ABSTRACT
Irreversible pulpitis is an extremely painful dental pathology. Its emergency treatment, pulpotomy, should include the use of a pulp dressing in the pulp chamber until the final treatment. Various antalgic products have been suggested as efficient medications to relieve the patient's pain and are commonly used, but data for scientific validation are scarce. OBJECTIVE: We evaluated the efficacy of articaine or eugenol in the diminution of pain after pulpotomy. DESIGN: We included 100 patients with irreversible pulpitis and evaluated their initial pain levels. Pain was measured using a 0-10 numeric rating scale. After treatment through pulpotomy, we randomized them into two groups using either articaine or eugenol as a pulp dressing and evaluated their pain level at 1, 3 and 7 days. RESULTS: Initial pain levels were severe (7.53). The use of painkillers was not associated with lower levels of pain. Both treatments showed great efficiency on day 1, with stronger efficiency of eugenol than articaine, showing a decrease of 6.24 versus 4.89 (p = 0.025). Both treatments were efficient, whatever the age or sex of the patient, the initial pain level, and the causal tooth. CONCLUSION: Pulpotomy is an efficient way to relieve pain, using either articaine or eugenol. When choosing a pulp dressing, eugenol should be the first choice.
ABSTRACT
INTRODUCTION: Complete pulpotomy is the removal of the coronal portion of a vital pulp and is a means of preserving the vitality of the remaining root portion. The objective of this study was to evaluate the 12-months success rate of complete pulpotomy with Biodentine on mature permanent molars with signs and symptoms of symptomatic irreversible pulpitis. MATERIALS AND METHODS: A total of 68 molars diagnosed with symptomatic irreversible pulpitis in 68 patients aged 20 years and older were included in this study. The exclusion criteria were intraoperative clinical signs of pulp necrosis on the molar to be treated such as no bleeding, or uncontrollable pulp hemorrhage (more than 5 minutes of hemostasis) on at least 1 canal. A complete pulpotomy with Biodentine was performed on molars with symptomatic irreversible pulpitis by the same operator and with the same protocol. A 12-months postoperative follow-up was conducted to evaluate clinical and radiologic success. RESULTS: A total of 66 patients received complete pulpotomy; 52 could be examined 12 months postoperatively. Clinical and radiologic analysis at 12 months postoperatively revealed a success rate of 87% (45 of 52 molars) and a failure rate of 13% (7 of 52 molars). There was a relationship between age, tooth type, and preoperative periapical condition and treatment success with P < .05. CONCLUSION: Compliance with the indications and protocol for complete pulpotomy with Biodentine on mature permanent molars with symptomatic irreversible pulpitis gives positive results at the 12-month follow-up.
Subject(s)
Pulpitis , Pulpotomy , Adult , Calcium Compounds , Follow-Up Studies , Humans , Molar/surgery , Pulpitis/surgery , Pulpotomy/methods , Silicates , Treatment Outcome , Young AdultABSTRACT
Rheumatoid arthritis (RA) is an autoimmune disease affecting 1% of the world population and is characterized by chronic inflammation of the joints sometimes accompanied by extra-articular manifestations. K/BxN mice, originally described in 1996 as a model of polyarthritis, exhibit knee joint alterations. The aim of this study was to describe temporomandibular joint (TMJ) inflammation and damage in these mice. We used relevant imaging modalities, such as micro-magnetic resonance imaging (μMRI) and micro-computed tomography (μCT), as well as histology and immunofluorescence techniques to detect TMJ alterations in this mouse model. Histology and immunofluorescence for Col-I, Col-II, and aggrecan showed cartilage damage in the TMJ of K/BxN animals, which was also evidenced by μCT but was less pronounced than that seen in the knee joints. μMRI observations suggested an increased volume of the upper articular cavity, an indicator of an inflammatory process. Fibroblast-like synoviocytes (FLSs) isolated from the TMJ of K/BxN mice secreted inflammatory cytokines (IL-6 and IL-1β) and expressed degradative mediators such as matrix metalloproteinases (MMPs). K/BxN mice represent an attractive model for describing and investigating spontaneous damage to the TMJ, a painful disorder in humans with an etiology that is still poorly understood.
