Effect of Pulpotomy Procedures With Mineral Trioxide Aggregate and Dexamethasone on Post-endodontic Pain in Patients with Irreversible Pulpitis: A Randomized Clinical Trial.

OBJECTIVE: Endodontic post-treatment pain continues to be one of the main problems encountered by dental professionals. Therefore, pain control during and after endodontic treatment is one of the most important issues in endodontics. The purpose of this clinical trial was to compare postoperative pain relief achieved with dexamethasone (DEX) and mineral trioxide aggregate (MTA) used as pulp coverage after pulpotomy in human molars with irreversible pulpitis. METHODS: This prospective double-blind study was conducted on 54 patients complaining of dental pain due to irreversible pulpitis. The standard pulpotomy procedure was performed by the same dentist in all patients. At the time of the cotton pellet placement, patients were randomly divided into three groups: those in whom a sterile dry cotton (DC) pellet was used, patients treated with a cotton pellet soaked in MTA, and those who were treated with a cotton pellet soaked in DEX. After completion of the treatment, patients received rescue medication every 6 hours for the first day. Postoperative pain was assessed at 6-hour intervals for 24 hours, and then every day until day 7 using a visual analog scale. RESULTS: In general, patients treated with MTA suffered the lowest levels of pain at all time intervals. Post-pulpotomy pain was significantly reduced at 18 and 24 hours and from days 2 to 7 post-treatment in the MTA group. DEX lowered the pain level more than the DC pellet. However, the differences observed in the mean pain scores of the DEX and DC pellet groups at all-time intervals were not statistically significant. CONCLUSION: Pulpotomy procedures can reduce pain related irreversible pulpitis. Pulpotomy with MTA-soaked cotton pellet significantly reduces pain intensity in patients with irreversible pulpitis.

Clinical, Radiographic, and Histologic Evaluation of Regional Odontodysplasia: a Case Report with 5-year Follow-up.

Regional odontodysplasia is a developmental anomaly that affects the primary and permanent dentitions. This disorder is generally localized in only one arch and its etiology is still unknown. Clinically, the affected teeth have an abnormal morphology and are typically discolored. Radiographically, these teeth show a ghost-like appearance. This paper reported the results of radiographic, histologic and laboratory findings about the case of a 5-year-old girl presenting this rare anomaly. Her familial history was negative for any genetic anomaly, regional odontodysplasia or other dental anomalies. The patient's general health was good and no congenital or acquired disease was reported. She was kept under follow-up care until she reached the age of 10 years. Panoramic radiograph showed the involvement of permanent teeth on the right maxillary quadrant. The affected edentulous quadrant was rehabilitated with temporary acrylic maxillary partial denture. The presentation of this case would hopefully have valuable information for pediatric dentists to review the clinical and radiographic features of regional odontodysplasia, yet expediting the diagnosis and treatment of patients with this condition.

The effects of a dairy probiotic product, espar, on salivary calcium and mutans streptococci.

Background and aims. Espar is a dairy product of probiotic nature that contains useful bacteria and high calcium content. The aim of this study was to analyze effects of daily consumption of Espar on the number of salivary mutans streptococci and the level of calcium content in a population of 15 to 17 year-old female students. Materials and methods. A double-blind randomized crossover study (n = 50) of healthy female adolescents was implemented in four stage intervals. The first and third stages were 'run-in' and 'wash-out' intervals. For the second and fourth stages, two weeks long in duration, the participants consumed 100 grams of Espar or 200 grams of plain yogurt. At the end of each stage, the number of salivary mutans streptococci and the level of calcium content were documented. Results. There was a statistically significant decrease in the number of salivary mutans streptococci subsequent to Espar consumption when compared to ordinary yogurt (p < 0.01). Additionally, salivary calcium content increased significantly subsequent to the consumption of Espar and yogurt. However, Espar yielded a higher level of significant increase in salivary calcium when compared to plain yogurt (p < 0.01). Conclusion. This study found that daily consumption of Espar increased the salivary calcium level while decreasing mutans streptococci of the saliva.

Success of ultrasonic technique in removing fractured rotary nickel-titanium endodontic instruments from root canals and its effect on the required force for root fracture.

INTRODUCTION: Fracture of rotary nickel-titanium files is a real concern among endodontists; it affects the long-term prognosis of treatment. Ultrasound is a favorable technique for removing broken files, although it may result in some complications. The aim of this study was to determine the success rate of ultrasonic technique in removing file fragments and to evaluate its influence on the force required to fracture a tooth root. METHODS: An in vitro study was carried out on 70 extracted maxillary premolars. In the experimental group a #30/.04 taper Hero file was guided into the canal to break and lodge therein. The lodged file was removed by ultrasonic vibration and use of a dental operating microscope. The canals were instrumented with Hero files by using crown-down technique and then obturated. All the teeth were prepared for mechanical testing in Testometric machine to measure the required force for root fracture. The Fisher exact test and independent two-sample t test were used to analyze data. RESULTS: Ultrasonic technique exhibited a success rate of 80% in removing broken files. Success rate in the roots with file fracture before the curve was 11.5 times more than that of file fracture cases beyond the curve. Other factors such as bypass possibility did not affect success rate. The average time required for removing file fragments was 36.3 ± 7.15 minutes, which did not significantly differ in different file locations within the canal. According to mechanical test results, ultrasonic application did not significantly affect the required force for root fracture. The force required to fracture a root did not significantly differ in various file locations. Vertical fracture in the buccolingual direction (split tooth) was the most incident fracture pattern. Procedural errors observed in this study predominantly included transportation, perforation, and craze line. CONCLUSIONS: Ultrasonic technique was successful in removing 80% of fractured rotary files and did not significantly affect the required force for root fracture.

Effect of MRI on the mechanical properties of stainless steel orthodontic wires.

AIM: To assess whether the forces created by the magnetic resonance imaging (MRI) field cause a deflection of orthodontic stainless steel archwires or a change of their mechanical properties. METHODS: Sixty stainless steel 0.016-inch archwires were divided into three groups of 20 wires each. The control group was as received from the manufacturer, the MRI 1 group had wires attached to brackets on artificial teeth subjected to MRI (1.5 Tesla), and the MRI 2 group had activated T-loops subjected to MRI (1.5 Tesla). The mechanical properties were compared between the control group and MRI 1 group, whereas in the MRI 2 group, the change in the amount of activation was measured. The data were evaluated by repeated measurement analysis with independent and paired t tests. RESULTS: Tensile strength did not differ significantly between the control group and the MRI 1 group (P=.64). In the MRI 2 group, the mean distance between the vertical loop legs before and after MRI did not differ significantly (P=.53). CONCLUSION: The magnetic field did not significantly affect the mechanical properties of the tested stainless steel wires, nor did it change the loop activation.