Influence of the apical limit of instrumentation and photodynamic therapy on the postoperative pain of lower molars with asymptomatic apical periodontitis.

INTRODUCTION: The aim of present study was to evaluate the influence of apical limit of instrumentation and PDT on the postoperative pain of lower molars with asymptomatic apical periodontitis. METHODS: Forty patients were included in the present study and were divided into 4 groups (n=10), according to apical limit of instrumentation and use of PDT: instrumentation at 0.0 measurement; instrumentation at 0.0 measurement+PDT; instrumentation 1mm beyond 0.0 measurement; instrumentation 1mm beyond 0.0 measurement+PDT. In the PDT, the root canals were filled with 0.01% methylene blue, remaining for 5 min. The low-intensity laser was used with 100 mW, 660-690 nm wavelength), using intra-canal fibre. Root canals were irradiated for 90 s, delivering total dose of 9 J and energy density of 320 J/cm2. After root canal preparation and PDT protocols, root canals were filled with gutta-percha and AH Plus endodontic sealer, being sealed with composite resin.The evaluation of postoperative pain was performed by visual analog scale after 24, 48, 72 hours and 7 days. Data were analysed by specific statistical tests, at level of 5%. RESULTS: No statistical significant difference was observed among experimental groups in all evaluation periods, as well as in the intragroup analysis over time, regarding postoperative pain and analgesic medication consumption (p>0.05). CONCLUSIONS: Apical limit of instrumentation and PDT have no influence on the postoperative pain of lower molars with asymptomatic apical periodontitis.

Glycolic acid as the final irrigant in endodontics: Mechanical and cytotoxic effects.

The aim of this study was to investigate the effects of glycolic acid (GA) on the microhardness, roughness, dentin mineral content distribution; smear layer removal and cytotoxicity. One hundred human teeth were randomly divided into six groups: distilled water (control group), 17% EDTA, 10% citric acid (CA), 5% GA, 10% GA, and, 17% GA. Microhardness and roughness were measured in the canal lumen. Scanning electron microscopy (SEM) images (2000×) for smear layer removal evaluation; energy dispersive X-ray spectroscopy (EDS) for chemical analysis. Cell viability assay was made on fibroblast cells. The lowest microhardness and higher roughness were observed for 17% GA. GA showed the ability to remove the smear layer to a similar level as EDTA and CA, with no statistical difference between the concentrations used. GA and CA were cytotoxic in a dose-dependent manner. GA showed potential as an endodontic agent for final irrigation in root canal terapies.