How to cite this article:
Krishna EM M, Theruvil R, Mathew J, George S, Paul M, Jacob J, Baby A. Evaluation of the Effect of Remineralizing Agent on Bleached Enamel Surfaces Subjected to Erosion: An In vitro Study. Cons Dent Endod J 2019; 4 (1):1-5.
Tooth bleaching helps to improve the appearance of discolored teeth. But the use of acidic food can lead to increased erosion after bleaching. Remineralizing treatment with a remineralizing agent is capable of reestablishing the lost enamel surface hardness after bleaching. In this study, changes in microhardness were analyzed upon the application of a remineralizing agent after subjecting the enamel surfaces to bleaching and erosive challenge.
Aim: The aim of this study is to evaluate the effect of a remineralizing agent on bleached enamel surfaces subjected to erosive challenge.
Materials used: (1) 35% carbamide peroxide (Opalescence PF, Ultradent)—a bleaching agent; (2) Remin Pro—a remineralizing agent; (3) 1% citric acid solution—an erosive agent.
Methodology: Samples were divided into three groups and subjected to bleaching and erosion treatment. Group I—treated with 35% carbamide peroxide then treated with 1% citric acid solution; group II —treated with 35% carbamide peroxide and a remineralizing agent followed by 1% citric acid solution; group III—without bleaching with 1% citric acid solution. The sample size calculated using the statistical package G*power (3.1.5) with a level of significance of 0.05. The sample size obtained is n = 15, 5 samples per group. G1, G2, and G3 were subjected to the Vickers microhardness analysis. Loss of surface hardness loss (% SHL) was analyzed.
Result: The lowest % SHL is in group II—24.718 when compared with group I—35.048.
Conclusion: Post-bleaching application of a remineralizing agent helps to decrease the effect of erosion occurring as a consequence of bleaching.
How to cite this article:
Pius A, Mathew J, Theruvil R, George S, Paul M, Baby A, Jacob J. Evaluation and Comparison of the Marginal Adaptation of an Epoxy, Calcium Hydroxide-based, and Bioceramic-based Root Canal Sealer to Root Dentin by SEM Analysis: An In Vitro Study. Cons Dent Endod J 2019; 4 (1):6-13.
Aim: The aim of this study is to evaluate and compare the sealer penetrability and gap formation of root canal sealer to root dentin filled with AH Plus, Sealapex, and BioRoot RCS.
Materials and methods: Twenty-seven mandibular second premolars were selected and were radiographed at two angulations. The teeth were stored in labeled plastic vials containing artificial saliva and were randomly assigned to three groups based on the sealer, group I—AH Plus (n = 9), group II—Sealapex (n = 9), and group III—BioRoot RCS (n = 9); teeth were de-coronated and the conventional root canal therapy was done with Protaper gold rotary files. Three groups were filled with AH Plus, Sealapex, and BioRoot RCS with the single-cone technique. About 1-mm sections of apical, middle, and cervical third were taken using a water-cooled low-speed saw. All specimens are evaluated using a scanning electron microscope.
Clinical significance: The main goal of obturation is to provide a three-dimensional seal, thereby preventing the reinfection of the root canal and preserving the health of periapical tissues. Because of the hydrophobic nature of gutta-percha, the sealer tends to pull away from gutta-percha on the setting. To overcome these drawbacks, new sealer systems have been introduced to enhance the sealing ability. Resin-based sealers have gained more popularity in recent years because these sealers penetrate deep into the dentinal tubules due to their better flowability, long setting time, and provide long-term dimensional stability. The resin-based sealer used in this study is the AH Plus. It is compared with the newly introduced bioceramic sealer BioRoot RCS for marginal adaptation.
Results: It was found that the AH Plus group had a higher depth of sealer penetration than other groups and the BioRoot RCS group revealed a minimum gap formation than other groups of sealers evaluated in the study.
Conclusion: The Bioceramic sealer revealed better sealer penetrability at the apical third and minimal gap formation compared to the epoxy resin-based and the calcium hydroxide-based sealer.
Background: Endodontic therapy of a tooth with open apex and necrotic pulp presents multiple challenges during treatment. Microbial elimination from chronic lesions makes treatment all the more difficult. Apexification and pulp revascularization are the treatment options available. Apexification with calcium hydroxide has certain disadvantages and mineral trioxide aggregate (MTA) may be considered as a promising alternative.
Case description: This case report describes the management of a symptomatic maxillary left central incisor with immature apex and a chronic periapical lesion. Sodium hypochlorite of 3% and EDTA were used as irrigants for microbial elimination. Repeated intracanal dressings with calcium hydroxide were given for better periapical healing. MTA was used for apical barrier formation. After confirming the hard set of MTA, obturation was done with thermoplasticized gutta-percha and access cavity sealed with composite resin restoration.
Conclusion: In this case, MTA helped to form an apical barrier in the immature necrotic maxillary central incisor and showed a good clinical and radiographic success. The use of irrigants and calcium hydroxide as an intracanal medicament promoted the periapical healing of the chronic apical periodontitis.
Background: Traumatized anterior teeth with subgingival crown-root fractures are a challenge to treat. Treatment of crown-root fractures often requires a multidisciplinary approach. Gingivectomy of the affected tooth can violate gingival contour of the tooth so orthodontic extrusion is a conservative procedure that allows extrusion of a tooth without any bone loss.
Case description: This case report details the multidisciplinary management of the traumatized anterior tooth including endodontic treatment, orthodontic extrusion, and post-core-crown procedure to restore a right maxillary central incisor to achieve a satisfactory cosmetic result. The fractured fragment was removed and pulp tissue extirpation was done in 11. Obturation was completed at next appointment. The fracture line was extended subgingivally, so orthodontic extrusion was planned. After 8 weeks, the tooth had extruded around 2 mm of palatal tooth structure sufficient to provide a ferrule of 1 mm. A cast post and core was prepared, and a definitive metal-ceramic crown was placed over 11. The patient was reviewed for 6 months and 1 year.
Conclusion: Management of cervical third fracture has various treatment options. Orthodontic extrusion is a conservative procedure that allows retention of a tooth without any bone loss. Cast post and core can adapt to the canal and strengthen the tooth. It can be considered as a conservative treatment option.
Background: Coronal fractures of the anterior teeth are a common form of dental trauma that mainly affects children and adolescents. One of the options for managing coronal tooth fractures when the tooth fragment is available and there is no or minimal violation of the biological width is the reattachment of the dental fragment. Sometimes the reattachment alone does not give favorable esthetic result if a fragment is missing and composite restoration may be combined with reattachment for restoring the crown morphology.
Case description: This case report describes the management of a complicated oblique crown fracture of a maxillary right central incisor. The mobile fractured segment was removed under local anesthesia (LA) and stored in normal saline. Endodontic treatment was given with a master cone size of 50. Reattachment of the tooth fragment was done using the dual-cure resin cement. Access cavity and missing portion of the tooth were restored with composite resin to regain the tooth morphology.
Conclusion: In this case, oblique crown fracture of a young patient was effectively managed with a single-visit endodontic treatment followed by reattachment of tooth fragment. The missing coronal part was restored with composite which gives a better reinforcement to the fractured segment and the remaining tooth structure.
Clinical significance: Reattachment of the tooth is a viable treatment alternative to crowning in anterior tooth trauma for a young patient. It is a viable technique that restores function and esthetics with a very conservative approach and can be considered as a choice when treating a patient with coronal fractures of the anterior teeth especially in a young patient.