ABSTRACT
This equivalence, randomized, clinical trial aimed to compare the postoperative pain of root canal therapy (RCT) with pulpotomy with mineral trioxide aggregate (PMTA) or calcium-enriched mixture (PCEM) in permanent mature teeth. In seven academic centers, 550 cariously exposed pulps were included and randomly allocated into PMTA (n = 188), PCEM (n = 194), or RCT (n = 168) arms. Preoperative "Pain Intensity" (PI) on Numerical Rating Scale and postoperative PIs until day 7 were recorded. Patients' demographic and pre-/intra-/postoperative factors/conditions were recorded/analysed. The arms were homogeneous in terms of demographics. The mean preoperative PIs were similar (P=0.998), the mean sum PIs recorded during 10 postoperative intervals were comparable (P=0.939), and the trend/changes in pain relief were parallel (P=0.821) in all study arms. The incidences of preoperative moderate-severe pain in RCT, PMTA, and PCEM arms were 56.5%, 55.7%, and 56.7%, which after 24 hours considerably decreased to 13.1%, 10.6%, and 12.9%, respectively (P=0.578). The time span of endodontic procedures was statistically different; RCT = 69.73, PMTA = 35.37, and PCEM = 33.62 minutes (P < 0.001). Patients with greater preoperative pain, symptomatic apical periodontitis, or presence of PDL widening suffered more pain (P=0.002, 0.035, and 0.023, resp.); however, other pre-/intra-/postoperative factors/conditions were comparable. Pulpotomy with MTA/CEM and RCT demonstrate comparable and effective postoperative pain relief.
Subject(s)
Pain, Postoperative/etiology , Pulpotomy/methods , Root Canal Filling Materials/therapeutic use , Root Canal Therapy/methods , Adult , Aluminum Compounds/therapeutic use , Calcium Compounds/therapeutic use , Dental Cements/therapeutic use , Drug Combinations , Female , Humans , Male , Molar , Oxides/therapeutic use , Pain, Postoperative/epidemiology , Prevalence , Pulpotomy/adverse effects , Root Canal Therapy/adverse effects , Silicates/therapeutic use , Treatment OutcomeABSTRACT
BACKGROUND AND AIM: Long term success in endodontic therapy is attributed to removal and debridement of intracanal microorganisms. The aim of this study was to compare the antimicrobial effects of calcium hydroxide (Ca(OH)2), triple antibiotic paste (TAP), photodynamic therapy(PDT), toluidine blue(TOL), light emitting diode (LED) and 940 nm diode laser (DL) on the biofilm of Enterococcus faecalis and Candida albicans in the root canal system of ex-vivo human teeth. MATERIALS & METHODS: 84 intact, uniradicular, extracted human premolar teeth were prepared and the apical foramina were sealed with glass ionomer. The samples were transformed to microtubes containing sterile BHI and were sterilized. After incubation of E. faecalis and C. albicans into the canals, the samples were kept in an incubator for 8 weeks to form the biofilm. Then the samples were randomly divided into 7 groups of 12, including: control and groups treated with Ca(OH)2,TAP, TOl, LED, PDT, and DL. Then the samples were fixed, gold coated and observed under scanning electron microscope (SEM). RESULT: Significant reductions in biofilm thickness were noted in TAP,PDT and LED (P < 0.05). The greatest reduction in biofilm thickness was seen in TAP; however, the differences between TAP and PDT and LED were not significant (P > 0.05). CONCLUSION: Since one of the main purposes in root canal therapy is to eliminate the bacteria, this study showed that the application of TAP, PDT, and LED exposure lead to least biofilm thickness.
