Background: Mineral trioxide aggregate (MTA) is known as a common biomaterial for pulpotomy of primary molars, with limitation including high cost, difficult handling, and long setting time. This study was conducted to compare the clinical and radiographic success rate of Allium sativum oil and MTA in pulpotomy of primary molar teeth. Materials and Methods: This randomized, controlled, clinical trial was performed on a group of children with at least two symptom-free primary molars requiring pulpotomy. A total of 90 teeth were randomly assigned into two groups: After pulp amputation and hemostasis, Group I received MTA as medication in the pulp chamber and Group II received Allium sativum oil over the pulp stumps. Pulp chamber was then filled with reinforced ZOE paste (zinc oxide eugenol) and teeth were restored using stainless steel crowns. The follow-up scheme of 6, 12, and 18 months was set, and teeth evaluation was conducted by a calibrated pediatric dentist based on the modified criteria proposed by Zurn and Seale. The results were analyzed using the generalized estimating equation analysis with the P = 0.05 as the level of significance. Results: The clinical success rate was 100% in both groups after all follow-ups. The radiographic success rate was, however, 91.1% after 6.75. 6% after 12 and 18 months in Group II while it was 95.6% after 6, 91.1% after 12 and 18 months in Group I in those follow-up points. The difference between the two groups was not statistically significant. Conclusion: According to the results, Allium sativum oil has a high clinical and radiographic success rate comparable to those of MTA.

Background: This study aimed to assess the color change of two amine-free dual-cure resin cements following aging in comparison with a light-cure resin cement. Materials and Methods: This in vitro, experimental study evaluated 6 groups (n = 10), including three groups of cements bonded to feldspathic porcelain and three groups of resin cements alone. Panavia V5 (Kuraray) and G-CEM LinkForce (GC) dual-cure resin cements and Choice 2 (Bisco) light-cure resin cements were bonded to porcelain according to the manufacturers' instructions. The color parameters of the groups were measured before and after 5000 thermal cycles by spectrophotometry. Data were analyzed using two-way ANOVA and Tukey's post hoc test (α =0.05). Results: The color change (ΔE) of the cement groups alone was significantly greater than that of porcelain-bonded cements. The ΔE of G-CEM LinkForce cement group was significantly higher than that of Panavia V5 group (P = 0.020), and the ΔE of the latter group was significantly higher than that of Choice 2 cement group (P = 0.021). Conclusion: Considering the color change of cements evaluated in this study, Choice 2 and Panavia V5 cements bonded to porcelain showed acceptable color change, which indicates that they are suitable for cementation of esthetic dental restorations. Ceramic laminates have become an ideal esthetic treatment for anterior restorations. The resin cement discoloration can affect final appearance of these restorations. Besides that, exposed resin cement line can lead to the esthetic problem over time.

Tricho-dento-osseous syndrome (TDO) is a rare autosomal dominant disorder with complete penetrance. Common clinical features include abnormalities of hair, teeth, and skull. Dental management of TDO patients is quite challenging in terms of existing dental and skeletal problems. The current article presents a 12-year-old girl suffering TDO, followed by a review on the published literature pertaining to the dental management of TDO patients. Patient history included, rejected corneal transplantation, stone-forming kidneys, and several previous dental treatments. She was noted to have signs of mandibular prognatia, frontal bossing of the skull, mild bilateral tibial bowing, microstomia, and labial fissures. Dental findings included severe generalized enamel defects, discolored teeth, microdontia, anterior open-bite, posterior cross-bite, deep periodontal pockets, hyperplastic inflamed gingiva, taurodontism of permanent molars, dental periapical radiolucencies, and missing teeth. She was the only child of healthy, nonconsanguineous parents with no familial history of similar congenital syndrome or dental abnormalities. A treatment plan was established based on medical/dental history and findings, using a team-based approach. This article emphasizes the importance of a multidisciplinary approach for the dental management of patients suffering TDO.

Background: To evaluate the effect of Ethanol Wet Bonding Technique (EWBT) on postoperative hypersensitivity (POH) of composite restorations in premolar teeth. Materials and Methods: In this randomized trial, 24 patients with at least three proximal carious lesions with similar axial depth and position of gingival floor in their premolars were enrolled. Following cavity preparation, the teeth were randomly assigned to one of three groups: (1) Class II resin-based composite (RBC) restoration using an etch-and-rinse adhesive + wet bonding technique (Control); (2) RBC restoration using EWBT + hydrophobic adhesive; and (3) RBC restoration using EWBT + hydrophilic adhesive. Tooth hypersensitivity was evaluated before and 1, 3, 7, 14 and 30 days after treatment according to the Visual Analog Scale. Data were analyzed statistically with Kruskal–Wallis and Friedman tests (P = 0.05). Results: All teeth showed similar levels of hypersensitivity after treatment (both P > 0.05). Furthermore, there was no difference between POH levels of the test and control groups at any control period (P < 0.05). Friedman test indicated that the POH significantly reduced within time in all groups (P < 0.05). Conclusion: Application of ethanol-wet bonding technique, either with hydrophobic or hydrophilic adhesives did not affect the POH of Class II composite restorations in premolars.

Background: Cention N has been introduced as an alternative material for amalgam. The purpose was to investigate the flexural strength and microhardness of this material in self-cure and dual-cure modes before and after thermocycling. Materials and Methods: In this experimental study, 40 samples of Cention N were prepared in order to determine and compare the microhardness. Half of the samples were set by self-cure method and the other half with dual-cure method. The Vickers microhardness test was performed once after 24 h and again after 10000 thermocyclings. Three-point flexural test was used to determine and compare the flexural strength of 52 rod-shaped samples. Half of the samples were set by self-cure method and the other half with dual-cure method. Among 26 samples in each group, 13 samples were randomly selected and three-point flexural test was performed after 24 h and for another 13 samples after 10,000 thermocyclings. Data were analyzed using two-way ANOVA and paired samples t-test (P < 0.05). Results: There was a statistically significant difference between the mean of microhardness values in two curing methods (P < 0.001) and in two storage conditions (P < 0.001). The mean of dual-cure microhardness (100.99 ± 7.22) was higher than that of self-cure (64.61 ± 12.51) and the mean value associated with pre-thermocycling (89.75 ± 15.84) was higher than that of the post-thermocycling (76.44 ± 23.56). There was no statistically significant difference between the mean flexural strength in the two curing methods (self-cure [72.85 ± 16.26], dual cure [79.87 ± 23.07]; [P > 0.05]). However, the mean flexural strength without thermocycling (85.98 ± 21.74) was higher than that of the thermocycled group (64.24 ± 6.40) (P < 0.001). Conclusion: The microhardness of Cention N in dual-cure mode was higher than that of self-cure mode, but the flexural strength of dual-cure was not significantly different from that of self-cure. Thermocycling had a significant effect on the microhardness and flexural strength.

Background: This randomized clinical trial (RCT) aimed to compare the 3-year survival rates of high viscosity glass ionomer restorations (HVGIC) using conventional cavity preparation and atraumatic restorative technique (ART) in primary molars. Materials and Methods: In this RCT, 139 schoolchildren aged 6–9 years with dentinal caries in primary molars were randomly allocated to groups, i.e. the ART group and the conventional group, utilizing a random number generator. Adequate allocation concealment was done. Intervention was delivered using standard procedure and GC Fuji IX ART HVGIC was used as restorations in both the groups. Analysis was carried in 92 participants, and survival rates in both the groups were compared at 12, 24, and 36-month intervals. IBM SPSS software was utilized to analyze the time taken for the procedure and the Kaplan–Meier estimate was used to assess the survival rates. P value of 0.05 was considered statistically significant. Results: The ART took longer to complete (16.48 ± 2.02 min) versus conventional rotary instrumentation (13.15 ± 1.32 min). The conventional method was slightly superior as compared to ART; excellent survival rates (i.e. >90%) were achieved in both groups at the end of 12-month follow-up with no significant differences at the end of 24 and 36 months as evident from Kaplan–Meier estimate (P = 0.255). Conclusion: Three-year follow-up showed that GIC restorations with ART and conventional method carried out using GC Fuji IX ART HVGIC were acceptably successful, substantiating the use of ART for the primary dentition in areas with high caries prevalence and limited access to dental care.

Background: The purpose of this in vitro study was to investigate drug release kinetics and cytotoxicity of a novel drug delivery system for treatment of periodontitis. Materials and Methods: This in vitro study addresses the fabrication of a polycaprolactone/alginic acid-based polymeric film loaded with metronidazole, as a basic drug in the treatment of periodontal diseases. Films were prepared by solvent casting technique. Four formulations with different percentages of drug by weight (3%, 5%, 9%, and 13%) were prepared. Drug release kinetics were investigated using ultraviolet–visible spectroscopy during (one week). Data were analyzed using repeated measures ANOVA. Cytotoxicity of drug-loaded system extracts was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay using L929 cells after 24-h incubation. The results were evaluated according to ISO standard 10993-5 and assessed using ANOVA and Tukey's tests at a significance level of P < 0.05. Results: All polymeric films showed a burst drug release followed by a gradual release. Drug release data were fitted well with the first-order kinetic model in all drug-containing formulations indicating that drug release is a fraction of remaining drug in the matrix. Drug release is mainly driven by diffusion of medium into the composite matrix. 3%wt metronidazole-containing formulation exhibited the best MTT result. Conclusion: The findings of this study supported the synthesis of drug-loaded periodontal films with 3% metronidazole due to better biological properties along with the ability of acceptable drug release to eradicate anaerobic periodontal bacteria.

Background: The aim of this study was to evaluate clinical and radiographic success rates of 3Mixtatin and Modified 3Mix-MP paste and compare it with conventional root canal treatment procedure in primary molars requiring pulpectomy. Materials and Methods: In this in vivo study, 66 primary molars in 52 children aged between 4 and 8 years with primary molars having chronic periapical abscess were treated randomly with 3Mixtatin, Modified 3Mix-MP paste, and Metapex. The subjects were reviewed at 6 and 12 months both clinically and radiographically after pulpal therapy to evaluate and compare the healing process. The data obtained were subjected to statistical analysis at a significance level of 0.05. Results: By the end of 12-month follow-up among the three groups, Group I seemed to be performing consistently better as compared to the other two groups when evaluated clinically and radiographically. However, Group III resulted in the greatest number of failures, with success rate being mere 42.9% at the end of follow-up period. Conclusion: Radiographic and clinical healing occurred in all the three groups; however, based on our results, Group I seemed to be performing consistently better among the three groups at 12-month follow-up. Hence, it can be inferred that 3Mixtatin used as a localized agent is effective and comparable to both Modified 3Mix-MP paste and conventional pulpectomy procedure involving calcium hydroxide and iodoform paste in primary teeth.

Background: COVID-19 pandemic has impacted the academic and clinical training of postgraduate dental students. This study aimed to assess various factors causing psychological stress in them, and the extent of stress perception during pandemic. Materials and Methods: In this cross-sectional study, 250 postgraduate students from nine dental colleges of Haryana and National Capital Region, India, responded to an online questionnaire sent electronically to them in September 2020, which included modified dental environment stress (DES) score, Perceived Stress Scale (PSS), and questions regarding COVID-associated stress (CAS). Students already diagnosed with any psychiatric disorder or having a history of any major adverse event during the last 6 months likely to affect their psychological health were excluded from this study. The data obtained were analyzed using Chi-square test, Independent t-test, univariate ANOVA with post hoc tests, Pearson moment correlation, and multiple hierarchical regression tests. P < 0.05 was considered statistically significant. Results: DES score was moderate for 48.8% and high for 34.4% of the participants. PSS was moderate for 69.2% and high for 18.8% of the participants. The most stressful factor in dental environment was the pattern of university examination, while the most stressful factor specific to COVID-19 was the fear of family members contracting the infection. PSS score was significantly higher in female participants. DES and CAS scores were significantly higher in students staying in hostels. Multiple hierarchical regression model depicted gender, mean health, and DES score as significant predictors of PSS. Conclusion: Postgraduate dental students reported the adverse impact of COVID-19 pandemic upon their training and prospects as a reason for the increase in stress.

Background: Patients with diabetes mellitus suffer from an additional macrophage dysfunction in the secretion of growth factor, which later decreases transforming growth factor beta 1 (TGF-β1). This condition disrupts proliferation and angiogenesis. Extract of okra fruit (Abelmoschus esculentus) contains flavonoid, an active substance which acts as antioxidant, anti-inflammation, and antidiabetes. The purpose of this study is to analyze the difference in TGF-β1 expression in wound-healing process after tooth extraction of diabetic Wistar rats. Materials and Methods: This is a laboratory experimental study using pretest and posttest on 24 Wistar rats which are divided into two groups: control group (treated with streptozotocin induction but without administration of okra fruit extract) and treatment group (treated with streptozotocin induction and oral administration of 250 mg/kg okra fruit extract once a day). Extractions of the rats' mandibular left incisors were performed using a pair of modified forceps and an elevator. The tooth sockets were then irrigated using saline solution. Four rats in each group were sacrificed on day 3 (KO1, PO1), 5 (KO2, PO2), and 7 (KO3, PO3). The socket tissues from the rats were then immunohistochemically analyzed. Data were analyzed at level significance of 0.05. Results: The average level of TGF-β1 expression in the treatment groups was higher compared to the control group: PO1 (11.59 ± 0.58), PO2 (15.15 ± 1.07), and PO3 (18.75 ± 2.73) as compared to KO1 (5.32 ± 1.69), KO2 (8.47 ± 0.60), and KO3 (9.28 ± 1.16) with P = 0.001. Conclusion: The administration of okra fruit extract can increase the level of TGF-β1 in wounds after tooth extraction of diabetic Wistar rats.