A case is presented of a patient attending with a sodium hypochlorite (NaOCl) accident of the left maxillary sinus during endodontic retreatment of a maxillary molar tooth. Sodium hypochlorite accidents are relatively uncommon but when they occur there is potential for severe complications. A literature review has been carried out reviewing current recommendations to reduce the likelihood of a sodium hypochlorite accident and the management of a sodium hypochlorite accident if occurs.

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Proanthocyanidin (PA), a plant flavonoid, has recently been used in adhesive and restorative dentistry as a natural collagen cross-linking agent. As the long-term stability of the resin-bonded dentin is still questionable due to hydrolysis of collagen by collagenolytic enzymes, the use of collagen cross-linking agents has been proposed to enhance mechanical properties of dentin matrix and reduce biodegradation rates of collagen. Therefore, this paper discusses the chemistry and properties of PA, its role in stabilizing the bonded interface and enhancing the clinical longevity of adhesive restorations, and also considers various factors related to its incorporation in the bonding protocol.

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Vertical root fractures are the most common cause of tooth loss. These fractures have a multifactorial etiology. They lead to advanced periodontal breakdown with deep periodontal pockets and vertical bone defects. Clinical signs and symptoms are often elusive in nature and may be difficult to detect. In this review, the etiology, diagnosis, prevention and management of vertical root fractures is discussed.

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Crown fractures of the permanent dentition comprise the most frequent form of traumatic dental injuries and often require an immediate procedure for their treatment. Reattachment of the fractured fragment to its original position is an optimal approach to esthetic and functional rehabilitation. This paper reports the case of a permanent maxillary central incisor with crown fracture treated by adhesive fragment reattachment.

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Background: The aim of this study is to examine the Shear Bond Strength (SBS) to repairing acrylic or acrylic artificial teeth which applied to four different surface treatments. Materials and Methods: Fourty molar acrylic denture teeth were ground on the ridge lap area with a water sand paper to provide a uniform surface for bonding. Acrylic teeth embedded in cold cured acrylic resin and specimens were randomly seperated into four roups (n = 10), according to the urface treatments applied; 1-Control, 2-Air abrasion, 3-Er-YAG laser and 4-Femtosecond laser. The cold cured acrylic resin (Vertex self curing) was then mixed according to the manufacturer's instructions and injected into the Teflon tubes with an internal diameter and height of 4 and 3 mm, respectively. The SBS of the acrylic denture teeth was evaluated using a universal testing machine. Acrylic denture teeth bonding areas were observed with a stereomicroscope to identify the mode of fracture. Results: The data were evaluated statistically Kruskal Wallis one-way analysis of variance (ANOVA) and Mann Whitney U-tests with bonferronni correction. There were no statistically significant difference of mean bond strengths for shear tests among control, Er-YAG and Femtosecond laser application groups. But the highest SBS values were found for air abrasion groups. Conclusion: A quick and simple air abrasion surface treatment technique could be an effective option for denture repair.

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Background: Tooth wear is becoming more apparent in the early stages of life. Consumption of alcoholic beverages and non-alcoholic beverages have highest buffering capacity and low pH values show pronounced erosive effect on enamel and degradation rate of composite materials. Hence the purpose of this study is to compare wear and degradation of two resin composite materials and teeth in presence of different alcoholic and non-alcoholic beverages. Materials and Methods: Total 75 specimens comprising of composite blocks (Z350 and P90) and mandibular molars were divided into experimental groups (A, B, and C) ( n = 25). The experimental liquids were water, Sprite^® , Coke^® , Kingfisher^® Beer, and Golconda^® Wine ( n = 5). The specimens were weighed using a digital weighing balance. Wear was carried in Wet Abrasive Wear Tester. SEM evaluation was done. Fracture toughness performed with universal testing machine. Results: In Groups A and B significant weight loss in all experimental beverages, maximum in alcoholic beverages ( P < 0.05). SEM showed surface irregularities, filler/matrix interfacial failure, and significant decrease in fracture toughness in Groups A and B. In Group C significant weight loss and decrease in fracture toughness maximum in non-alcoholic beverages ( P < 0.05). SEM showed significant wear and surface irregularities. Conclusions: It was concluded that significant amount of wear of dental composite materials and teeth seen in presence of alcoholic and non-alcoholic beverages. All the experimental groups displayed statistical significant decrease in fracture toughness in presence of all beverages.

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Aim: To evaluate the relationship between dental caries and salivary immunoglobulins (S-Igs) in unstimulated saliva of young adults between the age group of 20 and 30 years from South Canara district, Karnataka with varying caries experience as determined by their Decayed Missing Filled Teeth (DMFT) scores. Materials and Methods: The study was conducted on 80 healthy adult subjects with age group between 20 and 30 years. The healthy subjects without any chronic diseases were selected. The patients were divided into four groups according to DMFT status (WHO, 1997) as G-I, DMFT 0; G-II, DMFT 1-5; G-III, DMFT 6-10; and G-IV, as DMFT above 10. Unstimulated saliva samples were collected from each subjects and checked for S-IgA and IgG. The obtained data was statistically analyzed using one-way ANOVA and Tukey`s Honestly Significant Difference test. Results: Correlation of DMFT with S-IgA showed that as the S-IgA levels decreased in the saliva, there was increase in the DMFT levels. With intergroup comparison of S-IgA, there is no significant difference between group I and group II. There was no significant correlation seen between the S-IgG G levels and dental caries experience. Conclusion: The S-IgA increases with decrease in caries activity and S-IgG does not show any correlation with dental caries.

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Objectives: The objective of this study was to evaluate the effect of rotational speed and angle of curvature in curved root canals on the fracture of different nickel-titanium rotary instruments that is Profiles, ProTaper, and K ₃ files. Materials and Methods: Freshly extracted 180 human maxillary and mandibular molars were selected and divided into two groups of 90. Each group was then divided into three sub groups A, B, and C according to angle of curvature, Group I < 30° and Group II > 30°, which was measured by Schneider's method. Instrumentation was performed using the profile, ProTaper, and K3 (Company and in Literature name of Rotary file is K3) rotary instrument at 3 rotational speeds of 150, 250, and 350 rpm (10 molars at each rotational speed). Results: There were total of 32 instrument fractured out of 120 files. In a multivariable analysis, it was demonstrated that the rotational speed of 350 rpm fractured than those used at 150 rpm (odd's ratio [OR]: 3.6, 95% confidence interval [CI]: 1.3-10.5). An increase in the angle of curvature of the canal did not significantly increase the likelihood of fracture (OR: 1.9, 95% CI: 0.8-4.2). No significant differences were found between various designs of files used. Conclusion: Instrument fracture was associated with rotational speed and the angle of curvature.

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Background: The purpose of this study was to compare the clinical performance of Class II direct and indirect composite restorations according to the United States Public Health Service criteria (USPHS). Materials and Methods: Seventy patients were included and four different composite resins, P60 (FP), SureFil Posterior (SP), Gradia Posterior (GP), and Bisco Aelite LS Packable (BAP) were used as direct restorative material. All of the composite resins except BAP were used as indirect restorative material. Instead of BAP, Tescera Laboratory composites were polymerized in Tescera inlay oven. All restorations were evaluated according to USPHS criteria during a one-year period. Results: There were no statistically significant differences between direct and indirect composite restorations according to the retention, marginal discoloration, surface staining, proximal contact continuity, and secondary caries. Indirect restorations have less surface roughness, postoperative sensitivity (P < 0.05), and soft tissue irritation (P < 0.1) than direct ones. Conclusion: The clinical performances of the indirect restorations were more satisfactory than the direct restorations.

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Objective: The aim of this study was to compare the diagnostic efficacy of an electronic apex locator (EAL), conventional radiography, and digital radiography in working length (WL) determination. Materials and Methods: This study was performed on 25 vital premolar teeth, scheduled for extraction in orthodontic patients. After administration of local anesthesia, the teeth were isolated and the pulp cavities were accessed. The WL for each tooth was measured by an EAL (Justy II; Yoshida Dentcraft, Tokyo, Japan), conventional and digital radiographies. Immediately after WL determination, the teeth were extracted and actual WL was measured with a file under magnifying loupes (X3). Ability to measure WL was detected precisely and in acceptable range that is ± 0.5 mm of actual WL. Results: The mean value of differences between three experimental methods length and the actual WL were statistically significant (P < 0.05). EAL gave the most accurate readings out of all the experimental groups, with 100% accuracy within the acceptable range where as digital radiography gave the least accurate reading. Conclusion: The electronic method (Justy II apex locator) demonstrated significant accuracy in determining the working length.

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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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Successful endodontic therapy is largely dependent on a triad of access cavity, canal preparation, and three-dimensional hermetically sealed obturation of the canals. Canal preparation is the most vital part of the triad that can be very challenging due to the complex morphology of the root canal system. Clinicians quite frequently encounter severe canal curvatures of different degrees within the roots that lead to a variety of problems including ledge formation, separation of instruments, canal blockage, and tear-drop transportation at the apex or perforation. Anatomical variations within the complex root canal morphology are the commonest cause of endodontic treatment failure. It is, therefore, essential to have a thorough knowledge about the internal and external morphologies of teeth. The aim of the current paper is to review the methods used to determine the root canal curvature and its management.

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Tooth wear is a general term describing the loss of dental hard tissues from the surfaces of the teeth. As the lifespan of individuals increase and the teeth are increasingly retained for life the incidence of non-carious tooth surface loss has also shown a rise. Little is understood about the aetiology and management of these lesions and there are several occasions where the condition is often neglected. The prevalence of tooth surface loss is difficult to establish and the reported clinical and epidemiological data are difficult to compare, due to differences in terminologies and many indices involved. The purpose of current review is to focus on the classification, aetiology and management of common non-carious conditions causing tooth surface loss.

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Caries persists throughout the world, and patients have multiple restorations that are likely to need replacement throughout the remainder of their lives. The selection of the best restorative material that can be used in the oral cavity is a challenging job for both the dentist and the manufacturer. While material properties and clinical performance are critically important, local economies, health care systems, will be important determinants of whether and where new materials can be easily adopted. Challenges exist not only in specifying how the material should be manipulated and perform clinically but also in understanding and incorporating implications of the skill of the operator placing the restoration. Many restorative materials currently exist like amalgam, composites, glass ionomers, and resin ionomers. It is important that the dentist must make the selection of the material with great care because, in future years, those restorations needing replacement will result in the loss of increasing amounts of tooth structure. Amalgam has a lot of disadvantages such as lack of adhesion, toxicity, poor esthetics, and marginal leakage; however, the advantages score better over other materials.

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Clinical trials are considered as a gold standard for assessing bonding effectiveness of adhesive materials. However, clinical trials with long evaluation periods (5 years or more) are necessary to discriminate significant differences within the clinical performances of current improved adhesive materials. The present short communication discusses this issue and possible alternatives.

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In recent years, pentacarbon sugars including xylitol are employed as supplements in the preparation of oral health products. The main purpose of this study was to measure Streptococcus mutans and Lactobacillus acidophilus count treated with different xylitol concentrations. Bacterial solutions were mixed separately in to 2 M (30.43%) xylitol stock solution. The mixture provided bacterial growth medium with 3-18% of xylitol. The solutions stored in a 37°C incubator for 48 h. Initial optical density and optical density of samples after 48 h taken using spectrophotometer. Result shown in average, bacterial growth in L. acidophilus was higher than S. mutans and even in higher xylitol concentration this difference preserved. The present study indicates that the addition of xylitol drastically can enhance the effect of antibacterial agent.

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