Comparative Evaluation of the Anesthetic Efficacy of Needle-Free Anesthesia and Conventional Anesthesia in Patients With Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial.

Introduction Pain is the primary reason for which most of the patients seek endodontic treatment. Local anesthesia is considered to be the most important step in the procedure to reduce the pain. However, the majority of the patients do not cooperate due to the fear of syringe anesthesia. The aim of this clinical trial was to compare the anesthetic efficacy of needle-free anesthesia and conventional anesthesia in patients with symptomatic irreversible pulpitis undergoing root canal therapy. Materials and methods A total of 54 patients were enrolled in the study, and the treatment was administered by a single operator. The initial assessment of vitality included cold testing, heat testing, and electric pulp testing. Preoperative pain was assessed using the Visual Analog Scale (VAS) before the administration of anesthesia. Local anesthesia was administered according to the group assigned: Group 1 (conventional anesthesia) and Group 2 (needle-free anesthesia). The pain was assessed during the administration of anesthesia. Following the administration of anesthesia, the vitality of the tooth was evaluated using cold testing, heat testing, and electric pulp testing. Subsequently, the tooth was isolated with a rubber dam, and the access cavity was prepared. The pain was assessed during access cavity preparation and during the first file insertion. Working length was determined using an apex locator (Root ZX Mini, J Morita, Saitama, Japan) and was confirmed using intraoral periapical radiographs. Later on, further treatment was carried out. Results A total of 54 participants were included in this clinical trial. There was no significant difference in mean age distribution between the two groups (p=0.852). Considering the frequency distribution of gender, there was no significant difference; however, Group 1 had more female participants (59.3%) compared to Group 2 (33.3%). There was a significant reduction in the mean pain score in Group 2 compared to Group 1 during the delivery of anesthetic agents (p=0.000). Conclusion Needle-free anesthesia proves to be equally effective as the conventional syringe system in patients experiencing symptomatic irreversible pulpitis undergoing root canal treatment. However, it is noteworthy that patients exhibited greater comfort levels with needle-free anesthesia systems specifically during the administration of the anesthetic solution.

Comparative Analysis of the Surface Roughness of Class V Composite Restorations Using a Conventional Polishing System and Pre-contoured Cervical Matrices: An In Vitro Study.

BACKGROUND: Rough surfaces of restorations have an impact on the accumulation of plaque, unaesthetic contour, and marginal adaptation, thereby affecting their functional, aesthetic, and clinical performance and the long-term stability of the restoration. Several polishing systems are currently in use for composite restorations, but information on their impact on surface roughness is limited. The present study aimed to determine the surface roughness of class V composite restorations polished using pre-contoured cervical matrices and to compare it with a conventional disc polishing system. MATERIALS AND METHODS: Twenty maxillary anterior teeth were collected and used in the study. Class V cavity preparation was done, and the cavities were restored with two types of composites (microhybrid and nanohybrid) from commercially available brands (Ivoclar and Dentsply) and finished and polished using two polishing systems (super-snap and pre-contoured cervical matrices). The evaluation of surface roughness was done using an atomic force microscope (AFM). RESULTS: The surface roughness parameters (Ra-arithmetic mean/average line roughness and Sa-average surface roughness) of the class V cavities restored using pre-contoured cervical matrices were significantly lower for both the tested resin composites. CONCLUSION: The surface roughness of Class V cavities restored using pre-contoured cervical matrix systems was significantly less for both microhybrid and nanohybrid composites.

In Vitro Evaluation of the Effects of Different Beverages on the Surface Microhardness of a Single-Shade Universal Composite.

AIM: The aim of this in vitro study was to analyze the influence of various beverages on the surface microhardness of a single-shade composite resin. MATERIALS AND METHODS: Seventy-five Omnichroma composite discs were fabricated and divided into five subgroups according to the beverages. The groups were Group A: tea; Group B: coffee; Group C: beer; Group D: whisky; and Group E: artificial saliva. The samples were immersed in their respective beverages for 15 minutes per day for 15 days. The Vickers microhardness values were taken before and after the immersion of the composite disc samples in their respective beverages. A one-way analysis of variance (ANOVA) test was conducted using IBM SPSS Statistics software version 23 (IBM Corp., Armonk, New York, USA), with a statistical significance level of 5%. RESULTS: It was observed that there was a reduction in the surface microhardness of the composite resin after immersion in most of the solutions. An increase in the mean percentage change of surface microhardness was observed in the beer group (29%; mean difference = 16.52±12.05), followed by the coffee group (27.2%; mean difference = 15.51±9.28). The least mean percentage change in microhardness was noted in group E, artificial saliva (8.5%; mean difference = 4.81±3.04). CONCLUSION: The surface microhardness of composite resin can be influenced by the type of beverages used for immersion and the duration of immersion. However, it is important to note that the interaction between composite resin and various beverages is influenced by a complex interplay of multiple variables.

Endodontic Management of Middle Mesial Canal in Mandibular Molars: A Report of Three Cases.

Knowledge of both normal and aberrant root canal anatomy is the key to any successful root canal treatment. A mandibular molar demonstrates considerable variations with respect to additional canals or roots. The clinician must aim to identify all possible canals with the help of any magnification aids. This report discusses the variations of the middle mesial canal in mandibular molars.