Effect of preoperative ibuprofen in controlling postendodontic pain with and without low-level laser therapy in single visit endodontics: A randomized clinical study.

AIM: The aim of this study is to evaluate the effect of low-level laser irradiation and ibuprofen in reducing the onset and severity of postoperative pain following single visit endodontics. MATERIALS AND METHODS: One hundred and twenty patients were recruited for this study. Group A (n = 30) patients were administered 400 mg of ibuprofen orally 1 h before the institution of an endodontic procedure. Group B (n = 30) patients were given irradiation of a low-level laser at 50 Hz for 3 min after the standard endodontic procedure at the periapical region on both buccal and lingual aspect. Group C (n = 30) patients were given preoperative ibuprofen followed with a low-level laser at 50 Hz for 3 min after endodontic treatment. Group D (n = 30) patients were administered no preoperative ibuprofen nor low-level laser irradiation after the endodontic procedure. The patient immediately recorded his/her pain perception on the Heft Parker pain survey after completion of the appointment and at 4, 8, 12, 24, and 48 h postoperatively. Inter group analysis was carried out using the analysis of variances with "least significant difference" post hoc test. For intra group analysis, Student's t-test was used. Chi-square test was applied for nonparametric data. RESULTS: Pain was significantly reduced in all the treatment groups postoperatively. Ibuprofen showed significant pain reduction at 4 h and 8 h period. The combination of low-level laser and ibuprofen showed the best results in terms of postoperative pain reduction. CONCLUSION: This study proved that low-level laser therapy can be an effective alternative for conventional use of nonsteroidal anti-inflammatory drugs in controlling postendodontic pain thereby eliminating the adverse effects of such drugs on the patients.

Effect of diode laser and ultrasonics with and without ethylenediaminetetraacetic acid on smear layer removal from the root canals: A scanning electron microscope study.

AIM: To evaluate the effect of diode laser and ultrasonics with and without ethylenediaminetetraacetic acid (EDTA) on the smear layer removal from root canals. MATERIALS AND METHODS: A total of 120 mandibular premolars were decoronated to working the length of 12 mm and prepared with protaper rotary files up to size F3. Group A canals irrigated with 1 ml of 3% sodium hypochlorite (NaOCl) followed by 3 ml of 3% NaOCl. Group B canals irrigated with 1 ml of 17% EDTA followed by 3 ml of 3% NaOCl. Group C canals lased with a diode laser. Group D canals were initially irrigated with 0.8 ml of 17% EDTA the remaining 0.2 ml was used to fill the root canals, and diode laser application was done. Group E canals were irrigated with 1 ml distilled water with passive ultrasonic activation, followed by 3 ml of 3% NaOCl. Group F canals were irrigated with 1 ml EDTA with passive ultrasonic activation, followed by 3 ml of 3% NaOCl. Scanning electron microscope examination of canals was done for remaining smear layer at coronal middle and apical third levels. RESULTS: Ultrasonics with EDTA had the least smear layer scores. CONCLUSION: Diode laser alone performed significantly better than ultrasonics.

Mineral trioxide aggregate apexification: A novel approach.

The treatment of choice for necrotic teeth with immature root is apexification, which is induction of apical closure to produce more favorable conditions for conventional root canal filling. The most commonly advocated medicament is calcium hydroxide although recently considerable interest has been expressed in the use of mineral trioxide aggregate (MTA). MTA offers the option of a two-visit apexification procedure so that the fragile tooth can be restored immediately. However, difficulty in placing the material in the wide apical area requires the use of an apical matrix. Materials such as collagen, calcium sulfate, and hydroxyapatite have been used for this purpose. This article describes the use of resorbable suture material to form the apical matrix which offers many advantages over the contemporary materials.

A comparative evaluation of propolis and 5.0% potassium nitrate as a dentine desensitizer: A clinical study.

AIM: The purpose of this clinical study was to evaluate the efficacy of saturated ethanolic solution of Propolis for the treatment of dentin hypersensitivity. MATERIALS AND METHODS: Ten patients aged 20-40 years with 156 hypersensitive teeth were selected for a 3-month study. Each patient was subjected to treatment with saturated ethanolic solution of Propolis, 5% potassium nitrate and distilled water. The patients were recalled at seventh day, 2 weeks and 4 weeks for the application of the agent and re-evaluation. The final re-evaluation of the patients was done after 3 months from the first application. The responses of the patients to the test temperatures were converted to a ranking and data was statistically analyzed. A statistical analysis was done using ANOVA and Bonferroni test and Tukey HSD test for multicomparison. RESULTS: The results between the Propolis group and the potassium nitrate group showed no significant difference in the immediate post-treatment period; however, the results were significant at the end of first week and second week. At 4 weeks and 3 months period, a comparison between the groups again showed no significant difference. CONCLUSION: It was concluded that Propolis was more effective than 5% potassium nitrate in relieving dentinal hypersensitivity and had an immediate and sustained effect.

Comparative Evaluation of Physical Surface Changes and Incidence of Separation in Rotary Nickel-Titanium Instruments: An in Vitro SEM Study.

INTRODUCTION: The aim of the present study was to comparatively evaluate the physical surface changes and incidence of separation in rotary nickel-titanium (NiTi) instruments using scanning electron microscope (SEM). METHODS AND MATERIALS: A total number of 210 freshly extracted human maxillary and mandibular first molars were selected and distributed between three groups. Three different systems of rotary NiTi instruments, namely ProFile (PF), RaCe (RC) and Twisted File (TF), were used to prepare the canals using crown-down technique. All instruments were evaluated by means of SEM with 500× and 1500× magnifications, at four different stages; before use, after preparation of 7 and 14 canals and after instrument separation. Photomicrographs were also taken. The data was analyzed using the Kruskal-Wallis test and the level of significance was set at 0.001. It was found that H (HAT matrix) was 15.316 with 2 degrees of freedom. Moreover the various groups were compared using the Student-Newman-Keuls test with P<0.05 and it was found that all groups were significantly different. RESULTS: RC showed the maximum wear of the surface followed by TF (P<0.05). PF showed the minimum wear except for its tip. There was no correlation between electropolishing and file fracture. Insignificant difference was observed in the mean number of canals shaped by PF and TF before their separation. CONCLUSION: Clinically, TF performance was superior, followed by PF then RC. RC fracture rate was the greatest after preparing the least number of canals.

Aesthetic replacement of an anterior tooth using the natural tooth as a pontic; an innovative technique.

This article presents a novel technique for replacing an anterior tooth. A new modification to the clinical technique of direct fabrication of a resin-bonded bridge was employed, in which the patient's natural tooth was used as a pontic. Treatment with this modification led to overall improved aesthetics and reduced treatment cost. The natural tooth pontic was stabilized in the extraction socket with a resin-wire splint as a provisional restoration to maintain the gingival architecture while the permanent bridge was being constructed.

Evaluation of biological, physical and chemical properties of mineral trioxide aggregate mixed with 4-META/MMA-TBB.

AIM: To evaluate the change in physical, chemical and biological properties when mineral trioxide aggregate (MTA) is mixed with a resin 4-methacryloxyethyl trimellitate anhydride (4-META)/methyl methacrylate-tri-n-butyl-borane (MMA)-TBB. MATERIALS AND METHODS: For biological evaluation MTA was inoculated in Wistar rat's subcutaneous tissue and peripheral tissue response was checked after 72 h, 7 days, 15 days and 30 days. Setting time was evaluated using Gillmore needle. The Ca++ release at the end of 24 h was checked using ethylenediaminetetraacetic acid titration method. For all the trials MTA mixed with water was kept as a control and the ratio of MTA with resin was 1:1 by weight. RESULTS: The biological reaction was verified by two observers and their readings were matched using kappa test and there was an excellent relevance. There was no significant difference in the tissue reaction at the end of 30 days where both the groups seemed to show healing. Setting time of MTA with 4-META/MMA-TBB was coming to a mean of 26 min (approx.), which is almost 6 times lesser than that of MTA with water. After applying t test, the difference in Ca++ release was found significant (P = 0.00), with mean of 0.044 and 0.031 mol/L of MTA with water and MTA with 4-META/MMA-TBB respectively. CONCLUSION: Under the parameters of this study, this new experimental cement has better handling, physical and chemical properties. Even its subcutaneous tissue reaction is comparable to MTA mixed with water.

Spiral computed tomographic evaluation and endodontic management of a mandibular second molar with four roots. A case report and literature review.

The vast majority of mandibular second molars have two roots with three root canals; however, variations in molar root canal anatomy are not uncommon. To the best of our knowledge, four rooted mandibular second molar with three mesial roots and one distal root has never been reported. Herein, we present the endodontic management of a four rooted mandibular second molar tooth, diagnosed with the assistance of spiral computed tomography (SCT) with a brief review of literature.