The aim of this study was to evaluate the concentration and pH stability of four different 10% carbamide peroxide products: Opalescence PF 10% (OP), Whiteness Perfect 10% (FGM), Potenza Bianco PF 10% (PHS), and Power Bleaching 10% (BM4). The concentration of the products was obtained using the iodometry technique, and the pH was evaluated with a pH meter. The products were stored at room temperature and measurements were taken every 2 months for a period of 12 months. The data were analyzed and submitted to the Kruskal–Wallis non-parametric test complemented by Dunn (p <0.05). The results showed that all the groups presented significant variation in concentration, except group BM4. However, groups BM4 and FGM presented slightly more acid pH values throughout the study period. It was concluded that all products evaluated in this study presented acceptable stability within the international standards for bleaching agents. Vital tooth bleaching is usually performed using carbamide peroxide gel, which releases free radicals that oxidize the pigment molecule, while also generating oxidative stress in the pulp tissue. Bleaching gels that are more stable have better control of the release of these free radicals and have reduced adverse effects. Clinical relevance: Stable bleaching gels are safer for clinical use, as they gradually release free radicals, decreasing the oxidation of pulp tissue.

Introduction: The novel coronavirus disease-2019 (COVID-19) has spread rapidly all over the world. This large-scale infectious public health event has imposed enormous pressure on Governments, medical and healthcare providers, and the general public. There have been reports on the psychological impact of the COVID-19 pandemic on the general public, patients, medical staff, children, and older adults. However, no detailed study on the mental health status of Dental College teaching faculty, postgraduate students, interns, and undergraduates in Kerala, India, has been undertaken. Aim: This study assessed the anxiety level of faculty members, postgraduates, interns, and undergraduates during an epidemic and explored factors influencing their anxiety, and also compared the anxiety level between faculty members, postgraduates, interns, and undergraduates. Materials and methods: Assessment of the mental health of the participants during the COVID-19 outbreak was done by using structured questionnaire, and the participants also responded to a 7-item Generalized Anxiety Disorder Scale (GAD-7). Data analysis was done with SPSS Version 21.0, and the Statistical test used was the Chi-square test. Result: We found that faculty members experienced a high level of moderate anxiety compared with other participants, which was statistically significant (p <0.05). Participants who had children had moderate anxiety which was statistically significant compared to participants with no children. Most (64.1%) of the participants are worried about the current COVID situation. More than 90% of the participants feel that the dental training will be compromised. Conclusion: The COVID-19 scenario has caused mental and emotional stress among the dental professionals as is with any other field of health. The mental health of dental professionals in colleges is significantly affected when faced with public health emergencies, and they require the attention, help, and support of the society, families, and colleges. It is suggested that the government and colleges should collaborate to resolve this problem in order to provide high-quality, timely crisis-oriented psychological services to the vulnerable candidates.

Objective: The purpose of this in vitro study was to assess the cuspal deflection of endodontically treated human premolars restored with different types of resin composites. Materials and methods: Forty-eight intact human upper premolars were selected, and standardized mesio-occluso-distal cavities were prepared and randomly divided into four experimental groups according to different direct restorative materials as follows (n = 12): Group I: Filtek Bulk Fill; Group II: SureFil SDR Flow + Ceram X Mono; Group III: GCeverX posterior + G-aenial posterior; and Group IV: Tetric N-Ceram. After storage in distilled water for 24 h at 37°C, specimens were subjected to thermocycling (5–55°C, ×1000). The cuspal deflection measurements were performed in microns at “after preparation”, “after endodontic treatment”, “24 h after restoration”, and “after thermocycling”. Data were statistically analyzed using Friedman and Kruskal Wallis tests (α = 0.05). Results: There were no statistically significant differences between groups in terms of cuspal deflection either after 24 hours or after thermocycling measurements (p >0.05). When comparing 24 hour and thermocycling cuspal deflection values within each restorative material group, none of the materials showed a significant difference (p >0.05). While no significant difference was detected between “after endodontic treatment” and “24 h after restoration” for each group (p >0.05), the difference between “after endodontic treatment” and “after thermocycling” cuspal deflection values increased statistically significantly for group II and group III (p <0.05). Conclusion: Endodontic treatment did not affect the cuspal movement of the upper premolars. Twenty-four hours after the restoration procedure and thermocycling procedure made no significant difference in the tested conventional/bulk-fill/bulk-fill flowable/fiber-reinforced resin composites’ cuspal deflection.

Background: Microleakage is one of the major causes of endodontic treatment failure. Many microleakage testing techniques have been introduced through the years, but there has been no agreement as to which technique gives the most accurate results. The objective of this research was to assess the accuracy of fluid filtration when analyzing the apical sealing capability of the aggregate of mineral trioxide, Biodentine, and total putty. Materials and methods: A sample of 40 human central incisors was collected. The samples were decoronated at cementoenamel junction followed by preparing the canal up to size 80. Using the lateral compaction method, the obturation was done with AH plus sealer. The apical 3 mm root was resected after which ultrasonic retro tips have been utilized to make the retrograde preparation. Apical microleakage evaluation for each of the specimens was performed utilizing the fluid filtration method at specific time intervals, i.e., immediate, 1 week, 1 month, 3 months, and 6 months. Results: The outcomes of the current study inferred that MTA revealed better apical sealing properties than that of Biodentine and total putty. Overall, comparative analysis of microleakage immediately and post restoration at different time intervals was done using one-way ANOVA ‘F’ test that was highly significant, p <0.001. Pairwise comparison was done using Tukey's post-hoc test p <0.001. Conclusion: Thus, the results of the present study conclude that MTA with its superior sealing ability might provide long-term sealing benefits to the root canal system than that of Biodentine and total putty. Key message: In this study, MTA has shown a better long-term sealing ability as compared to Biodentine and total putty. In a surgically attempt to repair the tooth, it is necessary to select a material with promising long-term sealing ability, MTA as a root-end filling material can be suggested as a better alternative to the other bioactive materials.

Aim: This case report presents an overview of clinical presentation, diagnosis, and non-surgical endodontic management of a cracked tooth. Background: The cracked tooth is a distinct type of longitudinal tooth fracture. Clinical diagnosis is difficult because the signs and symptoms are variable. Timely and proper management of cracked teeth is necessary to save the tooth. Case description: A 67-year-old male patient reported pain in the upper left back tooth. On examination tooth-26 presented with a crack line in the palatal aspect. The case was diagnosed as pulp necrosis with symptomatic apical periodontitis in relation to 26 due to crack. The case was managed by sealing of crack, banding of the tooth, nonsurgical endodontic treatment, and a full metal crown. Conclusion: Treatment of cracked tooth depends on the position and extent of the crack. Management options vary from routine monitoring, occlusal adjustments, placement of a cast restoration, and endodontic treatment. This case report presents a successful management of a cracked tooth by combined use of restorative sealing of crack, banding of the tooth to prevent further crack propagation, followed by endodontic and prosthodontic intervention. Clinical significance: Cracks can act as a pathway for the bacterial penetration which has the potential to cause pulpal and periapical pathology. They should be addressed both biologically and mechanically for the successful management. Early diagnosis and appropriate treatment plans are equally important.