Effect of intra-canal cryotherapy on post-endodontic pain in single-visit RCT: A randomized controlled trial.

AIM: To evaluate the effect of cold and room-temperature normal saline as a final irrigation on post-endodontic pain and to compare the post-endodontic pain level between the different protocols. MATERIALS AND METHODS: A randomized controlled trial was conducted on 105 patients who underwent RCT and were distributed blindly and randomly into three equal groups (n = 35): Group 1, Cryotherapy group; Group 2, Room- temperature normal saline group; and Group 3, Control group. The patients were asked to fill out the VAS questionnaire and register their post-endodontic pain at 6, 24, and 48 h. One-way analysis of variance (ANOVA) and was used to determine statistical difference (α = 0.05) among the groups. Tuckey's test was used to calculate P-value (α = 0.05) between two each group. RESULTS: The highest post-endodontic pain was in Group 3. There was no significance difference between Group 1 and Group 2. CONCLUSION: Final flushing of the canal with saline either cold or at room temperature was effective for post-endodontic pain control. This can be promising as an essential step in endodontic treatment to reduce post-endodontic pain. The room-temperature saline as final irrigation showed comparable results to intra-canal cryotherapy.

Laboratory Study of Micro-shear Bond Strength of Two Resin Cements to Leucite Ceramics using Different Ceramic Primers.

AIM: To evaluate the effect of Monobond Etch & Prime on the micro-shear bond strength (MSBS) of resin cements to leucite surface and to compare the MSBS of two different resin cements to conditioned leucite surfaces with different primer systems. MATERIALS AND METHODS: Twenty-one leucite ceramic disks (10 mm diameter, 2 mm thickness) were divided into three groups (n = 7). Group I: 9.6% hydrofluoric (HF) acid and Monobond S (Ivoclar Vivadent, Liechtenstein), then conventional resin cement was applied. Group II: Monobond Etch & Prime (Ivoclar Vivadent, Liechtenstein), then conventional resin cement was applied. Group III: 9.6% HF acid and with Monobond N (Ivoclar Vivadent, Liechtenstein), then adhesive resin cement was applied. The assigned resin cement was applied in each disk through five plastic tubes with an inner diameter of 1.6 and 1.9 mm height, and then light cured. Micro-shear bond strength was determined by pulling out the resin cement using universal testing machine (Instron®, USA). RESULTS: One-way analysis of variance (ANOVA) and Student's t-test were used to determine statistical difference (a = 0.05) between each two groups. The results showed that group III had the highest MSBS values (7.32 ± 2.47) followed by group II (6.24 ± 2.16), whereas group I had the lowest MSBS values (5.7 ± 2.7). Nevertheless, there was no statistically significant difference between the results of all the groups. CONCLUSION: Monobond Etch & Prime has shown comparable results to the most popular combination of HF acid and silane. The combination of HF acid and Monobond N and self-adhesive resin cement has shown the best MSBS results, though not statistically significant. CLINICAL SIGNIFICANCE: The clinicians can use simplified ceramic primer technique (Monobond Etch & Prime) which has comparable MSBS to the most popular combination of HF acid and silane.

Treatment options for the closure of secundum atrial septal defects: A systematic review and meta-analysis.

BACKGROUND: Secundum atrial septal defects (ASDs) are treated by surgical closure (SC) or transcatheter device closure (TCC). Due to a scarcity of data directly comparing these approaches, it remains unclear which is superior. This meta-analysis compares the clinical outcomes of the two treatment options. METHODS: A literature search was performed in MEDLINE, Embase, PubMed, Google Search, and Cochrane databases for studies directly comparing SC and TCC of ASDs. Outcomes studied were major and minor acute complications, all-cause mortality, residual shunt, reinterventions, and length of stay (LOS). Relative risk (RR), difference in mean (DM) and 95% confidence intervals (CI) were calculated using the Mantel-Haenszel method with a fixed effect model. In cases of heterogeneity (defined as I2>25%), random effect models were used. Sensitivity and meta-regression analyses were performed for each outcome. RESULTS: Of the 1742 manuscripts screened, 26 observational studies fulfilled the inclusion criteria (total n=14,559 patients). TCC was superior to SC for the following outcomes: all-cause mortality (RR, 0.66; 95% CI 0.64-0.99), total complications (RR, 0.48; 95% CI 0.35-0.65), major complications (RR, 0.57; 95% CI 0.40-0.81), minor complications (RR, 0.35; 95% CI 0.23-0.53), and LOS (DM, -2.92; 95% CI -3.25 to (-2.58)). Residual shunts were more common with TCC (RR, 3.35; 95% CI 1.72-6.51). No difference was observed regarding the need of reintervention (RR, 1.45; 95% CI 0.60-3.51). Meta-regression analysis showed that older age increases the risk of death and complications in patients undergoing TCC. CONCLUSIONS: Though both approaches are effective, TCC is associated with lower mortality, complications, and LOS while SC has a lower rate of residual shunting.