Context: Pretreatment of radicular dentin with chelating agents improves the bond strength of fib... more Context: Pretreatment of radicular dentin with chelating agents improves the bond strength of fiber-posts luted with a self-adhesive resin cement. Aims: The aim of this study was to assess the effects of the three chelating agents as final rinse of the postspace on bond strength of fiber posts luted with a self-adhesive resin cement. Settings and Design: This is an in vitro laboratory study. Materials and Methods: Forty-five mandibular premolars were prepared using MTwo rotary system and irrigation was done with 2.5% sodium hypochlorite. Three groups of teeth samples were considered for postspace preparation and irrigated with different solutions: Group 1: 17% ethylenediamine tetraacetic acid (EDTA); Group 2: 7% Maleic acid; Group 3: 1% Phytic acid. This was followed by the luting the posts with RelyX U200. After a week, from each sample, 2 mm thick slices were obtained from each third of the root and subjected to push-out bond strength testing. Statistical Analysis Used: One-way analysis of variance and Bonferroni's Post hoc analysis was used for assessing the results. The statistical significance level was set at P < 0.05. Results: Bond strength values were improved with maleic acid and phytic acid pretreatment with slight or no significant difference between these groups. A final rinse of postspace with EDTA significantly reduced the bond strength. Conclusions: Maleic acid (7%) pretreatment of postspace improved the adhesion of fiber posts luted with a self-adhesive resin cement.
Background: Accurate estimation of the working length (WL) from the coronal reference point to th... more Background: Accurate estimation of the working length (WL) from the coronal reference point to the minor diameter (apical constriction) is critical in endodontic therapy. Many electronic apex locators are available to precisely measure this apical limit. Aim: To assess the precision of three current electronic apex locators-Root ZX Mini, CanalPro, and Apex ID in the mesial canals of mandibular molars. Cone-beam computed tomography (CBCT) was employed to verify their accuracy. Materials and methods: Thirty mandibular first molars with curved mesial roots were selected. Cone-beam computed tomography (CBCT) was used to assess the length of the teeth. Samples were decoronated and mesiobuccal canal orifices were enlarged with Hyflex CM 25/08 and irrigated with 2 mL 3% sodium hypochlorite. Canals were prepared with size 10 K-file and the measurements were recorded with apex locators at marks "APEX 0/0" and "0.5 mark" as electronic tooth length and the electronic WL, respectively by visual means, and this was verified using CBCT. Statistical analysis was done using the repeated measures of ANOVA test. Results: CanalPro, Root ZX Mini, and CBCT values were very similar. Apex ID values were longer than CBCT values. Conclusion: CanalPro readings closely matched those of CBCT measurement followed by Root ZX mini. Apex ID showed longer readings.
The endodontic treatment of teeth with dens invaginatus, characterized by an infolding of enamel ... more The endodontic treatment of teeth with dens invaginatus, characterized by an infolding of enamel and dentin, extending deep into the pulp cavity near the root apex, may be complicated and challenging. The complexity of the internal anatomy may create challenges for the complete removal of diseased pulpal tissue and the subsequent sealing of the canal system. Because of the bizarre root canal anatomy and widely open apex, a combination of nonsurgical and surgical endodontic treatment or extraction is the most common choice of therapy. This article describes case reports of nonsurgical endodontic treatment of Type II dens invaginatus associated with periradicular lesion.
Corticosteroids are used in the treatment of chronic autoimmune diseases and many long-term illne... more Corticosteroids are used in the treatment of chronic autoimmune diseases and many long-term illnesses. While these drugs may be considered essential for the patient's health, adverse reactions do occur. The incidence of adverse reactions depends upon the dose level and the duration of treatment. A pilot study was conducted on ten patients on long-term corticosteroids therapy. Pulpal obliteration was assessed by radiographic records. In most instances, pulpal changes to some degree were observed.
Journal of Multidisciplinary Dental Research, Dec 25, 2019
Introduction Furcal perforations compromise the health of the periradicular tissues and threaten ... more Introduction Furcal perforations compromise the health of the periradicular tissues and threaten the viability of the tooth. Perforation repair is a very attractive and frequently successful alternative to extraction of the involved tooth. Diagnosis and repair of furcal perforation, abscess have remained a diagnostic and therapeutic dilemma for the clinician. We believe this case report is the first of its kind to compare the repair of furcal perforation due to iatrogenic causes with mineral trioxide aggregate (MTA) and bone graft by conventional surgical technique and laser assisted periodontal therapy in mandibular molars. Case presentation Two patients presenting with clinical presentation and diagnosis of furcal abscess due to iatrogenic causes were treated and followed up for six months. The furca were exposed surgically. The furcation area in one patient was debrided by conventional periodontal therapy while in the other laser assisted periodontal therapy was instigated using diode laser, and the perforation sealed with mineral trioxide, bone graft was placed in the interradicular area. Clinical and radiographic examinations were conducted at base line and 6 months. Conclusion: During the 6 month follow up satisfactory resolution of the clinical and radiographic defect in the interradicular region was achieved by both conventional surgical and laser assisted periodontal therapy.
Aim: This study aims to evaluate the effect of three endodontic chelating agents (17% ethylenedia... more Aim: This study aims to evaluate the effect of three endodontic chelating agents (17% ethylenediamine tetra-acetic acid [EDTA], 1% peracetic acid [PAA], 0.2% Chitosan) on the push out bond strength of gutta percha with a new bioceramic sealer (BioRoot RCS). Materials and Methods: Forty-eight single-rooted mandibular premolars were selected and decoronated to obtain standardized root length of 15 mm. The root canals were prepared up to #30 files (Hyflex CM) and copious irrigation was done with 3 ml of 5.25% of NaOCl. According to the final irrigation, specimens were divided into three groups: Group 1 (n = 16) 0.2% chitosan, Group 2 (n = 16) 17% EDTA, and Group 3 (n = 16) 1% PAA for 1 min. Samples from each group were obturated with bioceramic sealer and gutta percha and sealed with temporary filling material. Two horizontal slices of 2 mm was obtained from the middle third of each sample (n = 32). Push out bond strength and failure modes were assessed. Kruskal–Wallis test followed by Mann–Whitney post hoc analysis was used for push out analysis. Chi square test was used to compare the modes of failure. The statistical significance level was set at P = 0.05. Results: The highest push out bond strength was obtained with Group 1 (0.2% chitosan) followed by Group 3 (1% PAA). Group 2 (17% EDTA) showed least push out bond strength when compared to Group 1 (0.2% chitosan) and Group 3 (1% PAA). The mode of failure was mainly cohesive for all groups. Conclusions: The highest push-out bond strength of BioRoot RCS was seen after treatment with 0.2% chitosan while the least was after EDTA treatment. 1% PAA treatment also favorably affected push-out bond strength of BioRoot RCS.
This review highlights the importance of atraumatic restorative treatment (ART) as a minimal inte... more This review highlights the importance of atraumatic restorative treatment (ART) as a minimal intervention procedure for managing dental caries (pit and fissures caries) and restoring cavitated dentin carious lesions using restorative materials such as glass-ionomer cement. ART technique uses only hand instruments and requires no electricity. Its low cost and simplified protocol makes it more convenient and suitable for use in remote areas as well as underdeveloped nations with insufficient resources to provide the adequate restorative care. This technique can be used in all population groups including children, older people, and disabled. In the present scenario of the COVID-19 pandemic, the dental profession is facing a challenging task in managing restorative needs of the patients all over the world. ART technique is a safe and effective approach to manage the progression of carious lesions. As this technique involves no aerosol generation during the procedure, it should be well a...
International Journal of Oral Health Dentistry, 2019
Treating a flared root canal always poses a challenge to the clinician. If treated inappropriatel... more Treating a flared root canal always poses a challenge to the clinician. If treated inappropriately, the root is prone to fracture thereby leading to catastrophic failure of the tooth. Reinforcing the canal with the help of anatomic post provides optimal stability and strength to the tooth. This case report focuses on the clinical technique of fabricating an anatomic post and reviews the various options to treat a flared canal.
IP Indian Journal of Conservative and Endodontics, 2019
Various options are presently available to address the challenge of immediately replacing a missi... more Various options are presently available to address the challenge of immediately replacing a missing anterior tooth. These include a removable /fixed temporary/ permanent acrylic prosthesis, or resin-bonded bridges. Ribbond single-visit bridges provide strength, durability, and immediate convenience. They are cost effective and reliable and are excellent for emergencies like: implant temporization, congenitally missing teeth and patients who cannot afford conventional lab fabricated bridgework. In place of the pontic, a natural tooth, denture tooth can be used or composite build-up can be done. Conclusions: The procedure was completed at the chair side, thereby avoiding additional laboratory costs. Creating an adhesive FRC bridge by using a composite resin pontic is a successful treatment option for the direct aesthetic replacement of missing anterior teeth.
Journal of Evolution of Medical and Dental Sciences, 2017
BACKGROUND Objectives-Tooth erosion is a common dental problem. It is a localised loss of tooth s... more BACKGROUND Objectives-Tooth erosion is a common dental problem. It is a localised loss of tooth surface by a chemical process of acidic dissolution of non-bacterial origin. Softening of the enamel surface is an early manifestation of the erosion process. In recent times, the prevalence of dental erosion is steadily increasing. Management of erosion is thus becoming important to the long-term health of the human dentition. In the initial stages, erosion can be reversed by remineralising agents. Several remineralising agents are available in the market. Hence, the aim of the present study was to assess the enamel microhardness of teeth demineralised following exposure to an acidic beverages like carbonated drink-coca cola and evaluating the remineralising potential of recently available remineralising pastes, namely CPP-ACP (GC-Tooth Mousse), Amine fluoride (Amflor) and NaF with functionalised tricalcium phosphate (Clinpro). MATERIALS AND METHODS Thirty extracted human maxillary incisors were decoronated and embedded in self-cured acrylic resin. Baseline microhardness of enamel was measured and samples were randomly divided into 3 main groups with each having two subgroups. After demineralisation with carbonated drink (cola), they were tested for microhardness. For Group I-0.5 mm layer of CPP-ACP was applied on enamel surface for 3 min and samples were stored in artificial saliva (Group IA) and deionized water (Group IB). For Group II-0.5 mm layer of amine fluoride was applied for 3 min and samples were stored in artificial saliva (Group IIA) and deionized water (Group IIB). For Group III-0.5 mm layer of functionalised Tricalcium Phosphate (Clinpro) was applied for 3 min and samples were stored in artificial saliva (Group IIIA) and deionized water (Group IIIB). All the samples were stored in respective solution for six hours at 37 0 C. After this microhardness values were evaluated for all the groups and data analysis was done by One-Way ANOVA technique. RESULTS Among all the groups, Samples stored in artificial saliva showed increased microhardness than the samples in deionized water. Statistically significant difference was seen between Group IIA (Amflor in artificial saliva) and Group IIB (Amflor in deionized water). Group IIA (Amflor in artificial saliva) demonstrated increased microhardness values after remineralisation. CONCLUSION All the three remineralising agents {CPP-ACP (GC-Tooth Mousse), Amine fluoride (Amflor), NaF with fTCP-(Clinpro)} are effective in reversing the effects of tooth erosion. Their remineralising potential is comparable. All these pastes demonstrated superior results in artificial saliva as opposed to deionized water.
This study compared the amount of aqueous-based and oil-based calcium hydroxide remaining in the ... more This study compared the amount of aqueous-based and oil-based calcium hydroxide remaining in the canal, after removal with two different chelators 17% EDTA, 20% Citric acid and 0.2% Chitosan in combination with ultrasonic agitation. Cleaning and shaping of root canals of 28 mandibular premolar was done and canals were filled either with Metapex or Ca(OH)2 mixed with distilled water. Volumetric analysis was performed utilizing cone beam-computed tomography (CBCT) after seven days of incubation. Ca(OH)2 was removed using either 17% EDTA, 20% Citric acid or 0.2% Chitosan in combination with ultrasonic agitation. Volumetric analysis was repeated and percentage difference was calculated and statistically analyzed using Kruskal-Wallis and Mann-Whitney U test. All the three chelators failed to remove aqueous-based as well as oil-based Ca(OH)2 completely from the root canal. Aqueous-based Ca(OH)2 was easier to be removed than oil-based Ca(OH)2. 0.2% Chitosan in combination with ultrasonics ...
Successful management of ICR relies on the location, size and accessibility of the lesion as well... more Successful management of ICR relies on the location, size and accessibility of the lesion as well as the structural integrity of the tooth and periodontium after treatment is completed. The present case demonstrates that ICR can be arrested by the approach recommended by Heithersay. Here, a diode laser was used as an adjunct to aid in disinfecting the resorptive defect as well as the flap. Clinical Relevance to Interdisciplinary Dentistry Invasive cervical resorption is a poorly understood and often misdiagnosed lesion. Careful clinical, radiographic and periodontal examinations hold the key to successful management. Teamwork by restorative dentists and periodontists is important for salvaging such damaged teeth.
Dental caries is one of the most prevalent infectious diseases affecting the human dentition. Flu... more Dental caries is one of the most prevalent infectious diseases affecting the human dentition. Fluorides are effective anti-carious agents and have been widely used for caries prevention in the form of systemic and topical fluorides. Neutral sodium fluoride (NaF) is commonly used as a topical fluoride agent. A special category of topical fluorides are organic fluorides in the form of amine fluorides (AmF). Researchers have reported that AmF is superior to inorganic fluorides in improving the caries resistance of enamel due to the significant anti-enzyme effect of the organic fragment. The aim of the present study was to compare the enamel surface micro hardness after topical application of NaF and AmF solutions. Twenty fresh samples of sound human enamel were treated with demineralizing solution for 72 h and divided into Group A (treated with NaF) and Group B (treated with AmF) solutions for 3 min twice daily for 7 days. In between treatment, the samples were stored in artificial saliva. The enamel surface hardness was measured with Vickers hardness test at baseline, post-demineralization and post-treatment with two different fluoride solutions (NaF and AmF) and a comparative analysis was made. The increase in mean micro hardness of human enamel after treatment with AmF application was found to be statistically significant (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01) when compared to the mean micro hardness after treatment with NaF. Fluoride enhances the remineralization process by accelerating the growth of enamel crystals that have been demineralized. It can be concluded from the present study that AmF compounds result in a marked increase in enamel micro hardness when compared to NaF.
Veneer restorations provide a valid conservative alternative to complete coverage as they avoid a... more Veneer restorations provide a valid conservative alternative to complete coverage as they avoid aggressive dental preparation; thus, maintaining tooth structure. Initially, laminates were placed on the unprepared tooth surface. Although there is as yet no consensus as to whether or not teeth should be prepared for laminate veneers, currently, more conservative preparations have been advocated. Because of their esthetic appeal, biocompatibility and adherence to the physiology of minimal-invasive dentistry, porcelain laminate veneers have now become a restoration of choice. Currently, there is a lack of clinical consensus regarding the type of design preferred for laminates. Widely varying survival rates and methods for its estimation have been reported for porcelain veneers over approximately 2-10 years. Relatively few studies have been reported in the literature that use survival estimates, which allow for valid study comparisons between the types of preparation designs used. No survival analysis has been undertaken for the designs used. The purpose of this article is to attempt to review the survival rates of veneers based on different incisal preparation designs from both clinical and non-clinical studies. The purpose of this study is to review both clinical and non-clinical studies to determine the survival rates of veneers based on different incisal preparation designs. A further objective of the study is to understand which is the most successful design in terms of preparation. This study evaluated the existing literature - survival rates of veneers based on incisal preparation designs. The search strategy involved MEDLINE, BITTORRENT and other databases. Data were tabulated. Because of variability in the follow-up period in different studies, the follow-up period was extrapolated to 10 years in common for all of them. Accordingly, the failure rate was then estimated and The weighted mean was computed. The study found that the window preparation was of the most conservative type. Incisal coverage was better than no incisal coverage and, in incisal coverage, two predictable designs - incisal overlap and butt were reported. In butt preparation, no long-term follow-up studies have been performed as yet. In general, incisal overlap was preferred for healthy normal tooth with sufficient thickness and incisal butt preparation was preferred for worn tooth and fractured teeth.
Mesiodens is the commonly occurring supernumerary tooth seen between the maxillary central inciso... more Mesiodens is the commonly occurring supernumerary tooth seen between the maxillary central incisors which causes compromised aesthetics and malocclusion. Till date orthodontic therapy provides an excellent solution for the management of mesiodens. Recently, Restorative Space Management (RSM) has been used successfully to correct tooth shape, proportions and colour with minimal tooth preparations. This case report describes the successful management of an unaesthetic smile due to presence of a mesiodens in the midline primarily using aesthetic treatment only.
To study the concentration of stress in class V restoration of four different restorative materia... more To study the concentration of stress in class V restoration of four different restorative materials subjected to occlusal load of 100N, 150N, 200N, 250N and to analyse the obtained data with the listed properties of the restorative material. Using FEM analysis the stresses generated in a class V lesion in a mandibular premolar was studied. Within the framework of the aforementioned views, and from the results of the study it can be concluded that microfilled composite is the most suitable restorative material followed by flowable composite, glass ionomer cement and resin modified glass ionomer cement. Restoration of Class V lesions with materials of higher modulus of elasticity will enable better stress distribution.
THIS IS A COMPARATIVE STUDY OF INTRA CANAL STRESS PATTERNS IN ENDODONTICALLY TREATED MAXILLARY CE... more THIS IS A COMPARATIVE STUDY OF INTRA CANAL STRESS PATTERNS IN ENDODONTICALLY TREATED MAXILLARY CENTRAL INCISOR WITH: average sized canal diameter and wide canals reinforced with three different post systems - cast post and core, carbon fiber post, stainless steel post; restored with ceramic crown using finite element analysis (FEA). All the models were subjected to a force of 100N applied at 450 to the long axis of the tooth at the middle third of the palatal surface of the restored ceramic crown. The FEA revealed that all the post systems showed maximum stress in the coronal and middle third of the root. Maximum stress was seen on the inner dentinal wall in case of stainless steel post followed by cast gold and carbon fiber post, both in the models without reinforcement as well as in the reinforced models.
The endodontic treatment of teeth with dens invaginatus, characterized by an infolding of enamel ... more The endodontic treatment of teeth with dens invaginatus, characterized by an infolding of enamel and dentin, extending deep into the pulp cavity near the root apex, may be complicated and challenging. The complexity of the internal anatomy may create challenges for the complete removal of diseased pulpal tissue and the subsequent sealing of the canal system. Because of the bizarre root canal anatomy and widely open apex, a combination of nonsurgical and surgical endodontic treatment or extraction is the most common choice of therapy. This article describes case reports of nonsurgical endodontic treatment of Type II dens invaginatus associated with periradicular lesion.
Veneer restorations provide a valid conservative alternative to complete coverage as they avoid a... more Veneer restorations provide a valid conservative alternative to complete coverage as they avoid aggressive dental preparation; thus, maintaining tooth structure. Initially, laminates were placed on the unprepared tooth surface. Although there is as yet no consensus as to whether or not teeth should be prepared for laminate veneers, currently, more conservative preparations have been advocated. Because of their esthetic appeal, biocompatibility and adherence to the physiology of minimal-invasive dentistry, porcelain laminate veneers have now become a restoration of choice. Currently, there is a lack of clinical consensus regarding the type of design preferred for laminates. Widely varying survival rates and methods for its estimation have been reported for porcelain veneers over approximately 2-10 years. Relatively few studies have been reported in the literature that use survival estimates, which allow for valid study comparisons between the types of preparation designs used. No survival analysis has been undertaken for the designs used. The purpose of this article is to attempt to review the survival rates of veneers based on different incisal preparation designs from both clinical and non-clinical studies. The purpose of this study is to review both clinical and non-clinical studies to determine the survival rates of veneers based on different incisal preparation designs. A further objective of the study is to understand which is the most successful design in terms of preparation. This study evaluated the existing literature - survival rates of veneers based on incisal preparation designs. The search strategy involved MEDLINE, BITTORRENT and other databases. Data were tabulated. Because of variability in the follow-up period in different studies, the follow-up period was extrapolated to 10 years in common for all of them. Accordingly, the failure rate was then estimated and The weighted mean was computed. The study found that the window preparation was of the most conservative type. Incisal coverage was better than no incisal coverage and, in incisal coverage, two predictable designs - incisal overlap and butt were reported. In butt preparation, no long-term follow-up studies have been performed as yet. In general, incisal overlap was preferred for healthy normal tooth with sufficient thickness and incisal butt preparation was preferred for worn tooth and fractured teeth.
Context: Pretreatment of radicular dentin with chelating agents improves the bond strength of fib... more Context: Pretreatment of radicular dentin with chelating agents improves the bond strength of fiber-posts luted with a self-adhesive resin cement. Aims: The aim of this study was to assess the effects of the three chelating agents as final rinse of the postspace on bond strength of fiber posts luted with a self-adhesive resin cement. Settings and Design: This is an in vitro laboratory study. Materials and Methods: Forty-five mandibular premolars were prepared using MTwo rotary system and irrigation was done with 2.5% sodium hypochlorite. Three groups of teeth samples were considered for postspace preparation and irrigated with different solutions: Group 1: 17% ethylenediamine tetraacetic acid (EDTA); Group 2: 7% Maleic acid; Group 3: 1% Phytic acid. This was followed by the luting the posts with RelyX U200. After a week, from each sample, 2 mm thick slices were obtained from each third of the root and subjected to push-out bond strength testing. Statistical Analysis Used: One-way analysis of variance and Bonferroni's Post hoc analysis was used for assessing the results. The statistical significance level was set at P < 0.05. Results: Bond strength values were improved with maleic acid and phytic acid pretreatment with slight or no significant difference between these groups. A final rinse of postspace with EDTA significantly reduced the bond strength. Conclusions: Maleic acid (7%) pretreatment of postspace improved the adhesion of fiber posts luted with a self-adhesive resin cement.
Background: Accurate estimation of the working length (WL) from the coronal reference point to th... more Background: Accurate estimation of the working length (WL) from the coronal reference point to the minor diameter (apical constriction) is critical in endodontic therapy. Many electronic apex locators are available to precisely measure this apical limit. Aim: To assess the precision of three current electronic apex locators-Root ZX Mini, CanalPro, and Apex ID in the mesial canals of mandibular molars. Cone-beam computed tomography (CBCT) was employed to verify their accuracy. Materials and methods: Thirty mandibular first molars with curved mesial roots were selected. Cone-beam computed tomography (CBCT) was used to assess the length of the teeth. Samples were decoronated and mesiobuccal canal orifices were enlarged with Hyflex CM 25/08 and irrigated with 2 mL 3% sodium hypochlorite. Canals were prepared with size 10 K-file and the measurements were recorded with apex locators at marks "APEX 0/0" and "0.5 mark" as electronic tooth length and the electronic WL, respectively by visual means, and this was verified using CBCT. Statistical analysis was done using the repeated measures of ANOVA test. Results: CanalPro, Root ZX Mini, and CBCT values were very similar. Apex ID values were longer than CBCT values. Conclusion: CanalPro readings closely matched those of CBCT measurement followed by Root ZX mini. Apex ID showed longer readings.
The endodontic treatment of teeth with dens invaginatus, characterized by an infolding of enamel ... more The endodontic treatment of teeth with dens invaginatus, characterized by an infolding of enamel and dentin, extending deep into the pulp cavity near the root apex, may be complicated and challenging. The complexity of the internal anatomy may create challenges for the complete removal of diseased pulpal tissue and the subsequent sealing of the canal system. Because of the bizarre root canal anatomy and widely open apex, a combination of nonsurgical and surgical endodontic treatment or extraction is the most common choice of therapy. This article describes case reports of nonsurgical endodontic treatment of Type II dens invaginatus associated with periradicular lesion.
Corticosteroids are used in the treatment of chronic autoimmune diseases and many long-term illne... more Corticosteroids are used in the treatment of chronic autoimmune diseases and many long-term illnesses. While these drugs may be considered essential for the patient's health, adverse reactions do occur. The incidence of adverse reactions depends upon the dose level and the duration of treatment. A pilot study was conducted on ten patients on long-term corticosteroids therapy. Pulpal obliteration was assessed by radiographic records. In most instances, pulpal changes to some degree were observed.
Journal of Multidisciplinary Dental Research, Dec 25, 2019
Introduction Furcal perforations compromise the health of the periradicular tissues and threaten ... more Introduction Furcal perforations compromise the health of the periradicular tissues and threaten the viability of the tooth. Perforation repair is a very attractive and frequently successful alternative to extraction of the involved tooth. Diagnosis and repair of furcal perforation, abscess have remained a diagnostic and therapeutic dilemma for the clinician. We believe this case report is the first of its kind to compare the repair of furcal perforation due to iatrogenic causes with mineral trioxide aggregate (MTA) and bone graft by conventional surgical technique and laser assisted periodontal therapy in mandibular molars. Case presentation Two patients presenting with clinical presentation and diagnosis of furcal abscess due to iatrogenic causes were treated and followed up for six months. The furca were exposed surgically. The furcation area in one patient was debrided by conventional periodontal therapy while in the other laser assisted periodontal therapy was instigated using diode laser, and the perforation sealed with mineral trioxide, bone graft was placed in the interradicular area. Clinical and radiographic examinations were conducted at base line and 6 months. Conclusion: During the 6 month follow up satisfactory resolution of the clinical and radiographic defect in the interradicular region was achieved by both conventional surgical and laser assisted periodontal therapy.
Aim: This study aims to evaluate the effect of three endodontic chelating agents (17% ethylenedia... more Aim: This study aims to evaluate the effect of three endodontic chelating agents (17% ethylenediamine tetra-acetic acid [EDTA], 1% peracetic acid [PAA], 0.2% Chitosan) on the push out bond strength of gutta percha with a new bioceramic sealer (BioRoot RCS). Materials and Methods: Forty-eight single-rooted mandibular premolars were selected and decoronated to obtain standardized root length of 15 mm. The root canals were prepared up to #30 files (Hyflex CM) and copious irrigation was done with 3 ml of 5.25% of NaOCl. According to the final irrigation, specimens were divided into three groups: Group 1 (n = 16) 0.2% chitosan, Group 2 (n = 16) 17% EDTA, and Group 3 (n = 16) 1% PAA for 1 min. Samples from each group were obturated with bioceramic sealer and gutta percha and sealed with temporary filling material. Two horizontal slices of 2 mm was obtained from the middle third of each sample (n = 32). Push out bond strength and failure modes were assessed. Kruskal–Wallis test followed by Mann–Whitney post hoc analysis was used for push out analysis. Chi square test was used to compare the modes of failure. The statistical significance level was set at P = 0.05. Results: The highest push out bond strength was obtained with Group 1 (0.2% chitosan) followed by Group 3 (1% PAA). Group 2 (17% EDTA) showed least push out bond strength when compared to Group 1 (0.2% chitosan) and Group 3 (1% PAA). The mode of failure was mainly cohesive for all groups. Conclusions: The highest push-out bond strength of BioRoot RCS was seen after treatment with 0.2% chitosan while the least was after EDTA treatment. 1% PAA treatment also favorably affected push-out bond strength of BioRoot RCS.
This review highlights the importance of atraumatic restorative treatment (ART) as a minimal inte... more This review highlights the importance of atraumatic restorative treatment (ART) as a minimal intervention procedure for managing dental caries (pit and fissures caries) and restoring cavitated dentin carious lesions using restorative materials such as glass-ionomer cement. ART technique uses only hand instruments and requires no electricity. Its low cost and simplified protocol makes it more convenient and suitable for use in remote areas as well as underdeveloped nations with insufficient resources to provide the adequate restorative care. This technique can be used in all population groups including children, older people, and disabled. In the present scenario of the COVID-19 pandemic, the dental profession is facing a challenging task in managing restorative needs of the patients all over the world. ART technique is a safe and effective approach to manage the progression of carious lesions. As this technique involves no aerosol generation during the procedure, it should be well a...
International Journal of Oral Health Dentistry, 2019
Treating a flared root canal always poses a challenge to the clinician. If treated inappropriatel... more Treating a flared root canal always poses a challenge to the clinician. If treated inappropriately, the root is prone to fracture thereby leading to catastrophic failure of the tooth. Reinforcing the canal with the help of anatomic post provides optimal stability and strength to the tooth. This case report focuses on the clinical technique of fabricating an anatomic post and reviews the various options to treat a flared canal.
IP Indian Journal of Conservative and Endodontics, 2019
Various options are presently available to address the challenge of immediately replacing a missi... more Various options are presently available to address the challenge of immediately replacing a missing anterior tooth. These include a removable /fixed temporary/ permanent acrylic prosthesis, or resin-bonded bridges. Ribbond single-visit bridges provide strength, durability, and immediate convenience. They are cost effective and reliable and are excellent for emergencies like: implant temporization, congenitally missing teeth and patients who cannot afford conventional lab fabricated bridgework. In place of the pontic, a natural tooth, denture tooth can be used or composite build-up can be done. Conclusions: The procedure was completed at the chair side, thereby avoiding additional laboratory costs. Creating an adhesive FRC bridge by using a composite resin pontic is a successful treatment option for the direct aesthetic replacement of missing anterior teeth.
Journal of Evolution of Medical and Dental Sciences, 2017
BACKGROUND Objectives-Tooth erosion is a common dental problem. It is a localised loss of tooth s... more BACKGROUND Objectives-Tooth erosion is a common dental problem. It is a localised loss of tooth surface by a chemical process of acidic dissolution of non-bacterial origin. Softening of the enamel surface is an early manifestation of the erosion process. In recent times, the prevalence of dental erosion is steadily increasing. Management of erosion is thus becoming important to the long-term health of the human dentition. In the initial stages, erosion can be reversed by remineralising agents. Several remineralising agents are available in the market. Hence, the aim of the present study was to assess the enamel microhardness of teeth demineralised following exposure to an acidic beverages like carbonated drink-coca cola and evaluating the remineralising potential of recently available remineralising pastes, namely CPP-ACP (GC-Tooth Mousse), Amine fluoride (Amflor) and NaF with functionalised tricalcium phosphate (Clinpro). MATERIALS AND METHODS Thirty extracted human maxillary incisors were decoronated and embedded in self-cured acrylic resin. Baseline microhardness of enamel was measured and samples were randomly divided into 3 main groups with each having two subgroups. After demineralisation with carbonated drink (cola), they were tested for microhardness. For Group I-0.5 mm layer of CPP-ACP was applied on enamel surface for 3 min and samples were stored in artificial saliva (Group IA) and deionized water (Group IB). For Group II-0.5 mm layer of amine fluoride was applied for 3 min and samples were stored in artificial saliva (Group IIA) and deionized water (Group IIB). For Group III-0.5 mm layer of functionalised Tricalcium Phosphate (Clinpro) was applied for 3 min and samples were stored in artificial saliva (Group IIIA) and deionized water (Group IIIB). All the samples were stored in respective solution for six hours at 37 0 C. After this microhardness values were evaluated for all the groups and data analysis was done by One-Way ANOVA technique. RESULTS Among all the groups, Samples stored in artificial saliva showed increased microhardness than the samples in deionized water. Statistically significant difference was seen between Group IIA (Amflor in artificial saliva) and Group IIB (Amflor in deionized water). Group IIA (Amflor in artificial saliva) demonstrated increased microhardness values after remineralisation. CONCLUSION All the three remineralising agents {CPP-ACP (GC-Tooth Mousse), Amine fluoride (Amflor), NaF with fTCP-(Clinpro)} are effective in reversing the effects of tooth erosion. Their remineralising potential is comparable. All these pastes demonstrated superior results in artificial saliva as opposed to deionized water.
This study compared the amount of aqueous-based and oil-based calcium hydroxide remaining in the ... more This study compared the amount of aqueous-based and oil-based calcium hydroxide remaining in the canal, after removal with two different chelators 17% EDTA, 20% Citric acid and 0.2% Chitosan in combination with ultrasonic agitation. Cleaning and shaping of root canals of 28 mandibular premolar was done and canals were filled either with Metapex or Ca(OH)2 mixed with distilled water. Volumetric analysis was performed utilizing cone beam-computed tomography (CBCT) after seven days of incubation. Ca(OH)2 was removed using either 17% EDTA, 20% Citric acid or 0.2% Chitosan in combination with ultrasonic agitation. Volumetric analysis was repeated and percentage difference was calculated and statistically analyzed using Kruskal-Wallis and Mann-Whitney U test. All the three chelators failed to remove aqueous-based as well as oil-based Ca(OH)2 completely from the root canal. Aqueous-based Ca(OH)2 was easier to be removed than oil-based Ca(OH)2. 0.2% Chitosan in combination with ultrasonics ...
Successful management of ICR relies on the location, size and accessibility of the lesion as well... more Successful management of ICR relies on the location, size and accessibility of the lesion as well as the structural integrity of the tooth and periodontium after treatment is completed. The present case demonstrates that ICR can be arrested by the approach recommended by Heithersay. Here, a diode laser was used as an adjunct to aid in disinfecting the resorptive defect as well as the flap. Clinical Relevance to Interdisciplinary Dentistry Invasive cervical resorption is a poorly understood and often misdiagnosed lesion. Careful clinical, radiographic and periodontal examinations hold the key to successful management. Teamwork by restorative dentists and periodontists is important for salvaging such damaged teeth.
Dental caries is one of the most prevalent infectious diseases affecting the human dentition. Flu... more Dental caries is one of the most prevalent infectious diseases affecting the human dentition. Fluorides are effective anti-carious agents and have been widely used for caries prevention in the form of systemic and topical fluorides. Neutral sodium fluoride (NaF) is commonly used as a topical fluoride agent. A special category of topical fluorides are organic fluorides in the form of amine fluorides (AmF). Researchers have reported that AmF is superior to inorganic fluorides in improving the caries resistance of enamel due to the significant anti-enzyme effect of the organic fragment. The aim of the present study was to compare the enamel surface micro hardness after topical application of NaF and AmF solutions. Twenty fresh samples of sound human enamel were treated with demineralizing solution for 72 h and divided into Group A (treated with NaF) and Group B (treated with AmF) solutions for 3 min twice daily for 7 days. In between treatment, the samples were stored in artificial saliva. The enamel surface hardness was measured with Vickers hardness test at baseline, post-demineralization and post-treatment with two different fluoride solutions (NaF and AmF) and a comparative analysis was made. The increase in mean micro hardness of human enamel after treatment with AmF application was found to be statistically significant (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01) when compared to the mean micro hardness after treatment with NaF. Fluoride enhances the remineralization process by accelerating the growth of enamel crystals that have been demineralized. It can be concluded from the present study that AmF compounds result in a marked increase in enamel micro hardness when compared to NaF.
Veneer restorations provide a valid conservative alternative to complete coverage as they avoid a... more Veneer restorations provide a valid conservative alternative to complete coverage as they avoid aggressive dental preparation; thus, maintaining tooth structure. Initially, laminates were placed on the unprepared tooth surface. Although there is as yet no consensus as to whether or not teeth should be prepared for laminate veneers, currently, more conservative preparations have been advocated. Because of their esthetic appeal, biocompatibility and adherence to the physiology of minimal-invasive dentistry, porcelain laminate veneers have now become a restoration of choice. Currently, there is a lack of clinical consensus regarding the type of design preferred for laminates. Widely varying survival rates and methods for its estimation have been reported for porcelain veneers over approximately 2-10 years. Relatively few studies have been reported in the literature that use survival estimates, which allow for valid study comparisons between the types of preparation designs used. No survival analysis has been undertaken for the designs used. The purpose of this article is to attempt to review the survival rates of veneers based on different incisal preparation designs from both clinical and non-clinical studies. The purpose of this study is to review both clinical and non-clinical studies to determine the survival rates of veneers based on different incisal preparation designs. A further objective of the study is to understand which is the most successful design in terms of preparation. This study evaluated the existing literature - survival rates of veneers based on incisal preparation designs. The search strategy involved MEDLINE, BITTORRENT and other databases. Data were tabulated. Because of variability in the follow-up period in different studies, the follow-up period was extrapolated to 10 years in common for all of them. Accordingly, the failure rate was then estimated and The weighted mean was computed. The study found that the window preparation was of the most conservative type. Incisal coverage was better than no incisal coverage and, in incisal coverage, two predictable designs - incisal overlap and butt were reported. In butt preparation, no long-term follow-up studies have been performed as yet. In general, incisal overlap was preferred for healthy normal tooth with sufficient thickness and incisal butt preparation was preferred for worn tooth and fractured teeth.
Mesiodens is the commonly occurring supernumerary tooth seen between the maxillary central inciso... more Mesiodens is the commonly occurring supernumerary tooth seen between the maxillary central incisors which causes compromised aesthetics and malocclusion. Till date orthodontic therapy provides an excellent solution for the management of mesiodens. Recently, Restorative Space Management (RSM) has been used successfully to correct tooth shape, proportions and colour with minimal tooth preparations. This case report describes the successful management of an unaesthetic smile due to presence of a mesiodens in the midline primarily using aesthetic treatment only.
To study the concentration of stress in class V restoration of four different restorative materia... more To study the concentration of stress in class V restoration of four different restorative materials subjected to occlusal load of 100N, 150N, 200N, 250N and to analyse the obtained data with the listed properties of the restorative material. Using FEM analysis the stresses generated in a class V lesion in a mandibular premolar was studied. Within the framework of the aforementioned views, and from the results of the study it can be concluded that microfilled composite is the most suitable restorative material followed by flowable composite, glass ionomer cement and resin modified glass ionomer cement. Restoration of Class V lesions with materials of higher modulus of elasticity will enable better stress distribution.
THIS IS A COMPARATIVE STUDY OF INTRA CANAL STRESS PATTERNS IN ENDODONTICALLY TREATED MAXILLARY CE... more THIS IS A COMPARATIVE STUDY OF INTRA CANAL STRESS PATTERNS IN ENDODONTICALLY TREATED MAXILLARY CENTRAL INCISOR WITH: average sized canal diameter and wide canals reinforced with three different post systems - cast post and core, carbon fiber post, stainless steel post; restored with ceramic crown using finite element analysis (FEA). All the models were subjected to a force of 100N applied at 450 to the long axis of the tooth at the middle third of the palatal surface of the restored ceramic crown. The FEA revealed that all the post systems showed maximum stress in the coronal and middle third of the root. Maximum stress was seen on the inner dentinal wall in case of stainless steel post followed by cast gold and carbon fiber post, both in the models without reinforcement as well as in the reinforced models.
The endodontic treatment of teeth with dens invaginatus, characterized by an infolding of enamel ... more The endodontic treatment of teeth with dens invaginatus, characterized by an infolding of enamel and dentin, extending deep into the pulp cavity near the root apex, may be complicated and challenging. The complexity of the internal anatomy may create challenges for the complete removal of diseased pulpal tissue and the subsequent sealing of the canal system. Because of the bizarre root canal anatomy and widely open apex, a combination of nonsurgical and surgical endodontic treatment or extraction is the most common choice of therapy. This article describes case reports of nonsurgical endodontic treatment of Type II dens invaginatus associated with periradicular lesion.
Veneer restorations provide a valid conservative alternative to complete coverage as they avoid a... more Veneer restorations provide a valid conservative alternative to complete coverage as they avoid aggressive dental preparation; thus, maintaining tooth structure. Initially, laminates were placed on the unprepared tooth surface. Although there is as yet no consensus as to whether or not teeth should be prepared for laminate veneers, currently, more conservative preparations have been advocated. Because of their esthetic appeal, biocompatibility and adherence to the physiology of minimal-invasive dentistry, porcelain laminate veneers have now become a restoration of choice. Currently, there is a lack of clinical consensus regarding the type of design preferred for laminates. Widely varying survival rates and methods for its estimation have been reported for porcelain veneers over approximately 2-10 years. Relatively few studies have been reported in the literature that use survival estimates, which allow for valid study comparisons between the types of preparation designs used. No survival analysis has been undertaken for the designs used. The purpose of this article is to attempt to review the survival rates of veneers based on different incisal preparation designs from both clinical and non-clinical studies. The purpose of this study is to review both clinical and non-clinical studies to determine the survival rates of veneers based on different incisal preparation designs. A further objective of the study is to understand which is the most successful design in terms of preparation. This study evaluated the existing literature - survival rates of veneers based on incisal preparation designs. The search strategy involved MEDLINE, BITTORRENT and other databases. Data were tabulated. Because of variability in the follow-up period in different studies, the follow-up period was extrapolated to 10 years in common for all of them. Accordingly, the failure rate was then estimated and The weighted mean was computed. The study found that the window preparation was of the most conservative type. Incisal coverage was better than no incisal coverage and, in incisal coverage, two predictable designs - incisal overlap and butt were reported. In butt preparation, no long-term follow-up studies have been performed as yet. In general, incisal overlap was preferred for healthy normal tooth with sufficient thickness and incisal butt preparation was preferred for worn tooth and fractured teeth.
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Papers by Ashish Shetty