Comparison of apical transportation and centering ability of Mtwo and Reciproc R25 in severely curved canals using cone-beam computed tomography.

BACKGROUND: Apical transportation (AT) of the root canal moves the physiologic canal terminus to a new location on the external root surface and results in the accumulation of debris and residual microorganisms due to inadequate cleaning and shaping of the canal end. This study aimed to assess the prevalence of AT following canal preparation with Mtwo and Reciproc R25 using cone-beam computed tomographic (CBCT). MATERIALS AND METHODS: In this in vitro study, 40 mesiobuccal root canals of the maxillary molars with 19-22 mm length and (>40°) taper were prepared in two groups using Mtwo and Reciproc R25 rotary systems along with irrigation with 2.5% NaOCl. CBCT scans were obtained of the canals before and after preparation under similar conditions, and the values were measured using the device software. The amount of AT was measured according to Gambill et al. Data were analyzed using SPSS 17 and Chi-square and t-tests. P < 0.05 was considered significant. RESULTS: Both systems caused some degrees of AT. No significant difference was found between the two systems in terms of the amount and direction of AT (P > 0.05); overall, the frequency of AT toward the mesial wall was greater than that toward the distal direction. However, this difference was not statistically significant. CONCLUSION: The mean amount of AT and the ability to keep the instruments in severely curved canals were not significantly different in canals prepared by Mtwo and Reciproc rotary systems. Thus, these systems can be used in the clinical setting with the lowest risk of AT.

Alprazolam role in the analgesic effect of ibuprofen on postendodontic pain.

BACKGROUND: Postendodontic pain (PEP) has always been a major problem for patients and dentists and NSAIDs are being used to relieve PEP and it is supposed that some benzodiazepines may potentiate facilitate the analgesic effects of the NSAIDs. This study was conducted to evaluate the effect of alprazolam on the analgesic effect of ibuprofen in PEP treatment. METHODS: This randomized double-blind clinical trial was conducted on 45 patients aged 20-45 years who were subjected of root canal treatment. A written informed consent was obtained from each patient. The subjects were randomly divided into three groups; placebo, ibuprofen (400 mg) and alprazolam (0.5) mg + ibuprofen (400 mg). The intensity of pain was recorded using visual analog scale (VAS) at 4, 6, 12, 24, 48 and 72 hours after drug administration. RESULTS: Of the participants, twenty six (57.8%) were males and 19 patients (42.2%) were females. Four hours after starting treatment, the VAS scores in the placebo and ibuprofen -treated groups were significantly higher than ibuprofen and alprazolam+ibuprofen groups (4.93±1.16, 3.67±1.88 and 2.67±1.11, respectively, p<0.0001). The VAS scores in alprazolam + ibuprofen group (2.33±1.05) were significantly lower at 6 hours after treatment when compared to the other groups (Ibuprofen: 3.00±1.36 and placebo: 3.08±1.74, P=0.002). This decrease in VAS score sustained to 12 hours after the start of alprazolam + ibuprofen treatment when compared to ibuprofen or placebo receiving group alone (p<0.003). The average pain score in female patients who received alprazolam + ibuprofen was significantly lower than males at 12 hours (1.3±0.6 v.s 2.14±0.9, P=0.002) and 24 hours after treatment (0.88±0.6 v.s 1.86±0.9, P=0.003). CONCLUSION: According to the results, it can conclude that alprazolam may enhance the analgesic efficacy of ibuprofen in postendodontic pain.

The Prophylactic Effects of Zintoma and Ibuprofen on Post-endodontic Pain of Molars with Irreversible Pulpitis: A Randomized Clinical Trial.

INTRODUCTION: Post endodontic pain is often linked to the inflammatory process as well as additional central mechanisms. The purpose of the present double-blind randomized clinical trial study was to compare the prophylactic effects of a derivative of Zingiber Officinale, Zintoma, and Ibuprofen on post endodontic pain of molars with irreversible pulpitis. MATERIALS AND METHODS: The post endodontic pain of 72 enrolled patients suffering from irreversible pulpitis was assessed after prophylactic use of 400 mg Ibuprofen, 2 gr Zintoma and placebo. Using the Heft-Parker Visual Analogue Scale, the patients recorded their perceived pain before taking the medicament (baseline), immediately after and also at 4, 8, 12, 24, 48, and 72 h post one-visit endodontic treatment. The statistical analysis was done using Kruskal-Wallis, Mann-Whitney, and Freedman tests (P<0.05). RESULTS: At all times, there was significant difference between the Ibuprofen and Zintoma (P<0.05) and also between the Ibuprofen and placebo (P<0.05). However, there was no significant difference between Zintoma and the placebo in any of time intervals (P>0.05). No side effects were observed. CONCLUSION: The obtained results of the trial revealed that prophylactic use of 2 gr Zintoma is not an effective pain relieving agent.

Effect of calcium hydroxide and chlorhexidine medicaments on the apical seal.

INTRODUCTION: Leakage of the root canal system is an importent consideration when placing an intracanal medicament. The aim of this in vitro study was to compare the effect of calcium hydroxide and 1% chlorhexidine gel as intracanal medicaments on tooth apical seal. MATERIALS AND METHODS: Seventy extracted, single-rooted maxillary anterior teeth were divided into the three experimental groups (n=20). All root canals were instrumented with step-back technique and divided into three groups. Group 1 had root canal dressing with calcium hydroxide; group 2 had root canal dressing with 1% chlorhexidine gel and group 3, did not receive a dressing. The roots were incubated in 100% humidity at 37°C for 7 days. After removing the dressings, all canals of the experimental groups were obturated using a cold lateral condensation technique. The root surfaces of all specimens were coated with two layers of nail varnish, except for the 2 mm surrounding the apical foramen. Apical sealing ability was assessed by dye leakage method and the specimens were examined under a stereo-microscope. Dye penetrations were measured and analyzed using ANOVA and post-hoc Tukey test. RESULTS: Calcium hydroxide group had the least frequency of apical leakage at 2 mm level (0.46±0.40 mm), whilst chlorhexidine group showed the greatest apical leakage (0.86±0.42 mm). There was statistical difference between group 1 and 2 (P<0.05), but no statistical difference between group 1 and 3, or between groups 2 and 3 (P>0.05). CONCLUSION: Intracanal calcium hydroxide medicament may decrease apical leakage of gutta-percha root fillings when AH26 sealer is used; chlorhexidine may increase the leakage.