Evaluation of conventional, protaper hand and protaper rotary instrumentation system for apical extrusion of debris, irrigants and bacteria- An in vitro randomized trial

Endodontic instrumentation carries the risk of over extrusion of debris and bacteria. The technique used and the type of instrumentation influences this risk. The purpose of this study was to evaluate and compare the K-file, ProTaper hand and ProTaper rotary instrumentation systems for the amount of apically extruded debris, irrigant solution and intracanal bacteria. Experimental single blinded randomized type of in vitro study with sample of 30 single rooted teeth. Endodontic access cavities were prepared and the root canals were filled with the suspension of E. faecalis. Myers and Montogomery Model was used to collect apically extruded debris and irrigant. Canals were prepared using K files, Hand protapers and Protaper rotary files. Non Parametric test like Kruskal-Wallis and Mann-Whitney U test were applied to determine the significant differences among the group. Tests revealed statistically significant difference between the amount of debris and number of bacteria extruded by the ProTaper hand and the K-files. No statistically significant difference was observed between the amounts of irrigant extruded by the ProTaper hand and the K-file system. Statistically significant differences were observed between the amounts of bacteria and irrigant extruded by the ProTaper rotary and the Protaper hand. No statistically significant difference was observed between the amounts of debris extruded by the ProTaper hand and the K-file system. Amount of apical extrusion of irrigant solution, bacteria and debris are significantly greater with K File instruments and least with Protaper rotary instruments

In vitro evaluation of probiotic strains for lactic acid production

The growing interest on usage of probiotic lactobacilli in maintaining oral health has posed number of questions on its probable side effects. One such consideration could be an increased acid production in dental plaque, in turn leading to dental caries. Thus, the aim of this study was to comparatively evaluate the lactic acid producing ability of L. acidophilus and L. plantarum with and without dental plaque. The study consisted of five groups: 3 control groups (Supragingival plaque, L. acidophilus and L. plantarum) and 2 test groups (Supragingival plaque with L. acidophilus and Supragingival plaque with L. plantarum). 26 samples for each group were collected and their baseline spectrophotometric values were recorded. The acid production was initiated by adding 25?l fructose (10%) and stopped by centrifugation for 2 min. The concentration of the lactic acid produced was determined with the aid of COBAS INTEGRA 400 plus. On comparison of Lactic Acid estimation in mg/dl, the mean values of Plaque group was the highest followed by Plaque +L acidophilus, Plaque +L plantarum, L acidophilus and least in L plantarum. The posthoc analysis shows that the comparison of Group 1 (Plaque) and Group 2 (Plaque +L acidophilus) is statistically Significant results between all the groups except between the Plaque +L acidophilus and Plaque +L plantarum group. The lactic acid producing ability of pure suspensions of L.acidophilus and L.plantarum and the lactic acid producing efficiency becomes more when they are added to the supragingival plaque

Organic antibacterial modifications of high-viscosity glass ionomer cement for atraumatic restorative treatment: A review

High viscosity glass ionomer cement (HVGIC) has been employed as a restorative material for Atraumatic Restorative Treatment (ART). As residual caries persist after caries removal in ART, the antibacterial activity of HVGIC gains importance. Organic and inorganic substances with antibacterial properties have been incorporated into HVGIC over the years, and their effects on the antibacterial and physical properties have been studied. The objective of this paper is to review the various alterations made to HVGIC using organic compounds, their effect on the antibacterial activity, and the physical properties of the cement. Various in vitro investigations have been conducted by adding antiseptics, antibiotics, and naturally occurring antibacterial substances. Most of these compounds render superior antibacterial properties to HVGIC, but higher concentrations affect physical properties in a dose-dependent manner. However, some naturally occurring antibacterial substances, such as chitosan, improve the physical properties of HVGIC, as they enhance cross-linking and polysalt bridging. There is potential for clinical benefits to be gained from the addition of organic antibacterial compounds to HVGIC. In-depth research is required to determine the optimum concentration at which the antibacterial effect is maximum without affecting the physical properties of the cement

Utility of knowledge, attitude, and practice survey, and prevalence of dental caries among 11- to 13-year-old children in an urban community in India

Background: The school oral health education program is believed to be a cost-effective method for promoting oral health. The KAP (knowledge–attitude–practice) model of oral health education is often the foundation of most health education programs. Objectives: To assess the existing knowledge, attitude, and oral health care practices among 11- to 13-year-old children and the association of knowledge with attitude, oral health care practices, and dental caries prevalence. Design: Cross-sectional design, involving 858 children studying in class seven at various schools in the city of Mangalore, India. The children were selected using stratified random sampling method. Prevalence of dental caries was determined using decayed, missing, and filled permanent teeth (DMFT) index. A self-administered questionnaire on self-care practices in oral health, knowledge, and attitude toward oral health care was filled by children. The association of different variables with knowledge was analyzed using binary logistic regression analysis. Results: The dental caries prevalence was 59.4%, and 54.5% had low knowledge. They lacked knowledge regarding use of fluoridated toothpaste and did not use them. Children with low knowledge had significantly higher odds of having DMFT ≥ 1, not using fluoridated toothpaste, and being afraid of going to the dentist due to possible pain. There was no association of other oral health care practices and attitudes with knowledge. Conclusion: Oral health care practices and attitudes are not fully explained by knowledge, and other models of health education need to be considered

Ethanolic extracts of Aloe vera and propolis as cavity disinfectants: An in vitro study

Introduction: Though a large number of agents including chlorhexidine have been used for cavity disinfection during restorative procedures, till date none has proved to be "ideal." Thus, there is a need for an alternative cavity disinfectant, which is safe, effective, and economic. Herbal extracts of Aloe vera and propolis have shown the potential to be used as cavity disinfectants but not much is known about them. The aim of this study was to evaluate and compare the antibacterial activity of ethanolic extracts of Aloe vera and propolis against S. mutans and L. acidophilus, along with assessing the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Materials and Methods: The study included three groups: 2% chlorhexidine solution (group I), ethanolic extract of Aloe vera (group II), and ethanolic extract of propolis (group III). An MIC test was carried out using tissue culture microplates and serial dilution technique and later to MBC, an aliquot of each incubated well with concentrations higher than MIC was subcultured on brain heart infusion (BHI) medium. Antibacterial assay was carried out using agar disk diffusion technique and zones of inhibition were determined. One-way analysis of variance (ANOVA) was used for intergroup comparison followed by post hoc Tukey′s test for groupwise comparison. Results: Group II and Group III showed bacteriostatic effect but no bactericidal effect against both S. mutans and L. acidophilus. There was a significant difference in the antibacterial activity against both the tested microorganisms among all the groups, the highest being in group I followed by group II and group III. Conclusions: Ethanolic extracts of Aloe vera and propolis are only bacteriostatic and their antibacterial efficacy is inferior to chlorhexidine against both S. mutans and L. acidophilus

Preventing early childhood caries through oral health promotion and a basic package for oral care: A pragmatic trial

Introduction: Untreated caries in mothers is one of the common risk factors for early childhood caries (ECC). Aim: The aim of the study was to investigate the impact of an oral health promotion program on ECC. Methodology: We conducted a pragmatic trial at 12 primary health centers in a rural community of India with 311 pregnant women using fluoride toothpaste, oral health information through pamphlets, and referral to urgent dental care or atraumatic dental treatment as the test intervention. Data were collected through structured interviews at baseline and oral examination of the children at 2 years of age. Results: Of the 311 women who participated, 274 children were followed up with at 2 years of age. ECC was low and comparable in both groups. When compared with the control group, significantly, more children from the intervention group were breastfed for over 6 months of age (P = 0.012) and consumed less sugar (P < 0.001). The number of mothers' decayed teeth (P = 0.01), children's sweet scores (P < 0.001), and the age at which brushing commenced for children (P = 0.04) increased the likelihood of tooth decay in children. Conclusion: The oral health promotion program had some beneficial effects in preventing caries in children when provided to pregnant women

Remineralizing effectiveness of calcium sucrose phosphate and fluoride dentifrices: An In vitro study

Context: Dentifrices-containing remineralizing agents are known to be effective in remineralization of early enamel lesions. Aims: This study aimed to compare and evaluate the changes in surface roughness, surface morphology, and mineral content of demineralized enamel lesion after treatment with dentifrices-containing sodium monofluorophosphate, amine fluoride, and Anticay® (calcium sucrose phosphate with inorganic amorphous calcium phosphate). Settings and Design: This was an in vitro study. Subjects and Methods: Eighteen extracted maxillary molars were decoronated and sectioned into four to obtain 72 specimens. Specimens were demineralized and randomly divided into four different test groups: Group A: no treatment (control), Group B: sodium monofluorophosphate dentifrice (Colgate), Group C: amine fluoride dentifrice (Amflor), Group D: Anticay® dentifrice (EnaFix) and subjected to pH-cycling for 4 weeks. After 4 weeks, they were assessed using a profi lometer and scanning electron microscope (SEM)-energy dispersive X-ray analysis (EDAX) for changes in surface roughness, surface morphology, and mineral content. Statistical Analysis Used: Intergroup comparison was done using repeated measures ANOVA. Results: Intergroup comparison revealed no significant difference in surface roughness and mineral content after remineralization between the groups. SEM images showed mineral deposition in all the dentifrice groups obliterating the defects caused due to demineralization. Conclusions: Sodium monofluorophosphate, amine fluoride-containing dentifrices, and calcium sucrose phosphate with inorganic amorphous calcium phosphate-containing dentifrice were found equivocal in their remineralizing effectiveness of early enamel lesions