Abhishek Parolia

Introduction: This study aimed to evaluate the reproducibility and accuracy of the International Caries Detection and Assessment System (ICDAS) in both clinical and radiographic detection of caries as demonstrated by dental faculty during training workshops. Methods: Data from two evaluation exercises were used in this study, each conducted after dental faculty had completed ICDAS online training and an intensive 3‐h workshop, including coding practice with images, extracted teeth and radiographs. For the clinical site session, 75 unrestored tooth surfaces from 28 subjects were coded by 21 dental faculty members, with magnified images aiding clinical surface location. For the radiographic session, bitewing radiographs of 64 proximal surfaces from 25 subjects were coded by 22 faculty members using ICDAS radiographic codes. After a 3‐h break, the coding procedures were repeated. Performance in coding reproducibility and accuracy (the latter against the gold standard) was assessed using quadratically weighted kappa statistics. Results: Dental faculty coded clinical sites reproducibly, with 79.0% of kappa scores over 0.81 (excellent), and 21.0% between 0.61 and 0.80 (good), but equivalent percentages fell to 4.8% and 47.6% for coding accuracy (gold standard). The values for accuracy rose to 38.1% and 69.9% when ICDAS codes one and two were combined. With radiographs, 4.6% and 36.6% were found for reproducibility, and 4.5% and 45.5% for accuracy. Conclusions: ICDAS demonstrated very good reproducibility and accuracy with clinical sites when codes 1 and 2 were combined. Faculty performance with radiographs indicated a need for improved methods of training in ICDAS radiographic coding. Clinical Relevance: This study evaluated the reproducibility and diagnostic accuracy of ICDAS coding among dental faculty in clinical settings. These findings support visual ICDAS as a reliable clinical tool when one simple modification is made, producing excellent results with all types of specialist faculty. Integration of ICDAS into clinical teaching is supported, enhancing diagnostic precision in staging caries lesions and promoting uniformity in treatment planning. The study highlights the need to identify improved methods of training in ICDAS radiographic codes, which, if realized, will lead to further improvements in integrated oral healthcare.

Objective: To investigate the compressive, dimensional, and antimicrobial properties of thermoplastic Acrylonitrile Butadiene Styrene (ABS) 3D printed hollow blocks following chemical disinfection. Methods: Forty-two 3D printed ABS cubes were immersed in tap water, 0.12% chlorhexidine gluconate, 3% hydrogen peroxide, 5% sodium bicarbonate, 0.5% sodium hypochlorite, and commercial Potassium Caroate (Polident) for 28 days (4 cycles). Linear Outer (OM) and Inner (IM) dimensions, Root Mean Square (RMS), and mass were recorded before and after each immersion cycle. An additional set of seven cubes was untreated and served as a control. Fourier transform infrared spectroscopy (FTIR) was executed on one randomly selected sample from each group before and after immersion. Following the completion of the immersion cycles, an evaluation of compressive strength was performed using a universal testing machine. Subsequently, from each group, a single ABS cube was randomly selected for the introduction of Streptococcus mutans and Candida albicans, followed by a 14-day incubation period with Scanning Electron Microscope (SEM) evaluation. Results: There were no significant differences (p > 0.05) between OM, IM, and compressive strength measurements (F = 1.036, p = 0.443) across all groups. RMS values increased for OM and decreased for IM. Notably, cubes that underwent immersion in a 0.12% chlorhexidine gluconate solution displayed considerable changes in mass (p < 0.05), exhibiting a low positive correlation (ρ = 0.339). The 0.12% chlorhexidine gluconate group exhibited the emergence of a new OH peak (3000–3500) in FTIR, whereas the 3% hydrogen peroxide group experienced the disappearance of the styrene peak (1300–1500). Exposure of ABS to C. albicans and S. mutans demonstrated clear surfaces under SEM with 0.12% chlorhexidine gluconate, 0.5% sodium hypochlorite, and Polident. Conclusions: Disinfection with 0.5% sodium hypochlorite and Potassium Caroate produced minimal mechanical changes and resisted growth of C. albicans and S. mutans. 0.12% chlorhexidine gluconate and 3% hydrogen peroxide altered dimensional and chemical compositions of 3D printed ABS following disinfection.

Reparative tertiary dentinogenesis requires the recruitment and odontogenic differentiation of dental pulp stem cells (DPSCs). Extracellular vesicles (EVs) as bioactive molecules have gained attention in regenerative medicine for their ability to mediate tissue repair through intercellular communication, influencing cell recruitment, proliferation, and differentiation. This study aimed to evaluate the effects of EVs on DPSC homing and odontogenic differentiation for dentin regeneration. DPSC-derived EVs were cultured in either growth (EV-G) or odontogenic differentiation (EV-O) conditions and isolated using a modified precipitation method. EVs were characterized by nanoparticle tracking analysis, scanning electron microscopy, antibody array, and cellular uptake assay. Treatment with 5 × 10⁸ EVs/mL significantly enhanced DPSC chemotaxis and proliferation compared with a no-treatment control and a lower dosage of EV (5 × 10⁷ EVs/mL). Gene expression and biochemical analyses revealed that EV-O up-regulated odontogenic markers including collagen type 1A1 (COL1A1), runt-related transcription factor 2 (RUNX2), and alkaline phosphatase (ALP). EV-O enhanced dentin regeneration by approximately 55% over vehicle controls in a rabbit partial dentinotomy/pulpotomy model. We identified key microRNAs (miR-21-5p, miR-221-3p, and miR-708-3p) in EV-O involved in cell homing and odontogenesis. In conclusion, our EV-based cell homing and odontogenic differentiation strategy has significant therapeutic potential for dentin regeneration.

Introduction: The International Caries Detection and Assessment System (ICDAS) is a standardised method for recording caries severity. Effective training in ICDAS is essential for dental faculty and students. This pilot study aimed to compare the effectiveness of photographic images versus extracted teeth in ICDAS training and to assess whether restorative and nonrestorative dental faculty achieve similar accuracy in ICDAS coding. Methods: Following comprehensive ICDAS training, dental faculty participated in a rotation through diagnostic stations, where they assigned ICDAS codes to tooth surfaces. The specimens consisted of either extracted adult teeth or their corresponding photographic images, each was preassigned a gold standard ICDAS code. Faculty members were categorised as belonging to either restorative or nonrestorative disciplines. After each rotation, individual performance was assessed by calculating linearly weighted Kappa ( k _w ) values comparing each participant's coding to the gold standard. Data were analysed using nonpaired, nonparametric, statistical methods. The study was completed over two end‐of‐training sessions, one of which included a repeat circuit of stations following a 1 h rest period. Results: With k _w scores as measures of ability, dental faculty coded more accurately with extracted teeth carious surfaces than with photographic images ( p = 0.0005). When grouped by specialities, there were nearly identical median k _w scores ( p = 0.482), with extracted teeth suggesting that dental faculty of all types of speciality can use ICDAS effectively. Conclusions: Extracted teeth appear to have value in training ICDAS as well as photographic images. Dental faculty of all types of specialities can use ICDAS effectively after similar amounts of training. Clinical Relevance: This study contributes to the refinement of training strategies for the ICDAS caries detection system, an important component of the dental curriculum and a system which is widely recognised as facilitating effective early reversal of dental caries lesions. Specifically, in this pilot study, the use of extracted teeth as teaching tools appeared to offer additional diagnostic value compared to photographic images, possibly by improving the correct identification of ICDAS codes for early lesions. Also, the study demonstrates that dentists from both restorative and nonrestorative disciplines should be able to successfully adopt, apply and teach ICDAS coding, thereby promoting interdisciplinary collaboration and fostering uniformity in caries management practices.

Objectives: A retrospective clinical audit was carried out to evaluate and compare the quality of record-keeping (QRK) and quality of root canal therapy (QRCT) performed by 4th-year and 5th-year predoctoral students. Methods: Electronic records and periapical radiographs of 702 root canal treated teeth performed by 4th-year and 5th-year predoctoral students from July 2018 to December 2021 were evaluated in compliance with standard European Society of Endodontology (ESE) and American Association of Endodontists (AAE) guidelines. Associations between the QRK and the QRCT were statistically analysed using the chi-square test (p < 0.05). Results: Overall acceptability of the QRK and the QRCT was 72.08% and 50.57%, respectively. The reference point of working length was the most common criterion not recorded (33.91%). No significant difference was observed in the QRK between 4th-year (76.05%) and 5th-year (69.70%) students (p = 0.226), as well as the QRCT between 4th-year (51.33%) and 5th-year (50.11%) students (p = 0.755). Acceptable root canal fillings were significantly higher in anterior teeth (57.48%) than in posterior teeth (47.54%) (p = 0.015). Satisfactory QRK was significantly associated with satisfactory QRCT (p = 0.046). Conclusions: Both predoctoral cohorts showed no difference in QRK and QRCT. However, QRK was better than QRCT. Comprehensive and accurate record-keeping positively impacted the QRCT.

Objectives: This study evaluated the number and quality of working length (WL) and master cone (MC) radiographs taken during root canal treatment by dental undergraduates, and their associations with the technical quality of root canal fillings (TQRCF) and endodontic outcomes (EO).Methods: A retrospective evaluation of radiographs from 303 root canal-treated teeth in 231 patients was conducted, with 72 patients attending recall visits to assess EO. The chi-square and one-way analysis of variance tests were performed.Results: A total of 505 WL and 557 MC radiographs were reviewed, with 72.9% and 75% deemed satisfactory, respectively. Satisfactory TQRCF was achieved in 60.4% of cases. Significant associations were found between the extension of the file in WL and gutta-percha in MC radiographs and TQRCF (p = 0.000). Misinterpretation of these radiographs resulted in poor TQRCF. Furthermore, 64.2% of teeth had satisfactory EO. A significant relationship was noted between the quality of MC radiographs and both TQRCF (p = 0.043) and EO (p = 0.003).Conclusions: Unsatisfactory MC radiographs were linked to poor TQRCF and unfavorable EO. Regular radiographic training is recommended to enhance EO.

This study evaluated the technical quality (TQ) of root canal therapy (RCT) performed by predoctoral students and its impact on endodontic outcome (EO) and patients' quality of life (QoL). The TQ of RCT done by predoctoral students was evaluated and follow‐up visits were conducted to determine the clinical, radiographic outcome of RCT and patients' QoL. Frequency distribution, multiple regression, independent‐samples t test and one‐way anova were performed. A total of 226 teeth of 164 patients were clinically and radiographically examined. A satisfactory TQ was observed in 130 (57.5%), successful clinical outcomes in 155 (68.6%), successful radiographical outcomes in 206 (91%) and overall successful EO in 150 teeth (66.4%) with 80% of patients reporting a favourable QoL. A significant positive correlation was noted between EO and QoL (p = 0.002) with no significant correlation in between TQ‐RCT and EO (p = 0.07) and TQ‐RCT and QoL (p = 0.316). Successful EO had a positive impact on patients' QoL.

Objectives: This study evaluated the shear bond strength (SBS) of self-adhesive resin cements (SARC) to bulk-fill composite resins (BFCR) following mechanical and chemical surface treatments. Materials and Methods: The BFCR discs fabricated were divided into four groups, based on the presence or absence oxygen inhibited layer (OIL) and mechanical surface treatment, as follows; group I: OIL+no surface treatment (NT), group II: no OIL+NT, group III: no OIL+diamond abrasive (DA), group IV: no OIL+air abrasion (AA). Each group was further divided into two subgroups based on chemical treatment using a silane agent. Following this, SARC cylinders were bonded to the surfaces of the treated BFCR samples. SBS was evaluated for all samples and failure analysis was carried out. The data were analyzed using independent t-test, one-way ANOVA and post hoc Tukey test, and a p value of

Wei SZ, et al. Restor Dent Endod. 2024 Jan;49:e8. https://doi.org/10.5395/rde.2024.49.e8

The objectives of this study were to compare the effects of various acid solutions combined with ultrasonics as an aid to remove mineral trioxide aggregate (MTA)-based root canal filling and to assess their effect on the surface topography and microhardness of root canal dentin. Materials and Method: Fifty human permanent single rooted and single canaled freshly extracted teeth were decoronated and sectioned apically to prepare the middle third of root sections of 5 mm length. The canals were prepared in a step-back manner. OrthoMTA was packed throughout the prepared canals. These root sections were incubated for one week and subsequently randomly allocated to five groups (n = 10) according to the OrthoMTA removal method: No treatment (NT); 5% glycolic acid + ultrasonics (5% GA+U); 10% glycolic acid + ultrasonics (10% GA+U); 10% citric acid + ultrasonics (10% CA+U); Distilled water + ultrasonics (DW+U). A 1 mm deep well was created within the coronal end of the set OrthoMTA. Wells were filled with each respective test solution and left for 5 min. Thereafter, further removal of OrthoMTA used a specific ultrasonic tip. Finally, the canals were flushed using 1 mL of the respective test solutions and activated with a Controlled Memory ultrasonic tip for two cycles of 20 s each followed by flushing with 1 mL of distilled water and paper point drying of the canals. Then, specimens were longitudinally split into two halves and examined under a scanning electron microscope (1000×) to assess the residual OrthoMTA and surface topography of root canal dentin. The Vickers surface microhardness of treated radicular dentin was measured using the HMV-2 microhardness tester. Result: Data were analysed using one-way ANOVA followed by Tukey’s post hoc test. Significant differences for residual OrthoMTA were observed between (10% GA+U) with (5% GA+U), (10% CA+U), (DW+U) and (NT) (p value < 0.01). In the context of microhardness, (5% GA+U) and (10% GA+U) showed statistically significant difference compared to (NT), (10% CA+U) and (DW+U) (p value < 0.01). Conclusion: 10% GA+U was superior to other tested groups in removing OrthoMTA, but it substantially reduced dentin microhardness.