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   Table of Contents - Current issue
January-February 2023
Volume 15 | Issue 1
Page Nos. 1-118

Online since Tuesday, February 28, 2023

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Antibacterial activity of nanoparticle-coated orthodontic archwires: A systematic review p. 1
Mathew T Maliael, Remmiya M Varghese, Aravind K Subramanian
Aim: The purpose of this review is to conduct a systematic assessment of the literature and report on the antibacterial activity of nanoparticle-coated orthodontic archwires. Materials and Methods: A systematic search of the following scientific databases PubMed, Google Scholar, SCOPUS, LILACS, and Cochrane CENTRAL was performed to identify relevant articles that were published until December 2021. Articles satisfying the eligibility criteria were included in the review process. Methodological evaluation was done to determine the methodological quality of the included studies. The data of antibacterial activity evaluated by the studies were extracted. Results: A total of five studies were included in the qualitative analysis. All of the included studies showed that nanoparticle-coated orthodontic archwires showed good antibacterial activity when compared with uncoated control archwires. The overall methodological quality of the included studies was assessed to be moderate. Conclusion: Qualitative assessment of the available literature suggests a significant in-vitro antibacterial activity of orthodontic archwires that were subjected to surface modification by nanoparticle coating.
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Correlation between the variation of head type and malocclusion: A Scooping Review Highly accessed article p. 8
Ari Triwardhani, Alif Rakhman Effendi, I Gusti Aju Wahju Ardani, Raihan Nadia Utami
Aim: Examination of head type in orthodontics is pivotal. Examining the head type aims to monitor growth patterns and predict the outcome of an orthodontic treatment. Malocclusion is a disease with a complex etiology. Anomaly in the development pattern of the oral and maxillofacial region can be suspected as the etiology of malocclusion. A specific type of head will result from specific growth patterns. As a result, dental and skeletal malocclusion occurrences are linked to particular head forms. Materials and Methods: These articles’ literature sources were from various databases that described cephalic index correlation and cephalic index malocclusion. Results: A correlation is found between mesocephalic head type with skeletal and dental malocclusion class II, mesocephalic head type with skeletal and dental malocclusion class I, mesocephalic head type with skeletal malocclusion class I and dental class II, mesocephalic head type with skeletal malocclusion class I, and dental class III. Meanwhile, dolichocephalic head type correlates with dental and skeletal malocclusion class II, dolichocephalic head type with skeletal 111 class II, and dental class I, dolichocephalic head type with skeletal malocclusion class I, and dental class II. In addition, brachycephalic head type correlates to skeletal and dental malocclusion class II and the relationship between brachycephalic head type with skeletal malocclusion class III and dental class II. Class I malocclusion is associated with the mesocephalic head type because the mesocephalic head type favors balanced development of the craniomaxillofacial complex. Class II malocclusion is associated with dolichocephalic head type, selecting the face’s predominantly long morphology. Class III malocclusion is associated with brachycephalic head type, favoring the maxilla’s retrusion. Conclusion: Malocclusion classification correlates with variations in head types. Genetic and environmental variables, or possibly both, impact this disease.
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3D printing in orthodontics: A narrative review p. 15
Sruthi Harikrishnan, Aravind Kumar Subramanian
Aim: Digital technology profoundly impacts every aspect of orthodontics, from diagnosis and treatment planning to appliance fabrication. Integrating computer-aided designing tools and rapid prototyping hardware has allowed orthodontic practices and laboratories worldwide to revolutionize their workflows. This narrative review aims to consolidate literature findings regarding the use of three-dimensional (3D) printing technology in orthodontics in terms of its current state of development and availability while also exploring the type of printing technology used, accuracy, and efficiency of its potential use in clinical orthodontics. Materials and Methods: 3D printing in orthodontics has been the subject of a comprehensive electronic literature search from 2010 to 2020 using PubMed and Google Scholar databases with relevant MeSH terms and keywords. Orthodontics, 3D printing, 3D-printing processes, accuracy, precision, and efficiency were used to identify studies for this review. Two calibrated reviewers separately applied inclusion and exclusion criteria to each article. Selected article references were checked to expand the article search. Types of 3D printers, assessment techniques, and examined parameters were considered for data extraction, and qualitative analysis was done for evidence synthesis. Results: The search strategy yielded 108 titles. Thirty-six articles that met our inclusion criteria were included in the qualitative analysis: 20 articles were about cast models, seven about indirect bonding, three about aligners, and six about surgical splint fabrication. The most common 3D-printed device types were models. The most commonly used 3D-printing techniques are stereolithography and digital light processing for orthodontic applications. 3D-printed clear aligners are more precise than thermoformed clear dental aligners. Digital occlusal splint and surgical templates increase accuracy, reliability, and efficiency than a conventional one. Conclusions: A 3D printer can be used by the orthodontist to create an entirely digital workflow. Although the 3D-printing technologies used for orthodontic appliance fabrication have demonstrated equal or superior accuracy to conventional models, there is insufficient evidence to conclude that one type of printing is more accurate and efficient than the others. These findings suggest that conventional impressions and stone models can be eliminated, reducing the amount of storage required in the office and improving practice efficiency, appliance fit, and model reuse. Digital 3D-printed appliances are more accurate, reliable, and efficient than conventional ones. Future research must identify potential 3D-printing technology specific to various orthodontic procedures.
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Polyether ether ketones (PEEK): Properties and applications as implants for alternative dentistry materials: A narrative review p. 28
Imam S Azhar, Rania G Syaharani, Vanya S Smeer, Multazan Multazan
Aim: Titanium has been a popular material for dental implants. However, there are several drawbacks to these materials, including the occurrence of allergies, bone resorption, surface damage, contamination linked to peri-implantitis, high modulus of elasticity, and less aesthetically pleasing hue. As a result, polyether ether ketone (PEEK) can be utilized as a substitute material in dentistry. The purpose of this review of the literature is to identify the attributes and uses of PEEK in dentistry, particularly for implant applications. Materials and Methods: The articles were independently evaluated during the screening procedures in accordance with the eligibility requirements. The criteria also include studies that are written in English and published on PubMed, ScienceDirect, ResearchGate, and Web of Science, as well as narrative reviews, research articles, and other studies. Articles published before 2014, case reports, case series, book chapters, and articles not related to PEEK in dentistry were excluded in the criteria. Strategy to find articles using PICO includes patients in needs of dental implants, PEEK, titanium, and PEEK as an alternative material for dental implant. The risk of bias was assessed using Cochrane Risk of Bias Tool 2 (RoB 2). Results: A total of 26 articles were identified, of which 16 were of particular relevance to the use of PEEK in dental applications, especially implants. Conclusion: Due to its low elastic modulus, good mechanical structures, and bone-contact biocompatibility when used as a bulk implant, PEEK can be a substitute material in oral implantology. It is possible to improve PEEK’s bone-contact biocompatibility and lessen its downsides by altering the material’s surface and mixing.
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Anticaries vaccine as a promising alternative for protection against dental caries: A literature review p. 34
Sebastian Contreras, Frank Mayta-Tovalino, Arnaldo Munive-Degregori, Roman Mendoza, John Barja-Ore, Cesar Mauricio-Vilchez
Aim: The aim of this review was to describe the scientific progress regarding anticaries or dental caries vaccines. Material and Methods: An electronic search without date restriction prioritizing those scientific articles belonging to the last 5 years was performed in the PubMed and Scopus databases. The following keywords were used: “anticaries vaccine,” “vaccine against dental caries,” and “caries vaccine.”Results: A total of 11 studies were considered for the present investigation, of which seven were in vivo, one was in vitro, two were both in vivo and in vitro, and one was a theoretical article. The most frequently investigated parameter was the induction of antigen-specific antibodies generated by the administration of the different types of anticaries vaccines. Conclusions: More in vivo studies aiming at solving the few disadvantages of the current anticaries vaccines need to be carried out to start studies in human samples in the not-too-distant future.
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Evaluation of shade matching of monochromatic versus polychromatic layering techniques in restoration of fractured incisal angle of maxillary incisors: A randomized controlled trial p. 43
Basma Badry Hashem, Mohammed Adel Khairy, Omar Osama Shaalan
Aim: To evaluate shade matching potential of monochromatic layering technique (Filtek Universal) compared to polychromatic layering technique (Filtek Z350XT) in restoration of fractured incisal angle. Materials and Methods: A total of 26 patients received 26 class IV restorations divided randomly between groups (n = 13) using either; monochromatic layering technique (Filtek Universal) or polychromatic layering technique (Filtek Z350XT) in a parallel study design with superiority framework. After preparation, class IV resin composite restorations were performed according to manufacturers’ instructions. Shade matching of class IV restorations was evaluated by two blinded and calibrated assessors using the modified USPHS criteria and digital photography at baseline and after three-days. Association between the layering technique for restoration of fractured incisal angle and shade matching potential was done using the chi square test; statistical significance was set at P ≤ 0.05. Results: Inter-group comparison between layering techniques for shade matching using the modified USPHS criteria have shown statistically significant difference at baseline (P = 0.0001), while there was no statistically significant difference after 3 days (P = 0.2864). Intra-group comparison between follow-up periods within monochromatic layering technique have revealed statistically significant difference (P = 0.0001), while within polychromatic layering technique there was no statistically significant difference (P = 0.2864). Inter-group comparison between both layering techniques using digital photography have shown no statistically significant difference at baseline (P = 0.3592), while after 3 days there was statistically significant difference (P = 0.0071). Intra-group comparison between follow-up periods within monochromatic layering technique have shown statistically significant difference (P = 0.0002), while within polychromatic layering techniquethere was no statistically significant difference (P = 0.3592). Conclusions:Monochromatic resin composite restorations showed satisfactory shade matching potential when compared to polychromatic resin composite restorations.
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Hepatitis C associated oral lesions: A hospital-based retrospective case control study in Egypt p. 52
Radwa M Ismail, Amira R Elansary, Ola M Ezzatt, Mohamed G Hamed, Yasmine Gamil
Aim: Investigate the association of hepatitis C virus (HCV) infection on incidence of various oral lesions in a sample of Egyptian population. Materials and Methods: This case control observational retrospective study was conducted on outpatients’ clinics of a University Hospital. The predicted total sample size (n) was 100 with 1:1 ratio by using G*Power (version In which, incidence and frequency of different oral manifestations in 50 HCV patients (cases) were compared to that of 50 healthy individuals(controls). Demographic and clinical data were collected using a structured questionnaire. Frequencies of findings were compared and analyzed using Fisher’s exact test, and regression analysis was performed to ascertain the effects of hepatitis C as well as age, sex and diabetes mellitus on the likelihood of different oral findings. Results: The oral mucosal signs and symptoms were generally more frequent among HCV compared to healthy controls. The frequency was statistically significant higher in HCV patients regarding xerostomia (40%), altered taste (24%) and oral lichen planus (20%), but insignificant regarding atrophic tongue (18%), oral pigmentation (14%) and pallor (10%). The presence of HCV was significantly associated with increased odds of xerostomia (P = 0.028, OR=4.3), oral pigmentations (P = 0.013, OR=12.6) and atrophic tongue (P = 0.039, OR=7.8). While other predictors had no significant effects on any of oral findings. Conclusion: In a hospital-based sample of Egyptian population; Xerostomia, altered taste and oral lichen planus were significantly frequent with HCV infection in comparison to healthy individuals. While xerostomia, oral pigmentations and atrophic tongue were associated with HCV.
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Perception of the COVID-19 vaccination process in Peruvian dental professionals: A logistic regression analysis p. 59
César F Cayo-Rojas, Gissela Briceño-Vergel, Nancy E Córdova-Limaylla, Marysela Ladera-Castañeda, Carlos López-Gurreonero, Alberto Cornejo-Pinto, Luis A Cervantes-Ganoza
Aim: Because of the situation regarding COVID-19, dentists are constantly exposed to being infected with the coronavirus, since they have direct contact with the patient. Therefore, agreeing to be vaccinated against COVID-19 seems to be a promising solution to reduce the risk of death in these professionals. Therefore, the present study aims to assess the perception of the vaccination process against COVID-19 in Peruvian dental professionals. Materials and Methods: An analytical, observational, and cross-sectional study was conducted in 360 Peruvian dentists between June and August 2021. An instrument that measured the perception of the COVID-19 vaccination process was developed and validated. A crude and adjusted logit model was used to assess the association of the following variables: age (X1), gender (X2), marital status (X3), number of children (X4), place of origin (X5), occupation (X6), years of experience (X7), academic degree (X8), specialization (X9), vulnerability (X10), COVID-19 history (X11), origin of vaccine (X12), dose received (X13), and professional association location (X14), with the perception of dentists toward the COVID-19 vaccination process, considering a P value < 0. 05. Results: Of the 360 Peruvian dentists surveyed, the prevalence of poor perception was 53.61% (95% confidence interval [CI] = 48.45%–58.75%). Of the variables analyzed, the only one that proved to have a significant influence on the development of poor perception, according to the logistic regression analysis (logit model), was the location of the professional association, with an odds ratio (OR = 0.37, CI = 0.22–0.62), whereas Sinopharm vaccine (OR = 1.70, CI = 0.35–8.25) or Pfizer/BioNTech (OR = 2.31, CI = 0.45–11.88) and the other variables were not considered as influential factors in the development of poor perception toward the COVID-19 vaccination process (P > 0.05). Conclusions: More than half of the Peruvian dentists surveyed had a poor perception of the COVID-19 vaccination process. However, those whose professional association was located in the capital city were 63% less likely to have a poor perception than those dentists from the provinces. In addition, the origin of the vaccine and other variables such as age, gender, marital status, number of children, origin, occupation, years of experience, academic degree, specialization, vulnerability, history of COVID-19 and dose received were not considered influential factors for developing poor perception.
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Efficiency of orange oil solvent combined with disinfectants and bioactive glass (BAG) on the cleanness of root canal after endodontic retreatment: An in vitro study p. 71
Reem Ashraf, Heba Badra, Ahmed Abdou
Aim: Endodontic retreatment is associated with clinical complication with doubtful success rate due to limited removal and cleaning of remnants and bacteria. This study investigated the effect of orange oil solvent containing bioactive glass on the removal of root canal filling material and bacterial loading during root canal retreatment. Materials and Methods: Thirty single-rooted, freshly extracted human central teeth were collected. Access opening and instrumentation were done. Samples were injected with 10 µL bacterial suspension (Enterococcus faecalis [E. faecalis]) at 37°C for 48 h and then filled with root canal filling using lateral compaction technique. Upon removal of the filling materials by retreatment kits, samples were divided based on the type of irrigating solution into three groups (n = 10): G1, 5 mL orange oil solution only; G2, 5 mL of 5% sodium hypochlorite with an orange oil solvent solution; G3, 5 mL of orange oil solution with bioactive glass (10%). All groups were subjected to a turbidity analysis and tested for colony-forming units (CFU)/mL. Afterward, longitudinal sections of samples were obtained from the root, and scanning electron microscopy was used to scan root wall. Scanned images were analyzed by two evaluators using a scoring system. Data were then statistically analyzed using Kruskal–Wallis test. Results: Significant difference resulted between tested groups for bacterial count (log CFU) at P = 0.015. G2 showed the highest significant bacterial count compared with G3 (P = 0.018). G1 showed an insignificant difference with other groups (P > 0.05). For cleaning efficiency scores, the highest significant scores resulted for G2, which was significant with +ve ctrl group (P = 0.01). Conclusion: The addition of bioactive glass did not influence antibacterial activity of orange oil irrigants in the removal of residual root canal filling materials.
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Antifungal effect of acrylic resin denture base containing different types of nanomaterials: A comparative study p. 78
Mohamed A A Ismaeil, Mohamed I Ebrahim
Aim: Denture stomatitis is a frequent condition that has an influence on denture users’ oral mucosa, and it is related to the presence of Candida albicans. Silver and titanium nanoparticles are antimicrobial agents with a broad spectrum of activity. This research sought to represent and compare the antifungal properties of acrylic resins modified with two concentrations of silver nanoparticles (AgNPs) and titanium-oxide nanoparticles (TiO2 NPs) against a clinical isolate of C. albicans. Materials and Methods: One-hundred discs of acrylic resin specimens were classified into five groups based on nanoparticles’ concentration: group A: unmodified acrylic resin; groups B1 and B2: modified by adding 0.5% and 1% AgNPs to the acrylic resin powder, respectively; groups C1 and C2: modified by adding 0.5% and 1% TiO2 NPs to the acrylic resin powder, respectively. The antimicrobial efficacy of different acrylic resin discs against C. albicans clinical isolates was assessed using disc agar diffusion and elution tests (surface-plate method). The analysis of variance test was employed to evaluate the data that differentiate among means of different groups at P ≤ 0.05 significance level. Results: The bioactivity and biomass of C. albicans biofilm reduced as the nanoparticle content rises; about 0.5%, 1% of AgNPs, and 1% TiO2 NPs exhibited higher antimicrobial and antibiofilm effects against C. albicans clinical isolates caused by inhibition zone and reduction of the colony counts. Conclusion: Acrylic resins modified by adding AgNPs or TiO2 NPs exhibited antimicrobial activity against C. albicans clinical isolates.
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Comparative evaluation of the antimicrobial efficacy of different concentrations of the novel root canal filling material for primary teeth: A microbiological study p. 84
Lavanya Govindaraju, Ganesh Jeevanandan
Aim: To determine the antimicrobial efficacy of the different concentrations of a novel root canal filling material and to proclaim the best concentration with maximal antimicrobial effect against Streptococcus mutans and Enterococcus faecalis. Materials and Methods: The present study is an in vitro microbiological study to check the antimicrobial efficacy of different concentrations of the novel obturating material which was prepared using calcium hydroxide, zinc oxide cement, and metronidazole against S. mutans and E. faecalis using Muller Hilton Agar for 24 hours at 37°C. A total of 30 samples were tested (15 for S. mutans and 15 for E. faecalis). The zone of inhibition was measured in millimeters after 24 hours. The values were entered in a Microsoft Excel spreadsheet and subjected to statistical analysis using Friedman test and Kruskal–Wallis test. Results: The mean zone of inhibition was statistically greater against S. mutans at 100 µL with 2% and 3% concentration of the novel root canal filling material (P = 0.01). Comparison in between the groups at different concentrations shows no statistically significant difference among the three different concentrations; however, the zone of inhibition is greater with 3% metronidazole. Conclusion: The formulation obtained with 3% metronidazole at 80-20 (calcium hydroxide–zinc oxide) concentration of the novel obturating material at 100 µL showed better antimicrobial activity against both S. mutans and E. faecalis.
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Comparative evaluation of the antibacterial efficacy of herbal agents as intracanal medicaments individually or in combination with chitosan: An in vitro RTPCR study p. 89
Gaurav Patri, Kotni Sheetal, Prasanti Kumar Pradhan, Pratik Agrawal, S Lata
Aim: To evaluate and compare the antimicrobial efficacy of herbal agents as intracanal medicaments with or without a carrier against E. faecalis. Materials and Methods: In this in vitro study, 80 extracted human single-rooted anterior or premolar teeth were used. They were decoronated to obtain standardized 6 mm blocks of the mid root. The internal root diameter was standardized(GG drill #3). All samples underwent 21-day contamination with E. faecalis after which they were randomly divided into(n = 20) Group 1, Triple antibiotic paste (Control); Group 2, Curcumin; Group 3, Propolis and Group 4, Aloe Vera gel. The groups were further sub grouped(n = 10) based on presence / absence of carrier (chitosan). 14 days post medication, E. faecalis from samples was quantified using qPCR and the data was analysed using One-way ANOVA and Tukeys Post-Hoc test. Results: All medicaments exhibited antimicrobial properties. TAP performed the best, Individually, Propolis showed almost similar efficacy (P = 0.598). With chitosan combination, Curcumin was a close contender to TAP (P = 0.963). Aloe Vera gave the poorest result, but on addition of chitosan there was a significant increase (P = 0.000) in the antimicrobial efficacy. Conclusion: Based on the aim and the results obtained it can be concluded that all the test medicaments exhibited antimicrobial properties. TAP had superior antimicrobial properties compared to others. Individually, propolis and in combination with chitosan, curcumin showed similar antimicrobial efficacy. Aloe vera performed the poorest but when combined with chitosan, its antimicrobial properties significantly improved.
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Behavior management techniques adopted by pediatric dentists in Cairo, Egypt: A cross-sectional study p. 97
Samah M Kanzel, Kamal El Motayam, Fatma Abdelgawad
Introduction: The child patient is exposed to the dental environment that triggers natural fear response, so behavior management strategies are required to meet their needs. Objective: The objective of the study was to identify the most common behavior management techniques adopted by pediatric dentists in three Egyptian universities for each patient group. Materials and Methods: In this cross-sectional study, we applied convenient sample to the three major governmental universities located in Cairo. Ninety-two questionnaires were distributed to all pediatric dentistry specialists of the three universities. They were designed to record participants’ demographic and practice information and their current use of behavior management techniques for each patient age. Descriptive statistics, Chi-square (χ2) test, and Bonferroni corrections were used to analyze data. Results: Questionnaires were returned by 72 pediatric dentists (27.8% were males and 72.2% were females). Parental presence was practiced by all participants mainly for patients less than 2 years (93.1%). Tell-show-do is the most used technique (95.8%) for patients of 3–5 years. The use of advanced techniques by respondents was less than basic techniques, being least for sedation and highest for general anesthesia. Female respondent preferred basic behavior management techniques, whereas male participants chose advanced techniques more than females. Conclusions: Different behavior management techniques are being practiced for each patient group. The choice of the technique was influenced by the practitioner gender, years in practice, and position in the faculty.
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Prevalence of malocclusion and orthodontic treatment needs among Saudi primary school male children aged 6–12 years: A cross-sectional study p. 106
Saleh H Alwadei, Abdulrahman Ali Hattan, Khalid Faqihi, Ali Alhawiatan, Farhan Alwadei, Abdurahman Alwadei
Aim: To evaluate the prevalence of malocclusion and the need for early orthodontic treatment (EOT) using dental health component (DHC) of the index of orthodontic treatment need (IOTN). Materials and Methods: In this cross-sectional study, clinical examination was performed on 357 male children, aged 6–12 years who were randomly selected from five public schools and one public pediatric dental clinic, in Al-Kharj province, Saudi Arabia. The examination assessed various occlusal parameters using IOTN, across the total sample and further between two subgroups (early and late mixed dentitions). Results: For the total sample 58.8% had Angle’s Class I malocclusion, 26.7% had Angle’s Class II, 9.8% had Angle’s Class III, while crowding was present in 44.5%. Over 1/4 of the younger group and 42.8% of the older group exhibited at least one feature indicating EOT: anterior crossbite, posterior crossbite, open bite, impinging overbite, ≥7 mm overjet, and Class III malocclusion. However, no statistical differences were found between the two groups (P > 0.05). According to DHC score, 77 participants (21.6%) were in definite OTN. The DHC score demonstrates its validity in identifying evidence-based malocclusion features as significant indicators for EOT. Compared to DHC, the esthetic component significantly overestimated lack of OTN and significantly underestimated definite OTN (P < 0.05). Conclusion: The prevalence of malocclusion and EOT need is generally similar among younger and older children, but the distribution is higher among older children. Orthodontic screening at early mixed dentition stage is essential.
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Comparative evaluation of the microleakage of Cention N and glass ionomer cements in open-sandwich class II restorations—An in vitro study p. 113
Namith Rai, Shobana Shetty, Ravi Gupta
Aim: To evaluate the microleakage of Cention N in comparison with glass ionomer-based Giomer and Vitremer in class II open-sandwich cervical lining restorations with Fuji II as a control. Materials and Methods: Cavity preparation and grouping of specimens were performed as follows: the sample size was statistically derived at 50 samples into five groups of n = 10 cavities each. Standardized cavity preparation on the mesial surface at the cementoenamel junction of each tooth was: the width was 5 mm, the occlusal depth was 2 mm, and the axial wall length was 6 mm. The teeth were randomly assigned into five (groups 1–5) groups of n = 10 cavities each; group I and group II are the control groups. The samples were stored in artificial saliva at 37°C for 14 days to ensure resinous hydration of the restorations and then placed in water baths for thermocycling and immersed in methylene blue dye and then sectioned and viewed under a stereomicroscope (20×). The microleakage was scored at the occlusal, cervical, and interfacial surfaces. Results: Statistical analysis for microleakage was done with analysis of variance followed by Tukey’s post hoc test. For the interfacial microleakage, group IV (Cention N as a base) was significantly better than group III (Vitremer as a base) and group V (Giomer as a base) (Table 3, Graph 1). Conclusion: In this in vitro study, microleakage scores of Cention N were better than Giomer and Vitremer and comparable with Fuji II LC, suggesting it could be placed as a cervical lining for class II restoration.
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