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   Table of Contents - Current issue
September-December 2016
Volume 4 | Issue 3
Page Nos. 71-100

Online since Wednesday, August 10, 2016

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Importance of coronal seal: Preventing coronal leakage in endodontics Highly accessed article p. 71
Lalitagauri Mandke
The primary goal of endodontic treatment is to keep the pulpal space free of microorganisms and to prevent recurrent infection. Oral bacteria and their by-products can penetrate this space if there is inadequate coronal or apical seal. Apical leakage leading to reinfection of an obturated canal has been the major cause of failed endodontic treatment. However, recently, attention has been drawn to the significance of coronal seal in endodontic success. Microbial contamination through the occlusal surface, leading to coronal leakage constitutes a large percentage of failed root canal treatments. This paper highlights the clinical and biological implications of coronal leakage and the means to prevent the same.
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Evaluation of disinfection of gutta-percha cones and their surface changes using different chemical solutions p. 76
Kanika Yadav, Ida de Noronha de Ataide, Anuja Ganoo, Marina Fernandes, Rajan Lambor
Context: Disinfection of obturating materials is mandatory for the successful root canal therapy. In literature, various disinfectants have been used to sterilize gutta-percha including sodium hypochlorite (NaOCl). Effectiveness of peracetic acid over NaOCl is documented in literature, but no study to date has shown the effect of peracetic acid disinfection on gutta-percha surface. Aim: This study aims to evaluate and compare the efficacy of 3% NaOCl, 1% peracetic acid, 0.5% octenisept in disinfecting gutta-percha cones and to analyze surface alterations of gutta-percha cones after chemical disinfection. Materials and Methods: One hundred and twenty gutta-percha cones were immersed in bacterial suspensions of Staphylococcus aureus and Escherichia coli for 5 min. Cones were then immersed in 3% NaOCl, 1% peracetic acid, 0.5% octenisept for 1 and 5 min. After disinfection, cones were incubated in Mueller Hinton Broth at 37°C for 7 days. Samples were observed at 24 h interval and those showing turbidity were subcultured. For morphologic evaluation, cones were immersed in disinfecting solutions for 1 and 5 min, dried on a paper pad for 10 min and analyzed under scanning electron microscope. Data was analyzed using Pearson Chi-square test. Results: One percent of peracetic acid was found to be most effective disinfectant. Surface alterations were found in all the groups. Conclusion: The outcome of this study confirmed the efficacy of 1% peracetic acid in the disinfection of gutta-percha cones. Topographic changes caused by peracetic acid should be evaluated further to determine its effect on gutta-percha properties and obturation seal.
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Evaluation of fear of injections and its association with avoidance of dental treatment p. 81
Talha Mufeed Siddiqui, Aisha Wali, Habiba Abdullah, Fatima Naseem A Khan, Rabiya Tanvir, Mudassir Razi Siddiqui
Aim: The aim of this study was to assess the intensity of needle phobia and to evaluate the different dimensions of fear of dental injections to help provide better care to the patients. Materials and Methods: A simple random technique was used and 250 adult patients above 18 years of age were selected who attended outpatients Department of Operative Dentistry, Baqai Dental College. A modified form of the structured questionnaire used by Milgrom et al. was generated. The items were scored based on the 5-point traditional Likert scale ranging from strongly disagree to strongly agree. Data were analyzed for descriptive analysis (mean, standard deviation) using the software SPSS version 19. Association of gender with fear of dental injections was evaluated using Chi-squared test (P = 0.05). Results: There was a statistically significant difference in fear of dental injections among male and female subjects. The most fearful aspect of dental injection was found to be fear of cross-infection. Fears associated with local anesthesia, for example, inadequate numbness, adverse reaction, and trouble in breathing or swallowing were the least common fears reported by the patients. Conclusion: This study highlighted that understanding the nature and extent of patients' fear of injection is important for dentists to expand their knowledge of the association of fear of dental needles for the impact on the treatment outcome and reluctance of the patients intervene.
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Bonding effectiveness of contemporary composite cements to dentin after 6-month water storage p. 86
Mouhamed Sarr, Babacar Faye, Fatou Leye-Benoist, Khaly Bane, Adjaratou Wakha Aidara, Babacar Touré
Purpose: To evaluate the bonding effectiveness to dentin of eight dual-cure composite cements after 6-month water storage. Materials and Methods: This study is a follow-up of a recent study that investigated the 1-week bonding effectiveness of feldspathic ceramic blocks luted to dentin using the same composite cements and experimental protocol. The microtensile bond strength (μTBS) of different composite cements, including two etch-and-rinse cements (Calibra, Dentsply; Variolink II, Ivoclar-Vivadent), two self-etch cements (Panavia F2.0, Kuraray; Clearfil Esthetic Cement, Kuraray), and four self-adhesive cements (Unicem, 3M ESPE; Maxcem, Kerr; Monocem, Shofu; G-Cem, GC), was measured using a standardized μTBS protocol after 6-month water storage. As control, a two-step self-etch adhesive (Clearfil SE, Kuraray) combined with a microhybrid restorative composite (Clearfil AP-X, Kuraray) was used. Twenty-seven human third molars were used with specific preparation, and after 6-month water storage, microspecimens were prepared and subjected to a μTBS test. Results: The mean μTBS varied from 0 to 26.1 MPa, the latter being measured for the control adhesive composite combination. All specimens prepared using the self-adhesive composite cements Maxcem and Monocem failed during specimen processing. Most specimens failed at the dentin-cement interface, except the self-etch composite cement Panavia F2.0 that failed in 53% of the cases at the cement-ceramic interface and the control of which all specimens failed in the resin part of the microspecimens. Conclusion: The largely varying bonding effectiveness recorded for the different composite cements highlights the need for material specifications. Such specifications should also include a bond durability test as the specimens in the present study that were subjected to 6-month water storage. To lute ceramic restorations that allow light transmission to a sufficient degree, a conventional light-curable adhesive and composite should be considered.
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Effect of thermal cycling and microhardness on roughness of composite restorative materials p. 93
Efe Cetin Yilmaz, Recep Sadeler
Objective: This study is aimed to investigate the effect of thermal cycling and microhardness on surface roughness of four different composite restorative materials. Materials and Methods: In this study Nonofilled(Ivoclar Heliomolar, 3M ESPE Filtek Supreme) and microhybrid(3M ESPE Filtek Z250, Kuraray Clearfil AP-X) composites were used. The surface roughness (Ra) was initially measured in a profilometer using a cut off 0,25mm, after 6000 and 12000 thermal cycles. In addition to microhardness of composites Vicker hardness (HV) were determined. Data were subjected to Anova and Tukey's test.(α=0,05). Results: One-way Anova indicated significant differences in Vicker hardness(HV) between four composite resins. Significant lowest HV was found for Heliomolar (HV=22); mean values were considerably lower than three composite resins. In addition to overall 6000 thermal cycles increased the surface of roughness values for all materials and there was a trend in all groups to decrease the roughness after 12000 thermal cycles. Conclusion: The material composition including type of organic matrix could be more relevant to roughness maintenance over time than the general behavior of composites based on particle fillers. Moreover, this study revealed that correlations between microhardness (HV) and surface of roughness were poor.
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Restorative management of grossly mutilated molar teeth using endocrown: A novel concept p. 97
Sarika Chaudhary, Ashok A Rathod, Pankaj Yadav, Sangeeta Talwar, Mahesh Verma
The endocrown is a restorative option for endodontically treated teeth. It consists of a circular butt-joint margin and a central retention cavity inside the pulp chamber and lacks intraradicular anchorage. Endocrowns are formed from a monoblock containing the coronal portion integrated into the apical projection that fills the pulp chamber space and possibly the root canal ingresses. This article describes the rationale and clinical guidelines for the placement of endocrowns. In the cases presented, extensively damaged teeth were superseded with endocrowns composed of pressed ceramics (Empress 2, Ivoclar), following endodontic and periodontal therapy. The substructure of this technique is to utilize the surface available in the pulpal chamber to assume the stability and retention of the restoration through adhesive procedures. By eliminating the utilization of a post and filling core, the number of adhesive bond interfaces is reduced, thus making the restoration less susceptible to the adverse effects of degradation of the hybrid layer. In these clinical cases, the 24 months survival of the endocrown restoration may be considered prosperous.
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