Pulpal Irritation Research Articles

A pH-sensitive, renewable invisible orthodontic aligners coating manipulates antibacterial and in situ remineralization functions to combat enamel demineralization.

During invisalign treatment, as salivary proteins or glycoproteins fill the space between the teeth and the aligners, they can easily adhere to the teeth, forming an acquired cellular film on which bacteria are highly susceptible to colonizing, which in turn leads to the development of enamel white staining lesions (WSLs), one of the major complications of orthodontic treatment. Inhibiting the activity of cariogenic bacteria while promoting the remineralization of demineralized enamel is the key to preventing and treating WSLs. Currently, the drug commonly used in clinical practice for the treatment of WSLs is silver diamine fluoride, which, although it has both antimicrobial and remineralizing effects, suffers from problems such as pulpal irritation and tooth discoloration. In this study, based on the principle of coordination chemistry, copper ions and plant polyphenol tannins were assembled on invisible orthodontic aligners to form a metal-phenol network coating (TA-Cu MPNs), and zwitterionic sulfonamethyldopamine was introduced for bionic mineralization to obtain the multifunctional coating TA-Cu MPNs@ZDS@CaP (TZC). The coating exhibits acid-responsive release of Ca2+ and PO4 3-, and the decomposed CaP layer can be regenerated by a simple dipping method. The TZC coating strongly inhibits common cariogenic bacteria and their biofilms. In addition, the results of the in vitro mineralization experiment show that TZC-coated invisible orthodontic aligner treatment of demineralized enamel has significant remineralization effects. It is worth mentioning that the constructed coating has a durable antibacterial effect and can meet the service cycle of invisible orthodontic aligners. This study provides theoretical and experimental bases for the prevention or treatment of WSLs in invisible orthodontic treatment.

Marginal integrity of prototype bioactive glass-doped resin composites in class II cavities.

This in vitro study examined the marginal integrity of experimental composite materials doped with bioactive glass (BG). Class-II MOD cavities were prepared and restored with one of the following composite materials: a commercial composite material as a reference (Filtek Supreme XTE), an experimental composite doped with BG 45S5 (C-20), and an experimental composite doped with a fluoride-containing BG (F-20). Six experimental groups (n = 8) were used, as each of the three composites was applied with (+) or without (-) a universal adhesive (Adper Scotchbond Multipurpose). All specimens were subjected to thermocycling (10,000 x, 5-55°C) and then additionally stored in artificial saliva for eight weeks. Scanning electron micrographs of the mesial and the distal box were taken at three time points (initial, after thermocycling, and after eight weeks of storage in artificial saliva). The margins were classified as "continuous" and "non-continuous" and the percentage of continuous margins (PCM) was statistically analyzed (α = 0.05). In most experimental groups, thermocycling led to a significant decrease in PCM, while the additional 8-week aging had no significant effect. F-20 + performed significantly better (p = 0.005) after 8 weeks storage in artificial saliva than the reference material with adhesive, while no statistically significant differences were observed at the other two time points. C-20 + exhibited significantly better PCM than the reference material with adhesive after thermocycling (p = 0.026) and after 8 weeks (p = 0.003). Overall, the experimental composites with BG showed at least as good marginal adaptation as the commercial reference, with an indication of possible re-sealing of marginal gaps. Maintaining or improving the marginal integrity of composite restorations is important to prevent microleakage and its likely consequences such as pulp irritation and secondary caries.

A Retrospective Analysis of the Need for the Root Canal Therapy for the Full Crown Restorations: An Original Study.

There are numerous chances for pulpal irritation during the placement of a crown on a tooth. This study's goal was to find and examine the variables that influence the prevalence of routine root canal therapy after the teeth were restored with full coverage crowns. The hospital records were retrospectively evaluated from 2000 to 2010 for a decade. The demographics as well as the various variables that caused for the intervention with the root canal therapy for the teeth with the full crowns were evaluated. The values were compared for the significance. The total number of the teeth that were finalized in the study was 4308. Of the total teeth that were treated with full coverage crowns, 50% were metal ceramic, 42% were full ceramic, and 9% were full metal crowns. After 10 years, possibility that every tooth with a crown would survive was 91%. The most frequent adverse incident was the intervention with the RCT. Metal ceramic crowns had poor survival rates and needed the maximum intervention. Younger age-group had least survival rate than the older age-groups. Endodontic therapy is unlikely to be necessary after crown installation. As the patient's age declines and all-ceramic or PFM crowns are used, this risk rises.

Heat generated during dental treatments affecting intrapulpal temperature: a review

IntroductionHeat is generated and transferred to the dentine-pulp complex during various dental procedures, such as from friction during cavity preparations, exothermic reactions during the polymerisation of restorative materials and when polishing restorations. For in vitro studies, detrimental effects are possible when intra-pulpal temperature increases by more than 5.5°C (that is, the intra-pulpal temperature exceeds 42.4°C). This excessive heat transfer results in inflammation and necrosis of the pulp. Despite numerous studies stating the importance of heat transfer and control during dental procedures, there are limited studies that have quantified the significance. Past studies incorporated an experimental setup where a thermocouple is placed inside the pulp of an extracted human tooth and connected to an electronic digital thermometer.MethodsThis review identified the opportunity for future research and develop both the understanding of various influencing factors on heat generation and the different sensor systems to measure the intrapulpal temperature.ConclusionVarious steps of dental restorative procedures have the potential to generate considerable amounts of heat which can permanently damage the pulp, leading to pulp necrosis, discoloration of the tooth and eventually tooth loss. Thus, measures should be undertaken to limit pulp irritation and injury during procedures. This review highlighted the gap for future research and a need for an experimental setup which can simulate pulp blood flow, temperature, intraoral temperature and intraoral humidity to accurately simulate the intraoral conditions and record temperature changes during various dental procedures.

Effects of Orthodontic Treatment on Pulp Stone Formation: A Retrospective Study.

This retrospective study was aimed at determining the incidence of dental pulp stone formation during fixed orthodontic treatment. A total of 100 patients who received fixed orthodontic treatment were included in this study. Pre- and posttreatment panoramic radiographs of the patients were examined to identify pulp stones. The data were analyzed using McNemar's and Pearson's chi-square tests to investigate the correlations between having a dental pulp stone and gender, age, treatment type, and duration. Dental pulp stones were detected in 17% of patients on pretreatment panoramic radiographs and 35% of patients on posttreatment panoramic radiographs. The incidence of pulp stones sharply increased in the pre- and posttreatment radiographs (38%) (P < 0.001). In addition, there were associations between age, treatment duration, and the incidence of pulp stones (P < 0.05). Nevertheless, no associations were found between treatment type, gender, and the presence of pulp stones. Dental pulp stones were most frequently observed in first molars (62%), followed by second molars (36%). Fixed orthodontic treatment may trigger pulp irritation and calcification, resulting in the formation of pulp stones. Although pulp stones have no serious consequences, an orthodontist must consider the probability of pulp stone formation because it can cause difficulties in endodontic treatment.

Clinical and Microbiological Evaluation of the Chemomechanical Caries Removal Agents in Primary Molars.

Chemomechanical caries removal (CMCR) is a noninvasive procedure that uses a chemical substance to remove the diseased dentin. The natural dental architecture is also preserved using this technique, preventing patient discomfort and pulp irritation. This method of eliminating caries is based on disintegration. This method removes soft carious dentin using chemical agents and non-traumatic mechanical force. This study was carried out to evaluate the clinical and microbiological evaluation of the chemomechanical caries removal agents in primary molars. For the elimination of caries, teeth in category I (polymer bur category) were treated with Smartburs II® (SS White Dental, Lakewood, New Jersey, United States) (n = 40). Teeth treated with the new Carisolv® technology (Mediteam, Sweden) to remove caries (n = 40). Teeth were treated for removal cavities in category III (conventional group) using excavators and carbon steel low-speed round burs from Dentsply Maillefer in Switzerland (n = 40). There was an evaluation of the efficacy of caries removal, the time required for caries removal, patient satisfaction, and microbial culture assessment. In comparison to the other two categories, the conventional category median caries detector dye values were considerably lower (p value<0.05). There was no substantial difference observed between study participants belonging to category I and category II with a p-value greater than 0.05. Time taken during the removal of caries was substantially greater in category I (455.46±73.7) as compared to category II (129.21±44.18) and the traditional category (113.26±37.7). The value of significance was less than 0.05. Contrarily, no discernible difference was observed between category I and category III (the p-value was greater than 0.05). In comparison to the other two categories, the conventional group's median facial expression scale scores were substantially higher (p = 0.02). In comparison, there was no discernible difference between categories I and II (p = 0.65). It was observed that there was no substantial variation in three categories regarding the number of colonies of bacteria prior to the eradication of caries (p-value greater than 0.05). After caries had been removed, the number of living bacterial colonies in category I was noticeably greater than those in the other two categories. However, there was no discernible variation between category II and category 1 (p-value greater than 0.05). The mechanical approach has the highest clinical efficacy for removing caries. Carisolv required the most time to remove cavities. Patient satisfaction levels were greater with Carisolv than with the mechanical approach. It was also observed that Carisolv as well as the mechanical technique had greater antibacterial effectiveness.

Effect of Three Different Cooling and Insulation Techniques on Pulp Chamber Temperature during Direct Temporization with Polymethyl methacrylate-based Resin

This in vitro study evaluates and compares the changes in pulp chamber temperature during direct fabrication of provisional restorations in maxillary central incisors after using three different cooling techniques. Total of 60 samples of maxillary central incisors along with their putty indices were divided into four groups (one control and three experimental) and were prepared using a surveyor cum milling machine. Teeth were sectioned 2 mm below cementoenamel junction and a K-type thermocouple wire was inserted in the tooth and secured at the pulpal roof using amalgam. Putty index filled with DPI tooth molding resin material [polymethyl methacrylate (PMMA)] was placed on the tooth and temperature changes per 5 seconds were recorded by temperature indicating device for the control, on-off, precooled putty, and dentin bonding agent (DBA) group. The highest mean obtained was of the control (11.04°C), followed by DBA group (9.53°C), precooled putty group (6.67°C), and on-off group (1.94°C). Precooled putty index group took maximum time to reach the baseline temperature (847.5 seconds). On-off technique is the most effective method to reduce the intrapulpal temperature during polymerization, as compared to the other techniques used in the study. Retardation in the polymerization process was seen in precooled putty group, which may make this technique clinically inadvisable. Thermal protection of pulp must always be considered during direct fabrication of provisional restoration when a PMMA-based resin is used. By using on-off technique, not only the thermal insult to the pulp can be effectively minimized but also the harmful effects of residual monomer (poor marginal fit and pulpal irritation) can be eliminated.

Comparative evaluation on the number of increments of composites used for restoring disto-occlusal cavities of maxillary and mandibular molars - A retrospective analysis

Over time and with the advancement of dental materials, a shift in the paradigm of how lost tooth structure can be restored has occurred. It is not very surprising to notice that many of the traditional amalgam restorations have been replaced with dental composites in the name of aesthetics. The factors that usually contribute to the failure of the composite restorations are secondary caries, pulpal irritation, post-operative sensitivity and marginal discoloration, all indicating microleakage being the cause. Microleakage, in turn, is caused by polymerization shrinkage, which is inherent to the material because of its composition. Amongst a few strategies to minimise polymerization drinking shrinkage is the use of the incremental technique. The aim of the present study was to evaluate and compare the number of increments of composites used for restoring disto-occlusal cavities of maxillary and mandibular molars in the South Indian population. It is a retrospective analysis. Data from 86,000 patient records were sieved and a total of 101 case sheets that presented with disto-occlusal composite restorations in maxillary and mandibular molars were included. The number of increments used to restore the cavity was assessed and tabulated in Microsoft Excel along with details like age, gender and tooth number. Frequency analyses and Chi-Square test was performed. Two increments of composite resin were reported to be used maximum in the restoration of the DO cavities in molars. The association of the number of increments to tooth number is found to be significant (p &lt;0.05). Within the limitations of the study, the number of increments of composite used to restore a DO cavity was more in a mandibular first molar. Thus to conclude that all the teeth were restored in a conservative approach.

The Incidence of Root Canal Therapy after Full-Coverage Restorations: A 10-Year Retrospective Study

IntroductionThe process of restoring a tooth with a crown leaves many opportunities for pulpal irritation. The objective of this study was to identify and analyze the factors that contribute to the incidence of nonsurgical root canal therapy (NS-RCT) after the delivery of single-unit full-coverage restorations. MethodsInsurance claims from 88,409 crown placements in the Delta Dental of Wisconsin insurance database were analyzed from the years 2008–2017. The Cox regression model was used to analyze the effect of the predictor variables on the survival of the tooth. Untoward events were defined as NS-RCT, tooth extraction, retreatment of root canal, or apicoectomy as defined by the Code on Dental Procedures and Nomenclature. ResultsOf 88,409 crowns placed, 8.97% were complete metal, 41.40% were all ceramic, and 49.64% were porcelain fused to metal (PFM). The probability of survival of all teeth with crowns placed was 90.41% after 9 years. NS-RCT was the most common untoward event. PFM crowns exhibited a higher rate of untoward events than complete metal crowns and a lower rate than all-ceramic crowns. Crowns placed on individuals 50 years of age and younger had higher rates of untoward events than those placed on individuals ages 51 years and older. ConclusionsThe risk of endodontic treatment after the placement of crowns is low. This risk increases with the placement of all-ceramic or PFM crowns and as the age of the patient decreases.

Endodontic management of internal inflammatory resorption

Management of internal resorptive defects are always a challenge for an endodontist. Internal resorption occurs mostly commonly due to trauma or a long stand chronic pulpal irritation following caries or trauma and is most commonly seen in the anterior teeth and sometimes in the posterior teeth as well. Early diagnosis and removal of underlying pathology are important for long-term success. The case paper reports nonsurgical management of a case of internal inflammatory resorption treated by root canal therapy followed by obturation with thermoplasticized gutta-percha.

DIFFERENCE IN SETTING TIME AND WORKING TIME INTERVAL OF CONVENTIONAL ZINC PHOSPHATE CEMENT AND NANOPARTICLE ZINC PHOSPHATE CEMENT (Research report)

Introduction: Zinc phosphate cement is one of cavity base material frequently used for pulp protection in the field of dentistry. This material demonstrates superiority in mechanical resilience and manipulation simplicity yet inducing pulp irritation as the reflection of high level acidity. Utilizing nano-particle ZPC may vanquish the shortcoming in conventional mechanical properties. However, brief setting time in nano-particle ZPC will generate higher exothermic reaction accompanied by the shortening of working period. Purpose: To assess the difference in setting time and working time interval of conventional ZPC and nano-particle ZPC. Methods: It is a true experimental laboratory study with post-test control group design. Four treatment groups were presented in five respective repetitions, comprising one scoop (0.318 gr) of conventional ZPC with three drops liquid in Group I, one scoop (0.386 gr) of nano-particle ZPC with four drops liquid in Group II, one scoop (0.386 gr) of nano-particle ZPC with three drops liquid in Group III, and one scoop (0.386 gr) of nano-particle ZPC with two drops liquid in group IV. ZPC was then manipulated in circular motion from powder to liquid. The setting time and working time was determined using stopwatch in second unit which then statistically analyzed using one-way ANOVA and post hoc Tukey HSD test. Result : Nano-particle ZPC with two drops liquid (Group IV) exhibited the shortest setting time value (mean 96.60s) which unveiled concurrently with the briefest working time interval (mean 34s). The longest setting time was presented in conventional ZPC (Group I) in the average of 627.80 seconds which also depicted the lengthiest working period with 84.20 seconds average. Statistical analysis revealed significant disparity in setting time value of conventional ZPC and nano-particle ZPC in each treatment group (p 0.05). Conclusion: There is a significant difference in setting time and working time interval of conventional ZPC and nano-particle ZPC.

Effect of sintering parameters on the mechanical properties of monolithic zirconia.

Background. Zirconia restorations with high mechanical properties are the current treatment options for fixed restorations with advantages of high biocompatibility and low pulp irritation. Although the effect of sintering time and temperature on the optical and mechanical properties of zirconia core material were investigated, the effect of these parameters on the translucent monolithic zirconia is still uncertain. This study aimed to evaluate the effect of the changes in sintering temperature and holding time on the mechanical and structural properties of monolithic zirconia. Methods. Totally, 340 self-colored (A2) zirconia specimens from two different monolithic zirconia groups (n=170) were prepared, measuring 15.5×12.5×1.2 mm. Then, 17 subgroups (n=10), including the control groups, were sintered according to sintering parameters. XRD analysis was used to determine phase transformations. The surface roughness of the specimens was evaluated using profilometry, and the flexural strength of the specimens was evaluated by the three-point bending test. The data were analyzed using three-way ANOVA and post hoc multiple comparison test with Bonferroni correction (a=0.05) at a significance level of 0.05. Independent-samples t-test was used to compare the subgroups between the control groups (P˂0.05). Results. No tetragonal-to-monoclinic phase transformation was observed in the groups. Changes in the sintering parameters did not significantly affect the surface roughness and flexural strength of monolithic zirconia. Surface roughness values for all the subgroups were above the clinically critical limit. Conclusion. According to the results of this study, changes in the sintering parameters did not affect the surface phase transformation, surface roughness, and flexural strength of monolithic zirconia.

QUANITATION OF PULP/PERIAPICAL INFLAMMATION USING PET MARKER 11C-MK-4232 CALCITONIN-GENE-RELATED PEPTIDE RECEPTOR: A PILOT STUDY

Background This study aimed to establish a quantitative method for measuring dental pulp disease in vivo. Current clinical examinations of the dental pulp use thermal (hot/cold), (percussive/palpatory), and electric pulp testing to evaluate tooth vitality. These tests offer some utility, but the results are extremely variable and subjective. Standard radiography has also been used, but it lacks diagnostic sensitivity until the disease process is advanced. Objective The study combines 2 novel areas of contemporary medical research: positron emission tomography (PET) and immune pathway modulation to develop a noninvasive diagnostic tool that can be used for the detection and localization of dental pulp disease. The calcitonin-gene-related peptide (CGRP), a neuropeptide released when the peripheral nervous system, regulates the immune system by activating the inflammatory process. We used a specific PET-tracer, [11C]MK-4232, a CGRP receptor marker to locate and quantify CGRP released and bound to the receptor at specific times in response to the progression of induced pulp disease. Materials and Methods This study used [11C]-CGRP-R produced in the Loma Linda University radiochemistry laboratory to quantitate the uptake of the PET tracer in diseased teeth of 6 ferrets after pulpal irritation of canines to induce pulp disease. Conjoint histopathologic studies were performed to quantitate cellular response to inflammation. These values were then compared with the PET tracer uptake. Preliminary Results Previous studies using the [11C]-CGRP-R marker in mini-pigs had reported promising results quantifying the CGRP pathway. Future Directions It is anticipated that investigations of the PET tracer [11C]MK-4232 (CGRP-R) to localize and monitor pulp disease will prove to be a dependable, objective, quantifiable, and repeatable diagnostic tool.

Pulp pathosis associated with ancient Maya dental inlays

ObjectiveThe ancient Maya used to practice dental inlays as part of the cultural traditions. Most of those inlays remain in place after more than one thousand years. The purpose of this paper is to investigate the incidence of pulp pathosis associated with ancient Maya dental inlays to assess the impact that such common practice had on the population’s oral health. DesignWe scored 193 anterior inlaid teeth from 107 pre-Hispanic Maya dentitions studied at three archaeological storage facilities (Universidad Autonoma de Yucatan, Harvard University, Atlas of Guatemala Project). Two hundred eleven untreated frontal teeth of pre-Hispanic Mayan collections were used as controls. We performed macroscopic, radiographic and microscopic analyses to assess the frequency of caries, pulp calcifications, internal root resorption (IRR), and periapical lesions (PALs). ResultsIn the inlaid teeth, the frequencies of pulp calcifications, IRR, caries and PALs were 59.8%, 2.2%, 18.5% and 19.2%, respectively. Compared with untreated teeth, inlaid specimens exhibited greater susceptibility to caries, pulp calcifications, IRR and PALs than untreated teeth (pulp calcifications: 44.5%, IRR: 0%, caries: 1.4%, and PAL: 1.9%). Age-at-death did not have any significant influence on susceptibility to pulp calcifications, IRR, caries or PALs. ConclusionsWe noted relatively low pulp irritation and a low frequency of carious infections, IRR and PALs in Mayan inlaid teeth. However, these levels exceeded the frequencies of untreated teeth from the same area and time period. We follow that the cements used by the pre-Hispanic Maya to fix the inlays into their sockets provided excellent sealing characteristics on average.

Concept and clinical application of the resin-coating technique for indirect restorations.

The resin-coating technique is one of the successful bonding techniques used for the indirect restorations. The dentin surfaces exposed after cavity preparation are coated with a thin film of a coating material or a dentin bonding system combined with a flowable composite resin. Resin coating can minimize pulp irritation and improve the bond strength between a resin cement and tooth structures. The technique can also be applied to endodontically treated teeth, resulting in prevention of coronal leakage of the restorations. Application of a resin coating to root surface provides the additional benefit of preventing root caries in elderly patients. Therefore, the coating materials have the potential to reinforce sound tooth ("Super Tooth" formation), leading to preservation of maximum tooth structures.

Effect of chronic stress on capsaicin-induced dental nociception in a model of pulpitis in rats

ObjectiveChronic stress can alter nociceptive sensitivity. However, the effect of stress exposure on dental nociception has been less addressed. Therefore, the present study investigated the effects of chronic exposures to some social and psychological stresses on pulpal nociceptive responses. DesignThe stress groups were constructed as follows: forced swimming (n=6), restraint (n=6), and mild (n=10) and severe (n=15) crowding stresses. Rats were subjected to stress for 1h per day for a week. At the end of the stress session, pulp irritation was induced by intradental application of capsaicin (100μg). There were another capsaicin or capsaicin plus stress training groups that received articaine 5min before the administration of capsaicin. Nociceptive responses were recorded for 40min. The time (ins) of continuous shaking of the lower jaw and excessive grooming and rubbing of the mouth near the procedure site was measured as nociceptive behaviors. Data was analyzed using one-way analysis of variance (ANOVA) followed by post hoc Tukey’s test. ResultsSignificant nociceptive responses were evoked by the administration of capsaicin. Exposures to forced swimming (p<0.01), restraint (p<0.001), and both mild and severe crowding stresses (p<0.05) exaggerated capsaicin-induced nociceptive reaction. There was, however, no significant difference in nociceptive reaction time between the different stress groups. Articaine buccal infiltration attenuated nociceptive time in capsaicin and capsaicin plus stress training groups (p<0.001). ConclusionsThe current data support the association between chronic stress exposures and nociceptive behavior following intradental capsaicin administration.

A testing method examining the dentinogenesis ability of the pulp cells for evaluation of the pulp irritation of the restorative materials

A testing method examining the dentinogenesis ability of the pulp cells for evaluation of the pulp irritation of the restorative materials

Cytotoxicity and biocompatibility of resin-free and resin-modified direct pulp capping materials: A state-of-the-art review.

Direct pulp capping is the placement of a dental material directly over exposed pulp to prevent dental pulp from dying and avoid the need for root canal treatments. Calcium hydroxide and calcium silicates/mineral trioxide aggregates (MTA) have been commonly used for direct pulp capping with great success clinically. In recent years, resin-modified calcium hydroxide and calcium silicates have been developed with the advantages of precise placement, command set, and superior physical strength. As pulp capping materials would be in direct contact with the pulp, the cytotoxicity and biocompatibility is of particular importance in order to avoid pulp irritation and maintain pulp vitality. Therefore, this review article will summarize the cytotoxicity and biocompatibility of direct pulp capping materials, particularly resin-modified materials.

Comparative Evaluation of Microleakage in Restored Primary Molars using Conventional and Chemomechanical Removal of Carious Tissue: An in vitro Study

ABSTRACTBackground and objectiveMicroleakage of restored teeth can be considered as a major contributing factor for the occurrence of tooth discoloration, secondary caries, deterioration of restorative material, postoperative tooth sensitivity, and pulpal irritation. The objective of this study was to compare the microleakage of primary molars restored with conventional glassionomer cement (GIC) and Giomer after caries removal using conventional cavity preparation (CCP) and chemo-mechanical caries removal (CMCR) techniques.Materials and MethodsSixty extracted carious human primary molars were randomly assigned into three groups of 20 each based on the method of caries removal: Group A: CCP technique; group B: CMCR using Papacarie gel; and group C: CMCR using Carisolv gel. Each group was further divided into two of 10 teeth each according to the restorative material used – conventional GIC (Fuji II) and Giomer (Beautifil II). The restored teeth were thermocycled, immersed in methylene blue dye, sectioned, and examined under stereomicroscope to elicit the dye penetration scores.ResultsThe results demonstrated that none of the restorative materials were free from microleakage. In Fuji II samples highest microleakage scores were noticed in group A (2.09) followed by group B (0.64), and least in group C (0.27), which were statistically significant. However, in Giomer samples no statistical significant difference in microleakage scores was noticed among the three groups.ConclusionChemo-mechanical caries removal technique showed less microleakage when compared to CCP technique and the marginal sealing ability of Giomer was superior to conventional GIC.How to cite this articleSankar AJS, Birra C, Bandi S, Chinta M, Enuganti S, Mukthineni S. Comparative Evaluation of Microleakage in Restored Primary Molars using Conventional and Chemomechanical Removal of Carious Tissue: An in vitro Study. J Contemp Dent 2016;6(2):108-113.

Resin Coating Technique for Protection of Pulp and Increasing Bonding in Indirect Restoration

A resin coating technique has been widely advocated in recent years. A combination of a dentin bonding system and a flowable composite is applied on the exposed dentin surfaces immediately after tooth preparation and before taking the final impression. The resin coating is beneficial to both minimize pulpal irritation and enhance the bond strength of a resin cement to dentin. Recently introduced thin-film coating materials based on all-in-one adhesive technology are used for resin coating of crown restorations. Thin-film coating materials can be applied in a single clinical procedure and followed by created a barrier-like film layer on the prepared dentin. Therefore, the resin coating technique may play an important role to protect the dentin phys- ically, chemically, and biologically. The coating materials also have the potential to cover exposed sound enamel and dentin, leading to maximum tooth structure preservation.