ABSTRACT
INTRODUCTION: Postoperative endodontic pain can negatively influence the quality of life of the patients. Mineral Trioxide Aggregate (MTA) has gained attention as a potential medicament in various endodontic procedures. MTA has been shown to have desirable properties such as biocompatibility, marginal adaptation, and sealing ability compared to other materials. Limited evidence is available about the effectiveness of MTA on the reduction of postoperative pain following endodontic treatment. This article aimed to compare the non-surgical post-endodontic pain-relieving effect of MTA compared with other materials. METHODS: Indexed databases (PubMed/Medline, EMBASE, OVID, Scopus, and Cochrane) were independently searched for relevant manuscripts published up to and until June 2023. Randomized controlled trials (RCTs) with a focus on teeth with pulp pathologies, with or without radiolucency, requiring primary endodontic treatment were included. Risk of bias across individual studies was performed using the Cochrane risk of bias tool for interventions. RESULTS: Out of the initial 169 articles searched, 9 RCTs met the selection criteria. The protocols were like all the studies, but the pain rating scales, filling material, and restoration materials varied. Out of the 9 included studies, in 4 studies MTA significantly reduced postoperative pain levels, 5 studies showed no difference between MTA and other materials, whereas 1 study reported an adverse effect of grey discoloration after MTA. CONCLUSION: The findings of the present review indicate that MTA may reduce postoperative pain following non-surgical endodontic treatment. However, future standardized studies should be conducted to validate the results.
ABSTRACT
Knowledge of the prevalent root canal anatomy and potential variations is necessary before the initiation of endodontic treatment. The purpose of this study was to aid in the detection and treatment of the Vertucci type V canal configuration when present in the distal root of the mandibular molars. This case series presents 3 radiographic indications of a type V configuration in the distal roots of the mandibular molars as revealed on conventional periapical radiographs: a "ghost" apex, a fast break canal, and eccentric canal tracing. Nonsurgical endodontic treatment was performed for 5 mandibular molars with the type V distal root canal. Four cases showed posttreatment resolution of symptoms and return of normal function. One case was classified as "failed" because of persistent symptoms and clinical signs. The tooth was surgically treated and subsequently healed. These case reports show the importance of visualizing and managing the anatomic variations of the canal system in distal roots of mandibular molars and incorporating these capabilities into clinical practice to enhance the occurrence of a successful outcome. Additionally, clinical guidelines are provided that can help clinicians overcome the challenges in diagnosing and treating such complex cases.
