In Vitro Alteration by Dentine and Protein of the Antimicrobial Activity of Two Endodontic Irrigants: HybenX® and Sodium Hypochlorite.

Irrigant solutions commonly used for the treatment of endodontic infections can be inhibited by both organic and inorganic substances. The aim of this study was to evaluate the in vitro antimicrobial activity of the novel irrigant HybenX® and 2.5% and 5% sodium hypochlorite against Enterococcus faecalis, in presence of dentine powder (DP) or bovine serum albumin 20% (BSA) as inhibitory agents. An E. faecalis American Type Culture Collection (ATCC) 29212 suspension was added to the irrigants (Hybenx® or NaOCl) and one or two different inhibitors (BSA and DP) either after one-hour pre-incubation at 35 ± 1 °C or not. The antimicrobial activity of HybenX® against E. faecalis was already proved at 15 min and was neither affected by BSA nor by DP or combinations thereof. NaOCl 2.5% showed an effective antimicrobial activity starting from 15 min and this activity was partially inhibited by BSA and BSA plus DP combination within one hour when pre-incubation occurred. NaOCl 5% showed antimicrobial activity within 15 min, which was inhibited within one hour only in the presence of both BSA and DP regardless of the pre-incubation period. HybenX® could represent a good alternative to common irrigants for the treatment of E. faecalis endodontic infections, showing a rapid antimicrobial activity not inhibited by organic and inorganic inhibitors.

Influences of 432 Hz Music on the Perception of Anxiety during Endodontic Treatment: A Randomized Controlled Clinical Trial.

INTRODUCTION: Patients undergoing endodontic therapy often have severe perioperative and intraoperative anxiety, which may lead to increased perceptions of pain and vital sign instability throughout treatment. The purpose of this study was to test the influences of music, as a nonpharmacologic adjuvant, in terms of significant changes for systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) before, during, and after endodontic treatment in a population with different levels of anxiety assessed with the Corah Dental Anxiety Scale. METHODS: A total of 100 patients were recruited in the present study; before starting the endodontic treatment, the interviewer administered the Corah Dental Anxiety Scale to the participants to assess the baseline level of anxiety. Patients were randomly divided into 2 groups: the first one listened to the music and the second one did not. Before, during, and after the endodontic procedures, the vital signs (diastolic and systolic blood pressure and heart rate) were recorded. Results were collected and statistically analyzed. RESULTS: Direct contrasts between patients listening or not listening to music showed that all the measured vital signs decreased considering the overall period (during and after the canal therapy) in the group of patients listening to music (P < .05). CONCLUSIONS: This study shows the effects of music therapy on vital values and on subjective perception of anxiety during endodontic therapy. Music and medicine always work together; the soothing effects of sounds and musical frequencies make this union an extraordinary tool of synergistic care. Music therapy is a valid nonpharmacologic adjuvant to anxiety perception in endodontic therapies.

Shaping ability of waveone primary reciprocating files and ProTaper system used in continuous and reciprocating motion.

INTRODUCTION: The purpose of this study was to compare the shaping effects of Wave One (Dentsply Maillefer, Ballaigues, Switzerland) and full-sequence ProTaper nickel-titanium (NiTi) files (Dentsply Maillefer) used in reciprocating and conventional movements in a simulated canal. METHODS: Seventy-five S-shaped canals in resin blocks were randomly allocated to 3 groups (n = 25): WaveOne (group 1), full sequence of ProTaper Universal files in conventional movements (group 2), and full sequence of ProTaper Universal files in reciprocating movements (group 3). Preoperative and postoperative photographs of the simulated canals were taken under standardized conditions, after which they were accurately superimposed. Two methods were adopted to evaluate the shaping ability of the 3 approaches: measuring the differences in apical and coronal curvature modifications and measuring the amount of resin removed for both curvatures on the right and left sides of the simulated canals. Differences in canal curvature modifications and in the amount of resin removed were analyzed using 1-way analysis of variance (P < .0001) followed by a Tukey-Kramer multiple comparison post hoc test and mixed-effects linear model (P < .05), respectively. METHODS: Group 3 maintained better coronal and apical canal curvature and less straightening of the simulated canals with respect to groups 1 and 2. CONCLUSIONS: When preparing S-shaped canals, full-sequence ProTaper Universal NiTi files used in a reciprocating motion exhibited better shaping effects than full-sequence ProTaper Universal NiTi files used in a conventional motion and WaveOne.

Mineral trioxide aggregate as apical plug in teeth with necrotic pulp and immature apices: a 10-year case series.

INTRODUCTION: This 10-year study evaluated the clinical and radiologic outcomes of teeth with necrotic pulp, immature apices, and periapical lesions treated with the mineral trioxide aggregate (MTA) apical plug technique. METHODS: Seventeen single-rooted immature teeth with necrotic pulp and periapical lesion from 17 patients treated between January 2001 and December 2001 were included in this study. Apical obturation on all teeth included in the study was completed in 2 visits: first using calcium hydroxide as an interappointment intracanal medication and a second visit for the creation of the artificial apical barrier with MTA. The outcome, based on clinical and radiographic criteria, was assessed by 2 calibrated investigators using the periapical index (PAI). The Friedman test was used to verify the differences between baseline and the 1-, 5-, and 10-year PAI scores. RESULTS: Of the 17 patients treated, 1 patient dropped out at 5 years. At the 10-year follow-up, 15 teeth were healed (PAI ≤2), and 1 tooth had been extracted because of the presence of a longitudinal root fracture. The PAI score exhibited a significant decrease between baseline and 1 year and between 1 and 5 years. The difference between 5 and 10 years was not significant. CONCLUSIONS: The apical plug with MTA was a successful and effective technique for long-term management of this group of teeth with necrotic pulps with immature root development and periapical lesions.