The effect of ketorolac buccal infiltration on postoperative endodontic pain: a prospective, double-blind, randomized, controlled clinical trial.

OBJECTIVES: The aim of the present double-blind, randomized, controlled clinical trial was to evaluate the effect of ketorolac buccal infiltration of on postendodontic pain of patients with symptomatic irreversible pulpitis in mandibular first/second molars. METHOD AND MATERIALS: Sixty patients meeting the inclusion criteria were evaluated. After receiving a standard inferior alveolar nerve block (IANB) followed by a buccal infiltration injection with lidocaine, half of the participants randomly received a supplemental buccal infiltration of 30 mg/mL ketorolac tromethamine and the other half received a buccal infiltration of normal saline adjacent to the periapical region of the tooth being treated. Afterwards, all participants received a single-visit root canal treatment. Pre- and postoperative (immediately after treatment, and at 2, 4, 6, and 24 hours) pain levels were evaluated via Heft-Parker visual analog scale (HP-VAS). Analgesic consumption was also recorded. The data were statistically analyzed using repeated-measures ANOVA and Friedman tests. The significance level was set at P < .05. RESULTS: There was a significant difference in postoperative pain between the two groups in overall evaluations and in each time interval (P < .001 and P = .043 respectively). Of those patients receiving ketorolac, 60% (18/30) did not require any analgesic consumption up to 24 hours postoperatively, whereas this number was 43% (13/30) for the placebo group. CONCLUSION: Ketorolac buccal infiltration could reduce the postoperative pain experienced by patients requiring endodontic treatment diagnosed with symptomatic irreversible pulpitis.

Formation of biofilm on various implant abutment materials.

The characteristics of prosthetic implant components, such as the type, material, and surface roughness of abutments, can affect biofilm formation. Since an ideal abutment surface for the reduction of bacterial adhesion has yet to be found, this in vitro study aimed to quantify biofilm formation on laser-treated titanium, zirconia, and titanium surfaces. Sterile titanium, zirconia, and laser-treated titanium discs were placed in sterile 48-well plates. Biofilm formation was induced by adding sterilized, unstimulated human saliva and suspensions of Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans (Aa), and Prevotella intermedia (Pi) to the wells. Viable bacteria in the biofilm were quantified with real-time polymerase chain reaction in conjunction with propidium monoazide. The disc material, the type of bacteria, and their interactions had significant effects on the bacterial counts. On all surfaces, the Pg count was significantly higher than both the Pi and Aa counts (P = 0.0001). The highest count of periodontal pathogens was found on laser-treated surfaces. The second highest and the lowest counts were found on zirconia and titanium surfaces, respectively.

Morphology, proliferation, and gene expression of gingival fibroblasts on Laser-Lok, titanium, and zirconia surfaces.

Soft tissue seal plays a critical role in long-term success of dental implants, and the effects of implant surface treatments such as laser ablation have been a topic of particular interest in this respect. Considering the existing controversy regarding soft tissue behavior in contact with implant surfaces, this study sought to assess the morphology, proliferation, and gene expression of human gingival fibroblasts (HGFs) on different abutment surfaces. In this in vitro, experimental study, HGFs were cultured on 45 discs (Laser-Lok, titanium, and zirconia). Cell morphology, proliferation rate, and interleukin 10 (IL-10), tumor necrosis factor alpha (TNFα), fibronectin, and integrin gene expressions were assessed by electron microscopy, methyl thiazol tetrazolium (MTT) assay, and real-time polymerase chain reaction (PCR), respectively. Data were analyzed using ANOVA and the Kruskal-Wallis H test. Fibroblast attachment was noted in all the three groups. Spindle-shaped cells with pseudopod-like processes were more frequently seen in the Laser-Lok group. Cell proliferation was significantly higher in the Laser-Lok group compared to those in the other groups (P = 0.0002). Significant differences were found in the expression of IL-10, TNFα, fibronectin, and integrin genes among the groups (P < 0.01). Within the limitations of this study, HGFs on Laser-Lok surfaces had a more mature morphology and greater proliferation and differentiation as compared to those on zirconia and titanium surfaces. This indicates better attachment of these cells to laser-modified surfaces, creating a more efficient soft tissue seal around dental implants.

Correlation Between Bone and Soft Tissue Thickness in Maxillary Anterior Teeth.

OBJECTIVES: The purpose of this study was to determine buccal bone and soft tissue thicknesses and their correlation in the maxillary anterior region using cone beam computed tomography (CBCT). MATERIALS AND METHODS: In this cross sectional study, 330 sound maxillary incisors in 60 patients with a mean age of 37.5 years were assessed by CBCT scans. For better visualization of soft tissue, patients were asked to use plastic retractors in order to retract their lips and cheeks away from the gingival tissue before taking the scans. Measurements were made in three different positions: at the crest and at 2 and 5mm apical to the crest. The cementoenamel junction-crest distance was measured. for data analyses, the Pearson's correlation coefficient, ANOVA and intraclass correlation coefficient were used. RESULTS: There were mildly significant linear associations between labial soft tissue and bone thickness in the canines and incisors (r<0.40, P<0.05), but no association was found for the lateral incisors. The mean thickness of buccal bone differed significantly in the maxillary anterior teeth, being greater for the lateral incisors (P<0.05). For soft tissue thickness, the results were the same, and the least thickness was recorded for the canines. There was a mild association between labial soft tissue and bone thickness in canines and incisors (r=0.2, P=0.3), but no such linear association was seen for the lateral incisors. CONCLUSIONS: The mean thickness of buccal bone and soft tissue in the anterior maxilla was <1mm and there was a mild linear correlation between them.

Effect of a procedural video CD and study guide on the practical fixed prosthodontic performance of Iranian dental students.

Dental students in programs around the world typically pass preclinical courses before entering the clinic and working on actual patients. Since fixed prosthodontics is a preclinical course that requires a great deal of effort, students may experience a substantial amount of stress that may affect their self-confidence and/or clinical performance. In this study, an instructional video CD (VCD) and study guide depicting the step-by-step procedures involved in a metal-ceramic tooth preparation and provisional crown fabrication was prepared. Students at the Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran, were divided randomly into two groups. Group A students trained as usual with live patients, and Group B students were given a copy of the VCD and study guide following a lecture. The students in Group B were encouraged to read the study guide and watch the VCD after live demonstrations. Then, both groups practiced individually on mannequins. At the end of the course, the students completed a sixteen-item questionnaire about their stress level, self-confidence, and knowledge base. The results showed that the students exposed to the extra media performed significantly better on some practical phases, e.g., laboratory procedures. A moderate, insignificant correlation was detected between exposure to media and decreasing the students' stress and self-esteem. We concluded that supplementary teaching aids such as a VCD and study guide may improve the clinical performance of dental students to some extent, but the live demonstration is still preferred by students.