Comparative evaluation of anesthetic efficacy of inferior alveolar nerve block and inferior alveolar nerve block plus buccal or lingual infiltration using articaine in mandibular molars with irreversible pulpitis: a preliminary prospective randomized single-blind clinical trial.

OBJECTIVES: This study was designed as a prospective randomized single-blind clinical trial to compare the anesthetic efficacy of inferior alveolar nerve block (IANB), IANB plus buccal infiltration, and IANB plus lingual infiltration of 4% articaine with 1:100,000 epinephrine in mandibular molars with irreversible pulpitis. METHOD AND MATERIALS: Sixty healthy volunteers who had a first or second mandibular molar diagnosed with irreversible pulpitis participated in the present study. This study was composed of three arms for the first molar and three arms for the second molar. Subjects in test arm A received two IANB injections (3.6 mL). Subjects in test arm B received 1.8 mL IANB injection plus 1.8 mL buccal infiltration. Subjects in test arm C received 1.8 mL IANB injection plus 1.8 mL lingual infiltration. Articaine (4%) with 1:100,000 epinephrine was used for all injections. The subject's pain during access preparation and pulp extirpation was recorded on the Heft-Parker visual analog scale. Success was defined as "none" or "mild" pain during treatment. Kruskal-Wallis test was used to compare pain categories in three groups of interventions for each mandibular molar. RESULTS: IANB with a supplemented buccal infiltration provided more success than IANB alone or IANB plus lingual infiltration, in first molars (P = .019). There were no significant differences between the three injection techniques in second molars (P = .795). CONCLUSIONS: Adding a supplemental buccal infiltration to a standard IANB was more successful in providing pain-free treatment for patients experiencing irreversible pulpitis in mandibular first molars.

Antibiofilm efficacy of silver nanoparticles as a vehicle for calcium hydroxide medicament against Enterococcus faecalis.

OBJECTIVES: The aim of the present study was to investigate antibacterial characteristic and Enterococcus faecalis (E. faecalis) biofilm suppression effect of different vehicles of calcium hydroxide as intracanal medicaments in short and long-term. METHODS: Fifty-four human single-root teeth were contaminated with E. faecalis bacteria. The teeth were randomly divided into three experimental (n=16) and one control group (n=6). Each group was then exposed to various intracanal medicaments, namely calcium hydroxide paste (group 1), calcium hydroxide with chlorhexidine (group 2), calcium hydroxide with silver nanoparticles suspension (AgNPs) (group 3), and saline as the control group (group 4). Cultures were made from each group after one week and one month, and the number of colonies was counted. Moreover, a sample of each group was examined under electron microscope. Kruskal-Wallis test served for inter-group comparisons, and Mann-Whitney test served for comparison between the two incubation periods. RESULTS: All the intracanal medicaments resulted in significant decrease in number of colonies compared to control group in both incubation periods. After one week, the mixture of calcium hydroxide and AgNPs was the most effective medicament against E. faecalis bacteria (p<.05). No significant difference in antibacterial effect of the medicaments existed after one month incubation period (p>.05). CONCLUSION: AgNPs was more effective on the E. faecalis biofilm than other tested vehicles in short-term medication. CLINICAL SIGNIFICANCE: AgNPs seems to have a good potential to be used as an appropriate vehicle of calcium hydroxide in order to eliminate of E. faecalis biofilm from human dentine in short-term.

The effect of remin pro and MI paste plus on bleached enamel surface roughness.

OBJECTIVE: The growing demand for enhanced esthetic appearance has led to great developments in bleaching products. The exposure of hard tissues of the tooth to bleaching agents can affect the roughness of the enamel surface. The freshly bleached enamel surface exposed to various surface treatments such as fluoride and other remineralizing agents have been assessed in this study. The aim of this experimental study was to compare the effect of Casein Phosphopeptide-Amorphous Calcium Phosphate with Fluoride (MI Paste Plus) and Remin Pro on the enamel surface roughness after bleaching. MATERIALS AND METHODS: Thirty enamel samples of sound human permanent molars were prepared for this study. After initial roughness measurement with profilometer, the samples were exposed to 37% carbamide peroxide bleaching agent 20 minutes twice, and randomly divided into three groups of ten. In group 1, a CPP-ACPF containing paste (MI Paste Plus) and in group 2, Remin Pro were applied to the teeth during a 15 day period for 5 minutes, twice a day. Samples of group 3 (control) were immersed in artificial saliva for 15 days. The roughness of all samples were measured at the beginning, after bleaching and after the study intervention and statistically analyzed. RESULTS: The surface roughness significantly increased in all groups following bleaching, and then it showed a decrease after application of both Remin Pro and CPP-ACPF in comparison to using bleaching agent (P<0.005). The surface roughness after using Remin Pro and CPP-ACPF was statistically similar to each other (P>0.05). CONCLUSION: There was no difference between surface roughness of MI Paste Plus and Remin Pro groups. Also the surface roughness was decreased compared to the initial enamel surface roughness.