Evaluation of salivary parameters and dental status in adult hemodialysis patients in an indian population

Renal failure is a process that expresses a loss of functional capacity of the nephrons, independently of its etiology. The most widely used technique to combat renal failure is hemodialysis. Renal failure causes various systemic alterations including oral complications such as variations in the flow and composition of the saliva. Caries is a multifactorial disease and impaired stimulated salivary flow rate and buffering capacity are the best-known risk factors. The present study aims to evaluate the salivary pH, buffering capacity and the flow rate of saliva to the DMFT status in adult hemodialysis patients among the Indian population. Twenty healthy individuals and sixty patients undergoing hemodialysis were divided into four groups based on the following criteria: Group 1: Control group; healthy individuals,Group 2: Patients before undergoing dialysis or undergoing dialysis2 years. Dental examinations were performed according to the modified WHO oral health survey 2013 criteria and DMFT index. Saliva was collected after pre-stimulation to measuring the flow rate, buffering capacity and pH. The results exhibited a decrease in the salivary flow rate and buffering capacity with the increase in the time interval of hemodialysis, but salivary pH was found to be increasing with time. A direct relationship was seen between the DMFT scores with the increasing time interval. There was a significant correlation between DMFT index, stimulated salivary flow rate, and buffering capacity in the patients. Oral health impairment can beacon to grave problems in infection-prone hemodialysis patients. Hence, the patients on hemodialysis should have regular dental examinations and treatment. Regular dental examination and instruction in patients awaiting a renal transplantation is of vital importance to ensure optimal oral health

Cyclic Fatigue Resistance and Surface Roughness of Rotary NiTi Instruments after Simulated Clinical Use in Curved Root Canals – An Atomic Force Microscopy Study

Objective: To examine the cyclic fatigue resistance and surface topography of TruNatomy and ProTaper Gold nickel-titanium rotary files and evaluate the presence of alterations to surface topography following instrumentation in simulated curved canals. Material and Methods: Twenty-four nickel-titanium instruments, twelve each of TN and PTG file systems, were evaluated for cyclic fatigue resistance. The rotary files were rotated in a simulated root canal with standardized diameter, angle of curvature, and radius of curvature in a custom-made cyclic fatigue testing device until the instrument fracture occurred. The time to fracture for each instrument was recorded with a stopwatch; in seconds in each group. Fractured instruments were subjected to atomic force microscopy analysis measuring the average roughness and the root mean square values to investigate surface features of endodontic files. Mean values and standard deviation were calculated. Data were analyzed using the Mann-Whitney U test. Results: Time to fracture was marginally higher in PTG instruments than in the TN file systems. PTG files exhibited higher surface roughness when compared with TN files (p<0.05). Conclusion: TN file system had a higher cyclic fatigue resistance than PTG. Cyclic fatigue causing file breakage did affect the surface topography of the files. PTG files showed a higher surface porosity value than the TN files

Cyclic Fatigue Resistance and Surface Roughness of Rotary NiTi Instruments after Simulated Clinical Use in Curved Root Canals – An Atomic Force Microscopy Study

Objective: To examine the cyclic fatigue resistance and surface topography of TruNatomy and ProTaper Gold nickel-titanium rotary files and evaluate the presence of alterations to surface topography following instrumentation in simulated curved canals. Material and Methods: Twenty-four nickel-titanium instruments, twelve each of TN and PTG file systems, were evaluated for cyclic fatigue resistance. The rotary files were rotated in a simulated root canal with standardized diameter, angle of curvature, and radius of curvature in a custom-made cyclic fatigue testing device until the instrument fracture occurred. The time to fracture for each instrument was recorded with a stopwatch; in seconds in each group. Fractured instruments were subjected to atomic force microscopy analysis measuring the average roughness and the root mean square values to investigate surface features of endodontic files. Mean values and standard deviation were calculated. Data were analyzed using the Mann-Whitney U test. Results: Time to fracture was marginally higher in PTG instruments than in the TN file systems. PTG files exhibited higher surface roughness when compared with TN files (p<0.05). Conclusion: TN file system had a higher cyclic fatigue resistance than PTG. Cyclic fatigue causing file breakage did affect the surface topography of the files. PTG files showed a higher surface porosity value than the TN files

Efficiency of a semiconductor diode laser in disinfection of the root canal system in endodontics: An in vitro study

Context: The success of endodontic treatment depends on the eradication of microbes from the rootcanal system and prevention of reinfection. The root canal is shaped with hand and rotary instruments under constant irrigation to remove the inflamed and necrotic tissue, microbes/biofilms, and other debris from the root canal space. The main goal of instrumentation is to facilitate effective irrigation, disinfection, and filling. Throughout the history of endodontics, endeavors have continuously been made to develop more effective irrigant delivery and agitation systems for root canal irrigation. Aim: The purpose of this study was to evaluate the efficacy of three different newer irrigation delivery techniques; namely Endovac, Stropko Irrigator, and laser disinfection with 5.25% sodium hypochlorite. Materials and Methods: Forty teeth after disinfection by Occupational Safety and Health Administration (OSHA) regulations were instrumented and inoculated with bacterial strains of Enterococcusfaecalis. The teeth were divided into four groups, in the experimental group, the irrigants were delivered with the Endovac, Stropko Irrigator, and laser irradiation and the control group which received no irrigation. The samples were incubated in Muller-Hilton media plates and incubated for 24 h. Statistical analysis used: The colony forming units were determined and statistically analyzed using the chi-square test. Results: According to the results obtained, laser irradiation resulted in complete disinfection of the root canal system. The Endovac system resulted in significant disinfection as compared to the Stropko Irrigator system. Conclusion: Laser irradiation resulted in significantly higher antimicrobial effects compared with the Endovac and Stropko irrigation groups when in conjunction with sodium hypochlorit

Role of oral microbiota in irreversible pulpitis - Current strategies and future perspectives

Irreversible pulpitis is an inflammation of the tooth pulp caused by an opportunity-driven invasion of the pulp space by oral microbiota typically prevalent in the oral cavity. Microbial organisms are extensively recognised to be the fundamental cause of endodontic infections and treatment failures. Previously, bacterial species responsible for these infections were largely recognised using conventional microbial culture techniques, lending credence to the widely held belief that anaerobic Gram-negative bacteria frequently enter the pulp space and trigger endodontic infections. The advent of novel technologies grants the advantage of detecting and studying microbial populations via an amalgamation of the modern "Omics" techniques and meticulous bioinformatics analysis, additionally detecting the metatranscriptome, metaproteome and metabolome along with the metagenome. Amongst these analytical strategies, metagenomic analyses are essentially pragmatic for investigating the oral microbiome. Metagenomics favor not only assessment of microbial composition in diseased conditions, but also contributes to detection of novel, potentially pathogenic species inclusive of non-viable bacteria. The present review describes current knowledge of root canal microbiome, including its composition and functional attributes, the novel strategies available for detection of microbiome as well as challenges associated and provides some crucial pointers for areas of future research