Cavity Disinfectants Research Articles

Marginal Integrity of Composite Restoration with and without Surface Pretreatment by Gold and Silver Nanoparticles vs Chlorhexidine: A Randomized Controlled Trial

This study was conducted to evaluate the marginal adaptation, marginal staining, and postoperative sensitivity of resin composite restorations after disinfection of class II cavities with NanoCare Gold and chlorhexidine in class II cavities immediately, after 6 months, 1, and 2 years using World Dental Federation (FDI) criteria for assessment of dental restorations. In this study, 19 participants were recruited, 3 carious lesions in each one. After preparation of these lesions, they were randomly allocated into three parallel groups according to the disinfection protocol. The first group was for NanoCare Gold, the second was for chlorhexidine, and the third was for the control. The three groups were evaluated clinically and radiographically using (FDI) criteria at different intervals till 2 years of clinical service. There was no statistically significant difference in age, gender, arch, and tooth type distribution among study groups. Regarding marginal adaptation, there was no statistically significant difference among the different groups but the difference was only statistically significant within each group after 2 years. Regarding the marginal staining, the difference was only significant between the NanoCare and the other groups after 2 years. In case of postoperative sensitivity, there was no statistically significant difference among the different groups and within each one at different intervals. NanoCare Gold could be promising in durability preservation of direct tooth-colored restorations. Marginal staining and postoperative sensitivity are regulated by other factors than surface pretreatment. As long as restorations are inserted under rubber dam isolation, proper application steps, proper filling, and adequate finishing and polishing, the performance of the restorations would be satisfactory up to 1 year without any surface disinfection. However, after a longer follow-up, some changes may be noticed. NanoCare Gold and chlorhexidine are accepted as a cavity disinfectant without any negative effect on marginal adaptation of resin composite restorations.

Antibacterial effects of the combined use of cavity disinfectants and adhesive resin agents with antibacterial content

Amaç: Bu çalışmada kavite dezenfektanlarıyla antibakteriyel içerikli adeziv ajanların kombine kullanımının Streptococcus mutans, Lactobacillus acidophilus ve Enterococcus faecalis suşları üzerindeki antibakteriyel etkisini değerlendirmek amaçlanmıştır.Yöntem: Değerlendirme disk difüzyon yöntemiyle yapıldı. Sırasıyla 15 μL kavite dezenfektanı ve 15 μL adeziv ajan ilave edilen 5 mm çapındaki standart, steril, boş antibiyogram diskleri 2,5–3 cm aralıklarla agar plakları üzerine yerleştirildi. 37°C’de 24–48 saat inkübasyona bırakılan disklerin etrafında oluşan inhibisyon zon çapları mm olarak ölçüldü. Veriler istatistiksel olarak tek yönlü varyansanaliziyle incelendi. Bulgular: Oksijenli Su ile Clearfil SE Protect Bond kombinasyonunun S. mutans ve E. faecalis, klorheksidin diglukonat içeren Cavity Cleanser ile Clearfil SE Protect Bond kombinasyonunun ise L. acidophilus üzerinde daha güçlü antibakteriyel etki gösterdiği gözlendi. Tüm örneklerde 48. saat sonundaki antibakteriyel etkinin 24. saat sonundakinden fazla olduğu görüldü; ancak fark istatistiksel olarak anlamlı değildi (p>0,05).Sonuç: Bulgularımız restoratif diş tedavilerinde S. mutans, L. acidophilus ve E. faecalis’e karşı kavite dezenfektanlarının ve antibakteriyel adeziv ajanların kombine kullanımının çürük oluşum ve gelişim mekanizmasında rol oynayan bu mikroorganizmaları uzaklaştırdığı ve dolayısıyla sekonder çürük oluşumunu azaltacağı yönündedir.

In vitro evaluation of EDTA combined with photodynamic therapy to reduce Streptococcus mutans in carious dentin

BackgroundThis in vitro study aimed to evaluate the use of EDTA combined with photodynamic therapy to reduce Streptococcus mutans in carious dentin. MethodsSixty third molars were sectioned to obtain flat dentin surfaces. All specimens were waterproofed, except for the coronal dentin, and subjected to cariogenic challenge in brain-heart infusion (BHI) broth supplemented with 0.5% yeast extract, 1% glucose, 1% sucrose, and standard strain of S. mutans (ATCC 25175). The specimens were divided into 6 groups (n = 10 each): (1) control – caries collection; (2) EDTA - 17% EDTA was actively applied with a microbrush for 1 min; (3) aPDT – antimicrobial photodynamic therapy with 0.01% methylene blue photosensitizer (wavelength of 660 nm, energy of 4 J, power of 100 mW, spot size of 0.028 cm2, energy density of 142 J/cm2 for 40 s); (4) EDTA+aPDT – 17% EDTA actively applied for 1 min plus aPDT; (5) (EDTA+PT) + L – application of EDTA compounded with photosensitizer plus laser irradiation; and (6) PT – photosensitizer alone. Collection of caries was performed after the different cavity disinfection protocols. Aliquots from each dilution were seeded for colony-forming unit (CFU) counts. The results were log10-transformed and analyzed by the Kruskal-Wallis test (Student-Newman-Keuls). ResultsThere was a significant reduction in S. mutans after aPDT (p<0.05), EDTA+aPDT (p<0.001), and (EDTA+PT) + L (p<0.001). The percentage of microbial reduction in ascending order was as follows: EDTA: 1.65%; PT: 15.51%; aPDT: 38.28%; EDTA+aPDT: 75.24%; and (EDTA+PT) + L: 97.35%. ConclusionApplication of 17% EDTA prior to photosensitization or compounded with a photosensitizer increased the antimicrobial effect of aPDT on S. mutans in carious dentin.

Antibacterial Effect of Azadirachta Indica (Neem Extract) and Antibacterial Effect of Azadirachta Indica (Neem Extract) and Chlorhexidine as Cavity Disinfectants in Primary Teeth in a Group Chlorhexidine as Cavity Disinfectants in Primary Teeth in a Group of Egyptian Children (A Randomized Clinical Trial)

Introduction: The prevention and control of caries requires the eradication of cariogenic microorganisms that produce acids responsible for reducing the pH and starting the demineralization process. With the increasing incidence of drug resistance in the prevalent pathogens and an associated risk with chemotherapeutic agents, it is essential to find an alternative to existing drugs. Aim: The aim of this study was to investigate the effect of neem extract and 2% chlorhexidine (CHX) as cavity disinfectants in the reduction of total viable count in Atraumatic Restorative Treatment (ART) in children. Subjects and Methods: The study included two test groups, Group I (2% chlorhexidine) and Group II (neem extract). Nine patients with at least one tooth with a carious lesion suitable for ART were selected for each group; samples of dentin were collected using sterile spoon excavators at three stages from each tooth: pre-excavation, post-excavation and post-disinfection of the cavities. These dentinal samples were subjected to microbiological analysis for Total Viable Count (TVC). The data collected were statistically analysed using ANOVA and Shapiro-Wilk tests. Results: The results of present study showed that there was a statistically significant reduction in TVC when compared between pre and post excavation in both groups. Conclusion: Natural antibacterial agents like neem could be effectively used as cavity disinfectant which will help in minimizing secondary caries and rendering a long term restorative success

English

BACKGROUND Cavity disinfectants are frequently used for the elimination of bacteria that remain in the cavity, which are shown as the cause of secondary caries. However, its effect on microleakage from the tooth-restoration interface is still under investigation. The purpose of this study was to compare and evaluate the effects of the use of three different cavity disinfectants on microleakage in Class V composite restorations. METHODS For this study, 28 permanent third molar teeth without caries and restoration were used. Class V cavities of 4 mm x 3 mm x 3 mm were prepared on the buccal surfaces of each tooth. The teeth were randomly divided into 4 groups, with 7 teeth in each group. No cavity disinfectant was applied to the teeth in group 1. Tubulicid Red Label (Dental Therapeutics AB, Sweden) cavity disinfectant was applied to the 2nd group teeth, Cavity Cleanser (BISCO Inc., USA) cavity disinfectant to the 3rd group teeth, and Oxygenated Water (Dermosept, Turkey) cavity disinfectant to the 4th group teeth. Composite resin with universal adhesive and nanohybrid filler was applied to all samples in the groups in accordance with the recommendations of the manufacturers, and finishing and polishing processes were performed. Then, the thermal cycle (NOVA, Konya, Turkey) procedure was applied. After the restorations were covered with nail polish, they were kept in a 5 % basic fuchsin solution. The teeth were cut vertically in the buccolingual direction and examined with a stereomicroscope at x 40 magnification. The results were statistically evaluated with Kruskal-Wallis and Mann-Whitney U tests. RESULTS When the microleakage scores were compared between the control group and the groups treated with Tubulicid Red Label (p:0.204), Cavity Cleanser (p:0.204) and Oxygenated Water (P: 0.788), it was determined that there was no statistically significant difference (P &gt; 0.05). CONCLUSİONS It was determined that different cavity disinfectants applied in Class V cavities did not have a negative effect on microleakage and the closest results to the control group were seen in the group where cavity cleanser disinfectant containing 2 % chlorhexidine digluconate was applied. KEY WORDS Cavity Disinfectants, Class V Cavity, Microleakage.

INFLUENCE OF DIFFERENT CAVITY DISINFECTION SOLUTIONS AND LASER SYSTEMS ON REPAIR BOND STRENGTH OF SILORANE BASED COMPOSITE

Purpose: Evaluating effects of Nd:YAG-laser, Er:YAG-laser, chlorhexidine and ozonated water application which is used for purpose of antibacterial effects, on repair bond strength of silorane based composite. Materials and Methods: 100 cavities (2 mm deep, 3 mm diameter) prepared in acrylic blocks were filled with silorane composite and subjected thermal cycle and divided into 5 groups (N=20). Group 1:Chlorhexidine; Group 2:Ozonated-water; Group 3:Nd:YAG-laser; Group 4:Er:YAG-laser; Group 5 (control): untreated. Composite repair procedure was implemented with the same silorane based composite. Groups divided into 2 subgroups (n=10). One of the subgroups for each group was subjected second thermal cycle. All of the samples tested by a universal test device. Data were analyzed statistically and significance test of the difference between the two means (Kolmogorov-Simirnov), the variance analysis, and Student-t Test used. Results: No statistical difference was observed among groups after first thermal cycle (p&amp;gt;0,05). After the composite repair, there were no statistically significant difference between groups that were subjected to second thermal cycle (p&amp;gt;0,05). When each group was evaluated in themselves on comparing before and after the thermal cycle after the repair operation; as no statistically significant difference between Ozonated-water, Nd:YAG, Er:YAG and Control groups (p&amp;gt;0,05), a statistically significant decrease was observed only in the Chlorhexidine group after thermal cycle (p&amp;lt;0.05). Conclusion: Ozonated-water, Nd:YAG-laser and Er:YAG-laser applications can be used in the repair of silorane-based composite restorations as an alternative antibacterial application, since the application of chlorhexidine reduces the repair bonding strength.

English

BACKGROUND Contamination by hemostatic agent and rinsing with different disinfectant solutions can influence on micro shear bond strength between dentin and resin composite. The major objective of this study was to investigate the micro shear bond strengths of an etch and rinse technique and self-etch technique to human dentin contaminated with a hemostatic agent containing AlCl3 followed by chlorhexidine (CHX) and boric acid cleaning. METHODS A 50 non-carious, permanent, third molar teeth were randomly divided into five groups (N = 10 per group); Group 1: Self etch technique (OptiBond All - In - One, Kerr) was used on dentin contaminated with hemostatic agent (Alustat, Cerkamed). Group 2: Etch and rinse technique (Phosphoric acid then OptiBond Universal, Kerr) was used. Group 3: Contaminated dentin was cleaned with CHX for 60 seconds and then self-etch technique was used. Group 4: Contaminated dentin was cleaned with boric acid for 60 seconds and then self-etch technique was used. Group 5: Hemostatic agent was not applied, only self-etch technique was used. Flat occlusal dentin surfaces were prepared and then restored with resin composite rod (Herculite Classic, Kerr) (1 mm diameter × 1 mm height). After thermocycling (1,000 cycles), composite sticks were subjected to microshear until fracture occurred at a crosshead speed of 0.5 mm / min. Statistical analysis was made with one-way analysis of variance (ANOVA) and multiple comparison tests with Tukey. RESULTS The mean microshear bond strength values of group 1 to group 5 were 21.89 ± 12.43, 26.15 ± 22.79, 20.05 ± 12.03, 35.08 ± 13.20 and 19.41 ± 6.53 MPa, respectively. When the values of the groups were compared, the difference was not significant. (P = 0.108). CONCLUSIONS Boric acid and CHX may be used as alternatives to other materials that are used as cavity disinfectants on contaminated dentin by hemostatic agent. KEY WORDS Boric Acid, CHX, Hemostatic Agent, Adhesive Systems, Shear Bond Strength

Comparison of Efficacy of Diode Laser and Grape Seeds Extract as Cavity Disinfectants in Primary Teeth- an in vitro study

Purpose: Cavity disinfection is an essential procedure for success of Atraumatic restorative treatment. This study was designed to test the efficacy of diode laser and grape seeds extract as primary teeth cavity disinfectants. Methods: A total of 96 sound primary molars were divided into two groups according to the test performed (n=48); antimicrobial effect/ shear bond strength. Each group was subdivided into four subgroups according to cavity disinfectants: (n=12); group1: Control (no treatment), group 2: 2% chlorhexidine gluconates (CHX), group 3: diode laser, group 4: 5%w/v grape seed extract (GSE). Occlusal cavities were inoculated with the Streptococcus mutans (S.mutans) suspension and incubated under aerobic conditions. Dentine chips were collected and S.mutans colony forming units were counted. For shear bond strength, cylindrical glass ionomer specimens were bonded to dentine surface then loaded at tooth-restoration interface till debonding. Results: Diode laser exhibited the highest antibacterial effect. No difference was detected in mean values of shear bond strength in diode laser (5.88±1.28) and GSE (3.47±1.55) groups when compared to the negative control group (4.97±1.80). Conclusion: Diode laser system is preferred over GSE and CHX as a potent cavity disinfectant for primary teeth. GSE can be used as a natural alternative for CHX

The application of plan, do, check, act (PDCA) quality management in reducing nosocomial infections in endoscopy rooms: It does work.

The role of plan, do, check, act (PDCA) cycle quality management in reducing nosocomial infections in endoscopy rooms remains unclear; we aimed to evaluate the effects of PDCA in the nosocomial infections control of endoscopy rooms. This present study was a before and after design. The patients treated in our endoscopy room from 1 January 2019 to 31 December 2019 were included in the control group, which were managed according to current department practice. The patients from 1 January 2020 to 31 December 2020 were included in the PDCA group, which were managed according to PDCA cycle quality management including formulation of cleaning and disinfection process, establishment of an infection control team and improvement of inspection standards. The nosocomial infections of patients, the pass rate of medical staff's knowledge on the nosocomial infection and hand hygiene, the pass rate of disinfection of endoscope cavity and surface, the incidence of sharp injury and biological pollution were compared between two groups. A total of 1020 patients were included, with 512 patients in PDCA group and 508 patients in the control group. The incidence of nosocomial infections in PDCA group was significantly lower than that of control group (0.98% vs. 2.76%, P=.002). The pass rate of medical staff's knowledge on the nosocomial infection and hand hygiene was significantly higher than that of control group (all P<.05). The pass rate of disinfection of endoscope cavity in PDCA group was significantly higher than that of control group (P=.037). The incidence of sharp injury and biological pollution in PDCA group were significantly lower than that of control group (all P<.05). PDCA cycle management is beneficial to reduce the risk of nosocomial infection, enhance the awareness of infection control and reduce the risk of occupational exposure of medical staff in the endoscopy room.

Effect of Cavity Disinfectants on Adhesion to Primary Teeth-A Systematic Review.

Some authors have been proposing the use of cavity disinfectants in order to reduce, or even eliminate, the effect of the microorganisms present in a dental cavity before a restoration is placed. The aim of this study was to evaluate the effect of different cavity disinfectants on bond strength and clinical success of composite and glass ionomer restorations on primary teeth. The research was conducted using Cochrane Library, PubMed/MEDLINE, SCOPUS, and Web of Science for articles published up to February 2021. The search was performed according to the PICO strategy. The evaluation of the methodological quality of each in vitro study was assessed using the CONSORT checklist for reporting in vitro studies on dental materials. Sixteen in vitro studies and one in situ study fulfilled the inclusion criteria and were analyzed. Chlorhexidine was the most studied cavity disinfectant, and its use does not compromise dentin bonding. Sodium hypochlorite is a promising alternative, but more research on its use is required to clearly state that it can safely be used as a cavity disinfectant for primary teeth. Although other disinfectants were studied, there is a low-level evidence attesting their effects on adhesion, therefore their use should be avoided.

Comparative Evaluation of Cavities Disinfected with Ozone Gas and Photodynamic Therapy and Restored with Two Different Reinforced Glass Ionomer Cements on Microleakage and Color Change

ABSTRACT The aim of this study is to examine the effect of chlorhexidine (CHX), ozone and photodynamic (PDT) therapy on the microleakage of reinforced glass ionomer cement and on tooth discoloration. The class V cavities were opened on the buccal faces of 96 extracted molar teeth and the samples were divided into four groups (n = 24). Before and after cavity disinfection, color measurement of teeth was determined by using a spectrophotometer. The groups were separated into two subgroups and restored with ACTIVA and Giomer. One thousand thermal cycles were applied to the teeth at 5–55 C. After the penetration of 0.5% basic fuchsin, teeth were examined with a stereomicroscope and SEM. The data were statistically analyzed using the Mann Whitney U-test and the Kruskal Wallis test. The differences were statistically significant among the cavity disinfectants on the occlusal edge in the ACTIVA groups (p < .05), There was no significant difference considering cavity disinfectants on occlusal and gingival margins in the Giomer groups (p > .05). While ozone gas showed an acceptable color change in teeth, CHX and PDT caused the discoloration in teeth. It was concluded that the Ozone gas does not affect the microleakage of the reinforced glass ionomer cements and does not cause detectable color change. CHX and PDT reduce the microleakage of ACTIVA at the enamel level.

Atuação do Cirurgião-Dentista na equipe multidisciplinar em Unidade de Terapia Intensiva: Percepção dos acadêmicos

Objetivo: Descrever a percepção dos acadêmicos, do décimo período do curso de Odontologia de duas Instituições de Ensino Superior, sobre a atuação do cirurgião-dentista (CD) em Unidade de Terapia Intensiva (UTI). Metodologia: Trata-se de um estudo observacional transversal, com aplicação de questionário para acadêmicos concluintes do curso de Odontologia, sobre a atuação do CD na UTI, os protocolos de higiene e a relação dos patógenos bucais com doenças sistêmicas. Os dados foram analisados descritivamente e de forma analítica por meio do teste do qui-quadrado. Resultados: Dos 71 participantes, 87,3% afirmaram conhecer sobre a atuação do CD na UTI. Todos os entrevistados julgaram como importante o tema Odontologia Hospitalar e a presença do CD na equipe multidisciplinar, porém 7% se consideravam aptos para atuar nesta área. Cerca de 87% dos acadêmicos consideraram a solicitação de exames complementares, prescrição e realização da desinfecção da cavidade bucal como atribuições do CD em ambiente hospitalar. O procedimento de prescrição medicamentosa e solicitação de exames complementares foi mais relatado pelos alunos que tiveram aulas sobre Odontologia Hospitalar na graduação (p&lt;0,05). Cerca de 62% dos acadêmicos têm conhecimento sobre os protocolos de higiene bucal que devem ser realizados na UTI e todos os acadêmicos avaliados afirmaram que a doença periodontal tem influência nas patologias sistêmicas. Conclusão: Os acadêmicos consideraram que o CD deve participar da equipe que compõe a UTI, possuíam algumas informações sobre a atuação da Odontologia no ambiente hospitalar, no entanto, poucos se sentem aptos para atuar nesse espaço de trabalho.

Does Cavity Disinfectant Affect Sealing Ability of Universal Self-etch Adhesive?

The purpose of this study was to evaluate 2% chlorhexidine disinfectant (CHX), chitosan, and octenidine dihydrochloride (as cavity disinfectants) on microleakage in cavities restored with universal self-etch adhesive. Eighty extracted human permanent premolars were selected. Class V cavities were prepared on the facial surface of each tooth. The teeth were then divided into four groups of 20 teeth each. For the control group after cavity preparation, no disinfectant was applied. The other 3 groups were treated with 0.1% chitosan, 2% CHX, and 0.1% octenidine dihydrochloride (OCT). All the groups were restored with universal adhesive followed by composite resin. The teeth were then immersed in 1% methylene blue dye and were sectioned buccolingually. Microleakage was checked under a stereomicroscope on both occlusal and gingival margins. Among all the groups chitosan-treated cavities showed the least microleakage. Chlorhexidine treated cavities showed less leakage as compared to control, OCT group at both the margins. Chitosan as a cavity disinfectant improves the sealing ability of the self-etch adhesive. Furthermore, in vivo studies need to be conducted to examine the interaction and long-term effect of chitosan with the other self-etch adhesive systems. Chitosan a natural polysaccharide can be used as a cavity disinfectant as it improves the sealing ability of self-etch adhesive.

EFFECTIVENESS OF CHLORHEXIDINE AS A CAVITY DISINFECTANT IN ATRAUMATIC RESTORATIVE TREATMENT IN PRIMARY TEETH (RANDOMIZED CONTROLLED CLINICAL TRIAL)

Introduction: Since the removal of caries in the Atraumatic restorative treatment (ART) is performed with hand excavation, its survival would increase if more bacteria could be inhibited under the restoration. The use of antibacterial agents such as Chlorhexidine gluconate (CHX) was found to hinder the growth of bacteria under restorations, reducing the risk of recurrent caries. Objective: Evaluate the effectiveness of CHX as a cavity disinfectant, on residual cariogenic bacteria, in ART restorations. Materials and methods: Atraumatic restorative treatment procedures were performed to the whole sample (N=40), with identical protocols except for the antibacterial agent used. Bacteriological samples from the center of the cavity were cultivated for Mutans streptococci (MS), Lactobacilli (LB) and total viable count (TVC). Chlorhexidine was applied onto the cavity floor in group I (N=20) and conventional ART without disinfectant was performed in group II (N=20). After 14 days, the restorations were removed and a second dentin sample was cultivated for bacteriologic assessment of the outcome. Results: After 14 days, Group I showed 22.17, 8.25, 6.88 mean percent reduction of MS, LB, and TVC, respectively whereas group II showed 12.67, 6.87, 6.11 mean percent reduction of MS, LB, TVC, respectively. MS and LB showed significantly higher percent reduction in group I compared to group II. Moreover, group I showed higher mean percent reduction in TVC than group II; however, it was not statistically significant. Conclusion: Chlorhexidine disinfection showed superior effectiveness in inhibiting residual bacteria under ART restoration compared to ART restorations using glass ionomer cement (GIC) alone.

Case report: 2 cases of cardiac arrest caused by rhino-cardiac reflex while disinfecting nasal cavity before endonasal transsphenoidal endoscopic pituitary surgery

BackgroundTrigeminal-cardiac reflex (TCR) is a brainstem vagus reflex that occurs when any center or peripheral branch of the trigeminal nerve was stimulated or operated on. The typical clinical manifestation is sudden bradycardia with or without blood pressure decline. The rhino-cardiac reflex which is one type of TCR is rare in clinical practice. As the rhino-cardiac reflex caused by disinfection of the nasal cavity is very rare, we report these two cases to remind other anesthesiologists to be vigilant to this situation.Case presentationThis case report describes two cases of cardiac arrest caused by rhino-cardiac reflex while disinfecting nasal cavity before endoscopic transsphenoidal removal of pituitary adenomas. Their heart rate all dropped suddenly at the very moment of nasal stimulation and recovered quickly after stimulation was stopped and the administration of drugs or cardiac support.ConclusionAlthough the occurrence of rhino-cardiac reflex is rare, we should pay attention to it in clinical anesthesia. It is necessary to know the risk factors for preventing it. Once it occurs, we should take active and effective rescue measures to avoid serious complications.

Radiological Appraisal of Biodentine and Pulpotec Individually or in Combination with Photo-activated Disinfection as Pulp-capping Cements in Mature Teeth

The aim of the study was to evaluate and compare radiographically, Pulpotec cement and Biodentine as direct pulp-capping agents in mature teeth, individually and in combination with photo-activated disinfection (PAD). In the present study, 80 mature teeth with deep occlusal caries were selected for direct pulp-capping procedure and randomly assigned to one of the four groups [Pulpotec (I), Biodentine (II), Pulpotec + PAD (III), and Biodentine + PAD (IV)] allocating 20 teeth to each group. Direct pulp capping and cavity disinfection were performed based on the group allotted followed by permanent restoration with composite. The teeth were evaluated radiographically (densitometric analysis) at intervals of 3, 6, and 12 months. The radiographic gray values obtained at follow-up periods for each group were subjected to two-way analysis of variance (ANOVA) with repeated measures. There was a significant improvement (p <0.0001) in the scores of all the groups at follow-ups as compared to the baseline. There was a significant difference between group I/group II with groups III and IV (p = 0.000) with group IV scoring highest at all follow-ups. However, the difference between groups I/II and groups III/IV was nonsignificant. Both, Biodentine and Pulpotec can be used for direct pulp capping of mature teeth. Furthermore, PAD prior to material application significantly improved the radiographical success of Biodentine and Pulpotec, with Biodentine showing better results than Pulpotec. Biodentine and Pulpotec demonstrated comparable success as a pulp-capping agent and PAD application exhibited a synergistic effect when used in conjunction with these materials.

Effect of dental acid etchant-mediated photodynamic therapy on bacterial reduction and microshear bond strength of composite to dentin - An in vitro study.

Objective:The objective of this study was to assess the effect of dental acid etchant (DAE)-mediated photodynamic therapy on bacterial reduction and microshear bond strength of composite to dentin.Materials and Methods:Eighty permanent third molars after sample preparation were exposed to a cariogenic challenge with Streptococcus mutans. After incubation, specimens were randomly divided into four groups (n = 20): Group I – DAE, Group II – low-level laser (LLL), Group III – diode laser + methylene blue (MB + L), and Group IV – diode laser + DAE (DAE + L). Half of the specimens from each group were selected for bacterial reduction assessment and the other half for microshear bond strength. All the samples for assessment of bacterial reduction (before and after intervention) were seeded onto the surface of mitis-salivarius-bacitracin medium. After incubation, the viable bacterial count was determined in colony-forming unit/mL. For microshear bond strength assessment, samples were subjected to various treatment modalities and then bonding and debonding procedure was performed for blocks of composite and values were recorded.Results:Significant reductions in S. mutans were observed in all the groups – Group I (DAE) 68.50%, Group II (LLL) 55.90%, Group III (MB + L) 88.60%, and Group IV (DAE + L) 87% with comparable bacterial reduction between Group III (MB + L) and Group IV (DAE + L). Furthermore, a significant difference in bond strength values was seen in Group III (MB + L) 10.99 MPa and Group IV (DAE + L) 17.99 MPa whereas an insignificant difference was found between Group I (DAE) 20.74 MPa, Group II (LLL) 18.27 MPa, and Group IV (DAE + L).Conclusion:DAE caused a comparable reduction in bacterial count to MB-assisted PDT and also there was no adverse effect on bond strength values. PDT can be performed while acid etchant containing MB dye is being applied in the cavity, thus reducing operative time and enhancing cavity disinfection.

Effect of Cavity Disinfectants on Dentin Bond Strength and Clinical Success of Composite Restorations-A Systematic Review of In Vitro, In Situ and Clinical Studies.

Cavity disinfection becomes an important step before a dental restorative procedure. The disinfection can be obtained cleaning the dental cavity with antimicrobial agents before the use of adhesive systems. The aim of this study was to conduct a systematic review on the effect of different cavity disinfectants on restorations’ adhesion and clinical success. A search was carried out through the Cochrane Library, PubMed, and Web of Science. In vitro and in situ studies reporting results on dentin bond strength tests, and clinical studies published until August 2020, in English, Spanish and Portuguese were included. The methodological quality assessment of the clinical studies was carried out using the Revised Cochrane risk-of-bias tool. Chlorhexidine could preserve adhesion to dentin. EDTA and ethanol had positive results that should be further confirmed. Given the significant lack of scientific evidence, the use of lasers, fluoridated agents, sodium hypochlorite, or other products as cavity disinfectants should be avoided. Chlorhexidine is a safe option for cavity disinfection with adequate preservation of adhesion to dentin. Moreover, future researches should be focused on the efficacy of these disinfectants against cariogenic bacteria and their best application methods.

Cavity Disinfection With a 445 nm Diode Laser Within the Scope of Restorative Therapy - A Pilot Study.

Introduction: Cavity disinfection is necessary to prevent a progressive infection of the crown dentin and pulp. Increasing intolerance and resistance to antiseptics and antibiotics as well as the controversy over the effects of those on the dental hard tissue and composite have prompted the investigation of alternative treatment options. The objective of this pilot study is to evaluate the antibacterial potential of a diode laser with a wavelength of 445 nm in the cavity preparation using the bacterium Streptococcus salivarius associated with caries in conjunction with the characteristics and influences of dentin on light transmission. Methods: The bactericidal effect of the laser irradiation was determined in culture experiments by using caries-free human dentin samples on bacteria-inoculated agar. For this, dentin discs (horizontally cut coronal dentin) of 500 µm and 1000 µm thicknesses were produced and irradiated with the laser with irradiation parameters of 0.7-1 W in a cw-mode and exposure times of between 5-30 s. Based on the different sample thicknesses, the penetration depth effect of the irradiation was ascertained after the subsequent incubation of the bacteria-inoculated agar. Additional influential parameters on the irradiation transmission were investigated, including surface moisture, tooth color as well as the presence of a smear layer on the dentin surface. Results: The optical transmission values of the laser radiation for dentin were significantly dependent on the sample thickness (P = 0.006) as well as its moisture content (P = 0.013) and were independent of the presence of a smear layer. There was a 40% reduction in bacteria after the radiography of the 500-µm-thick dentin samples, which was shown as the lowest laser dose (443 J/cm2). Conclusion: These findings indicate that the diode laser with light emission at a wavelength of 445 nm is interesting for the supportive cavity disinfection within the scope of caries therapy and show potential for clinical applications.

Management of caries affected dentin (CAD) with resin modified glass ionomer cement (RMGIC) in the presence of different caries disinfectants and photosensitizers.

To evaluate Shear bond strength (SBS) of resin modified glass ionomer cement (RMGIC) on caries affected dentin after using different cavity disinfectants i.e., chlorhexidine gluconate (CHX), Er,Cr:YSGG laser (ECYL) and photodynamic therapy (PDT). Total 50 freshly extracted mandibular molars were obtained through non-traumatic extraction. All the samples were rooted vertically within self-cure acrylic resin blocks up to cervical level so that only coronal portion remain visible. Silicon carbide grinding discs 1200 and 600 grits was used to prepare the teeth. However affected dentin remains untouched. All samples were randomly distributed in to five groups (n = 10). Group 1: 2 % CHX, Group 2: 2 % solution of methylene blue (MB) and Diode laser, Group 3: Indocyanine green (ICGP) solution and Diode laser, Group 4: curcumin (CP) and LED curing unit, Group 5: ECYL. The specimens were then stored at a temperature of 37 °C for 24 h and 100 % humidity before specimens were placed in to universal testing machine for the SBS measurements. Failure mode examination was performed by a stereomicroscope. ANOVA test analyze inter group comparison. Tukey HSD test was used to analyze multiple group comparison. The level of significance was set at p < 0.05 value. Among all the groups, group 1 (control, CHX treated) demonstrated highest SBS value (18.31 ± 1.06 MPa). Whereas lowest SBS was displayed by group 2 (PDT, MB) (12.31 ± 0.57 MPa). Dentin disinfected with group 4 (PDT, CP) (16.86 ± 0.97 MPa) and group 5 (ECYL) (17.39 ± 2.26) showed comparable result to that of CHX (p > 0.05). Bond strength of RMGIC bonded to CHX disinfected caries affected dentin was highest among study groups. Use of MB showed lowest shear bond strength outcomes. Moreover, application of ECYL and curcumin with LED showed bond strengths comparable to CHX control.