MTA - The Barrier for Endodontic Success!

The elimination of microbiological colonization in any parts of human body is a crucial principle of treating infection  and root canal system is no exception. The major challenges associated with endodontic treatment of teeth with open apices are achieving complete debridement, canal disinfection and optimal sealing of the root canal system.In the absence of a natural apical constriction, the production of mineralized tissue in the apical region is important to create an apical barrier and allow 3-dimensional adaptation of obturating material within the root canal system.A clinical case of central incisor have been treated with the use of an apical plug of MTA for apexification that had suffered premature interruption of root development as a consequence of trauma.The remaining portion of the root canals was then closed with thermoplasticized gutta-percha. At 6-month follow-up period the clinical and radiographic appearance of the tooth showed resolution of the periapical lesions

Conservative Bridge with Natural Tooth Pontic: A Case Report

AIMS AND OBJECTIVES A CONSERVATIVE SOLUTION FOR AN ESTHETIC CHALLANGE PROVIDING SINGLE VISIT AND A CHAIR SIDE PROCEDURE TO IMPROVE A SMILE   CASE DISCRIPTION Conservative solutions  for the restoration of a single edentulous space in the anterior maxilla present an esthetic challenge to the clinician.A 24-year-old female patient whose left upper central tooth was planned to be extracted was referred to our department for a conservative, rapid, and economic treatment.After radiographic and clinical examinations, it was decided that the tooth which was to be extracted should be used for the restoration of its own extracted area. The extracted tooth was splinted using Ribbond fiber (Ribbond Inc., Seattle WA) to adjacent teeth with the aid of the surface modifications on extracted tooth and adjacent teeth . CONCLUSION  The conservative bridge with natural tooth pontic satisfied the patient with a good mechanical behavior, and long-term durability. &nbsp

Comparative Evaluation of Fracture Resistance of Simulated Immature Teeth Restored with Glass Fiber Posts, Intracanal Composite Resin, and Experimental Dentine Posts

Aim. The aim of this study was to compare the fracture resistance of simulated immature teeth restored with gutta-percha, glass fiber posts (GFP), experimental dentine posts (DP) or Intracanal composite Resin (ICR). Materials and Methods. Fifty maxillary canines were decoronated, standardized and enlarged until, number 5 Peeso reamers were allowed to simulate immature teeth. After placement of 5 mm of MTA, the canals were divided into 5 groups and filled as follows: Group 1: AH Plus + gutta-percha, lateral compaction; Group 2: GFP luted with PARACORE dual cure resin; Group 3: DP luted with PARACORE dual cure resin; Group 4: PARACORE dual cure resin. A standardized core was built in all groups except in Group 5. Each of the specimens was tested for fracture resistance by universal testing machine. Results. The mean fracture resistance were 817 ± 27.753, 1164.6 ± 21.624, 994.4 ± 96.8747, 873.8 ± 105.446 and 493.7 ± 6.945 newtons for Groups 1, 2, 3, 4, and 5 respectively. Independent " " test revealed statistically significant discrepancies, in the fracture resistance among the 4 groups except Group 1 and Group 4 ( < 0.05). Conclusions. This study suggests that GFP and DP may be preferred for additional reinforcement of immature teeth

The genetic architecture of type 2 diabetes

The genetic architecture of common traits, including the number, frequency, and effect sizes of inherited variants that contribute to individual risk, has been long debated. Genome-wide association studies have identified scores of common variants associated with type 2 diabetes, but in aggregate, these explain only a fraction of heritability. To test the hypothesis that lower-frequency variants explain much of the remainder, the GoT2D and T2D-GENES consortia performed whole genome sequencing in 2,657 Europeans with and without diabetes, and exome sequencing in a total of 12,940 subjects from five ancestral groups. To increase statistical power, we expanded sample size via genotyping and imputation in a further 111,548 subjects. Variants associated with type 2 diabetes after sequencing were overwhelmingly common and most fell within regions previously identified by genome-wide association studies. Comprehensive enumeration of sequence variation is necessary to identify functional alleles that provide important clues to disease pathophysiology, but large-scale sequencing does not support a major role for lower-frequency variants in predisposition to type 2 diabetes

Comparative evaluation of bond strength of three contemporary self-etch adhesives: An ex vivo study

Aim: This study evaluated the effect of 2-hydroxymethyl methacrylate (HEMA) and the type of solvent on the tensile bond strength of the following three self-etch adhesives: Adper easy one (HEMA-rich adhesive) which contained ethanol, G-Bond (HEMA-free adhesive) which contained acetone, and Xeno V (HEMA-free adhesive) which contained butanol as a solvent. Material and Methods: Intact mandibular molars were mounted in self-cured resin and the occlusal surfaces were ground with # 600 SiC paper. Adhesives were applied on the prepared dentinal surfaces and the resin composite was condensed in the split brass mold (5 × 3 mm) placed over the adhesive surface. The specimens were stored in normal saline and placed in incubator at 37°C. After 24 hours, the specimens were tested in tensile mode at a crosshead speed of 1 mm/min. Statistical analysis was done using One way ANOVA and Tukey′s HSD test. Results: The mean bond strengths of Adper easy one, G-Bond, and Xeno V were 12.41 MPa, 10.09 MPa, and 8.67 MPa, respectively. Conclusions: Comparison of contemporary adhesives in this ex vivo study revealed that the ethanol-based HEMA-rich self-etch adhesive is better than HEMA-free self-etch adhesive that contained acetone and butanol as the solvents, when compared in terms of bond strength

Corelation between Machines Assisted Endodontic Irrigant Agitation and Apical Extrusion of Debris and Irrigant: A Laboratory Study

Aims. To compare amount of root canal debris and irrigant extruded apically after irrigants agitation using closed and open chambers. Methods and Material. Sixty maxillary central incisors were selected, decoronated, and mounted in preweighed glass vials filled with distilled water. Biomechanical preparation was completed using ProTaper rotary files until number F4 and 1 mL of 3% NaOCl solution after each file use. Samples were randomly divided into closed or open chamber sets which were further subdivided into 6 groups, based on the agitation techniques: no agitation (control), canalBrush, lentulospiral, passive ultrasonic agitation (PUA), EndoActivator, and EndoVac. Canals were irrigated with 1 mL of 17% EDTA and agitated for 30 s and then flushed with 2 mL of distilled water. Apically extruded irrigant was measured and vials were kept in incubator for 5 days at 68°C for drying for weight calculation. Statistical Analysis. Analysis was done using Student’s t-test, one-way ANOVA, and post-hoc. Results. All agitation techniques showed apical extrusion of the debris and irrigant. The closed chamber apparatus showed significantly less extrusion of debris and irrigant than open chamber (P<0.05). Conclusions. EndoVac was found to be the safest agitation system among all test groups with regard to apical extrusion of debris and irrigant

Diastema Closure in Anterior Teeth Using a Posterior Matrix

Presence of diastema between anterior teeth is often considered an onerous esthetic problem. Various treatment modalities are available for diastema closure. However, not all diastemas can be treated the same in terms of modality or timing. The extent and the etiology of the diastema must be properly evaluated. Proper case selection is of paramount importance for a successful treatment. In this case report, diastema closure was performed with direct composite restorations. One bottle etch-and-rinse adhesive was used and a single shade was used to close the diastemas. Contoured sectional posterior matrix was used to achieve anatomic contouring of the proximal surfaces of the teeth. This was followed by finishing and polishing using polishing discs. Patient was kept on recall every 6 months. Conclusion. Diastema closure with correct anatomic contouring is easy to perform using the contoured sectional matrices. At 14-month recall, no clinical signs of failure like discoloration or fracture were evident. Also, patient did not complain of any sensitivity. Thus, direct composite restorations serve as durable and highly esthetic restorations leading to complete patient satisfaction

Three distal root canals in mandibular first molar with different canal configurations: Report of two cases and literature review

With the increasing number of reports of aberrant root canal morphology, the clinician needs to be aware of the variable anatomy. Various case reports have been published with the finding of middle mesial canal in mandibular first molar, however finding of three distal canals in distal roots of mandibular first molar is rare. This article reports endodontic management of two mandibular first molars presented with three distal canals present in a single distal root (Sert and Bayirli type XVIII) and distal and distolingual root