Comparative evaluation of intracanal cryotherapy and curcumin as a final irrigant in reducing post endodontic pain in primary teeth

Aim: The aim of this study was to evaluate the intracanal effectiveness of cryotherapy, curcumin irrigant, and normal saline as a final irrigant in reducing postendodontic pain in primary teeth. Materials and Methods: A total of 120 teeth between the ages of 4 and 7 years requiring pulpectomy in primary teeth were included in the study. The teeth were randomly assigned to one of the three treatment groups: intracanal cryotherapy using 2.5°C cold saline, curcumin irrigant, or normal saline. Following completion of chemomechanical preparation, final irrigation with 2.5°C cold saline, curcumin irrigant, and normal saline solution at room temperature were employed in the groups. Participants were asked to rate the severity of their postoperative pain on the Visual Analog Scale before, immediate postoperative after wearing of local anesthetic effect, and 24 h after the procedure. The results were analyzed statistically. Results: The differences in reduction of postendodontic pain between the three irrigating regimens were statistically not significant. Cryotherapy utilizing 2.5°C cold saline or curcumin irrigant can be used instead of normal saline as a final irrigant in pulpectomy of primary teeth. Conclusions: Cryotherapy can be a straightforward, cost-effective, and nontoxic treatment option for the management of postendodontic pain. Curcumin irrigant with its anti-inflammatory properties is also a better alternative as a final irrigant for reducing postoperative pain in primary teeth.

Effectiveness of a Canal Brush on Removing Smear Layer: A Scanning Electron Microscopic Study

This study evaluated the effectiveness of a highly flexible endodontic brush made of polypropylene canal brush (CanalBrush; Coltène) on smear layer removal from the canal walls when used according to the manufacturer's recommendations. Forty-four single-rooted mandibular incisors were prepared to apical size 30/0.06 and randomly divided into three groups A, B and C, where the final irrigation regimen was 10 mL 17% EDTA and 10 mL 2.5% NaOCl for group A, 10 mL EDTA, 5 mL NaOCl, CanalBrush for 20 s at 450 rpm and 5 mL NaOCl for group B, 10 mL NaOCl, CanalBrush and 10 mL NaOCl for group C. One medium-sized CanalBrush was used for each root canal and all brushes were examined under the optical microscope after application to evaluate bristle deformation. Afterwards, roots were split longitudinally and the presence of smear layer was evaluated under a scanning electron microscope. Used brushes invariably exhibited bristle deformation. Group C exhibited the highest means of smear layer in all thirds. Comparing the apical thirds in all groups, there was no statistical difference between groups A and B (3.64±0.48 and 3.68±0.62 respectively), while group C exhibited significantly higher scores (3.9±0.28) than the other two groups. In conclusion, the CanalBrush proved unable to remove smear layer from the instrumented root canals, when used according to the manufacturers' instructions.

O objetivo deste estudo foi avaliar a eficácia de um escova intra-canal (CanalBrush, Coltène) na remoção da smear layer das paredes do canal radicular, quando usada de acordo com as instruções do fabricante. Quarenta e quatro incisivos mandibulares unirradiculares foram instrumentados até o ápice com instrumentos 30/0.06 e aleatoriamente distribuidos em três grupos A, B e C, com regime de irrigação final de 10 mL a 17% EDTA e 10 mL NaOCl a 2,5% para o Grupo A; irrigação final de 10 mL EDTA, 5 mL NaOCl, uso da escovinha CanalBrush por 20 s a 450 rpm e 5 mL NaOCl para o Grupo B e 10 mL NaOCl, uso da escovinha CanalBrush e 10 mL NaOCl para o Grupo C. Foi utilizada escovinha CanalBrush de tamanho médio para cada canal e todas elas foram examinadas em microscópio para avaliação da deformação de cerdas. Depois as raízes foram cortadas longitudinalmente e a presença da smear layer foi avaliada por microscópio eletrônico de varredura. As escovinhas usadas apresentaram todas alguma deformação das cerdas. No Grupo C foi observada a maior média de área de smear layer em todos os terços dentais. Na comparação dos terços apicais de todos os grupos não houve diferença significativa entre os grupos A e B (3,64±0.48 e 3,68±0,62, respectivamente), enquanto que o Grupo C mostrou escores significativamente mais altos(3,9±0.28) que os outros dois grupos. Concluindo, a escovinha CanalBrush mostrou ser incapaz de remover a smear layer dos canais instrumentados, quando usada de acordo com as instruções do fabricante.