Coronal tooth discoloration induced by regenerative endodontic treatment using different scaffolds and intracanal coronal barriers: a 6-month ex vivo study

OBJECTIVE: The aim of this study was to evaluate discoloration of teeth undergoing regenerative endodontic procedures (REPs) using blood clot or platelet-rich fibrin (PRF) as the scaffolds and different calcium silicate-based materials as the intracanal coronal barriers in an ex vivo model. MATERIALS AND METHODS: Forty-eight bovine incisors were prepared and disinfected using 1 mg/mL double antibiotic paste (DAP). The specimens were then randomly divided into 2 groups (n = 24) according to the scaffolds (blood or PRF). After placement of scaffolds each group was divided into 2 subgroups (n = 12) according to the intracanal coronal barriers (ProRoot MTA or Biodentine). The pulp chamber walls were sealed with dentin bonding agent before placement of DAP and before placement of scaffolds. The color changes (∆E) were measured at different steps. The data were analyzed using 2-way analysis of variance. RESULTS: Coronal discoloration induced by DAP was not clinically perceptible (ΔE ≤ 3.3). Regarding the type of the scaffold, coronal discoloration was significantly higher in blood groups compared with PRF groups at the end of REP and after 1 month (p 0.05). Considering the type of intracanal coronal barrier, no significant difference existed between ProRoot MTA and Biodentine (p > 0.05). CONCLUSIONS: With sealing the dentinal tubules of pulp chamber with a dentin bonding agent and application of DAP as an intracanal medicament, coronal color change of the teeth following the use of PRF and blood sealed with either ProRoot MTA or Biodentine was not different at 6-month follow-up.

Post-endodontic pain: factors involved and analgesics

Despite significant advances in dentistry, pain after root canal therapy is still of concern for both patients and dentists. Although the pain does not necessarily indicate endodontic failure, relief of this pain is very important for the patient. In addition, the ability to prevent or control this pain is an important factor for a dentist's professional success. Pain in endodontics is usually due to a periapical inflammatory reaction, which occurs before, during, or following various endodontic procedures. The severity of the inflammatory response is variable, depending on local and systemic factors. The cause of pain and/or swelling in endodontic therapy is not always clear. There are numerous factors accounting for endodontic pain, suggested by researchers. These factors may be classified into three main groups: latrogenic factors, patient factors, and intracanal factors. The most important factor in controlling post-endodontic pain is to have sufficient knowledge about the causes of the problem and to prevent them. The aim of this review article is to discuss factors involved in post-endodontic pain and offer techniques, including the use of analgesics, to prevent or relieve the pain