar,
Jambai S Sivakumar,
Anjaneya S Prasad,
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Vineetha CS, Vaiyapuri R, Sivakumar AA, Sivakumar JS, Prasad AS, Soundappan S. Electron Microscopic Comparative Analysis of Smear Layer Removal by Ethylenediaminetetraacetic Acid and Chitosan Using Ultrasonic Activation: An In Vitro Study. J Oper Dent Endod 2019; 4 (1):37-41.
Aim: To compare the ability of smear layer removal by ultrasonic activation of ethylenediaminetetraacetic acid (EDTA) and chitosan.
Materials and methods: Forty-five freshly extracted human mandibular single-rooted premolars were collected and stored in distilled water. Teeth were radiographed to confirm the existence of a single canal. The crowns were sectioned to standardize the length of the root samples to 14 mm using a diamond disk under constant irrigation. Cleaning and shaping were done up to ProTaper F3, and the specimens were randomly divided into three groups of 15 samples each—group I-control group (ultrasonically activated-normal saline), groups II (ultrasonically activated-EDTA), and group III (ultrasonically activated-chitosan). After this, the roots of the teeth were split longitudinally, and the samples were placed in 2% glutaraldehyde for 24 hours. The samples were then desiccated, mounted, and scanning electron microscopic (SEM) photographs were taken at coronal, middle, and apical levels. Data were collected based on Gutmann\'s scoring criteria, and statistical analysis was carried out using one-way ANOVA and Tukey\'s post hoc test (p < 0.05).
Results: Ultrasonic activation of EDTA had the highest ability of smear layer removal.
Conclusion: Ultrasonically activated EDTA and chitosan showed significant difference in smear layer removal compared to normal saline; EDTA was found to be better than chitosan.
The ultimate goal of any operative procedure is to restore the tooth to its original form and function within the arch as well as to reestablish esthetics wherever applicable. The primary objective of the endodontic therapy is the elimination of bacteria and their by-products, pulpal remnants, and debris from the root canal system. To achieve this goal, the biomechanical aspects of the tooth structure are often compromised, leading to the questionable prognosis of the restorative factor of endodontically treated teeth (ETT). The current technological advancements in the field of endodontics that preserves more natural tooth structure and adhesive dentistry that enables better restoration of the lost tooth structure, when used in the optimal way, can pave a path for the right balance between the endodontic and restorative components of teeth. This narrative review highlights the ways in which the right balance can be achieved between the two.
Rohit A Tekwani,
Kranthi K Reddy,
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Tekwani RA, Nanda Z, Rudagi K, Reddy KK, Deore R, Fotani S. Nonsurgical Management of an Extraoral Sinus Tract of Endodontic Origin: A Case Report. J Oper Dent Endod 2019; 4 (1):54-56.
A longstanding odontogenic infection often leads to the formation of suppuration, which is drained either intraorally or extraorally through a sinus tract. Being a rare condition, the extraoral sinus tract of odontogenic origin is usually misdiagnosed as a non-odontogenic infection by physicians. As it is rightly said that a correct diagnosis is three-fourths the remedy, diagnosing the odontogenic extraoral sinus tract is of prime importance for its effective management. So, this case report demonstrates the diagnosis and the non-surgical endodontic management of an extraoral sinus tract.