Context:Sodium hypochlorite is the most commonly used irrigant but it has disadvantage like high cytotoxicity. So there is a need to find an alternative to 5.25% Sodium hypochlorite against microorganism Enterococcus faecalis and Candida albicans. Literature has shown that these 5 extracts namely Terminalia chebula, Myristica frangrans, Aloe barbadensis, Curcuma longa and Azadaricta indica has good properties which can be used as a potential endodontic irrigant.Aims:To evaluate the antimicrobial efficacy of various herbal extracts namely Curcuma longa (CL), Azadiracta indica (AI), Aloe barbadensis (AV), Myristica fragrans (MF) and Terminalia chebula (TC) as endodontic irrigant against Enterococcus faecalis and Candida albicans using real-time quantitative polymerase chain reaction (qPCR).Materials and Methods:Eighty-four teeth were extracted and suspended with Enterococcus faecalis and Candida albicans. A preliminary study was first performed to determine the minimum inhibitory concentration of extracts. The irrigating groups were divided into five herbal groups and 2 control groups. After irrigating the teeth the remaining microbial load was determined using qPCR.Statistical Analysis Used:Statistical analysis was performed using Oneway Anova/Kruskal-Wallis test with post-hoc Tukey's HSD and was statistically significant (P < 0.05).Results:It was shown that Neem was highly efficient to 5.25% NaOCl in reducing Enterococcus faecalis and Candida albicans within the root canals when compared with other extracts.Conclusions:Neem leaf extract has a significant antimicrobial efficacy against Enterococcus faecalis and Candida albicans compared to 5.25% sodium hypochlorite.
Objectives: The primary objective of this systematic review is to compare the fracture resistance of lithium disilicate (LDS)-based endocrowns and resin-based (RB) endocrowns of in-vitro studies, and the secondary objective is to compare their catastrophic failures. Materials and Methods: The review protocol was registered in the P ROSP ERO database (CRD42020166201). A comprehensive literature search was done in PubMed, Cochrane, EBSCOhost and Google Scholar using key terms. Only in-vitro studies that compared fracture resistance of LDS-based endocrowns and indirect RB endocrowns in molars were included. Data extraction, risk of bias assessment and qualitative analysis of the included studies were performed. Results: Five studies were included in this systematic review. The overall risk of bias for the included studies was moderate. Under axial loading, RB endocrowns showed similar fracture resistance when compared with LDS endocrowns. However, they showed better fracture resistance when compared with zirconia reinforced lithium silicate (ZLS) endocrowns. Furthermore, RB endocrowns showed fewer catastrophic failures than LDS-based endocrowns. Conclusions: RB endocrowns have similar or better fracture resistance and fewer catastrophic failures when compared to LDS-based endocrowns.
Introduction: It is well-known in the field of endodontics that the presence of a smear layer in the root canals can harbor bacteria and limit the penetration of irrigating solutions and intracanal medications into the dentinal tubules which, in turn, causes the failure of endodontic treatment. Removing the entire smear layer throughout the root canal is essential for the success of endodontic treatment and these chemical agents that facilitate the removal of the smear layer are called chelating agents. Ethylenediaminetetraacetic acid (EDTA), being the most widely used chelating agent, brings about increased reduction in the microhardness of the root dentin, thereby making it friable.N-acetyl cysteine (NAC) is naturally occurring antioxidant that has various beneficial properties for the human being. Several studies have been done in determining the antimicrobial efficacy of NAC against various endodontic pathogens and concluded NAC to be advantageous. The chelating property of NAC has been utilized in heavy metal detoxification, where it binds to the metal ion and removes them from the human system. However, this chelating property has not been explored in the field of endodontics.Aim: This study was aimed to compare the ability of N-acetyl cysteine with the conventional chelating agent in the removal of the smear layer and in altering the microhardness of root dentin.Materials and Methodology: A total of 84 single-rooted human mandibular premolars with relatively similar dimension and morphology, freshly extracted with closed apices, were collected from adult patients. The crowns of all specimens were cut transversally at the cementoenamel junction (CEJ) with the double-faced diamond disc at low speed, with water coolant, to obtain a 12 mm root length. The root canals were randomly divided into three equal groups according to the final irrigation solutions: Group I: 17% EDTA, Group II: 20% NAC, and Group III: distilled water (control). They were then randomly divided into two parts: scanning electron microscope (SEM) analysis for the extent of smear layer removal and microhardness evaluation using the Vicker’s hardness test.Results: The smear layer removal ability of EDTA and NAC were more effective in the coronal and middle thirds of the root canal. However, both groups showed less smear layer removal in the apical region. Specimens treated with distilled water showed the least reduction in the smear layer throughout the length of the root canals. Regarding the evaluation of microhardness, both EDTA and NAC had a significant reduction in root dentin microhardness. However, the percentage of dentin microhardness reduction was significantly more in the EDTA group (p < 0.05) than N-acetyl cysteine in the coronal, middle, and apical third of the root canals.Conclusion: The chelating property of NAC is equally effective to that of EDTA in the smear layer from the root canal, and it induced a significantly lesser reduction in microhardness of root dentin than EDTA.
The CYP1A1 gene encodes for the enzyme, aryl hydrocarbon hydroxylase, which is involved in the biotransformation of various aromatic tobacco precarcinogens. In the present study, the association between CYP1A1 gene polymorphisms (IVS1-728G > A, Thr461Asn and Ile462Val), and the risk of oral cancer, was examined among 157 patients with oral cancer and 132 age-matched controls, in a south Indian population. The strength of the association between CYP1A1 variants and oral cancer was estimated by logistic regression. It was found that Thr461Asn was not polymorphic. Both IVS1-728G > A and Ile462Val frequencies were consistent with Hardy-Weinberg equilibrium in the control group. There were no significant differences in genotype or haplotype frequencies between controls and cases with oral cancer. Hence, CYP1A1 SNPs can be considered as not being associated with oral cancer at either the genotype or haplotype levels in the population studied.
As genetic variation is thought to contribute to the etiology of oral cancer, microsomal epoxide hydrolase (EPHX1) was chosen as a candidate gene. This study thus sought to investigate possible genetic associations between the rs1051740, rs2292566, and rs2234922 polymorphisms of EPHX1 and oral cancer. Oral cancer patients (n=157) and healthy control subjects (n=132) were screened for the genotypes using TaqMan allelic discrimination. The associations between genotypes, alleles, and haplotypes of the three mutations and oral cancer were then analyzed using a case-control study. All the three single-nucleotide polymorphisms were polymorphic, with minor allele frequencies of 0.368, 0.249, and 0.232, respectively, for rs1051740, rs2292566, and rs2234922. None of the polymorphic sites deviated from Hardy-Weinberg equilibrium. There were no significant differences in genotype or allele frequencies of three single-nucleotide polymorphisms between controls and cases with oral cancer. Of the three studied polymorphisms, two were in strong linkage disequilibrium and formed one haplotype block. None of the haplotypes showed significant association with oral cancer. EPHX1 gene polymorphisms and haplotypes were not involved in the susceptibility to oral cancer in South Indian subjects.
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