Shaping abilities of two different engine-driven rotary nickel titanium systems or stainless steel balanced-force technique in mandibular molars.

The purpose of this study was to compare apical transportation, working-length changes, and instrumentation time by using nickel-titanium (Ni-Ti) rotary file systems (crown-down method) or stainless steel hand files (balanced-force technique) in mesiobuccal canals of extracted mandibular molars. The curvature of each canal was determined and teeth placed into three equivalent groups. Group 1 was instrumented with Sequence (Brasseler USA, Savannah, GA) rotary files, group 2 with Liberator (Miltex Inc, York, PA) rotary files, and group 3 with Flex-R (Union Broach, New York, NY) files. Pre- and postoperative radiographs were superimposed to measure loss of working length and apical transportation as shown by changes in radius of curvature and the long-axis canal angle. Sequence rotary files, Liberator rotary files, and Flex-R hand files had similar effects on apical canal transportation and changes in working length, with no significant differences detected among the 3 groups. Hand instrumentation times were longer than with either Ni-Ti rotary group, whereas the rotary NiTi groups had a higher incidence of fracture.

Diagnostic challenges of neuropathic tooth pain.

This article presents the clinical characteristics, epidemiology, pathophysiology and treatment of 2 neuropathic conditions: trigeminal neuralgia and atypical odontalgia. A case report highlights the complexities involved in diagnosing neuropathic pain. Neuropathic pain is chronic, diverse in quality, difficult to localize and it occurs in the absence of obvious pathology. To avoid multiple, ineffective dental treatments, general practitioners must be familiar with the signs of nonodontogenic sources of tooth pain.