Aim:The aim of this study was to determine remineralizing potential of grape seed extract (GSE) compared to casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and calcium glycerophosphate (CaGP) through pH-cycling model and subsequent evaluation using polarized light microscope (PLM).Subjects and Methods:Twenty sound human teeth fragments of ten teeth were obtained from the cervical portion of the roots and were stored in demineralizing solution for 96 h at 37°C to induce artificial root carious lesion. The sections then were divided into four treatment groups including: 6.5% GSE, CPP-ACP, 0.5% CaGP, and control group (no treatment). The demineralized samples were then pH cycled through treatment solutions, acidic buffer, and neutral buffer for 8 days at six cycles per day. The samples were subsequently evaluated using PLM.Statistical Analysis Used:Data were analyzed using ANOVA and Scheffe post hoc comparison test (P < 0.001).Results:PLM data revealed a significantly thicker mineral precipitation band on the surface layer of the GSE-treated lesions compared to the other groups (P < 0.001).Conclusion:GSE positively affects the demineralization and/or remineralization processes of artificial root caries lesions.

Aim: This ex vivo study was designed to evaluate and compare different endodontic irrigation and activation systems, the self-adjusting file (SAF) instrumentation/irrigation system, and XP-endo finisher for removal of intracanal smear layer. Materials and Methods: Fifty recently extracted, noncarious human intact single-rooted premolars were selected and divided into five groups ( n = 10) according to the root canal irrigation systems; syringe and needle irrigation, passive ultrasonic irrigation (PUI), EndoVac irrigation system, SAF system, and XP-endo finisher. All groups were prepared to apical size F4 file except for the SAF group which was prepared to apical size 20 K-file and then instrumented with the SAF file. Each sample was subjected to final irrigation using different irrigation/activation systems. After splitting the samples, one half of each root was selected for examination under scanning electron microscope. The irrigation systems were compared using the Fisher's exact test with significance set at P < 0.05. Results: In the coronal part, there was no difference among the groups. In the mid-root section, the results of the PUI, EndoVac, SAF, and XP-endo finisher groups tended to be better than syringe and needle irrigation, but the difference was not significant. The apical part of the canal, the SAF system, and XP-endo finisher group seemed to be cleaner than those of the EndoVac group, but this difference was not significant. Conclusions: Within the limitations of the present study, SAF system and XP-endo finisher group cleaned the apical part of the canal more efficiently than EndoVac, PUI, and syringe and needle irrigation.

A 30-year-old male patient reported to the Department of Conservative Dentistry and Endodontics with the chief complaint of pain and fractured restoration in the right lower back tooth region since one week. Pain was mild, intermittent, non-radiating in nature and aggravated on cold food and liquid intake and relieved after removal of stimulus. Intraoral examination revealed fractured restoration with right mandibular first molar on the occlusal surface. The tooth was not mobile and periodontal probing around the tooth was within physiological limits.The preoperative radiograph revealed radiopacity in the enamel of mandibular first molar and also uncommon morphology with the roots of mandibular first and mandibular second molar [Table/ Fig-1]. Additional 20° mesial and distal angulated Radio Visio Graphy (RVG) images revealed the presence of extra roots with right mandibular first and second premolar and first and second molar [Table/ Fig-2]. The RVG images of the contralateral side were taken, which also revealed extra roots with mandibular first and second premolar as well as first and second molar [Table/ Fig-3].All the images on right and left side of mandibular arch supported presence of three rooted first and second premolar and four rooted first and second molar.For further confirmation of this unusual morphology, the mandibular arch was subjected to Cone Beam Computed Tomography (CBCT) imaging. The mandibular arch was focused and morphology was obtained in transverse, axial, sagittal sections of 0.5mm thickness. CBCT scan confirmed the presence of three roots and three canals in relation to right and left first and second mandibular premolars and also four roots and four canals with respect to right and left first and second mandibular molars [Table /Fig-4]. DIsCUssIoNBarret has rightly stated that, "of all the phases of anatomic study in human system, one of the most complex is that of pulp canal morphology" [1].Variation in the tooth root number and form in the dental arch are not un-common. The mandibular premolars are generally single rooted [2]. Two rooted, three rooted and four rooted mandibular first premolar are reported, but are rare [3] The mandibular premolars and molars exhibit wide variations in the form of roots and root canals. A bilateral symmetry of three rooted mandibular first and second premolar and four rooted mandibular first and second molar in a same patient is a rare entity and one such case is presented in this case report.[table/ Fig-1 [table/ Fig-4]: CBCT images show bilateral four rooted mandibular first and second molar and bilateral three rooted mandibular first and second premolar.

Tooth rotation is a dental anomaly of position, in which there is a displacement of the tooth within the alveolar bone around its longitudinal axis. Although it is a common finding in the premolar-molar region, rotations of the maxillary centrals are extremely rare and such aberrations are multifactorial in their origin. It is important to have a thorough understanding of such anatomical variation, which can cause occlusal and esthetic problems in patients, to alert the dental surgeons, so that they are well prepared to carry out esthetic and functional rehabilitation of the teeth involved. A successful management of 180° rotated maxillary left central incisor by conservative approach is described here.

Background: Secretory immunoglobulin A (IgA) is the first line of defense against pathogens that invade mucosal surfaces. It has been reported that the immune system exhibits profound age-related changes. The aim of this study was to investigate the age-dependent changes of salivary IgA among healthy individuals. Materials and Methods: Saliva samples were collected from 120 healthy individuals (aged 11–70 years). The salivary IgA concentrations were measured by the use of a single radial immunodiffusion technique and analyzed using the Mann–Whitney U, Kruskal–Wallis, and Chi-square tests. Results: The mean salivary IgA levels were 81.11 ± 4.50 mg/dl at age 11–20 years, 92.71 ± 13.76 mg/dl at age 21–30 years, 96.50 ± 4.04 mg/dl at age 31–40 years, 104.96 ± 10.15 mg/dl at age 41–50 years, 113.22 ± 7.85 mg/dl at age 51–60 years, and 91.38 ± 4.77 mg/dl at age 61–70 years. There was a significant difference among the mean salivary IgA levels of different age groups ( P < 0.001). Conclusion: These results showed that the salivary IgA levels exhibit age-related changes. Oral immunization may be considered to improve oral immunity when the salivary concentrations of IgA begin to decrease during lifetime.