Journal of Clinical and Experimental Dentistry. 2017. Vol. 9, no. 7

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    Oral manifestations as the first presenting sign of Crohn?s disease in a pediatric patient
    (2017) Eckel, Ashley; Lee, Dale; Deutsch, Gail; Maxin, Anthony; Oda, Dolphine
    Crohn?s disease (CD) is a chronic inflammatory disorder affecting the gastrointestinal (GI) tract. Although the GI tract is the primary site of involvement, many patients, particularly in pediatric cases, first present with non-intestinal manifestations, including oral lesions. Oral manifestations of CD in children occur in around 50-80% of cases, and about 30% of CD cases in children occur first in the mouth. Recognizing such oral lesions in the pediatric population, and requesting a biopsy, may expedite the diagnosis of CD. We describe a 15 year old male who presented with oral findings of multiple aphthous ulcers and plaques of pink papules of the buccal vestibule. We highlight the initial pathology findings, including non-caseating granulomas, sialadenitis, and a notable plasmacytosis, from biopsy of the left retromolar pad area, which triggered further testing for CD. We provide discussion of how CD was eventually diagnosed and treated and highlight the significance of the pathological findings in this case as they relate to the pathogenesis of CD.
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    Erythema multiforme induced by alendronate sodium in a geriatric patient : a case report and review of the literature
    (2017) Arruda, José A.; Silva, Pedro; Amaral, Márcio Bruno Figueiredo; Cotta, Fernanda; Avendanho, Renata; Mesquita, Ricardo Alves
    Erythema multiforme is an uncommon acute inflammatory disorder caused by exposure to microbes or drugs. Erythema multiforme minor typically affects only one mucosa and can be associated with symmetrical target skin lesions on the extremities. The disease usually occurs in patients in their 3rd and 4th decade of life, but can also affect children and adolescents. Alendronate sodium has been approved for the prevention and treatment of osteoporosis in postmenopausal women, but is associated with adverse events. This study reports and discusses a case of erythema multiforme minor. In addition, a literature search of articles published in PubMed-Medline was performed. The case was a 96-year-old woman who had taken alendronate. Intraoral clinical examination demonstrated hypersalivation and macrocheilia of the lower lip, associated with an ill-defined ulcer with erythematous borders measuring 20 mm in greatest diameter and covered with serofibrinous exudates. The aging of the population in developed and developing countries has increased the use of alendronate sodium to prevent osteoporosis and clinicians should be aware of possible oral adverse events associated with this drug.
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    Comparative evaluation of the apical sealing ability of a ceramic based sealer and MTA as root-end filling materials : an in-vitro study
    (2017) Gandhi, Bhavana; Halebathi Gowdra, Ramesh
    The present study was aimed to evaluate and compare the apical sealing ability of two endodontic root-end filling materials namely, iRoot SP (ceramic based) and ProRoot MTA using the bacterial leakage system. A total of fifty recently extracted, single rooted teeth with a single straight canal were selected for the study. The teeth were chemo mechanically prepared. The apical 3mm of the root was resected and root end cavities were prepared. The teeth were randomly divided into two groups of twenty teeth each for the experimental root end filling materials namely, iRoot SP and ProRoot MTA. A two-chamber model was constructed using pippeter tips and plastic vials. The pipetter tips with the teeth were suspended in these caps and the entire assembly was reattached to the vial. The upper chamber was seeded withEnterococcus faecalis. An Enterococci-selective broth was used in the lower chamber. Leakage was assessed for 90 days and compared using survival statistics. The ProRoot MTA filled root end samples leaked within 30-72 days. The iRoot SP filled root end samples leaked within 51-69 days. Under the parameters of this study, it can be concluded that all the tested materials showed significant apical sealing ability as root-end filling materials over a period of 90 days. iRoot SP exhibited the most effective apical sealing ability as compared to ProRoot MTA.
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    Comparative evaluation of orthodontic bracket base shapes on shear bond strength and adhesive remnant index : an in vitro study
    (2017) Pham, Dennis; Bollu, Prashanti; Chaudhry, Kishore; Subramani, Karthikeyan
    The objective of this study was to evaluate the effect of orthodontic bracket base shape on shear bond strength and adhesive remnant index. In this in vitro study using 140 bovine incisors, shear bond strength (SBS) of brackets with different base shapes (rectangle, flower, round, heart, diamond, star, and football) were measured with an Instron testing machine and tested until bond failure. Adhesive Remnant Index (ARI) scoring was evaluated after debonding to evaluate the location of bond failure. Descriptive and one-way ANOVA post-hoc Tukey statistical analyses were performed with a statistical significance set at p?0.05. Statistically significant difference in mean SBS in Newtons was observed for multiple base shapes (p<0.05). The highest mean SBS (N ± SD) was observed in football and flower base shapes (73.83 N ± 53.46; 65.82 N ± 37.89 respectively); the lowest mean was observed with diamond and heart shapes (30.51 N ± 11.73; 33.28 N ± 16.89 respectively). When reported in Megaspascals, statistically significant difference was observed for rectangle base shape (3.54 MPa ± 2.69) when compared to all other base shapes. Bracket base shape has an effect on SBS. Higher SBS (N) for rectangle, flower, and football base shape indicates even stress distributions throughout the bracket base. Base shape with a pronounced converging tip over the axial plane may contribute to the reduction in SBS due to increased peak stress concentration resulting in bond failure.
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    Spectrophotometric analysis of crown discoloration following the use of silver nanoparticles combined with calcium hydroxide as intracanal medicament
    (2017) Afkhami, Farzaneh; Elahy, Sadaf; Mahmoudieh, Alireza
    Optimal antibacterial efficacy of intracanal medicaments containing silver nanoparticles (Ag-NPs) has been well documented. However, concerns remain regarding the effect of Ag-NPs on tooth color. This study aimed to assess the effects of calcium hydroxide (CH) mixed with Ag-NPs as intracanal medicaments on tooth color. The effect of location of application of medicament on the degree of discoloration was evaluated as well. Fifty extracted single-rooted, single-canal human teeth with straight roots, no caries, no cracks or fractures were collected and accessed. After cleaning and shaping of the root canals, the teeth were randomly divided into two experimental groups (n=20) with CH and CH plus Ag-NPs as intracanal medicaments and a control group of saline (n=10). Experimental groups were randomly divided into two equal subgroups of A, where medicament was applied below the cemento enamel junction (CEJ) and B where the medicament was applied to the root canal and pulp chamber. Color change (?E) was assessed using a spectrophotometer in CIELAB system at five time points of beforemedicaments application (T0), immediately medicaments placement (T1), one week (T2), one month (T3) and three months (T4) after the application of medicaments. Data were analyzed using two-way and three-way ANOVA. Color change in Ag-NPs plus CH and CH groups was not significantly different at any time point (P=0.23). Increased exposure time in both groups did not increase the ?E (P >0.05). Significant differences were noted in ?E between subgroups A and B (P<0.05). Addition of Ag-NPs to CH caused no significant change in tooth color compared to the application of CH alone. However, its use must be limited to the root canal space only.
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    Remineralizing effect of a zinc-hydroxyapatite toothpaste on enamel erosion caused by soft drinks : ultrastructural analysis
    (2017) Colombo, Marco; Mirando, Maria; Rattalino, Davide; Beltrami, Riccardo; Chiesa, Marco; Poggio, Claudio
    The aim of the present in vitro study was to evaluate the protective effects of a zinc-hydroxyapatite toothpaste on repairing enamel erosion produced by a soft drink (Coca-Cola) compared to toothpastes with and without fluoride using Scanning Electron Microscopy (SEM). Fifty specimens were assigned to 5 groups of 10 specimens each. (Group 1: no erosive challenge, no toothpaste treatment, group 2: erosive challenge, no toothpaste treatment, 3: erosive challenge, toothpaste without fluoride, group 4: erosive challenge, fluoride toothpaste treatment, group 5: erosive challenge, zinc-hydroxyapatite toothpaste treatment). Repeated erosive challenges were provided by immersing bovine enamel specimens (10 per group) in a soft drink for 2 min (6mL, room temperature) at 0, 8, 24 and 32 h. After each erosive challenge, the toothpastes were applied neat onto the surface of specimens for 3 min without brushing and removed with distilled water. Between treatments the specimens were kept in artificial saliva. The surface of each specimen was imaged by SEM. Statistically significant differences were found between the samples used as control and those immersed in Coca-Cola (group 1 and 2): indeed among all groups the highest grade of damage was found in group 2. Instead the lowest grade was recorded in the samples of group 5 (Zinc hydroxyapatite toothpaste). The results of this study confirmed the potential benefit the Zn-HAP technology could provide in protecting enamel from erosive acid challenges. The treatment of erosively challenged enamel with Zn-Hap toothpaste showed a clear protective effect.
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    Effect of saliva contamination on cementation of orthodontic brackets using different adhesive systems
    (2017) Robaski, Aliden Willian; Pamato, Saulo; Tomás-de Oliveira, Marcelo; Pereira, Jefferson Ricardo
    The enamel condition and the quality of surface are points that need to be considered for achieving optimal efficiency in the treatment with orthodontic brackets. The aim of this study was to assess the immediate bond strength of metallic brackets cemented to dental. Forty human premolars were double-sectioned, placed in PVC matrices and randomly divided into 10 groups (n=8). They received artificial saliva contamination before or after the application of adhesive systems, except for the control groups. The metallic brackets were cemented using two orthodontic cements (Transbond? Plus Color Change, 3M Unitek e Transbond? XT Light, 3M Unitek). The specimens were subjected to mechanical shear bond strength testing and classified according to the fracture pattern. The results were analyzed using a two-way ANOVA and Tukey?s test for multiple comparisons (p<0.05). ANOVA analysis showed statistically significant differences between the groups (p=0.01). The Tukey?s multiple comparison test indicated statistically significant difference between G6 and G7 groups (p<0.05). A high prevalence of adhesive failure in the groups receiving the hydrophobic adhesive system. The saliva contamination prior to the application of a hydrophobic simplified conventional adhesive system was responsible for decreasing the immediate bond strength values of brackets cemented on the dental enamel.
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    The application of diode laser in the treatment of oral soft tissues lesions. A literature review
    (2017) Ortega Concepción, Daniel; Cano Durán, Jorge A.; Peña Cardelles, Juan Francisco; Paredes Rodríguez, Victor Manuel; González Serrano, José; López Quiles, Juan
    Since its appearance in the dental area, the laser has become a treatment of choice in the removal of lesions in the oral soft tissues, due to the numerous advantages they offer, being one of the most used currently the diode laser. The aim of this review was to determine the efficacy and predictability of diode laser as a treatment of soft tissue injuries compared to other surgical methods. A literature review of articles published in PubMed/MEDLINE, Scopus and the Cochrane Library databases between 2007 and 2017 was performed. ?Diode laser?, ?soft tissue?, ?oral cavity? and ?oral surgery? were employed for the search strategy. Only articles published English or Spanish were selected. The diode laser is a minimally invasive technology that offers great advantages, superior to those of the conventional scalpel, such as reduction of bleeding, inflammation and the lower probability of scars. Its effectiveness is comparable to that of other types of lasers, in addition to being an option of lower cost and greater ease of use. Its application in the soft tissues has been evaluated, being a safe and effective method for the excision of lesions like fibromas, epulis fissuratum and the accomplishment of frenectomies. The diode laser can be used with very good results for the removal of lesions in soft tissues, being used in small exophytic lesions due to their easy application, adequate coagulation, no need to suture and the slightest inflammation and pain.
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    Comparison of the effect of different surface treatments on the bond strength of different cements with nickel chromium metal alloy : an in vitro study
    (2017) Kapoor, Saumya; Prabhu, Nayana; Balakrishnan, Dhanasekar
    For success of any indirect metal restoration, a strong bond between cement and the intaglio surface of metal is imperative. The aim of this study is to evaluate and compare the effect of different surface treatment on the tensile and shear bond strength of different cements with nickel?chromium alloy. 120 premolars were sectioned horizontally parallel to the occlusal surface to expose the dentin. Wax patterns were fabricated for individual tooth followed by casting them in nickel chromium alloy. 60 samples were tested for tensile bond strength, and the remaining 60 for shear bond strength. The samples were divided into three groups (of 20 samples each) as per the following surface treatment: oxidation only, oxidation and sandblasting, or oxidation, sandblasting followed by application of alloy primer. Each group was subdivided into 2 subgroups of 10 samples each, according to the bonding cement i.e RM-GIC and resin cement. Samples were subjected to thermocycling procedure followed by evaluation of bond strength. Two-way analyses of variance (ANOVA) was performed to compare the means of tensile and shear bond strength across type of surface treatment and cement, followed by post hoc parametric analysis. For all tests ?p? value of less than 0.05 was considered statistically significant. The surface treatment of oxidation and sandblasting followed by application of alloy primer offered the maximum tensile and shear bond strength for both RM GIC and resin cement. Resin cement exhibited greater tensile and shear bond strength than RM-GIC for all the three surface treatment methods.
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    Shear bond strengths of composite resin and giomer to mineral trioxide aggregate at different time intervals
    (2017) Ajami, Amir Ahmad; Bahari, Mahmood; Hassanpour-Kashani, Arezoo; Abed Kahnamoii, Mehdi; Savadi-Oskoee, Ayda; Azadi-Oskoee, Farhad
    The efficacy of the bond between the restorative materials and the pulp capping materials has an important role in the success of vital pulp therapy. Therefore, the aim of this study was to evaluate the shear bond strength of composite resin and giomer to MTA at different time intervals after mixing of MTA. Ninety cylindrical MTA samples were prepared and assigned to two groups (n=45) based on the restorative materials used (composite resin or giomer). Each group was subdivided into 3 subgroups (n=15) based on the evaluation intervals (immediately, 2.45 hours and 3 days after mixing MTA). After the bonding procedures, the shear bond strengths of the samples were measured in MPa at a strain rate of 0.5 mm/min. Data were analyzed with repeated-measures ANOVA, post hoc tests and t-test (P<0.05). Bond strength of composite resin was minimum at baseline but it increased significantly 2.45 hours after mixing MTA (P=0.002), with no significant changes in bond strength up to three days (P=0.08). Bond strength of giomer did not exhibit any significant changes from baseline to 2.45 hours after mixing MTA (P=078); however, at 3 days it reached a minimum (P=0.000). In addition, the means of bond strength of composite resin 2.45 hours and 3 days after mixing were significantly higher than those of giomer (P=0.001 and P=0.000, respectively). Bond strengths of composite resin 2.45 hours and also 3 days after mixing were significantly higher than those of giomer. In addition, the shear bond strength of giomer decreased over time; however, the shear bond strength of composite resin increased.
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    Comparative evaluation of shear bond strength of universal dental adhesives : an in vitro study
    (2017) Jayasheel, Arun; Niranjan, Nandini; Pamidi, Hemanthkumar; Suryakanth, Mayuri B.
    Patient demand for tooth colored restorations and desire for minimally invasive restorations have made composites an indispensable part of the restorative process. An important factor affecting the intra-oral performance of composite restorations is bonding. Ninty six freshly extracted molar teeth were collected and occlusal 3mm is removed using a diamond disc to expose dentine. Following with samples were divided in to two main groups (self-etch and total etch). Each main group is again sub divided in to three groups each according to bonding agent used (Tetric N- Bond Universal, Single Bond Universal, Tetric N Bond Total etch in total etch group and Clear Fill SE in self etch group). Following which bonding protocol is followed according to manufacture instructions, a composite buildup of 2x3 mm is done on each specimen and then specimen were subjected to shear bond test under universal testing machine. All the readings were noted and subjected to statistical analysis using One way ANOVA and Tukey?s posthoc test. It showed that there is no significant difference among the groups in both self-etch and total etch modes. It can be concluded that application of an etching step prior to Universal Adhesives significantly improves their dentine penetration pattern, although this does not affect their mean SBS. The bond strength values of the TBU regardless of application mode were comparable to SBU making them reliable for working under different clinical conditions.
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    Methodology in specimen fabrication for in vitro dental studies : standardization of extracted tooth preparation
    (2017) Fernández Estevan, Lucía; Millan Martínez, Diego; Fons Font, Antonio; Agustín Panadero, Rubén; Román Rodríguez, Juan Luis
    Specimen preparation for in vitro study suffers a general lack of methodological homogeneity, as well as a lack of uniformity in the materials selected for fabricating them. This situation prevents comparisons between studies. When a specimen is not of dental origin it is not possible to study adhesion or bonding techniques realistically. The objective is to design and implement a method of specimen preparation that permits universal standardization for use in in vitro studies. A metal stump of specified dimensions was designed and fabricated by hand. It was scanned, the data digitalized, perfecting and standardizing the dimensions. Ten human molars were adapted to the size and shape of a standard milling block. A Cerec 3D inLab Cerec milling unit was used to prepare the molars to match the digitalized model. Ten specimens with identical dimensions were obtained. CAD-CAM technology allows the preparation of natural extracted teeth to be standardized and could be used to establish a reproducible method that would facilitate comparison between different in vitro studies, and reduce bias arising from variations in sample fabrication.
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    Effects of the functional orthopaedic therapy on masticatory muscles activity
    (2017) Di Palma, Elena; Tepedino, Michele; Chimenti, Claudio; Tartaglia, Gianluca M.; Sforza, Chiarella
    The purpose of this study was to examine surface electromyographic (sEMG) activity of masticatory muscles before and after functional orthopaedic therapy with Sander appliance. Ten adolescents (5 girls, 5 boys) with an Angle Class II, division I malocclusion, 9-13 years old, were submitted to sEMG before and after functional orthopaedic therapy. To verify the neuromuscular equilibrium, the standardized EMG activities of right and left masseter and anterior temporal muscles were recorded during maximum voluntary clench, and analysed calculating: POC (index of the symmetric distribution of the muscular activity determined by the occlusion); TC (index of presence of mandibular torque) and Ac (index suggesting the position of occlusal barycentre). The total muscular activity was also calculated. Pre- and post- functional therapy data were compared with Wilcoxon Signed-Rank Test. Before treatment, all subjects had a good neuromuscular equilibrium, which was not altered by treatment. sEMG evaluations allow to quantify the impact of occlusion on masticatory muscle activity and to control that the functional orthopaedic therapy maintain a good muscular coordination.
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    Analysis of surface characteristics of protaper universal and protaper next instruments by scanning electron microscopy
    (2017) Bennett, Jeffery; Chung, Kwok-Hung; Fong, Hanson; Johnson, James; Paranjpe, Avina
    Many new rotary files systems have been introduced, however, limited research has been conducted related to the surface irregularities of these files and if these have any effects on the files themselves. Hence, the aim of the present study was to analyze surface irregularities of the ProTaper® Universal rotary files (PTU) and the ProTaper Next? rotary files (PTN) before and after instrumentation in curved canals. The main objective was to investigate the nature of these irregularities and how they might influence the use and fracture of rotary files during root-canal treatments. The files were examined pre-operatively using a stereomicroscope and scanning electron microscopy(SEM) to analyze surface imperfections and the presence of particles. Mesial roots of forty extracted mandibular molars were selected. Each instrument was used to prepare one of the mesial canals. The files were then rinsed with alcohol, and autoclaved and analyzed again. Of the 80 files used in this study, five files fractured, five files unwound and seven files were curved or bent and they all belonged to the PTU group. Irregularities and debris could be visualized with the SEM on both unused PTU and PTN files. Most of the debris was found associated with deeper milling grooves and defects on the surface of the metal. Surface analysis of the files that were used and sterilized were performed and the SEM images demonstrated organic debris, metal flash, and crack formation and initiation of fractures for both file types. All files showed machining grooves, metal flash, debris, and defects on cutting edges. These irregularities appear to be critical in the accumulation of debris and initiation of fatigue and crack propagation within the NiTi alloy. The accumulation of debris could be a concern due to the potential exchange of organic debris between patients.
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    Effect of polyethelene oxide on the thermal degradation of cellulose biofilm : low cost material for soft tissue repair in dentistry
    (2017) Akkus, Anna; Tyler, Rakim; Schiraldi, David; Roperto, Renato; Faddoul, Fady; Teich, Sorin
    Bio cellulose is a byproduct of sweet tea fermentation known as kombusha. During the biosynthesis by bacteria cellulose chains are polymerized by enzyme from activated glucose. The single chains are then extruded through the bacterial cell wall. Interestingly, a potential of the Kombucha?s byproduct bio cellulose (BC) as biomaterial had come into focus only in the past few decades. The unique physical and mechanical properties such as high purity, an ultrafine and highly crystalline network structure, a superior mechanical strength, flexibility, pronounced permeability to gases and liquids, and an excellent compatibility with living tissue that reinforced by biodegradability, biocompatibility, large swelling ratios. The bio-cellulose film specimens were provided by the R.P Dressel dental materials laboratory, Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University, Cleveland, US. The films were harvested, washed with water and dried at room temperature overnight. 1wt% of PEG-2000 and 10wt% of NaOH were added into ultrapure water to prepare PEG/NaOH solution. Then bio-cellulose film was added to the mixture and swell for 3 h at room temperature. All bio-cellulose film specimens were all used in the TA Instruments Q500 Thermogravmetric Analyzer to investigate weight percent lost and degradation. The TGA was under ambient air conditions at a heating rate of 10ºC/min. PEG control exhibited one transition with the peak at 380ºC. Cellulose and cellulose/ PEG films showed 3 major transitions. Interestingly, the cellulose/PEG film showed slightly elevated temperatures when compared to the corresponding transitions for cellulose control. The thermal gravimetric analysis (TGA) degradation curves were analyzed. Cellulose control film exhibited two zero order transitions, that indicate the independence of the rate of degradation from the amount on the initial substance. The activation energies for three transitions for cellulose and cellulose/PEG showed increasingly higher values for the transitions at higher temperatures.
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    The XP-Endo Finisher for the removal of calcium hydroxide paste from root canals and from the apical third
    (2017) Hamdan, Rami; Michetti, Jérôme; Pinchon, Déborah; Diemer, Franck; Georgelin Gurgel, Marie
    The aim was to compare the efficacy of the passive ultrasonic irrigation PUI and the Xp-endo Finisher (FKG-Dentaire, La-Chaux-de-Fonds, Switzerland) in removing the calcium hydroxide paste from root canals and from the apical third. Sixty-eight root canals of single-rooted teeth were shaped using the BT-Race files (FKG-Dentaire, La-Chaux-de-Fonds, Switzerland). Ca(OH)2 was placed in all samples except for the negative control group (n=4). Remaining teeth were randomly divided into three groups: G1-Xp (n=30), G2-PUI (n=30) and the positive control group (n=4). Removal procedure consisted of three repeated one-minute-cycles. Samples were split longitudinally, photos of halves were taken at X6.4 magnification and were analyzed using the ImageJ-Software (The National Institutes of Health NIH, Bethesda, Maryland, USA) to calculate the percentage of surfaces with residual Ca(OH)2; the results were compared using the Wilcoxon-Mann Whitney test. Photos of the apical thirds were taken at X16 and X40 magnifications and were scored by two examiners from (0) to (4). Scores of the apical third were compared using the Fisher test. The Xp-endo Finisher removed completely the Ca(OH)2 dressing from four teeth (13.33%) whereas the PUI in one tooth (3.33%). The mean values of the remaining Ca(OH)2 were (2.1%, 3.6%) respectively and the difference was not significant (p= 0.195). Both examiners found the Xp-endo Finisher more efficient in the apical third and the difference was significant; p= (0.025, 0.047) respectively. The Xp-endo Finisher showed a superiority over the PUI in removing the Ca(OH)2 from the apical third after 3 minutes of activation.
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    Comparison of postoperative pain after root canal treatment using reciprocating instruments based on operator?s experience : a prospective clinical study
    (2017) García Font, Marc; Duran-Sindreu Terol, Fernando; Calvo, Carmen; Basilio, Juan; Abella, Francesc; Ali, Akram; Roig Cayón, Miguel; Olivieri, Gonzalo
    The aim of the present study was to compare clinically the incidence of postoperative pain after endodontic treatment using the Reciproc System, taking into account the operator?s experience. One hundred patients scheduled for routine endodontic treatment were enrolled in this study. Endodontic treatment was carried out in a single visit by undergraduate and postgraduate students. The chemomechanical preparation of root canals was performed with Reciproc instruments. Pretreatment and postoperative pain was recorded using a visual analogue scale (VAS). Postoperative pain and the need for analgesic consumption were assessed at 4, 8, 16, 24, 48 and 72 hours post-treatment. The data were analyzed using the Mann?Whitney U and Chi-Square test, and the significance was set at P<0.05. The mean value of pain after root canal treatment was 1.13±1.94 and 1.91±2.07 on a VAS between 0 and 10 in treatments performed by undergraduate and postgraduate students, respectively. There was a significant difference in the incidence of postoperative pain between the two groups (P<0.05). The prevalence of postoperative pain was high in the treatments performed by postgraduate students in comparison with undergraduate students. This suggests that operator experience has an influence on the prevalence of postoperative pain after root canal treatment.
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    Effect of various dentin disinfection protocols on the bond strength of resin modified glass ionomer restorative material
    (2017) Sekhar, Anand; Anil, Akansha; Thomas, Manuel S.; Ginjupalli, Kishore
    Disinfection of dentin surface prior to any restorative therapy is important for the longevity of the treatment rendered. However, these dentin disinfection methods should itself not interfere with the adhesion of the restorative material. Therefore the aim of this study was to determine the effect of various dentin disinfection protocols on the shear bond strength (SBS) of resin modified glass ionomer cement (RMGIC). The occlusal surface of 40 extracted premolars were trimmed to obtain a flat dentinal surface and was randomly divided into four groups. CTRL was the control group; NaOCl was 1% sodium hypochlorite disinfection group; CHX was 2% chlorhexidine disinfection group; and PAD was the photo-activated disinfection group. Then a predetermined dimension of RMGIC was bonded to the pre-treated dentin surfaces. Following this, each sample was tested for SBS using universal testing machine at a crosshead speed of 0.5mm/min. Among the test groups, CHX showed the least reduction in SBS and NaOCl the highest reduction in SBS as compared to the control group. PAD on the other hand showed significantly lower SBS than CTRL and CHX groups, but the values were higher than the NaOCl group. Thus, it could be concluded from the present study that use of chlorhexidine based dentin disinfection does interfere with the adhesion of RMGIC. However, photo-activated disinfection should be done with caution. Moreover, sodium hypochlorite based disinfectants should be avoided prior to the use of RMGIC.