Post-instrumentation pain after the use of either Mtwo or the SAF system: a randomized controlled clinical trial.

AIM: This randomized controlled trial compared the incidence of post-instrumentation pain associated with Mtwo rotary NiTi files and the self-adjusting file system following canal shaping and cleaning. METHODOLOGY: Following sample size estimation, a total of 130 patients were randomized into two groups based on selection criteria [group Mtwo and group SAF (self-adjusting file)]. Root canal treatment was carried out in two appointments. The teeth were endodontically treated with the appropriate allotted systems following the similar clinical parameters. Patients were asked to rate the intensity of pre-instrumentation and post-instrumentation pain (at 2, 4, 6, 8, 24, 48 h) using the VAS score. The Kruskal-Wallis test was carried out for the overall comparisons of the two systems. The Friedman test was used to compare between time-points with each system. Subgroup analyses for independent variables (gender, pulp status and diagnosis) used the Mann-Whitney test and Wilcoxon signed ranks test (P < 0.05). RESULTS: No significant difference was found between the two groups with respect to post-instrumentation pain. Teeth with pulpal necrosis had significant pain at 8 h compared with teeth with vital pulps (P = 0.04). Teeth with vital pulps in the SAF group had significantly less post-instrumentation pain compared with those in the Mtwo group at 6 h (P = 0.042). Patients who had teeth with nonvital pulps in the SAF group experienced more post-instrumentation pain at 8 h (P = 0.017) and 24 h (P = 0.005). CONCLUSION: The incidence of post-instrumentation pain at different time intervals in patients undergoing root canal treatment was similar for both the self-adjusting file and Mtwo file systems.

Effect of reciprocating file motion on microcrack formation in root canals: an SEM study.

AIM: To compare dentinal microcrack formation whilst using Ni-Ti hand K-files, ProTaper hand and rotary files and the WaveOne reciprocating file. METHODOLOGY: One hundred and fifty mandibular first molars were selected. Thirty teeth were left unprepared and served as controls, and the remaining 120 teeth were divided into four groups. Ni-Ti hand K-files, ProTaper hand files, ProTaper rotary files and WaveOne Primary reciprocating files were used to prepare the mesial canals. Roots were then sectioned 3, 6 and 9 mm from the apex, and the cut surface was observed under scanning electron microscope (SEM) and checked for the presence of dentinal microcracks. RESULTS: The control and Ni-Ti hand K-files groups were not associated with microcracks. In roots prepared with ProTaper hand files, ProTaper rotary files and WaveOne Primary reciprocating files, dentinal microcracks were present. There was a significant difference between control/Ni-Ti hand K-files group and ProTaper hand files/ProTaper rotary files/WaveOne Primary reciprocating file group (P < 0.001) with ProTaper rotary files producing the most microcracks. No significant difference was observed between teeth prepared with ProTaper hand files and WaveOne Primary reciprocating files. CONCLUSION: ProTaper rotary files were associated with significantly more microcracks than ProTaper hand files and WaveOne Primary reciprocating files. Ni-Ti hand K-files did not produce microcracks at any levels inside the root canals.

Microscope-aided endodontic treatment of maxillary first premolars with three roots: a case series.

Maxillary premolars have a highly variable root canal morphology. However, the presence of three roots is a rare occurrence. This clinical article describes the unusual anatomy detected in maxillary premolars during routine endodontic treatment using microscope. The diagnosis and clinical management of maxillary first premolars with three roots and canals using radiographic interpretation, access cavity modification and visual enhancement with operative microscopes is discussed in the article.

Shear bond strength evaluation of resin composite bonded to GIC using three different adhesives.

The current study evaluated the bonding ability of composite to glass ionomer cement (GIC) using three different bonding systems. One hundred samples of composites bonded to GIC were prepared and divided into five groups. In Group A, the composite was bonded to GIC after the initial setting of the GIC being employed as a total-etch adhesive. In Group B, the self-etch primer was employed to bond composite to GIC before the initial setting of the GIC. In Group C, the self-etch primer was employed to bond composite to the GIC after the initial setting of the GIC. In Group D, the GIC-based adhesive was employed to bond composite to the GIC before the initial setting of the GIC. In Group E, the GIC-based adhesive was employed to bond composite to the GIC after the initial setting of the GIC. Shear bond strength analysis was performed at a crosshead speed of 0.5 mm/minute. The results were tabulated and the statistical analysis was performed with one-way ANOVA; the Tukey's test showed that the bond strength of composite to GIC was significantly higher for the self-etch primer group employed on unset GIC and the GIC-based adhesive group employed on the set GIC for bonding composite to GIC.