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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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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This paper reviews the history, clinical success and concerns regarding the safety of formocresol as a primary molar pulpotomy medicament. The alternatives to formocresol are discussed and their advantages and disadvantages are evaluated.

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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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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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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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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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The aim of this paper is to describe vital teeth bleaching employing a combination of techniques: In-office and at-home. We applied a 35% hydrogen peroxide with a pen applicator for the in-office process and 16% carbamide peroxide for in-home bleaching. We have concluded that, in-office bleaching in combination with take-home bleaching using hydrogen peroxide is an excellent option for esthetic and conservative treatment of teeth that have been chromatically altered.

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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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Background: Post retention to root canal dentin is an important problem that directly affects the success of the restoration. The aim of this study was to evaluate the influence of different adhesive resin cements on the bond strength of fiber posts to root canal dentin. Materials and Methods: A total of 44 human mandibular premolars were selected for the study. Posts were luted using four different resin cements: Group 1; RelyX Unicem, Group 2; Panavia F 2.0, Group 3; Kerr Maxcem and Group 4; Clearfil self-adhesive (SA) cement. After the cementation, three segments per tooth were obtained starting 1 mm below the cementoenamel junction including, cervical, middle and apical. The roots were sectioned into 6 slices of 1 mm thickness each. Push-out test was performed using the universal testing machine at a cross-head speed of 0.5 mm/min. Statistical analysis was performed using one-way ANOVA and Tukey's tests (α = 0.05). Results: Mean push-out bond strengths were: RelyX Unicem (22.4 ± 2.46), Panavia F 2.0 (19.8 ± 2.01), Kerr Maxcem (18.1 ± 2.45), Clearfil SA Cement (23.8 ± 2.49). Clearfil SA Cement showed significantly higher bonds strength than the other tested materials except RelyX Unicem (P < 0.05). Conclusion: SA 10-methacryloyloxydecyl dihydrogen phosphate-based resin cements yielded higher bond strength values than did self-etch or SA resin cements for fiber posts in push out tests. Bond strength values were higher in coronal than in the middle and apical root sections.

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Objective: The aim of this study was to assess the sealing abilities of two calcium hydroxide (Ca[OH] 2) pastes and two mineral trioxide aggregates (MTA) against leakage on direct pulp capping with a computerized fluid filtration (CFF) method. Materials and Methods: The 60 recently extracted sound human molar teeth were sectioned at the level of the highest pulp horn to obtain dentin discs of 0.5 ± 0.2 mm. The dentin discs were numbered and permeability measurements were done before and after the operation for the same sample. For simulating direct pulp capping, dentin discs were perforated with a standard diamond bur and restorated with four different capping materials: Dycal, Calcimol light-curing (LC), ProRoot MTA and DiaRoot BioAggregate. Fluid movement measurements were tested with a CFF method and a mean value was calculated for each specimen. Results: Calcimol LC and Dycal showed significantly higher fluid conductance values compared to other pulp capping materials (P < 0.05). There were no significant differences between ProRoot MTA and DiaRoot BioAggregate (P > 0.05). Conclusion: Within the limitations of this study, it can be concluded that using the MTA materials as a pulp-capping agent would be more efficient than Ca (OH) ₂ materials with regard to pulpal microleakage.

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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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Aim: To evaluate color changes of teeth after immersion in tea and cola following the application of two in-office bleaching products. Materials and Methods: A total of 60 specimens were obtained from 60 extracted sound human maxillary central teeth. The specimens were randomly divided into three groups (n = 20). Group A was the control group (no bleaching). In Group B, the specimens were bleached with Opalescence Xtra Boost (Ultradent), and in Group C, they were bleached with Smartbleach (High Tech Laser). These groups were then divided into two subgroups (n = 10 in each) according to the colorant solution used: tea and cola. Each bleaching agent was applied to the specimens according to the manufacturer's recommendations. After bleaching, the first color of the specimens was determined with a spectrophotometer according to the CIELAB color system (∆E). Following immersion in the staining solutions, the color was determined after 15 min, 6 h (second day), and 36 h (sixth day), and the color change values were calculated. The results were analyzed statistically by two-way analysis of variance (ANOVA) and Tukey's honest significant difference (HSD) test (P < 0.05). Results: The bleached specimens showed more staining than the unbleached specimens (control group). In all the groups, the staining was more severe in the cola solutions than in the tea solutions. There were no statistically differences in staining of the teeth in the control group (P > 0.05). In the specimens bleached with Smartbleach, staining in cola solution was greater than tea solution and this difference was statistically significant (P < 0.05). Conclusions: The staining of the bleached specimens was similar in the tea and cola solutions. The bleached specimens showed more staining than the unbleached specimens. The staining of the specimens in the tea and cola increased at all the time intervals evaluated.

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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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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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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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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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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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Objectives: The purpose of this study was to compare the incidence of dentinal defect formation after using EDTA gel during root canal preparations by three different instrumentation techniques. Materials and Methods: One hundred and forty maxillary central incisors were decoronated and roots were embedded in resin blocks. Twenty samples were left unprepared (Control group), and the remaining 120 samples were divided into three groups. Each group was divided equally into two subgroups according to the use of EDTA gel during root canal instrumentation. Roots were prepared with hand file (Group 1), ProTaper Universal (Group 2) and WaveOne (Group 3). Roots were sectioned 3, 6, and 9 mm from the apex, and the cut surface was observed microscopically and the presence of dentinal defects was checked. The differences between groups were analyzed using Fisher's exact test. Results: Unprepared roots did not show any dentinal defects. Dentinal defects were observed in all prepared roots. The difference between experimental groups and subgroups regarding the incidence of dentinal defects was not statistically significant. Conclusion: Canal preparation using hand or rotary files created radicular dentinal defects. The use of EDTA gel during root canal preparation did not reduce the incidence of dentinal defects.

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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: Caries detector (CD) dyes aid in caries diagnosis by staining the organic matrix of less mineralized infected dentine. However, detector dyes are not specific to bacteria and can discolor surrounding healthy tissues as dentino-enamel junction or the circumpulpal dentine. Possible discoloring effect of CD dye over restorative materials have not been evaluated until date. The aim of this study was to investigate the staining effects of four commercial CD dyes Caries Detector (CAD), Caries Marker (CAM),SEEK (SEE), Sable Seek (SES) on a variety of tooth colored restorative materials; Filtek Valux Plus (VLX), Filtek Z250 (Z25), Filtek Silorane (SIL) Fuji IX (FUJ). Materials and Methods: A total of 40 disc-shaped specimens were prepared from each restorative material. After 24 h distilled water storage, baseline color was measured according to the Commission International de l'Eclairage L* a* b* system by using a reflection spectrophotometer. Each CD dye was applied to 10 samples of each composite group for 10 s and applications were repeated for 2 times. Before the final color measurements, all samples was rinsed and dried. Color differences (ΔE) were measured and analyzed the data with two-way analysis of variance and Tukey honest significant difference post-hoc tests. Results: Independent of dyes, perceptible color changes were observed in glass ionomer restorative material (FUJ) (ΔE _ab * > 3.3). CAD, CAM and SES caused staining on highly triethylene glycol dimethacrylate monomer containing composite resin (VLX). Silorane based restorative material (SIL) and micro hybrid resin composite (Z25) were more resistant to discoloration then VLX and FUJ (P < 0.05). Conclusion: CD dyes may cause discolorations in some restorative materials and should be used with maximum care.

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Purpose: The aim of this study was to assess micro-tensile bond strength values to dentin of four different one-step self-etching adhesive systems in vitro in a comparative manner. Materials and Methods: In the present study, 20 caries-free human molar teeth were used. Occlusal surfaces were removed to achieve a uniform dentin surface under water cooling by using a low-speed diamond saw. The dentin surfaces obtained were abraded for one minute by using 600-grit silicon carbide papers. Then, the teeth were randomly assigned into four groups (n = 5). For restoration of teeth prepared, four different one-step self-etching adhesive systems, including Clearfil S ³ Bond Plus, Clearfil S ³ Bond, Xeno V Bond and Adper Easy Bond were used according to manufacturer's instructions. A 4 mm thick of composite resin crown (ClearfilAP-X) was applied to surfaces pre-treated with bonding agent. Samples were stored in distilled water at 37°C for 24 hours until micro-tensile bond strength tests were performed. Statistical analyses were performed by using one-way ANOVA and post-hoc Tukey tests (α =0.05). Fracture surfaces were evaluated using a stereomicroscope. Results: Significant differences were observed in bond strength to dentin among one-step self-etching adhesive systems (P < 0.05). The highest bond strength was achieved by Clearfil S ³ Bond Plus system (P < 0.05). No significant difference was observed in bond strength among other groups (P > 0.05). Conclusion: There were differences between bond strength values of tested one-step self-etch adhesives. Clearfil S ³ Bond Plus exhibited higher values.

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Purpose: Present study investigated microtensile bond strengths (μTBS) of four one-step self-etch dental adhesive systems, two two-step self-etch adhesive systems and one three-step etch-and-rinse adhesive system to pulp chamber dentin. Materials and Methods: The μTBS of seven current adhesives, including one three-step etch-and-rinse (Optibond FL, Kerr, USA), two two-step self-etch (Clearfil SE Bond, Kuraray, Japan; AdheSE, Ivoclar, Liechtenstein) and four one-step self-etch adhesives (Clearfil S3 Bond, Kuraray, Japan; Optibond all-in-one, Kerr, USA; iBond, Heraeus Kulzer, Germany; L-POP, 3M ESPE, Germany) were determined. Adhesives were applied to pulp chamber dentin according to their respective manufacturer's instructions, then μTBS tests were performed. Results: μTBS varied from 29.99 ± 7.82 to 38.15 ± 10.38 MPa. Highest μTBS mean was obtained with Optibond FL and lowest iBond, Heraeus Kulzer, Germany. There were no significant differences among all adhesives. Conclusion: Bonding effectiveness of one-step self-etch adhesive systems to pulp chamber dentin was comparable to two-step self-etch and three-step etch-and-rinse adhesive systems.

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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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