Aim: The present study aimed to compare the remaining dentin thickness (RDT) and fracture resistance of conventional and conservative access and biomechanical preparation in molars using cone-beam computed tomography (CBCT). Methodology: A total of 60 freshly extracted human molars were selected and were randomly divided into two groups of conventional and conservative access preparation group (n = 30). Samples were subjected to pre-CBCT scan at the pericervical region for the measurement of total dentin thickness. For the conventional group, samples were accessed and biomechanical preparation was done using K3 XF file. For conservative group, samples were accessed using CK microendodontic burs using a dental operating microscope and biomechanical preparation was done using self-adjusting file. After obturation and postobturation with nanohybrid composite restoration, samples of both groups were subjected to post-CBCT scan at pericervical region for the measurement of RDT. The samples were then loaded to fracture in the Instron Universal Testing Machine, and the data were analyzed using paired sample t-test and independent sample t-test. Results: The mean RDT was less in conventional group than conservative group. Pericervical dentin was preserved more in conservative group. The statistical difference among both the experimental group was highly significant (<0.001). The mean load at fracture was less in conventional group than conservative group (<0.001). Conclusion: Coronal dentin was conserved in molars when accessed through conservative than through conventional. The dentin conservation afforded an increased resistance to fracture in conservative group which is doubled the fracture resistance in conventional group.

The aim of this study was to compare and evaluate the clinical performance of nanohybrid composite with Activa™ bioactive composites in Class II carious lesion. After ethical approval, patients were selected according to the inclusion-exclusion criteria with minimum of two carious lesions in a single patient. Lesions were randomly divided into two groups: Group A – nanohybrid composite and Group B – Activa™ bioactive composite. After administration of local anesthetic agent, Class II cavity preparation was done followed by rubber dam application. For deep lesion, pulp protection was done with light-cured calcium hydroxide. Then, the cavities were restored. Finishing and polishing were done. Evaluation of the restorations was done at 1 week, 6 months, and 1 year time interval by second-blinded examiner according to the modified USPHS criteria. The results of the study were tabulated, and statistical analysis was done. The results showed no statistically significant difference in the clinical performance of nanohybrid composite and Activa™ bioactive composites in Class II carious lesions at the end of 1 week, 6 months, and 1 year. It can be concluded that both materials showed equal and acceptable clinical performance at the end of 1 year. Both materials can be successfully be used to restore Class II carious lesions.

Background: The present study was undertaken to evaluate the most suitable restorative for badly mutilated endodontically treated teeth. Aims: To evaluate and compare the fracture resistance of endodontically treated premolars restored with conventional nanohybrid, silorane composite with glass fibers and newer fiber-reinforced composite in mesio-occluso-distal (MOD) cavities. Materials and Methods: Sixty extracted human maxillary premolars were selected. Fifteen intact teeth served as positive controls (Group 1). Endodontic therapy was done in the remaining 45 teeth. MOD cavities were prepared in all the teeth with standardized dimensions and were randomly divided into three groups (Group 2 - nanohybrid + glass fibers, Group 3 - silorane + glass fibers, and Group 4 – fiber-reinforced composite). Restorations were done for all groups. Fracture resistance was measured by Instron universal testing machine. Statistical Analysis Used: One-way anova test and Tukey's post hoc test. Results: Highest fracture resistance was shown by intact teeth group followed by fiber-reinforced composite, nanohybrid, and silorane, respectively. Statistically Significant difference was revealed by anova test (P < 0.0001) and Tukey's post hoc test (P < 0.0001). Conclusions: Among the experimental groups, fiber-reinforced composite showed the highest fracture resistance. Statistically significant difference was observed for all the groups.

The aim of endodontic therapy is to use various antimicrobial medications for proper cleaning and shaping to create an environment free of microorganisms by eradicating as many as possible from the root canal space. Even although it is a gold standard irrigant, sodium hypochlorite (NaOCl) is known for its cytotoxic effects on vital periapical tissues, making its higher concentrations inappropriate for use in conditions such as wide, underdeveloped, or damaged apices and in cases of perforations. Consequently, if it is ascertained that a gel form of sodium hypochlorite has equivalent antibacterial activity to the aqueous solution form, it could be employed in such situations. The aim of this study was the microbiologic evaluation of 5.25% sodium hypochlorite gel and aqueous solution as root canal disinfectants in multirooted teeth with primary endodontic lesions. Following ethical approval and CTRI registration, 42 patients who gave their consent and had multirooted teeth with pulpal necrosis and asymptomatic apical periodontitis were considered for the study. Following the opening of the access, pre-endodontic build up in case of class-II cavities and working length determination, a pre-operative sample (S1), which was regarded as the pre-operative microbial load of that canal, was acquired from the largest canal using a sterile paper point while maintaining strict isolation and disinfection. The computer randomization approach was used to divide the teeth into two groups at random just before beginning of chemo-mechanical preparation: Group A (n = 21)—canal disinfection with 5.25% sodium hypochlorite gel; Group B (n = 21)—canal disinfection with 5.25% sodium hypochlorite aqueous solution. Following the canal disinfection, a post-operative (S2) sample which was regarded as the postoperative microbial load of that canal was collected from the same canal using a sterile paper point. The Colony-Forming Units (CFUs) for the S1 and S2 samples were determined after 48 h aerobic incubation on Brain Heart Infusion (BHI) agar plates. The patients and the microbiologist were blinded throughout the procedure. Using SPSS 20.0 software (USA), the Shapiro–Wilk test and the Lilliefors Significance Correction were used for normality, followed by the Mann–Whitney U test which was used to compare the CFU difference (×10⁵) between the two groups. A p value of <0.05 was perceived as statistically significant. The mean colony-forming units count difference between the 5.25% sodium hypochlorite gel and aqueous solution groups did not differ in a manner that was statistically significant (p = 0.744). In multirooted teeth with primary endodontic lesions, the 5.25% sodium hypochlorite gel and the aqueous solution demonstrated comparable antimicrobial effectiveness when implemented as root canal disinfectants.

Aim: This study aimed to evaluate the stress distribution in an endodontically treated tooth restored with two different reinforcing fibers followed by direct composite restoration using a finite element analysis (FEA). Settings and Design: FEA. Subjects and Methods: Two three-dimensional models of endodontically treated maxillary central incisors were restored with two reinforcing fibers: the polyethylene fibers (PFs) and the short fiber-reinforced composite (SFRC), respectively. The restoration was carried out without any intraradicular preparation using direct composite restoration. The models were generated using SolidWorks. The elastic modulus and Poisson’s ratio for various structures and materials were installed into the simulation software, Abaqus. A FEA was then conducted. Each model received a mixed-mode loading of 150 N as distributed pressure to the specified region, and stress distribution was evaluated using the von Mises criteria. Results: Both the reinforcing materials, PF and SRFC, showed maximum concentration of stresses in the cervical third of the tooth. The calculated values of the von Mises stresses for the PF and the SFRC models were 1.7 Mpa and 1.9 Mpa, respectively. Moreover, the stresses generated were of low intensity and were uniformly distributed, suggesting that by using this technique, stresses may be very well tolerated by the remaining tooth structure without any fracture. Conclusion: This no-posttechnique, using the two reinforcing fibers, showed minimal stress concentration in the cervical region of the tooth. Thus, using this ultraconservative approach that aims to preserve and reinforce the pericervical dentin and restore the remaining tooth structure with direct composite restoration could be a promising treatment option for the rehabilitation of badly mutilated teeth.

Aim: The aim of the study was to clinically evaluate the postoperative pain following use of cryotherapy in teeth with symptomatic irreversible pulpitis and symptomatic apical periodontitis after single‐visit-endodontics. Methods: After institutional ethical approval (SVIEC/ON/Dent/SRP/18115) and informed consent, a total of 120 patients were included as per inclusion and exclusion criteria. Patients with single-rooted, mature teeth having symptomatic irreversible pulpitis with symptomatic apical periodontitis were included in the study. All the enrolled individuals were randomly divided by computer randomization into two groups: Group A – normal saline (n = 60) and Group B – cryotherapy (n = 60). Endodontic access cavity along with cleaning and shaping was performed under isolation. In Group A, irrigation was done with normal saline for 5 min. In Group B, 2.5°C cold saline was used for 5 min. In both the groups, obturation and postendodontic restoration were performed at the same visit. An evaluation was done by the blinded evaluator using a modified Verbal Rating Scale at 24 h and 48 h. In this study, both patients and evaluators were blinded. Paired t-test and independent t-test were used with SPSS 18.0 version. P < 0.05 was considered statistically significant. Results: Both at 24 and 48 h, cryotherapy showed a highly statistically significant difference (P < 0.000) than normal saline irrigation in the reduction of postoperative pain after single-visit endodontic treatment. Conclusion: Final irrigation with 2.5°C cold saline can result in a significant reduction in postoperative pain as compared to that of normal saline after single-visit endodontics in single-rooted teeth with symptomatic irreversible pulpitis with symptomatic apical periodontitis.