Clinical efficacy of celecoxib with and without caffeine versus Ibuprofen for pain control following crown lengthening surgery

Objective: Non-steroidal anti-inflammatory drugs [NSAIDs] are the most commonly prescribed pain control medications following periodontal surgery. This study aimed to compare the efficacy of three drug regimens namely celecoxib, celecoxib + caffeine and ibuprofen for pain relief following crown lengthening surgery

Methods: This randomized, double blind clinical trial was performed on 45 patients aged 20-60 years requiring crown lengthening of maxillary teeth. The subjects were randomly divided into three groups [n=15] receiving ibuprofen [400mg], celecoxib [200mg] and celecoxib [200mg] + caffeine [30mg]. Each patient took one dose of the respective medications 30 minutes prior to surgery. Other doses were prescribed 1, 8, 16 and 24 hours after surgery. Pain scores were recorded using visual analog scale [VAS] at 1, 2, 4, 8, 16, 24 and 48 hours post operation

Results: The mean VAS scores were significantly lower in celecoxib + caffeine group than in celecoxib group at 1 and 2 hours after surgery [H1: 2.33 [1.95] vs. 4.47 [2.56], p=0.026] [H2: 2.47 [1.60] vs. 4.80 [2.40], p=0.009]. The pain scores were significantly lower in celecoxib + caffeine group than ibuprofen group at 8, 16 and 24 hours after the procedure [H8: 1.80 [1.21] vs. 3.73 [1.94], p=0.012] [H16: 1.07 [1.03] vs. 2.73 [1.87], p=0.012] [H24: 0.47 [0.64] vs. 1.87 [1.25], p=0.004]. No significant difference was found in analgesic efficacy of celecoxib and ibuprofen

Conclusion: The combination of celecoxib + caffeine showed higher efficacy than other medications for pain control following crown lengthening surgery. Caffeine may enhance the analgesic effect of celecoxib

Effect of calcium hydroxide and chlorhexidine medicaments on the apical seal

Leakage of the root canal system is an importent consideration when placing an intracanal medicament. The aim of this in vitro study was to compare the effect of calcium hydroxide and 1% chlorhexidine gel as intracanal medicaments on tooth apical seal. Seventy extracted, single-rooted maxillary anterior teeth were divided into the three experimental groups [n=20]. All root canals were instrumented with step-back technique and divided into three groups. Group 1 had root canal dressing with calcium hydroxide; group 2 had root canal dressing with 1% chlorhexidine gel and group 3, did not receive a dressing. The roots were incubated in 100% humidity at 37°C for 7 days. After removing the dressings, all canals of the experimental groups were obturated using a cold lateral condensation technique. The root surfaces of all specimens were coated with two layers of nail varnish, except for the 2 mm surrounding the apical foramen. Apical sealing ability was assessed by dye leakage method and the specimens were examined under a stereo-microscope. Dye penetrations were measured and analyzed using ANOVA and post-hoc Tukey test. Calcium hydroxide group had the least frequency of apical leakage at 2 mm level [0.46 +/- 0.40 mm], whilst chlorhexidine group showed the greatest apical leakage [0.86 +/- 0.42 mm]. There was statistical difference between group 1 and 2 [P<0.05], but no statistical difference between group 1 and 3, or between groups 2 and 3 [P>0.05]. Intracanal calcium hydroxide medicament may decrease apical leakage of gutta-percha root fillings when AH26 sealer is used; chlorhexidine may increase the leakage

ex-vivo study on the shaping parameters of two nickel-titanium rotary systems compared with hand instruments

Rotary nickel-titanium [NiTi] instruments are thought to allow shaping of narrow, curved root canals more efficiently and more effectively than stainless steel hand instruments. However, the continued search for even more effective and safer instruments has resulted in new rotary systems being introduced on a regular basis. The aim of this study was to compare shaping parameters of RaCe and Mtwo NiTi rotary files with stainless steel K-Flexofile hand instrument. A total of 60 mandibular first molars with 20-40 degree of curvature in mesial root were divided in to three groups and each was prepared with one kind of instrument [RaCe, Mtwo, stainless steel K-Flexofile]. Using pre and post-radiographs, canal curvature was measured, with the Schneider technique. Preparation time was recorded. For evaluating canal centering and transportation, the tooth was sectioned 3, 6 and 9 mm from the apex. Pre and post-preparation photographs were taken from mesiolingual canal. Data was statistically analyzed using One-way AN OVA and Chi-Square tests. RaCe and Mtwo maintained canal curvature better than K-Flexofile [P<0.001]. Mtwo prepared the canal in a shorter time [P<0.001]. Significant statistical difference was not found in the three canal sections between the various systems. RaCe resulted in significantly fewer canal aberrations and better centering ability

effects of beta-carotene and vitamin E on erythrocytes lipid peroxidation in beta-thalassemia patients

Thalassemia is the most common hereditary disease in the world. Thalassemic erythrocytes are exposed to higher oxidative stress and lipid peroxidation. The aim of this study was to investigate the effects of beta-carotene and vitamin E on erythrocytes lipid peroxidation in beta-thalassemia patients. A prospective double-blind, placebo-controlled study of the effect of beta-carotene and vitamin E on lipid peroxidation in erythrocytes membranes was performed on 120 beta-thalassemia major patients in four groups. The patients were supplemented for 4 weeks as follows: group 1 with beta-carotene [13 mg/day], group 2 with vitamin E [550 mg/day], group 3 with beta-carotene plus vitamin E and group 4 with placebo. We prepared all capsules for 4 roups in the same shape and color. Measurements of serum beta-carotene and vitamin E were performed by high performance liquid chromatography. After preparation of ghost cells from blood specimens, malondialdehyde [MDA] was determined as index of lipid peroxidation in erythrocytes membranes before and after treatment. The levels of serum beta-carotene and vitamin E were significantly lower and MDA concentrations in erythrocytes membranes were significantly higher in beta-thalassemia patients compared to controls [P < 0.001]. In groups that treated with vitamin supplements for 4-weeks, lipid peroxidation rates were significantly reduced after treatment [P<0.001], but in placebo group there was not significant difference [P > 0.05]. Our findings provide evidence that an oral treatment with beta-carotene and vitamin E can significantly reduce lipid peroxidation of erythrocytes membranes and could be useful in management of beta-thalassemia major patients

effects of piperine on the jumping induced by naloxone in morphine dependent mice

Black pepper has been used in traditional medicine as an analgesic. In this investigation, the effects of piperine, an alkaloid derived from black pepper seeds on the jumping induced by naloxone were studied on morphine dependent mice. This experimental study was conducted on case [piperine] and control [saline] groups of mice. Mice were made dependent to morphine using Marshall method. For evaluation of dependency, the number of jumps after naloxone injection was counted in a period of 30 minutes. There was a significant difference between number of jumps of mice in saline [10 ml/kg, IP] and drug groups [piperine 25, 50, 75 mg/kg, IP], as well as significant differences in latency period for jumping behavior in two groups. Based on these results, piperine may affect the intensity of morphine dependency