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.

IntroductionRoot canal irrigants play an important role in reducing intracanal microorganisms, which in turn helps in achieving a successful outcome for the root canal treatment.ObjectiveTo compare the antibacterial efficacy of alexidine and chlorhexidine against Enterococcus faecalis.MethodsA total of 50 extracted single-rooted teeth were randomly divided into five groups after being infected with Enterococcus faecalis. The groups were based on irrigants used: Group I - 0.4% alexidine; Group II - 1% alexidine; Group III - 1.5% percent alexidine; Group IV - 2% alexidine; Group V - 2% chlorhexidine. Following irrigation, colony-forming units were determined from the dentinal shavings collected at 400 µm depth.ResultsUse of 2% alexidine reduced the bacteria effectively when compared to 0.4%, 1%, and 1.5% alexidine. A statistically significant difference was not observed between 2% alexidine and 2% chlorhexidine.DiscussionAlexidine, due to its higher virulence factors for bacteria and better bacterial penetrability at 400 µm depth of dentin showed better eradication of Enterococcus faecalis in comparison to chlorhexidine.ConclusionThe use of 2% alexidine against Enterococcus faecalis at 400 µm depth of dentin has efficacy comparable to chlorhexidine. Hence, alexidine can be used as an alternative irrigant for chlorhexidine during endodontic procedures.

Introduction: Microorganisms have been known to cause pain and infection in the tooth. Fusobacterium nucleatum was always found predominantly in failed root canal treatments. Objective: The aim of the present study was to quantify Fusobacterium nucleatum at the inner and peripheral half of coronal, middle and apical region of the root by using real-time polymerase chain reaction (qPCR). Methods: Extracted maxillary incisors were taken. After shaping and cleaning, the root canals were inoculated with Fusobacterium nucleatum. Samples were taken from both the inner and peripheral halves of dentin. The inoculated teeth were maintained in anaerobic jars for two weeks, and the bacterial isolates were changed every third day. The quantification was done using qPCR. Results: The cycle threshold (Ct) value in all groups showed the presence of Fusobacterium nucleatum. Conclusion: Fusobacterium nucleatum penetrates to the entire thickness of dentin in the middle and apical region. The coaggregation with other microorganisms could be responsible for the symptomatic endodontic patients.

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Buccal surfaces of human extracted molars were obtained and divided into three groups for cavity preparation. Class V cavities were prepared using diamond bur for Group 1, tungsten carbide bur for Group 2, and Er,Cr:YSGG laser for Group 3. The surface roughness was measured using a 3D noncontact profilometer. The samples were subdivided into subgroups A and B, where subgroup B underwent additional acid-etching procedure. The temperature rise during cavity preparation was recorded using a digital thermostat. The samples were then restored with composite resin following application of bonding agent and light cured for 20 seconds for bond strength evaluation under Universal Testing Machine at a cross speed of 0.5 mm/minutes. The data obtained were finally statistically analyzed. On surface roughness evaluation, laser group (G3) produced maximum surface roughness when compared to conventional bur groups (G1 and G2). On depth of surface roughness evaluation, additional acid etching increased surface roughness of all three groups with laser group (subG3B) followed by acid etching exhibiting maximum surface roughness. On bond strength evaluation, diamond group (G1) exhibited increased bond strength when compared to laser (G3) and tungsten carbide group (G2). On thermal change estimation, all the three groups (G1, G2, and G3) produced minimal temperature rise which was below 5.5. Despite increased surface roughness produced by laser, conventional diamond bur (G1) produced highest bond strength when compared to laser (G3) and tungsten carbide groups (G2).