Context: Effective use of nonthermal atmospheric plasma (NTAP) to strengthen adhesive–dentin interfacial bonding while disinfecting with chlorhexidine (CHX). Aim: NTAP application at different time intervals on the dentinal shear bond strength (SBS) after pretreatment with 2% CHX as a cavity disinfectant. Settings and Design: The design of the study was an in vitro study. Materials and Methods: Forty permanent mandibular teeth were collected (n = 40) and the occlusal surfaces were flattened. For, all the specimens 37% phosphoric acid etching was done followed by pretreatment with 2% CHX as cavity disinfectant for 5 s. According to the surface treatment, divided into four groups of n = 10. Group I (Control): No NTAP pretreatment was done. Group II: NTAP pretreatment done for 15 s. Group III: NTAP pretreatment done for 30 s. Group IV: NTAP pretreatment done for 45 s. Later, all the specimens were treated with a bonding agent, incremental build-up of composite resin on the dentin surface was done and evaluation of SBS was done. Analyzed using One-way analysis of variance with a post hoc Tukey’s test (P < 0.05). Results: Two percent CHX pretreatment as cavity disinfectant followed by NTAP application for 30 s (Group III) exhibited greater values compared to the control group (Group I). Conclusion: Two percent CHX pretreatment as cavity disinfectant followed by NTAP pretreatment for 30 s was found to exhibit better bond strength values compared to 15 s as well as 45 s.

Objective: The objective of the study was to assess the shear bond strength of bulk-fill flowable composite resin smart dentin replacement plus when bonded to mineral trioxide aggregate (MTA)-angelus, biodentine, and calcium-enriched mixture (CEM) at two different aging periods (15 min and 72 h) using three distinct adhesive systems. In addition, the study identified the specific modes of failure (adhesive, cohesive, or mixed) using a stereomicroscope and scanning electron microscope. Materials and Methods: One hundred and twenty-six cylindrical acrylic blocks used in the study were sorted into three groups based on the bioactive substance used to fill the 3-mm diameter and 3-mm high hole in the center of each block. The groups were MTA, Biodentine, and CEM. The specimens were then divided into subgroups based on the aging interval (15 min and 72 h) of the bioactive material and the adhesive system used (two-step total-etch, two-step self-etch [SE], and one-step SE) while bonding to the restorative bulk-fill flowable composite. The shear bond strength values were measured with a universal testing machine, and the data were analyzed using two-way and one-way analysis of variance, followed by a post hoc test. The specimens were assessed under stereomicroscope and scanning electron microscope to characterize the mode of bond failure (cohesive, adhesive, or mixed). Results: The study showed that the type of adhesive system and the time of bonding affected the shear bond strength of bulk-fill composite to the pulp capping agents (P < 0.05). For MTA, the highest bond strength was observed with two-step SE group at 15 min (18.16 ± 2.97 MPa) (P < 0.05). CEM exhibited the highest bond strength with two-step SE group at 72 h intervals (8.77 ± 1.76) (P < 0.05). The highest bond strength for biodentine group was observed with total-etch group (8.54 ± 1.35 Mpa) and two-step SE (8.19 ± 1.94 Mpa) bonded at 72 h interval (P < 0.05). The majority of the samples in the MTA group (29/42) and CEM group (20/42) showed a cohesive fracture, whereas Biodentine group (22/42) had an adhesive fracture in most of its samples. Conclusion: MTA demonstrated the highest bond strength with two-step SE group at 15 min, and CEM exhibited the highest bond strength with two-step SE groups at 72 h interval. For biodentine group, the type of adhesive used did not impact the bond strength values.

Aim: The aim of the study was to assess and evaluate the antimicrobial effectiveness of chitosan nanoparticles (CSNPs) with calcium hydroxide in the elimination of Enterococcus faecalis. Materials and Methods: Using the broth microdilution method, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of calcium hydroxide and CSNPs were measured. The antibiofilm effect of calcium hydroxide and CSNPs against E. faecalis biofilm was qualitatively analyzed using a crystal violet assay. A 7-day-old biofilms of E. faecalis grown on dentine discs were assigned to the following three groups (n = 11 dentine discs), normal saline (group I), calcium hydroxide (group II), and CSNPs (group III). Quantification of live and dead cells using confocal microscopy was done to evaluate the antibiofilm efficacy of the medicaments included in the study. Results: MIC of calcium hydroxide and CSNPs against E. faecalis was observed at 2.5 mg/mL and 0.31 mg/mL, respectively. MBC of calcium hydroxide and CSNPs was observed at 2.5 mg/mL and 0.31 mg/mL, respectively. Using Crystal Violet (CV) assay, calcium hydroxide and CSNPs showed biofilm inhibition at concentrations of 2.5 mg/mL and 0.625 mg/mL, respectively. Confocal laser scanning microscopy analysis found that both calcium hydroxide and CSNPs showed a significant decrease in viable cells at their MBC values compared to the control group’s normal saline. CSNPs showed a significantly lower percentage of live cells than calcium hydroxide (P < 0.05). Conclusion: The study results reveal that the antimicrobial efficacy of CSNPs is better than calcium hydroxide and normal saline against E. faecalis biofilm.

Context: One of the crucial steps in endodontic treatment is determining the working length (WL). There are various methods for performing this procedure, one of which is an electronic apex locator (EAL) measurement. Aims: The aim of this study was to determine the accuracy of six EALs, i.e.. Root ZX, Root ZX Mini, Propex PiXi, Innvopex-1, Woodpex III, and Raypex 6 for WL estimation in the mandibular first molars. Material and Method: The study included 180 root canals with symptomatic irreversible pulpitis, divided into six groups using different apex locators. WL determination was compared with intraoral periapical radiographs. Results were categorized as accurate, short, or long. The data were statistically analyzed. Results: ROOT ZX had an accuracy of 96.7%, Root ZX Mini had an accuracy of 93.3%, PiXi had an accuracy of 90.0%, Innvopex-1 had an accuracy of 90.0%, Woodpex III had an accuracy of 86.7%, and Raypex 6 had an accuracy of 83.4%, respectively. There was a statistically nonsignificant difference between groups (P < 0.05). Conclusion: Newly developed apex locators, such as the Innvopex-1, have shown accuracy comparable to well-established EALs like the Root ZX. This highlights the importance of conducting more extensive, large-scale research to confirm and validate their effectiveness.

Aim: The aim is to evaluate the anatomical characteristics of mesiolingual and mesiobuccal canals in mandibular second molars particularly in terms of its exit direction, distance of confluence from the minor constriction, and the angle of confluence. Materials and Methods: The cone-beam computed tomography images of hundred mandibular second molars were analyzed. Endodontically treated teeth and those with anatomical variations such as C-shaped canal configuration were excluded from this study. The distance of the confluence from the minor constriction, angle of confluence, and the exit direction of the mesiobuccal and the mesiolingual canals were assessed. Data were analyzed using an independent t-test. Results: The course of the mesiobuccal and mesiolingual canals beyond the confluence was towards the center of the root. The average angle of confluence was 32.75°–35.28°. The average distance of confluence from the minor constriction was 2.19 to 2.68 mm. The mesiolingual canal was straighter whereas the mesiobuccal canal had a tortuous course. Considering the results of the present study, a new classification has been proposed for the root canal morphology of the mesial root of mandibular second molars. Conclusion: The variation in the morphology of mandibular second molars highlights that the mesiolingual canal presented a mild curvature through and beyond the confluence when compared to the mesiobuccal canal which exhibited a tortuous course through the confluence.

Context: The main objective of endodontic therapy is to achieve a sterile environment and three-dimensional filling of the root canals. Endodontic sealers play an important role in the obturation of the root canal system as they may provide a seal, which prevents the penetration of bacteria. Sealers are meant to entomb residual bacteria, prevent leakage of nutrients, and ideally possess antibacterial properties. Aim: The aim of the study was to evaluate and compare the antimicrobial effectiveness of calcium silicate-based bioceramic root canal sealers against Enterococcus faecalis and Staphylococcus aureus using the agar diffusion method. Materials and Methods: The materials were divided into four groups of nine samples each for both E. faecalis and S. aureus. Group I (control group) – MTA-Fillapex (Angelus), Group II – BioRoot RCS (Septodont), Group III – Bio-C Sealer (Angelus), and Group IV – Dia-Root Bio Sealer (Diadent). To evaluate the antibacterial activity of the samples, the agar diffusion method was utilized. To begin, a bacterial suspension was evenly spread onto sterile Petri dishes using sterile swabs. Four wells of 4 mm diameter were then punched, and the sealers were mixed following the manufacturer’s instructions and placed onto the prepared wells. The Petri dishes were then incubated at 37°C for 72 h. After incubation, the zones of inhibition around each well were measured at 24 h, 48 h, and 72 h, and the resulting values were statistically analyzed. Statistical Analysis Used: The data were analyzed using the ANOVA and post hoc Tukey’s test. Results: Calcium silicate-based root canal sealers showed significantly better efficacy than the control group. BioRoot RCS (3.44 ± 1.13 mm) showed maximum antibacterial effect against E. faecalis at 24 h, 48 h, and 72 h time intervals. Bio-C Sealer (16.44 ± 1.42 mm) showed maximum antibacterial effect against S. aureus at 24 h, 48 h, and 72 h time intervals. The effectiveness of root canal sealants eventually decreased over a period. Based on analysis using the ANOVA test, a statistically significant difference (P ≤ 0.05) was observed between the mean values of antimicrobial efficacy of sealers against both E. faeca lis and S. aureus. Conclusions: The study’s findings lead to the conclusion that BioRoot RCS showed a maximum antibacterial effect against E . faecal is and Bio-C Sealer showed maximum antibacterial effect against S. aureus at 24 h, 48 h, and 72 h.

Context: The purpose of this article is to evaluate the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of Herbal Irrigants. Aim: The aim of the study was to evaluate MIC and MBC of herbal extracts of Azadirachta indica, Curcuma longa, and Green Tea Against Enterococcus faecalis. Methodology: The MIC and MBC of extracts of A . indica (neem), C. longa (turmeric), and Green Tea were evaluated to establish them as standard root canal irrigants against E. faecalis using agar well diffusion method. Statistical Analysis Used: The collected data were statistically analyzed using the Statistical Package for the Social Sciences (SPSS) software. Results: The present study found that green tea exhibited the most substantial antimicrobial activity among the tested herbal extracts, which was comparable to chlorhexidine. Although A. indica and C. longa required higher concentrations for effectiveness, their antimicrobial properties were also apparent. Conclusions: Within the constraints of this study, it can be concluded that green tea could be considered a promising alternative to chlorhexidine in treating endodontic infections due to its substantial antimicrobial activity against E. faecalis at lower concentrations.

Introduction: Endocrown preparation of endodontically treated teeth as final restoration has been extensively studied for different teeth. Bindl et al. questioned the application of endocrowns for premolars due to the pulp chamber space’s smaller dimensions, which diminish bonding surface area. The addition of ferrule into the endocrown preparations of premolars has not been extensively studied. Aims and Study Design: Comparative evaluation of incorporation of the ferrule in premolars endocrown designs to check any alterations in their fracture resistance. Materials and Methods: The sample consisted of 40 maxillary first premolars without cracks or caries, extracted for orthodontic or periodontal purposes. The teeth were individually mounted with cold-cure acrylic resin. Group A: Composite endocrown without ferrule and Group B: Composite endocrown with ferrule. An endocrown former was prepared with elastomeric polyvinyl siloxane material (GC Exaclear). Endocrowns were then prepared with dual-cure core build-up composite-Core-x flow (Dentsply Maillefer, Switzerland) using the endocrown former so that morphologically, they all were almost identical. Endocrowns are cemented by dual-cure resin cement following manufacturer instructions. The fracture resistance of endocrowns with and without ferrule was evaluated and compared. Results and Observations: The data were tabulated in Microsoft Excel and analyzed with SPSS version 24 software. The variables were presented with mean, standard deviation, and independent t-test. The P ≤ 0.05 is considered statistically significant. Group B (with ferrule) showed higher fracture resistance (622.06 N) than Group A (537.59 N) (without ferrule). Independent t-test showed that the difference was statistically significant (P = 0.008). Conclusion: Comparing the failure load findings, it could be concluded that ferrule-containing endocrown needed greater loads than ordinary endocrown restorations for failure.

This systematic review evaluated the role of Potassium-titanyl-phosphate (KTP) lasers in dental bleaching by comparing tooth color change and rise in intrapulpal temperature after bleaching with KTP, Neodymium-doped yttrium aluminum garnet (Nd:YAG), Er:YAG, and diode laser system. Following were the inclusion criteria: in vitro studies in English available in full text. Articles published between 2000 and 2021 were selected. The search for was conducted on PubMed, Cochrane library/CENTRAL, Wiley online library, ProQuest, Science Direct, and Hand searching/specialized registers. Keywords were used: “Lasers” [Mesh] and “Tooth bleaching” [Mesh] using Boolean operators. A total of four articles fulfilled the inclusion criteria. The quality assessment of studies included was undertaken independently as part of data extraction process. KTP lasers demonstrated more effectiveness in attaining color change in stained teeth and showed the lowest rise in intrapulpal temperature. Based on the data obtained in the present review, the choice of bleaching treatment is directly related to the type of discoloration, activation of the bleaching agent, and esthetic requirement. Although all bleaching procedures were effective in color change, the KTP laser showed better results when compared to other laser activation. The bleaching treatment protocol is directly related to the type of discoloration, activation of the bleaching agent, and esthetic requirement. It has been demonstrated that a faster change in color can be obtained when bleaching is performed in combination with a light source, i.e., power bleaching aiming for a more in-depth change of color.