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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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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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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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 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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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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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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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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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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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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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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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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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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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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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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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: 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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Objective: The purpose of this in vitro study was to investigate the reliability of a prototype electronic caries monitor (ECM) for diagnosis of the dental caries on the occlusal surfaces of posterior teeth and to compare using histological examination as gold standard. Materials and Methods: Data were obtained from 93 occlusal sites of 33 extracted human molars. Electrical resistance to alternative currency of 21 Hz and 24 Vpp of the teeth was measured with the ECM, which produced in Selcuk University. After obtaining electrical conductance values, each tooth was then sectioned into two pieces mesiodistally and examined histologically for occlusal caries under the stereomicroscope. Statistical evaluations were made using Pearson correlation test. Results: A statistically significant negative correlation was found between electrical resistance of the teeth and occlusal caries presence ( P < 0.05). Conclusion: As a result, it is suggested that ECM is a nondestructive and suitable method at detection of occlusal caries.

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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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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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Coronal fractures of permanent dentition are the most frequent type of dental injury. Reattachment of the fractured anterior tooth, if the tooth fragment is available, is highly conservative and provides good esthetics as the (because the tooth's original anatomic form, color, and surface texture are maintained) esthetic treatment has gained popularity in the recent past. It also restores function, provides a positive psychological response, and is a relatively simple procedure. This article reports on two coronal tooth fracture cases that were successfully treated using tooth fragment reattachment.

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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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Context : Advances in composite restorative materials have positioned them as credible alternatives to dental amalgam. However, polymerization shrinkage and the resultant microleakage remain major obstacles in the successful use of these materials. Aims: The aim of this study was to investigate the effects of placement technique on microleakage of Quixfil^® composite restorations bonded with Xeno III^® bonding agent Settings and Design : In vitro study. Materials and Methods : Thirty-four cylindrical cavities measuring 5 mm in diameter and 3 mm in depth were prepared on the buccal aspect of extracted human teeth. The apices of all the teeth were sealed and the teeth randomly assigned into the bulk and the incremental groups for restoration. Restorations were polished and two layers of nail varnish applied on all tooth surfaces except a rim of 1 mm around the restorations. The teeth were thermo-cycled and stained with 2% methylene blue dye. The restorations were sectioned and examined under light microscopy. Dye penetration on the tooth-restoration interface was scored on an ordinal scale of 0 to 4. Statistical Analysis Used : Pair-wise comparison of the two placement groups was done using the Wilcoxon Signed Ranks Test. Results : No statistically significant difference was observed in the microleakage of the two study groups (P value > 0.05). Conclusions : There is no statistically significant difference in the microleakage of the bulk and the incremental Quixfil restorations. It is feasible to place Quixfil restorations in layers of up to 3 mm in depth.

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