Endodontic disease is a biofilm-mediated infection, and primary aim in the management of endodontic disease is the elimination of bacterial biofilm from the root canal system. The most common endodontic infection is caused by the surface-associated growth of microorganisms. It is important to apply the biofilm concept to endodontic microbiology to understand the pathogenic potential of the root canal microbiota as well as to form the basis for new approaches for disinfection. It is foremost to understand how the biofilm formed by root canal bacteria resists endodontic treatment measures. Bacterial etiology has been confirmed for common oral diseases such as caries and periodontal and endodontic infections. Bacteria causing these diseases are organized in biofilm structures, which are complex microbial communities composed of a great variety of bacteria with different ecological requirements and pathogenic potential. The biofilm community not only gives bacteria effective protection against the host's defense system but also makes them more resistant to a variety of disinfecting agents used as oral hygiene products or in the treatment of infections. Successful treatment of these diseases depends on biofilm removal as well as effective killing of biofilm bacteria. So, the fundamental to maintain oral health and prevent dental caries, gingivitis, and periodontitis is to control the oral biofilms. From these aspects, the formation of biofilms carries particular clinical significance because not only host defense mechanisms but also therapeutic efforts including chemical and mechanical antimicrobial treatment measures have the most difficult task of dealing with organisms that are gathered in a biofilm. The aim of this article was to review the mechanisms of biofilms’ formation, their roles in pulpal and periapical pathosis, the different types of biofilms, the factors influencing biofilm formation, the mechanisms of their antimicrobial resistance, techniques to identify biofilms.

Aims and Objectives: To compare the effect for fracture resistance of different coronally extended post length with two different post materials. Materials and Methods: One hundred and sixty endodontically treated maxillary central incisors embedded in acrylic resin with decoronated root portion were taken for the study. The postspaces were prepared according to standard protocol. The samples were divided into two groups according to the post material: glass-fiber post and Quartz fiber post. These groups were further subdivided on the basis of coronal extension of 4 and 6 mm for glass fiber and Quartz fiber posts, respectively. The posts were then luted with dual-polymerizing resin cement followed by core buildup. Samples were subjected to increasing compressive oblique load until fracture occurred in a universal testing machine. Data were analyzed with one-way ANOVA and independent Student's t -test. Analysis was done using SPSS version 15 (SPSS Inc., Chicago, IL, USA) Windows software program. Results: Glass fiber post with coronal extension of 4 mm (182.8 N) showed better results than with 6-mm length (124.1 N). Similarly, in quartz fiber posts group, 4-mm postlength (314 N) was better when compared with 6 mm (160 N). The 4-mm coronal extension of quartz fiber post displayed superior fracture resistance. Conclusions: Glass fiber posts showed better fracture resistance than Quartz fiber posts. 4-mm coronal length showed more fracture resistance than 6 mm.

Context:Where nonsurgical endodontic intervention is not possible, or it will not solve the problem, surgical endodontic treatment must be considered. A major cause of surgical endodontic failures is an inadequate apical seal, so the use of the suitable substance as root-end filling material that prevents egress of potential contaminants into periapical tissue is very critical.Aims:The aim of the present ex-vivo study was to compare and evaluate the three root-end filling materials of mineral trioxide aggregate (MTA) family (white MTA [WMTA], grey MTA [GMTA] and Portland cement [PC]) for their marginal adaptation at the root-end dentinal wall using scanning electron microscopy (SEM).Materials and Methods:Sixty human single-rooted teeth were decoronated, instrumented, and obturated with Gutta-percha. After the root-end resection and apical cavity preparation, the teeth were randomly divided into three-experimental groups (each containing 20 teeth) and each group was filled with their respective experimental materials. After longitudinal sectioning of root, SEM examination was done to determine the overall gap between retrograde materials and cavity walls in terms of length and width of the gap (maximum) at the interface. Descriptive statistical analysis was performed to calculate the means with corresponding standard errors, median and ranges along with an analysis of variance and Tukey's test.Results:The least overall gap was observed in GMTA followed by PC and WMTA. While after statistically analyzing the various data obtained from different groups, there was no significant difference among these three groups in terms of marginal adaptation.Conclusion:GMTA showed the best overall adaptation to root dentinal wall compared to PC and WMTA. Being biocompatible and cheaper, the PC may be an alternative but not a substitute for MTA.

Background:The most common cause of failure of endodontic therapy is inadequate apical and coronal seal. Proper coronal seal reduces the risk of endodontic failure. Hence, the present study was done to test the role of self-etching primers in reducing microleakage through coronal seal.Materials and Methods:Following root canal preparation and obturation, 46 specimen teeth were subjected to one of the test methods as follows: Group I – deproteinization with 3% sodium hypochlorite and etching with 37% phosphoric acid; Group II – deproteinization with 3% sodium hypochlorite and chelation with 15% ethylenediaminetetraacetic acid (EDTA) (Glyde) without etching. Group I and Group II were further divided into two subgroups with 10 specimens in each: In subgroup A, Clearfil Liner Bond 2V was used and in subgroup B, Excite was used. Group III (obturated without access restorative material) had six specimens.Results:Spectrophotometric analysis was done to quantitatively analyze the amount of dye leakage. Microleakage values obtained in Group I and Group II were comparable. In Group I, marginally better values were obtained with the Clearfil Liner Bond 2V in comparison with Excite. In Group II, microleakage values obtained with Clearfil Liner Bond 2V and Excite were similar and statistically not significant. In Group III (control) where no access restoratives were placed, maximum leakage was observed.Conclusions:Maximum leakage values were observed in Group III, when obturated without access restorative and when exposed to artificial saliva. Clearfil Liner Bond 2V as a self-etching primer showed better values in preventing microleakage. Deproteinization may be important to reduce microleakage when using the fifth-generation bonding system (Excite) and sixth-generation bonding system (Clearfil Liner Bond 2V).

A 17-year-old girl was referred to the private clinic at Jaipur, Rajasthan for aesthetic management of discoloured teeth. The patient primarily complained of an unpleasant smile due to stained teeth. Detailed clinical history was elicited. The patient was born at full term in Gangapur, Rajasthan, India after an uneventful pregnancy and had stayed in the same region ever since. The medical history of the patient was non contributory. She had an elder brother who also suffered from a similar condition.Intraoral examination revealed generalized discolouration of her dentition. All teeth were affected with pitting and chalky white areas . The pits on the enamel were generalized and yellowish brown in colour. A diastema was present between the maxillary central incisors. Both the maxillary lateral incisors had Ellis class I fractures of their incisal edges and both maxillary canines had Ellis class I fractures of their cusp tips.The preparatory stage of the treatment started with smile analysis, preliminary shade selection, photographs and study models. The occlusion of the patient was determined as class I. The various treatment modalities for dental fluorosis including polishing, micro/ macroabrasion, dental bleaching, composite veneering, porcelain laminate veneers and full veneer crowns were explained to the patient's parents. After discussing the treatment options and considering the age of the patient and the severity of fluorosis, it was decided to place ceramic veneers on the maxillary incisors and canines. Direct composite veneers were planned for the maxillary premolars and mandibular incisors, canines and first premolars. The palatal margins of the veneer preparations were planned to be kept as a butt joint [1]. On assessment of the patient's smile, teeth as far as the second maxillary bicuspids could be seen, which did not necessitate involvement of the first molars.Before commencing the tooth preparation, direct composite mockup [Table/ Fig-1b] was done to build up the fractured teeth and to close the midline diastema. The size and shape of the teeth were approved by the patient and her parents. A polyvinyl siloxane impression was made and was used as a preparation template in the further procedures [Table/ Fig-2a&b]. Tooth preparation was first started with a 0.5 mm depth cutting diamond point and the depth grooves were marked with non-water-soluble ink. The labial and incisal tooth reduction was completed [Table/ Fig-3a] using the preparation template as a guide to gauge the depth of preparation.Proximal preparation was not carried out and the contacts were not involved. Only the mesial surfaces of the maxillary central incisors were included in the preparation.After adequate gingival retraction with a retraction cord (Ultrapak, Ultradent, South Jordan, Utah, United States), a two step dual impression was made and sent to the laboratory for fabrication of IPS e.max veneers (Ivoclar Vivadent AG, Schaan/Liechtenstain, Germany). Tooth discolouration is a common problem and affects people of all ages. Apar...