Biofilms and microbial aggregates are the common mechanisms for the survival of bacteria in nature. In other words, the ability to form biofilms has been regarded as a virulence factor. Microbial biofilms play an essential role in several infectious diseases such as pulp and periradicular pathosis. The aim of this article was to review the adaptation mechanisms of biofilms, their roles in pulpal and periapical pathosis, factors influencing biofilm formation, mechanisms of their antimicrobial resistance, models developed to create biofilms, observation techniques of endodontic biofilms, and the effects of root canal irrigants and medicaments as well as lasers on endodontic biofilms. The search was performed from 1982 to December 2010, and was limited to papers in English language. The keywords searched on Medline were "biofilms and endodontics," "biofilms and root canal irrigation," "biofilms and intra-canal medicament," and "biofilms and lasers." The reference section of each article was manually searched to find other suitable sources of information.

Periodontal destruction is initiated by bacteria that stimulate host responses leading to excess production of cytokines. Anticytokine therapy for periodontal diseases especially targets proinflammatory cytokines, that is, TNF-α, IL-1, and IL-6, because these are essential for the initiation of the inflammatory immune reaction and are produced for prolonged periods in periodontitis. This therapy aims to bind the cytokines with the receptors present on target cells such as the fibroblasts. The three basic treatment strategies are: (1) neutralization of cytokines, (2) blockage of cytokine receptors, and (3) activation of anti-inflammatory pathways, such as, immune-suppressive pathways. This new therapy can act as a host response modulator in the control of inflammatory diseases of gums and may provide the basis for new molecular therapeutic approaches to the treatment of periodontitis.

Antibacterial activity of a herbal dentifrice Arodent™ against Streptococcus mutans and Lactobacillus acidophilus was evaluated using Colgate^® as standard. Both bacterial strains were isolated from the oral cavity on selective media and identified by standard methods. The antibacterial activity was assayed by cup-well method. The bacterial lawn of facultative anaerobe S. mutans was established between two layers of agar under microaerophilic conditions. Five and a half millimeters and 10 mm zones of inhibition were produced by Arodent against S. mutans and L. acidophilus , respectively, under microaerophilic conditions. On the other hand, the standard dentifrice Colgate produced 5.83 mm and 10.17 mm zones of inhibition against S. mutans and L. acidophilus , respectively, under microaerophilic condition. The results suggest that Arodent is an effective antibacterial herbal dentifrice.

The aim of this study was to evaluate the changes caused by different sterilization or disinfection methods on the vestibular surface of four commercially made preformed crowns using stereomicroscopy and scanning electron microscopy (SEM). Preformed crowns (NuSmile Primary Anterior Crown (NSC), Kinder Krowns (KK), Pedo Pearls (PP) and polycarbonate crowns (PC)) were sterilized and/or disinfected by one of the following techniques: no sterilization or disinfection (G1 control group); steam autoclaving at 134 °C (30 psi) for 4 min (G2); steam autoclaving at 134 °C (30 psi) for 12 min (G3); steam autoclaving at 121 °C (15 psi) for 30 min (G4); and ultrasonication in a bath containing 4% Lysetol® AF for 5 min at room temperature (chemical disinfection) (G5). Scanning electron micrographs of the crowns were taken before and after their sterilization or disinfection. The changes on the vestibular surface were then scored for the presence or absence of crazing, contour alteration, fracturing, and vestibular surface changes. The data were analyzed statistically using the chi-square test. No changes were observed before and after sterilization or disinfection in the stereomicroscopic evaluation of the vestibular surface of the crowns. However, all methods in which steam autoclaving was used to sterilize the crowns caused significant (P < 0.05) crazing and contour alterations of the vestibular surface of the crowns when they were examined by SEM. Chemical disinfection using an aldehyde-free disinfectant is the preferred method of disinfection for crowns that have been used previously in other dental patients.

Salmonella typhi developed resistance to ampicillin, chloramphenicol, streptomycin and tetracycline after passing through the disinfectants. The variants with altered antibiogram also showed changes in phase lytic patterns. The typables (K1, E1 and O) became nontypable after contact mostly with 4.8% chloroxylenol, and very few by formalin, chlorhexidine + cetrimide, 2% glutaraldehyde and tincture iodine. Some of the variants became susceptible to more number of phages.

The concept of smear layer removal prior to obturation has gained importance in recent times. The efficiency of sodium hypochlorite and EDTA in removing the smear lay, has been extensively studied. Yet, the perfect solution for root canal debridement is still elusive. This study aims at comparing the extent of smear layer removal by sodium hypochlorite, EDTA and an indigenously developed irrigant using Doxycycline, Citric acid and Tween 80. The non-availability of MTAD in India at present has made us to find out an indigenous mixture with sodium hypochlorite, citric acid and Tween 80, the detergent. The success of this indigenous irrigant would make it an effective and a cost effective alternative to MTAD.

Urethral strictures are difficult to manage. Some treatment modalities for urethral strictures are fraught with high patient morbidity and stricture recurrence rates; however, an extremely useful tool in the armamentarium of the Reconstructive Urologist is buccal mucosal urethroplasty. We like buccal mucosa grafts because of its excellent short and long-term results, low post-operative complication rate, and relative ease of use. We utilize it for most our bulbar urethral stricture repairs and some pendulous urethral stricture repairs, usually in conjunction with a first-stage Johanson repair. In this report, we discuss multiple surgical techniques for repair of urethral stricture disease. Diagnosis, evaluation of candidacy, surgical techniques, post-operative care, and complications are included. The goal is to raise awareness of buccal mucosa grafting for the management urethral stricture disease.

The primary objective of this study was to compare the efficacy of sodium fluoride (0.05%), chlorhexidine (0.12%) and triclosan (0.3%) mouth rinses in reducing the mutans streptococci count in saliva. 60 subjects in the age group of 12 to 14 years were selected from the schools of Mumbai and were equally divided into 4 groups. First 3 groups were test groups and the 4th group was control group. The subjects were instructed to rinse one full marked measure of mouth rinse for 1 minute, twice daily. Salivary samples were collected at baseline and after 2 weeks and cultured on M.S.B.agar. The number of mutans streptococci colonies were counted on agar medium. The results of the study confirmed that chlorhexidine mouth rinses are more efficient in reducing mutans streptococci count in saliva as compared to other mouth rinses.

Aim: The purpose of this in-vitro study is to determine the efficacy of various irrigants in removing the smear layer in primary teeth root canals after hand instrumentation. Materials and Methods: The present study consisted of 30 human primary incisors which were sectioned at the cementoenamel junction horizontally. The specimens were divided randomly into four experimental and one control group having six teeth each and each group was treated with the specific irrigant. 5.25% NaOCl, 5.25% NaOCl + 10% EDTA, 6% citric acid, 2% chlorhexidine, saline (control) were the irrigants evaluated for efficacy in removal of smear layer. The specimens were split along the longitudinal axis using a chisel after placing superficial grooves in cementum not extending to the root canal. The exposed surface was subjected to scanning electron microscopic analysis to reveal the efficacy of irrigants in removal of smear layer. The representative areas were evaluated twice at 15 days interval by a single evaluator. The scale for the smear layer removal by Rome et al was modified and used in the present study. Results: The pictures from the scanning electron microscopy showed that among the tested irrigants, citric acid has the best efficacy to remove the smear layer without altering the normal dentinal structures, which was supported by the lowest mean smear scores. The pictures from the 10%EDTA + 5.25% sodium hypochlorite group showed that even though it removed the smear layer, it adversely affected the dentine structure. SEM pictures of the other groups like sodium hypochlorite, chlorhexidine revealed that these irrigants does not have the capacity to remove the smear layer in primary teeth. Conclusions: The results of the present study clearly indicate the superior efficacy of 6% citric acid than the other tested irrigants on removing the smear layer in primary teeth root canals.

The normal root canal anatomy may be altered in various pathological processes and making it very difficult and at times impossible to achieve ideal obturation by normal methods. Internal resorption is one among them. There are several treatment protocols advised for this pathological condition. A crown-root fracture is defined as a fracture involving enamel, dentin and cementum and accounts for 5% of all traumatic injuries to the permanent dentition. In anterior teeth, these fractures are usually caused by direct trauma and often complicated in fully erupted teeth. In cases where the fracture line extends down along the long axis of the root, extraction of the tooth is indicated. The purpose of this report is to present the use of light transmitting post system to reinforce the crown root fractured maxillary central incisor due to trauma and internal resorption.