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Li Y, Wang W, Zeng Q, Tang M, Massey J, Bergeron BE, Gu L, Tay FR. Efficacy of pulpotomy in managing irreversible pulpitis in mature permanent teeth: A systematic review and meta-analysis. J Dent 2024; 144:104923. [PMID: 38461884 DOI: 10.1016/j.jdent.2024.104923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 02/29/2024] [Accepted: 03/02/2024] [Indexed: 03/12/2024] Open
Abstract
OBJECTIVES This paper evaluated the success rates of pulpotomy, compared its efficacy with non-surgical root canal treatment (NSRCT), evaluated different pulpotomy techniques, and analyzed the effectiveness of contemporary bioactive materials in managing irreversible pulpitis in mature permanent teeth. DATA SOURCES A comprehensive literature search was conducted across multiple databases including PubMed, Web of Science, Scopus, and the Cochrane Library. Search was conducted from the inception of each database to the present, adhering to PRISMA 2020 guidelines. STUDY SELECTION Studies were selected through a multi-step screening process, focusing on adult populations, randomized controlled trials, and single-arm trials. DATA Fifteen randomized controlled trials and eight single-arm trials were included. For a follow-up period of more than 24 months, pooled clinical success rate of pulpotomy was 92.9 % (95 %CI;82.1-99.0 %), whereas pooled radiographic success rate was 78.5 % (95 %CI;66.7-88.4 %). Meta-analyses showed that there was no significant difference in success rates between pulpotomy and NSRCT, between full and partial pulpotomy techniques, or between Mineral Trioxide Aggregate pulpotomy and Calcium Enriched Mixture pulpotomy. The results indicated comparable efficacy across these variables. CONCLUSIONS The study highlights the potential of less invasive treatments. Pulpotomy may be a viable alternative to NSRCT for managing irreversible pulpitis in mature permanent teeth. Limitations such as the low quality of some single-arm trials and the high risk of bias in some randomized controlled trials highlight the need for further research to standardize methodologies and broaden literature inclusion for a more comprehensive understanding of the efficacy of pulpotomy, considering the high success rates reported. Clinical Significance This quantitative systematic review recognizes the potential of full or partial pulpotomy as a viable treatment alternative to root canal therapy for managing irreversible pulpitis in mature permanent teeth. Future studies should aim for standardized protocols to validate these findings and improve patient treatment outcomes.
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Affiliation(s)
- Yuanyuan Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China; Department of General Dentistry, Xiamen University Affiliated Chenggong Hospital & The 73rd Army Hospital of Chinese PLA, Amoy, Fujian, PR China
| | - Wenying Wang
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, PR China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Qian Zeng
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, PR China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Michelle Tang
- The Dental College of Georgia, Augusta University, GA, USA
| | - Joshua Massey
- The Dental College of Georgia, Augusta University, GA, USA
| | | | - Lisha Gu
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, PR China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China.
| | - Franklin R Tay
- The Dental College of Georgia, Augusta University, GA, USA.
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Alfaisal Y, Idris G, Peters OA, Zafar S, Nagendrababu V, Peters CI. Vital pulp therapy-Factors influencing decision-making for permanent mature teeth with irreversible pulpitis: A systematic review. Int Endod J 2024; 57:505-519. [PMID: 38326290 DOI: 10.1111/iej.14036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND There is an increased tendency towards adopting minimally invasive interventions in dentistry, supported by advancement in materials and techniques. However, the decision-making process in choosing conservative or invasive treatments is influenced by several factors, particularly in permanent teeth with irreversible pulpitis. OBJECTIVES The objective of the study was to systematically review the literature regarding factors that influence decision-making for vital pulp therapy (VPT) as definitive treatment option in permanent mature teeth diagnosed with irreversible pulpitis. METHODS Two independent reviewers searched five electronic databases (PubMed, Embase, Web of Science, Scopus and Cochrane Library). Grey literature was searched through Google Scholar and contact with experts. Defined search keys were applied, and all peer-reviewed literature published with no language nor publication date limits were included. The All studies investigating the factors influencing treatment decision-making in mature permanent teeth with irreversible pulpitis were included. The quality of included studies was assessed by two independent reviewers using the Joanna Briggs Institute quality assessment tool. RESULTS Six articles were included in the review. All included studies used questionnaires to characterize clinician preferences and attitudes in choosing treatment options for mature permanent teeth with irreversible pulpitis. The available evidence suggests that dentist-related factors have a significant influence on the chosen treatment in teeth with irreversible pulpitis, with speciality training and years of experience influencing the choice of VPT over other treatment options. COVID-19 reportedly swayed the dentists' decision to favour VPT. Only one article studied the influence of patient-related factors, such as age and presence of spontaneous pain on decision-making. Of note, a history of cardiovascular disease moved dentists towards prescribing VPT. DISCUSSION Collectively, the included studies demonstrated an overriding influence of dentist-related factors on choosing among treatment options for painful teeth diagnosed with irreversible pulpitis. Patient-related factors were acknowledged but there are also potential factors such as socio-economic constraints that were not included in the component studies. CONCLUSION In teeth with irreversible pulpitis clinicians educational background influence the decision towards a specific treatment option. Further data, preferably derived from clinical records, is necessary in future investigations to explore the effect of other important factors related to both dentists and patients. REGISTRATION PROSPERO database (CRD42022339653).
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Affiliation(s)
- Yasmen Alfaisal
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Ghassan Idris
- Metro North Hospital and Health Services, Queensland Health, Brisbane, Queensland, Australia
| | - Ove A Peters
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Sobia Zafar
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | | | - Christine I Peters
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
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Han YX, Chen BZ, Yan QQ, Guo Y, Li JX. [Research progress in autophagy in the development of pulp inflammation and dental pulp injury reparation and regeneration]. Zhonghua Kou Qiang Yi Xue Za Zhi 2024; 59:274-278. [PMID: 38432661 DOI: 10.3760/cma.j.cn112144-20230718-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Pulpitis is an infectious disease characterized by persistent inflammation of dental pulp and severe pain of patients, root canal treatment increases the risk of tooth fracture, discoloration and reinfection. Therefore, pulp injury repair and pulp regeneration become the new targets of pulpitis treatment. Autophagy is considered as an important defense and protective mechanism, thus plays an important role in preventing the host from excessive inflammatory reaction. There are few reports on the regulative mechanisms and therapeutic strategies of autophagy on pulp inflammation progression, therefore, this paper reviewed the role of autophagy on the progression of pulpitis, also reviewed the research progress of autophagy on dental pulp injury repair and regeneration, aiming to provide theoretical support for further research and clinical application.
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Affiliation(s)
- Y X Han
- Department of Stamotology, The 940th Hospital of Joint Logistics Support Force of Chinese Peoples Liberation Army, Lanzhou 730050, China
| | - B Z Chen
- Department of Clinical Laboratory, Gansu Provincial Maternity and Child-care Hospital, Lanzhou 730050, China
| | - Q Q Yan
- Department of Stamotology, The 940th Hospital of Joint Logistics Support Force of Chinese Peoples Liberation Army, Lanzhou 730050, China
| | - Y Guo
- Department of Stamotology, The 940th Hospital of Joint Logistics Support Force of Chinese Peoples Liberation Army, Lanzhou 730050, China
| | - J X Li
- Department of Stamotology, The 940th Hospital of Joint Logistics Support Force of Chinese Peoples Liberation Army, Lanzhou 730050, China
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Kinjrawi L, Abdo A, Alnour A, Achour H, Rekab MS. Post-endodontic pain in curved canals prepared with different rotary instrumentation techniques: A randomized controlled trial. Dent Med Probl 2024; 61:191-196. [PMID: 38642392 DOI: 10.17219/dmp/155105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/03/2022] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Curved root canals are associated with the highest number of procedural errors during endodontic instrumentation. Recently, numerous rotary instruments have been developed, with both manual and automated mechanisms, to facilitate endodontic treatment and manage the complications related to it. OBJECTIVES The aim of the study was to assess post-endodontic pain after using the HyFlex® EDM OneFile (HEDM), WaveOne® Gold (WOG) and XP-endo® Shaper (XPS) systems in the preparation of curved canals in patients with asymptomatic irreversible pulpitis. MATERIAL AND METHODS A total of 45 molars with curved canals and asymptomatic irreversible pulpitis were randomly divided into 3 equal groups based on the instrumentation used: HEDM (group A); WOG (group B); and XPS (group C). All teeth were prepared according to the manufacturers' instructions. Postendodontic pain was assessed using the visual analog scale (VAS) at 6, 12, 18, 24, 48, and 72 h after root canal instrumentation. The data was analyzed using the one-way analysis of variance (ANOVA) and the paired-samples t test with the Bonferroni correction, with a p-value of 0.05 set for statistical significance. RESULTS The highest levels of post-endodontic pain were recorded at 6 h after treatment. Then, the values gradually decreased until the pain nearly vanished after 72 h. No statistically significant differences were observed in the VAS scores between groups A and B. At the same time, group C showed the lowest VAS scores at all follow-up time points. CONCLUSIONS The use of the XPS system resulted in the lowest pain scores at all follow-ups. The HEDM and WOG groups showed no differences in the pain scores throughout the whole follow-up period.
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Affiliation(s)
- Liana Kinjrawi
- Department of Endodontics, Faculty of Dentistry, Damascus University, Syria
| | - Anas Abdo
- Department of Endodontics, Faculty of Dentistry, Damascus University, Syria
| | - Amirah Alnour
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Damascus University, Syria
| | - Hassan Achour
- Department of Endodontics, Faculty of Dentistry, Damascus University, Syria
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El Karim IA, Duncan HF, Fouad AF, Taha NA, Yu V, Saber S, Ballal V, Chompu-Inwai P, Ahmed HMA, Gomes BPFA, Abushouk S, Cushley S, O'Neill C, Clarke M. Effectiveness of full Pulpotomy compared with Root canal treatment in managing teeth with signs and symptOms indicative of irreversible pulpitis: a protocol for prospectiVE meta-analysis of individual participant data of linked randomised clinical trials (PROVE). Trials 2023; 24:807. [PMID: 38102685 PMCID: PMC10722670 DOI: 10.1186/s13063-023-07836-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/27/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Full pulpotomy has been proposed as an alternative to root canal treatment in teeth with signs and symptoms indicative of irreversible pulpitis (IRP), but the evidence is limited, relying on underpowered studies with a high risk of bias. The aim of this study is to conduct a prospective meta-analysis (PMA) of individual participant data of a series of individual randomised trials to provide robust evidence on the clinical and cost-effectiveness of pulpotomy compared with root canal treatment. METHODS Individual participant data will be obtained from a series of randomised trials designed and conducted by a consortium of multi-national investigators with an interest in vital pulp treatment. These individualised trials will be conducted using a specified protocol, defined outcomes, and outcome measures. Ten parallel-group randomised trials currently being conducted in 10 countries will provide data from more than 500 participants. The primary outcome is a composite measure defined as (1) the absence of pain indicative of IRP, (2) the absence of signs and symptoms indicative of acute or chronic apical periodontitis, and (3) the absence of radiographic evidence of failure including radiolucency or resorption. Individual participant data will be obtained, assessed, and checked for quality by two independent reviewers prior to the PMA. Pooled estimates on treatment effects will be generated using a 2-stage meta-analysis approach. The first stage involves a standard regression analysis in each trial to produce aggregate data on treatment effect estimates followed by an inverse variance weighted meta-analysis to combine these aggregate data and produce summary statistics and forest plots. Cost-effectiveness analysis based on the composite outcome will be undertaken as a process evaluation to evaluate treatment fidelity and acceptability by patients and dentists. RESULTS The research question and trial protocol were developed and approved by investigators in all 10 sites. All sites use shared resources including study protocols, data collection forms, participant information leaflets, and consent forms in order to improve flow, consistency, and reproducibility. Each site obtained its own Institutional Review Board approval, and trials were registered in appropriate open access platforms. Patient recruitment has started in most sites, as of July 2023. DISCUSSION PMA offers a rigorous, flexible, and efficient methodology to answer this important research question and provide results with improved generalisability and external validity compared with traditional trials and retrospective meta-analyses. The results of this study will have implications for both the delivery of clinical practice and structured clinical guidelines' development. TRIAL REGISTRATION PROSPERO CRD42023446809. Registered on 08 February 2023.
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Affiliation(s)
- I A El Karim
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, The Wellcome-Wolfson Building, 97 Lisburn Road, Belfast, BT9 7AE, Northern Ireland, UK.
| | - H F Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Lincoln Place, Dublin 2, Ireland
| | - A F Fouad
- School of Dentistry, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - N A Taha
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - V Yu
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - S Saber
- Department of Endodontics, Faculty of Dentistry, The British University, Cairo, Egypt
| | - V Ballal
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences-ManipalManipal Academy of Higher Education, Manipal, India
| | - P Chompu-Inwai
- Division of Pediatric Dentistry, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - H M A Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - B P F A Gomes
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas-UNICAMP, Av. Limeira Piracicaba, Areião, SP, 90113414-903, Brazil
| | - S Abushouk
- Department of Oral Rehabilitation, Faculty of Dentistry, Khartoum University, Khartoum, Sudan
| | - S Cushley
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, The Wellcome-Wolfson Building, 97 Lisburn Road, Belfast, BT9 7AE, Northern Ireland, UK
| | - C O'Neill
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, The Wellcome-Wolfson Building, 97 Lisburn Road, Belfast, BT9 7AE, Northern Ireland, UK
- Centre for Public Health, School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Grosvenor Road, Belfast, BT12 6BJ, N. Ireland, UK
| | - M Clarke
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, The Wellcome-Wolfson Building, 97 Lisburn Road, Belfast, BT9 7AE, Northern Ireland, UK
- Centre for Public Health, School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Grosvenor Road, Belfast, BT12 6BJ, N. Ireland, UK
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Wang J. Vital pulp therapy of permanent teeth with irreversible pulpitis. Hua Xi Kou Qiang Yi Xue Za Zhi 2023; 41:622-627. [PMID: 38597025 PMCID: PMC10722450 DOI: 10.7518/hxkq.2023.2023193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/30/2023] [Indexed: 04/11/2024]
Abstract
Traditionally, vital pulp therapy (VPT) is mainly indicated for young permanent teeth. However, in recent years, VPT has been increasingly applied to mature permanent teeth. VPT was previously thought to be effective only for teeth with normal pulp or reversible pulpitis. However, an increasing body of evidence has demonstrated that VPT can successfully manage permanent teeth with irreversible pulpitis or apical periodontitis. This work discusses which teeth with irreversible pulpitis or apical periodontitis are suitable for VPT, the recommended method to evaluate and select this kind of case, and the clinical procedure involved to operate such a case.
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Affiliation(s)
- Jun Wang
- Dept. of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
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Chatzidimitriou K, Seremidi K, Balta MG, Katechi V, Petroleka K, Gizani S. Vital Pulp Therapy of Young First Permanent Molars: A Retrospective Study on Radiographic Findings 24 Months Post-treatment. Oral Health Prev Dent 2023; 21:357-364. [PMID: 37916546 DOI: 10.3290/j.ohpd.b4586789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
PURPOSE With success rates comparable to that of root canal treatment, vital pulp therapy (VPT) has gained clinical interest and has been used in the management of young permanent teeth with inflamed pulps. The aim of the present study was to retrospectively evaluate the radiographic success of VPT in young first permanent molars 24 months post-treatment and correlate findings with tooth and treatment-related characteristics. MATERIALS AND METHODS Dental records of all patients with first permanent molars which received VPT in the Department of Paediatric Dentistry (National and Kapodistrian University of Athens) were retrieved. Demographic characteristics and data regarding the treatment performed were recorded. Patients' radiographs were evaluated at 6, 12 and 24 months post-treatment by two qualified paediatric dentists blinded regarding the treatment performed. Radiographic success, reasons for failure and continuation of root development were evaluated. Differences were tested using the Χ2 and Student's t-test, and possible correlations were determined by calculating the odds ratio. RESULTS Overall radiographic success rate at 24 months was 77%, ranging between 50% for direct pulp capping and 92% for full pulpotomy. Differences were not statistically significant. Continuation of root development was recorded in almost 1/3 of the teeth and completion in almost 1/5. No statistically significant association was recorded between the outcome and any tooth and treatment-related variables. CONCLUSION VPT seems to be a reliable option in the long term for the treatment of deep carious lesions in young permanent molars.
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Mokhtari H, Milani AS, Zand V, Shakuie S, Nazari L. The effect of different concentrations and temperatures of sodium hypochlorite irrigation on pain intensity following endodontic treatment of mandibular molars with irreversible pulpitis: A randomized, double-blind clinical trial. Clin Exp Dent Res 2023; 9:859-867. [PMID: 37345724 PMCID: PMC10582240 DOI: 10.1002/cre2.754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 05/17/2023] [Accepted: 06/09/2023] [Indexed: 06/23/2023] Open
Abstract
OBJECTIVES This study aimed to determine the severity of pain after endodontic treatment of mandibular molars with irreversible pulpitis following the use of sodium hypochlorite (NaOCl) at different temperatures and concentrations. METHODS In this randomized, controlled clinical trial, 72 patients with mandibular molars with irreversible pulpitis were randomly assigned to six groups. The teeth were anesthetized and the root canals were prepared. During the instrumentation, the root canals were irrigated with NaOCl solution at concentrations of 0.5% and 1% and temperatures of 2.5°C, 22°C, and 40°C, 2.5°C were achieved through cryotherapy. Assessment of pain was conducted before, immediately after, and 3, 24, 48, and 72 h after treatment. After obturation, the patients recorded their pain intensity at different time intervals on the visual analog scale (VAS) and reported the number of analgesics tablets they used. The frequency of analgesics tablets and their effect on pain sensation was recorded in the second part of the form. Repeated measures two-way analysis of variance test was used to compare the trend of pain changes over time between two intervals of time in each group. Friedman's nonparametric test was used to compare the intragroup mean score of pain over time and Kruskal-Wallis for comparing the intergroup mean score. RESULTS Changes in VAS pain scores of all the groups were significant over time (p < .001). Pain in all the groups decreased immediately after treatment and increased 3 h after treatment. There were no significant differences in pain ratings and the number of analgesics tablets used in the groups of NaOCl with different concentrations and temperatures over time. CONCLUSIONS Within the study's limitations, we concluded that there was no significant difference between concentrations of 0.5%, and 1% and temperatures of 2.5°C, 22°C, and 40°C in pain intensity following endodontic treatment of mandibular molars with irreversible pulpitis.
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Affiliation(s)
- Hadi Mokhtari
- Department of Endodontic, Faculty of DentistryTabriz University of Medical SciencesTabrizIran
| | - Amin Salem Milani
- Department of Endodontic, Faculty of DentistryTabriz University of Medical SciencesTabrizIran
| | - Vahid Zand
- Department of Endodontic, Faculty of DentistryTabriz University of Medical SciencesTabrizIran
| | - Sahar Shakuie
- Department of Endodontic, Faculty of DentistryTabriz University of Medical SciencesTabrizIran
| | - Leila Nazari
- Department of Endodontic, Faculty of DentistryTabriz University of Medical SciencesTabrizIran
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Jakovljevic A, Jaćimović J, Aminoshariae A, Fransson H. Effectiveness of vital pulp treatment in managing nontraumatic pulpitis associated with no or nonspontaneous pain: A systematic review. Int Endod J 2023; 56 Suppl 3:340-354. [PMID: 35579062 DOI: 10.1111/iej.13776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The exposed pulp has been the topic of numerous studies, but well-designed and well-executed comparative trials on the outcome and treatment of these teeth have been limited. OBJECTIVES This study was conducted to answer the following questions: in patients with nontraumatic pulpitis associated with no or nonspontaneous pain in permanent teeth, (i) is direct pulp capping or pulpotomy (partial/full) as effective as selective or stepwise caries removal [Population/participants, Intervention(s), Comparator(s)/control, Outcome(s) (PICO) 1], (ii) is pulpotomy (partial/full) as effective as direct pulp capping (PICO 2) and (iii) is pulpotomy (partial/full) as effective as a pulpectomy (PICO 3), in terms of a combination of patient and clinical reported outcomes, with 'tooth survival' as the most critical outcome? METHODS A literature search was conducted using Clarivate Analytics' Web of Science, Scopus, PubMed and Cochrane Central Register of Controlled Trials from inception to November 3rd 2021. Grey literature and contents of the major subject journals were examined. Eligibility criteria followed the PICO questions. Two independent reviewers performed study selection, data extraction and appraisal; disagreements were resolved by a third reviewer. The risk of bias was assessed by the revised Cochrane risk-of-bias tool for randomized trials. RESULTS Three randomized clinical trials (RCTs) were included in the review. No study fulfilled the criteria to answer PICO 1. There were no significant differences in the reported outcomes between investigated treatments in all included RCTs. None of the included studies reported the most critical outcome 'tooth survival'. A high loss of patients during the follow-up period was observed. DISCUSSION Although a few studies fulfilled strict eligible criteria, the results of this systematic review clearly highlight a paucity of available evidence. At the present time, clinical decisions cannot be substantiated by direct comparative trials. CONCLUSIONS Based on limited evidence, this systematic review discovered no significant differences in effectiveness between compared vital pulp treatments in managing nontraumatic pulpitis associated with no or nonspontaneous pain. Further high-quality RCTs are necessary to investigate the effectiveness of direct pulp capping or pulpotomy (partial/full) compared to selective or stepwise caries removal. REGISTRATION PROSPERO database (CRD42021259742).
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Affiliation(s)
- Aleksandar Jakovljevic
- Department of Pathophysiology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Jaćimović
- Central Library, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Anita Aminoshariae
- Department of Endodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Helena Fransson
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Thomas AM, George S, Anandaraj S. Anesthetic efficacy of 4% articaine versus 2% lignocaine in root canal treatment of teeth with molar incisor hypomineralization. J Indian Soc Pedod Prev Dent 2023; 41:316-321. [PMID: 38235818 DOI: 10.4103/jisppd.jisppd_375_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/22/2023] [Indexed: 01/19/2024] Open
Abstract
CONTEXT Inferior alveolar nerve block (IANB) is considered the cornerstone in achieving anesthesia for mandibular molars. However, failure of routine lignocaine IANB to achieve profound anesthesia of the pulp has been reported in patients with molar incisor hypomineralization (MIH). Articaine 4% with epinephrine 1:100,000 has proven to provide total pain relief during most dental procedures. AIMS This study aimed to assess and compare the pain perception level in children using Visual Analog Scale (VAS) during root canal treatment after administering 4% articaine buccal infiltration (BI), 4% articaine IANB, and 2% lignocaine IANB. SUBJECTS AND METHODS Twenty-seven children aged 8-12 years, requiring root canal treatment of mandibular first permanent molars with MIH were randomly allocated into three groups - 4% articaine (1:100,000 epinephrine) BI, 4% articaine (1:100,000 epinephrine) IANB, and 2% lignocaine IANB. The efficacy of the anesthetic was determined by rating the pain perception of the child using a VAS. STATISTICAL ANALYSIS USED The scores marked by the children on the VAS were recorded and were statistically analyzed. Data were entered into Microsoft excel data sheet and were analyzed using SPSS for Windows version 17.0. RESULTS Patients anesthetized with 4% articaine IANB presented lesser pain scores compared to IANB with 2% lidocaine and 4% articaine BI on access opening and instrumentation of the root canals. CONCLUSION 4% articaine IANB has better anesthetic efficacy than 4% articaine BI and 2% lignocaine IANB in anesthetising mandibular first permanent molars with MIH.
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Affiliation(s)
- Ann Mary Thomas
- Department of Pediatric and Preventive Dentistry, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
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Karrar RN, Cushley S, Duncan HF, Lundy FT, Abushouk SA, Clarke M, El-Karim IA. Molecular biomarkers for objective assessment of symptomatic pulpitis: A systematic review and meta-analysis. Int Endod J 2023; 56:1160-1177. [PMID: 37392154 DOI: 10.1111/iej.13950] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 05/23/2023] [Accepted: 06/22/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Inflammatory biomarkers are potentially useful targets for pulpal diagnostic tests that can identify pulp status and predict vital pulp treatment (VPT) outcome, however, their accuracy is unknown. OBJECTIVES (1) Calculate sensitivity, specificity and diagnostic odds ratio (DOR) of previously investigated pulpitic biomarkers; (2) Determine if biomarker levels discriminate between clinical diagnoses of pulpitis based on the presence or absence of spontaneous pain (3) Evaluate if biomarker level can predict VPT outcome. METHODS Searches: PubMed/MEDLINE, Ovid SP, Cochrane Central Register of Controlled Trials (CENTRAL), International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, Embase, Web of Science and Scopus in May 2023. INCLUSION prospective and retrospective observational studies and randomized trials. Participants were humans with vital permanent teeth and a well-defined pulpal diagnosis. EXCLUSION deciduous teeth, in vitro and animal studies. Risk of bias was assessed with modified-Downs and Black quality assessment checklist. Meta-analysis was performed using bivariate random effect model in Meta-DiSc 2.0 and RevMan and the quality of the evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. RESULTS Fifty-six studies were selected, reporting >70 individual biomolecules investigating pulpal health and disease at the gene and protein level. Most studies were of low and fair quality. Among the biomolecules investigated, IL-8 and IL-6 demonstrated a level of diagnostic accuracy with high sensitivity, specificity and DOR to discriminate between healthy pulps and those exhibiting spontaneous pain suggestive of IRP (low-certainty evidence). However, none was shown to have high DOR and the ability to discriminate between pulpitic states (very low certainty evidence). Limited data suggests high levels of matrix metalloproteinase 9 correlate with poorer outcomes of full pulpotomy. DISCUSSION The inability of identified molecular inflammatory markers to discriminate between dental pulps with spontaneous and non-spontaneous pain should shift the focus to improved study quality or the pursuit of other molecules potentially associated with healing and repair. CONCLUSIONS Low-quality evidence suggests IL-8 and IL-6 demonstrated level of diagnostic accuracy to discriminate between healthy pulps and those exhibiting spontaneous pain. There is a need for standardized biomarker diagnostic and prognostic studies focusing on solutions that can accurately determine the degree of pulp inflammation. REGISTRATION PROSPERO CRD42021259305.
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Affiliation(s)
- Riham N Karrar
- Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | - Siobhan Cushley
- School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Henry F Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Fionnuala T Lundy
- School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | | | - Mike Clarke
- School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Ikhlas A El-Karim
- School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
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Duncan HF, Kirkevang LL, Peters OA, El-Karim I, Krastl G, Del Fabbro M, Chong BS, Galler KM, Segura-Egea JJ, Kebschull M. Treatment of pulpal and apical disease: The European Society of Endodontology (ESE) S3-level clinical practice guideline. Int Endod J 2023; 56 Suppl 3:238-295. [PMID: 37772327 DOI: 10.1111/iej.13974] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND The ESE previously published quality guidelines for endodontic treatment in 2006; however, there have been significant changes since not only in clinical endodontics but also in consensus and guideline development processes. In the development of the inaugural S3-level clinical practice guidelines (CPG), a comprehensive systematic and methodologically robust guideline consultation process was followed in order to produce evidence-based recommendations for the management of patients presenting with pulpal and apical disease. AIM To develop an S3-level CPG for the treatment of pulpal and apical disease, focusing on diagnosis and the implementation of the treatment approaches required to manage patients presenting with pulpitis and apical periodontitis (AP) with the ultimate goal of preventing tooth loss. METHODS This S3-level CPG was developed by the ESE, with the assistance of independent methodological guidance provided by the Association of Scientific Medical Societies in Germany and utilizing the GRADE process. A robust, rigorous and transparent process included the analysis of relevant comparative research in 14 specifically commissioned systematic reviews, prior to evaluation of the quality and strength of evidence, the formulation of specific evidence and expert-based recommendations in a structured consensus process with leading endodontic experts and a broad base of external stakeholders. RESULTS The S3-level CPG for the treatment of pulpal and apical disease describes in a series of clinical recommendations the effectiveness of diagnosing pulpitis and AP, prior to investigating the effectiveness of endodontic treatments in managing those diseases. Therapeutic strategies include the effectiveness of deep caries management in cases with, and without, spontaneous pain and pulp exposure, vital versus nonvital teeth, the effectiveness of root canal instrumentation, irrigation, dressing, root canal filling materials and adjunct intracanal procedures in the management of AP. Prior to treatment planning, the critical importance of history and case evaluation, aseptic techniques, appropriate training and re-evaluations during and after treatment is stressed. CONCLUSION The first S3-level CPG in endodontics informs clinical practice, health systems, policymakers, other stakeholders and patients on the available and most effective treatments to manage patients with pulpitis and AP in order to preserve teeth over a patient's lifetime, according to the best comparative evidence currently available.
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Affiliation(s)
- Henry F Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | | | - Ove A Peters
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Ikhlas El-Karim
- School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology, University Hospital of Würzburg, Würzburg, Germany
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Bun San Chong
- Faculty of Medicine & Dentistry, Institute of Dentistry, Queen Mary University of London, London, UK
| | - Kerstin M Galler
- Department of Operative Dentistry and Periodontology, Friedrich-Alexander-University Erlangen-Nuernberg, Erlangen, Germany
| | - Juan J Segura-Egea
- Department of Stomatology, Endodontics Section, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Moritz Kebschull
- School of Dentistry, Institute of Clinical Sciences, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK
- Birmingham Community Healthcare NHS Trust, Birmingham, UK
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
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Lerdrungroj K, Banomyong D, Songtrakul K, Porkaew P, Nakornchai S. Current Management of Dens Evaginatus Teeth Based on Pulpal Diagnosis. J Endod 2023; 49:1230-1237. [PMID: 37506764 DOI: 10.1016/j.joen.2023.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 07/15/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION Dens evaginatus (DE) is a dental anomaly with a supernumerary tubercle projection that typically contains dentin and pulp tissue. However, the tubercle projection can fracture, exposing the dentin and potentially the dental pulp, which induces pulpal diseases. Managing DE should be primarily based on the clinical diagnosis of the pulp. METHODS The literature search in prevalence, prophylaxis, and management of dens evaginatus was performed in PubMed database as well as by manual search, in which the related contents were collected and descriptively analyzed. RESULTS Of the 264 searched literatures, 62 articles were included for this scoping review. The prophylactic management of the tubercle of DE teeth with a normal pulp should be performed as early as possible by the prep-and-fill technique or the reinforcement technique to preserve tooth vitality and continued root development, with the former reported to be superior compared with the latter. Furthermore, DE teeth with reversible pulpitis should be managed with the prep-and-fill technique. For DE teeth with irreversible pulpitis, vital pulp therapy, ie, partial or full/coronal pulpotomy, should be considered when the pulpal inflammation is limited to the coronal pulp to preserve the vitality of the radicular pulp that induces apexogenesis. A pulpectomy should be performed if the pulpal inflammation has progressed into the radicular pulp. For DE teeth with pulpal necrosis (or after pulpectomy) and immature roots, mineral trioxide aggregate apexification or regenerative endodontic procedures are the treatment options. For DE teeth with pulpal necrosis and complete root formation, nonsurgical root canal treatment is the treatment of choice. A flow chart of the decision-making for managing DE teeth based on pulpal diagnosis is proposed. CONCLUSION DE teeth should be properly managed, by prophylaxis or treatment, depending on pulpal diagnosis and related factors.
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Affiliation(s)
| | - Danuchit Banomyong
- Faculty of Dentistry, Department of Operative Dentistry and Endodontics, Mahidol University, Bangkok, Thailand
| | - Kamolthip Songtrakul
- Department of Endodontics, New York University College of Dentistry, New York, New York
| | | | - Siriruk Nakornchai
- Faculty of Dentistry, Department of Pediatric Dentistry, Mahidol University, Bangkok, Thailand.
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Asaithambi R, Devi P, Pamei D, Rahul M, Tewari N, Bansal K, Mathur VP. A Critical Analysis of "Two-Year Outcomes of Coronal Pulpotomy in Young Permanent Molars with Clinical Signs Indicative of Irreversible Pulpitis ". Pediatr Dent 2023; 45:374-375. [PMID: 37904268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Affiliation(s)
- Rathika Asaithambi
- Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute Of Medical Science (AIIMS), New Delhi, Delhi, India
| | - Pavithra Devi
- Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute Of Medical Science (AIIMS), New Delhi, Delhi, India
| | - Dammuilung Pamei
- Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute Of Medical Science (AIIMS), New Delhi, Delhi, India
| | - Morankar Rahul
- Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute Of Medical Science (AIIMS), New Delhi, Delhi, India
| | - Nitesh Tewari
- Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute Of Medical Science (AIIMS), New Delhi, Delhi, India
| | - Kalpana Bansal
- Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute Of Medical Science (AIIMS), New Delhi, Delhi, India
| | - Vijay Prakash Mathur
- Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute Of Medical Science (AIIMS), New Delhi, Delhi, India
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Khoshbin E, Ghasemi L, Behroozi R, Khosravi Z, Rahmati A, Rezaeisoufi L, Karkehabadi H. Effect of 810 nm Diode Laser Irradiation on the Time of Initiation and Depth of Anesthesia for Endodontic Treatment of Mandibular First Molars with Symptomatic Irreversible Pulpitis: A Clinical Trial. Photobiomodul Photomed Laser Surg 2023; 41:475-482. [PMID: 37738369 DOI: 10.1089/photob.2023.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023] Open
Abstract
Objective: In endodontic treatments, performing appropriate anesthesia in patients with irreversible pulpitis in mandibular molars may result in pain and severe problems. The irradiation of low-level lasers could be effective in this regard due to its anti-inflammatory and regenerative properties. This study aimed to assess the effect of 810 nm diode laser on the time of initiation and depth of anesthesia for endodontic treatment of mandibular first molars with symptomatic irreversible pulpitis. Materials and methods: This randomized controlled clinical trial evaluated 60 patients requiring endodontic treatment of mandibular first molars with symptomatic irreversible pulpitis and pain score ≥114 according to the Heft-Parker visual analog scale (HP-VAS). The teeth were randomized into two groups of diode laser and control. In the diode laser group, 810 nm diode laser with 300 mW power and 15 J/cm2 energy density was irradiated to the buccal surface of tooth crowns for 20 sec at 2 mm distance immediately before anesthesia administration. Laser in off mode was used in the control group. Inferior alveolar nerve block was then performed using 2% lidocaine with 1:80,000 epinephrine. After anesthetic injection, the mandibular first molar and canine teeth (control) were tested by an electric pulp tester every 2 min. Two consecutive negative responses to 80 mA indicated the initiation of anesthesia. HP-VAS forms were filled out by patients to assess their level of pain during the procedure. Data were analyzed by the Student's t and Chi-square tests, and analysis of variance (α = 0.05). Results: No remarkable difference was noted between the laser group and control groups in pain severity or anesthesia onset (p > 0.05). Conclusions: Low-level (810 nm) diode laser did not affect the time of initiation or depth of anesthesia in endodontic treatment of mandibular first molars with symptomatic irreversible pulpitis. Clinical trials registration: Iranian Registry of Clinical Trials (IRCT20181222042076N1).
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Affiliation(s)
- Elham Khoshbin
- Department of Endodontics, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Leila Ghasemi
- Department of Endodontics, School of Dentistry, Arak University of Medical Sciences, Arak, Iran
| | - Rooholah Behroozi
- Department of Endodontics, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Zahra Khosravi
- Department of Pediatric Dentistry, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Afsaneh Rahmati
- Department of Endodontics, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Loghman Rezaeisoufi
- Dental Research Center, Department of Operative Dentistry, School of dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hamed Karkehabadi
- Department of Endodontics, Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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Teja KV, Ramesh S, Janani K, Srivastava KC, Shrivastava D, Natoli V, Di Blasio M, Cicciù M, Minervini G. Clinical correlation of salivary alpha-amylase levels with pain intensity in patients undergoing emergency endodontic treatment. BMC Oral Health 2023; 23:562. [PMID: 37573306 PMCID: PMC10423407 DOI: 10.1186/s12903-023-03195-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 07/01/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND Pain is usually subjective and thus it is challenging to describe its characteristics such as nature, intensity, and origin. Non-invasive methods such as assessing salivary alpha-amylase (SAA) may aid the practitioner to evaluate the pain intensity. Hence, the current study aimed to correlate the levels of SAA with the pain intensity in patients presenting with varied endodontic pain levels. METHODS Sixty patients who presented with varied intensities of endodontic pain were selected for the present study out of which seven patients were excluded/dropped, leaving a total sample of fifty-five patients for assessment. Mandibular molar with symptomatic irreversible pulpitis without periapical pathology were included in the study. A 5ml of un-stimulated was obtained from the patients, following which the local anesthesia was administered. Root canal treatment was then performed and the pain scores at pre-operative and post-operative were recorded. Additionally, salivary samples were collected after emergency endodontic treatment and sent for sialochemical analysis. IBM.SPSS statistics software 23.0 was employed to assess the obtained data. RESULTS A statistically significant drop in the pain score (P < 0.001) and SAA levels (P < 0.001) were observed post-operatively in the contract to pre-operative state. A strong positive correlation was reported between SAA levels and pain scores in patients undergoing emergency endodontic treatment at both time intervals namely pre-operative (P < 0.001) and post-operative (P < 0.001). CONCLUSION The results of this preliminary showed a strong association between the pain score and SAA levels in patients undergoing an emergency endodontic treatment.
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Affiliation(s)
- Kavalipurapu Venkata Teja
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hopitals, Saveetha Institute of Medical and Technical Sciences, Chennai, 600077, Tamil Nadu, India
| | - Sindhu Ramesh
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hopitals, Saveetha Institute of Medical and Technical Sciences, Chennai, 600077, Tamil Nadu, India
| | - Krishnamachari Janani
- Department of Conservative Dentistry and Endodontics, SRM Dental College, Ramapuram, Chennai, Tamil Nadu, India
| | - Kumar Chandan Srivastava
- Department of Oral & Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia.
| | - Deepti Shrivastava
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia.
- Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, 602105, Chennai, India.
| | - Valentino Natoli
- Department of Dentistry, School of Biomedical and Health Sciences, European University of Madrid, Madrid, 28670, Spain
- Private Dental Practice, Fasano, 72015, Italy
| | - Marco Di Blasio
- Department of Medicine and Surgery, University Center of Dentistry, University of Parma, Parma, 43126, Italy
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, Catania, 95123, CT, Italy
| | - Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania, Luigi Vanvitelli, Naples, 80138, Italy
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Abduljalil SMA, Ahmed NTH, Rahman MM, Marouf AA, Farghal NS, Gismalla BG. Effect of Photobiomodulation on the Depth of Local Anesthesia during Endodontic Treatment of Teeth with Symptomatic Irreversible Pulpitis. J Contemp Dent Pract 2023; 24:437-441. [PMID: 37622619 DOI: 10.5005/jp-journals-10024-3519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
AIM To determine whether photobiomodulation (PBM) therapy could increase the depth of analgesia during endodontic therapy of teeth affected with symptomatic irreversible pulpitis. MATERIALS AND METHODS Forty-nine patients with symptomatic irreversible pulpitis were randomized into two groups. In the laser group, before administering anesthesia, the lower molars' crowns were continuously treated with a diode laser (980 nm) for 20 s with a low-level laser tip in the buccal aspect close to the gingival margin. While the teeth of the second group who was blinded to the type of treatment received placebo treatment wherein the laser device was switched off. The visual analogue scale (VAS) was used to assess pain in both groups before the endodontic procedure, during dentin cutting, and at dropping pulp, wherein, the success was defined as no or mild pain. The Chi-square and independent sample t-tests were used to assess the data. RESULTS During dentin cutting and pulp dropping, the group receiving the laser therapy presented with less mean pain score than the placebo group which was statistically significant. Additionally, it was observed that the need for supplementary injection was less frequent in the laser-treated group than in the placebo group (p = 0.01). CONCLUSION The irradiation by diode laser (980 nm) prior to administration of local anesthesia appears to be useful in minimizing discomfort and additional injection during root canal therapy (RCT). CLINICAL SIGNIFICANCE Pain management is essential for providing the best possible treatment to patients before, during, and after endodontic therapy. Adequate pain control during treatment also aids in reducing postoperative discomfort. This implies the need for additional methods to reduce discomfort during endodontic treatment; hence, adjuncts are crucial to achieving this goal. Photobiomodulation may be used as an adjuvant to reduce discomfort and supplementary injections during RCT.
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Affiliation(s)
| | - Nada Tawfig Hashim Ahmed
- Rak College of Dental Sciences, RAK Medical & Health Sciences University, Ras-Al Khaimah, United Arab Emirates, Phone: +971585267057, e-mail:
| | - Muhammed Mustahsen Rahman
- Rak College of Dental Sciences, RAK Medical & Health Sciences University, Ras-Al Khaimah, United Arab Emirates
| | | | - Nancy Soliman Farghal
- Rak College of Dental Sciences, RAK Medical & Health Sciences University, Ras-Al Khaimah, United Arab Emirates
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Seet RF, Chan PY, Khoo ST, Yu VSH, Lui JN. Characteristics of Cracked teeth with Reversible Pulpitis after Orthodontic Banding - a Prospective Cohort Study. J Endod 2022; 48:1476-1485.e1. [PMID: 36150561 DOI: 10.1016/j.joen.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 09/11/2022] [Accepted: 09/11/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Cracked teeth with reversible pulpitis can be managed with orthodontic bands in the interim before definitive restorations. The aim of this study was to determine short-term outcomes of these teeth following orthodontic band placement. The time taken for definitive pulp diagnoses after orthodontic band placement and associated prognostic factors was also analyzed. METHODS One hundred and twenty-five patients with a cracked tooth with reversible pulpitis each were recruited. Pre-operative data including patient and tooth factors were collected. Cracked teeth were banded and reviewed until symptoms resolved before referral for coronal coverage. Kaplan-Meier and Cox analyses were performed to analyze pulp survival of these teeth. Prognostic factors were investigated using Pearson's Chi-Square and Student's T-Test. RESULTS One hundred and twenty-two cracked teeth were analyzed. One hundred and thirteen (92.6%) teeth had the pulpitis resolved within two months (Median 40.0; IQR 28-61). The median time taken for progression to irreversible pulpitis or pulp necrosis for teeth that required root canal treatment was three months (Median 90.0; IQR 68-110). No prognostic factors were associated with the resolution of pulpal symptoms. However, higher pre-operative triggered pain scores (p<0.05, HR 1.547) and absence of a distal marginal ridge crack (p<0.05, HR 0.638) were correlated with a longer duration before definitive pulp diagnoses. CONCLUSION Following orthodontic band placement, a normal pulp diagnosis was achieved in 92.6% of cracked teeth with pre-operative reversible pulpitis. Definitive pulp diagnoses could be determined in approximately two months. Teeth with higher pre-operative triggered pain scores may require a longer review period.
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Affiliation(s)
- Rachel Fangying Seet
- Department of Restorative Dentistry, National Dental Centre of Singapore, Singapore.
| | - Pei Yuan Chan
- Department of Restorative Dentistry, National Dental Centre of Singapore, Singapore
| | - Shi-Tien Khoo
- Department of Restorative Dentistry, National Dental Centre of Singapore, Singapore
| | - Victoria Soo Hoon Yu
- Faculty of Dentistry, National University of Singapore, Singapore; ORCHIDS: Oral Care Health Innovations and Designs Singapore, National University of Singapore, Singapore
| | - Jeen-Nee Lui
- Department of Restorative Dentistry, National Dental Centre of Singapore, Singapore
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Xiao W, Shi WT, Wang J. [Study of vital inflamed pulp therapy in immature permanent teeth with irreversible pulpitis and apical periodontitis]. Zhonghua Kou Qiang Yi Xue Za Zhi 2022; 57:287-291. [PMID: 35280007 DOI: 10.3760/cma.j.cn112144-20211223-00563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
To assess the treatment effectiveness of vital inflamed pulp therapy (VIPT) in immature permanent teeth with irreversible pulpitis and apical periodontitis. The faculty members in the Department of Pediatric Dentistry, the Ninth People's Hospital were invited to submit consecutive VIPT cases from June 2015 to June 2016 (follow-up periods>12 months). The cases were retrospectively reviewed, clinical symptoms and radiographic changes in periapical radiolucency were evaluated, meanwhile, the data of radiographic changes such as apical diameter and root length were calculated and analyzed with ANOVA. Totally thirteen submitted patients/cases were included (6 males and 7 females) in the present study,. The average age of patients was (9.9±1.4) years old. The average follow-up time was (26.5±6.8) months (17-37 months). At the 12-month visit, all 13 treated teeth survived, 9 out of 11 teeth with apical periodontitis showed normal radiographic manifestation. At the 3, 6 and 12 months visits, the within-case percentage changes in apical diameter were (8.0±5.1)%, (24.1±9.1)% and (70.3±10.7)%, respectively, while the within-case percentage changes in root length were (11.4±9.8)%, (14.5±9.8)% and (27.4±14.2)%, respectively. There were statistically significant differences in the changes of apical diameter (F=18.80, P<0.001) and root length (F=4.64, P=0.047) from the preoperative time to the postoperative follow-ups. VIPT might improve clinical outcomes, even achieve continued root development. VIPT can be an option in treating immature teeth with irreversible pulpitis and apical periodontitis.
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Affiliation(s)
- W Xiao
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - W T Shi
- Clinical Research Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
| | - J Wang
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
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He WX, Yu Q. [New advances in vital pulp therapy and pulp regeneration for the treatment of pulpitis: from basic to clinical application]. Zhonghua Kou Qiang Yi Xue Za Zhi 2022; 57:16-22. [PMID: 35012247 DOI: 10.3760/cma.j.cn112144-20210917-00417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In recent years, great progress has been made in research on the treatment of pulpitis, mainly due to the rapid development of basic and clinical researches in this field, and some achievement from basic research has been applied in clinical practice. Advances in the diagnostic methods for pulpitis can help the clinicians to recognize the true state of pulpitis more accurately and to adopt the corresponding treatment methods including indirect/direct pulp capping, pulpotomy, pulp regeneration and root canal therapy. The new theory of pulpitis diagnosis and the studies on immune defense, repair function of dental pulp and new pulp capping materials have significantly improved the success rate of vital pulp therapy. For diffuse coronary pulpitis or radicular pulpitis, which is difficult to achieve vital pulp therapy successfully, methods of pulp revascularization, cell homing and pulp stem cells-mediated pulp regeneration can also be used as treatment options in addition to root canal therapy. The present article focuses on the research progress on pulpitis treatments and related clinical transformation practices, in order to provide reference on vital pulp therapy and pulp regeneration for clinicians.
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Affiliation(s)
- W X He
- Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an 710032, China
| | - Q Yu
- Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an 710032, China
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Hussain MI, Bashar AM. Outcome of Mineral Trioxide Aggregate Pulpotomy for Mature Permanent Molars with Symptoms Indicative of Irreversible Pulpitis. Mymensingh Med J 2022; 31:223-229. [PMID: 34999706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Root canal treatment (RCT) is preferred treatment for mature teeth with irreversible pulpitis. But sometimes it is very difficult to perform due to complex pulpal anatomy and the vitality of tooth is completely lost by this procedure. A new hope has been emerged to consider pulpotomy treatment as an effective treatment in mature permanent teeth with irreversible pulpitis as with the new understanding of pulp biology and recent innovation of bioactive material like MTA. The aim of the study was to evaluate the outcome of MTA pulpotomy for mature third molars with symptoms indicative of irreversible pulpitis. This quasi-experimental study was conducted at Department of Conservative Dentistry and Endodontics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from September 2019 to August 2020. Twenty permanent mandibular third molar teeth with fully developed roots and diagnosed as irreversible pulpitis in 20 patients aged 25-50 years were selected for this study. After informed consent, each tooth was anaesthetized, isolated with dental dam and disinfected with 5% NaOCl before caries excavation; caries was removed, and then, a full pulpotomy was performed. Haemostasis was achieved and MTA (Angelus, Brazil) was placed as the pulpotomy agent over the pulp chamber floor covering the canal orifices and rest of the cavity was sealed with glass-ionomer filling over the set MTA. Clinical and radiographic evaluation was completed at 3 months, 6 months, and 1 year postoperatively. Descriptive statistics were used to assess outcomes. The recall rate ranged from 90% at 3 months to 85% at 1 year, with an overall 100% clinical and radiographic success during the 3 month and 6 month, and 95% success at the end of 1 year. MTA pulpotomy sustained a good success rate over the 1 year follow-up in mature third molar teeth clinically diagnosed with irreversible pulpitis.
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Affiliation(s)
- M I Hussain
- Dr Muhammad Imran Hussain, Lecturer, Department of Conservative Dentistry and Endodontics, Dental Unit, Sir Salimullah Medical College, Mitford, Dhaka, Bangladesh; E-mail:
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22
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Ilyas N, Sood S, Radia R, Suffern R, Fan K. Paediatric dental pain and infection during the COVID period. Surgeon 2021; 19:e270-e275. [PMID: 33663945 PMCID: PMC7920802 DOI: 10.1016/j.surge.2020.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/30/2020] [Accepted: 12/25/2020] [Indexed: 11/12/2022]
Abstract
BACKGROUND During the coronavirus pandemic, paediatric patients will still likely present with dental pain and infection. In order to streamline care at King's College Hospital (KCH), Paediatric Dentistry and Oral and Maxillofacial Surgery (OMFS) have developed a collaborative working approach allowing patients to be treated effectively and to streamline patient care in the absence of easy access to general anaesthetic facilities. METHOD Presenting complaints, treatment need and the treatment received were recorded for all paediatric patients presenting with dental pain and infection in the "lockdown" period (23rd March- 14th June) during "normal" working hours and "out of hours" to either paediatric dentistry or OMFS. RESULTS 420 calls were triaged which converted to 67 patients seen face-to-face for oro-facial pain and infection. 41% of children were treated successfully under Local anaesthetic alone, only 13% required a general anaesthetic (GA) in the "lockdown" period. The vast majority of patients had antibiotics prescribed prior to attendance (80%). CONCLUSION We have demonstrated the demographic, presenting complaints and treatment need of patients who presented to KCH during the lockdown period with dental pain and infection. The majority were able to be treated without needing for GA facilities. This paper highlights how a collaborative approach between paediatric dentistry and OMFS can help streamline patient care and is a model which can be adopted by other units in the event of further "lockdowns".
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Affiliation(s)
- Nabeel Ilyas
- Department of Paediatric Dentistry, King's College Hospital NHS Trust, London, SE5 9RS, UK
| | - Sanjeev Sood
- Department of Paediatric Dentistry, King's College Hospital NHS Trust, London, SE5 9RS, UK
| | - Ria Radia
- Oral and Maxillofacial Surgery Department, King's College Hospital NHS Trust, London, SE5 9RS, UK
| | - Rachael Suffern
- Oral and Maxillofacial Surgery Department, King's College Hospital NHS Trust, London, SE5 9RS, UK
| | - Kathleen Fan
- Oral and Maxillofacial Surgery Department, King's College Hospital NHS Trust, London, SE5 9RS, UK.
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23
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Gadzhula NG, Horlenko IM, Goray MA, Kvirikashvili AM. MODERN ASPECTS OF TRAUMATIC PULPITIS TREATMENT WITH THE USE OF BIOCERAMICS. Wiad Lek 2021; 74:1341-1345. [PMID: 34159916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The aim: The research was to evaluate the effectiveness of acute traumatic pulpitis treatment with the use of bioceramics according to the results of a clinical study. PATIENTS AND METHODS Materials and methods: Acute traumatic pulpitis of 25 teeth in 25 patients aged 18-25 years were treated by biological direct pulp capping. In 13 patients of the main group, bioceramics was placed on the exposed pulp, and in 12 patients of the control group, calcium hydroxide paste was applied on the exposed pulp. Treatment effectiveness was evaluated according to the following criteria: the absence of clinical signs of pulpal inflammation, on X-ray - signs of dentinal bridge formation, the absence of periapical changes. RESULTS Results: The use of bioceramic material in patients of the main group provided a positive dynamic of treatment in 12 teeth. The need for re-treatment was diagnosed only in 1 clinical case (7.7%), in the control group - in 4 cases (33.3%). CONCLUSION Conclusions: Pulpitis treatment with the use of bioceramics provides preserving the functional properties of pulp, creation of a calcified barrier - dentin bridge and prevents the periodontal complications compared to the pulp capping with a material based on calcium hydroxide. The effectiveness of treatment in the main group was 92.3%, in the control - 66.7%.
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Affiliation(s)
| | - Irina M Horlenko
- NATIONAL PIROGOV MEMORIAL MEDICAL UNIVERSITY, VINNYTSIA, UKRAINE
| | - Maryna A Goray
- NATIONAL PIROGOV MEMORIAL MEDICAL UNIVERSITY, VINNYTSIA, UKRAINE
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24
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Jadhav GR, Mittal P. Evaluation of aromatherapy on success rate of inferior alveolar nerve block in teeth with irreversible pulpitis: a prospective randomized clinical trial. Quintessence Int 2020; 51:864-870. [PMID: 32901242 DOI: 10.3290/j.qi.a45172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This prospective, block randomized clinical trial was conducted to evaluate the effect of aromatherapy on the success rate of inferior alveolar nerve block (IANB) in teeth with irreversible pulpitis. METHOD AND MATERIALS In this clinical trial, 46 patients fulfilling the inclusion criteria were randomly divided into two equal groups: group I (n = 22) received IANB in a closed operatory without any fragrance, whereas group II (n = 24) received IANB in a separate closed operatory saturated with lavender fragrance using a candle warmer. The modified dental anxiety scale (MDAS) for anxiety and visual analog scale (VAS) for pain were recorded preoperatively as well as during access cavity preparation. For MDAS, a total score of more than 18 was considered as tremendously anxious or dental phobic. No or mild pain on VAS was considered as success. Data were analyzed using paired t test and independent sample t test. P < .05 was considered as statistically significant. RESULTS Difference in mean VAS (P = .749) and MDAS (P = 1.000) between both the groups was statistically nonsignificant. However there was a statistically significant difference in mean VAS (P = .000) and MDAS (P = .001) during access opening. CONCLUSION Lavender aromatherapy can be used successfully to alleviate dental anxiety as well as to increase the anesthetic success rate of IANB in teeth with irreversible pulpitis.
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25
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Buchanan GD, Tredoux S, Nel C, Gamieldien MY. Endodontic treatment of dentin dysplasia type I D. AUST ENDOD J 2020; 47:343-349. [PMID: 32964546 DOI: 10.1111/aej.12444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/28/2020] [Accepted: 09/02/2020] [Indexed: 11/26/2022]
Abstract
Dentin dysplasia (DD) Type I is a developmental condition affecting dentin, inherited in an autosomal-dominant pattern or occurring due to a new mutation. Whilst the crowns of DD Type I affected teeth appear clinically normal, the roots are blunt and shortened. Pulp necrosis and periapical pathoses may be seen in the absence of obvious causes. Pulp stones and calcifications are frequently encountered. Endodontic management of DD may be challenging. A case of DD Type I, sub-classification d, in which spontaneous irreversible pulpitis developed on three mandibular incisors is documented. The case was managed by conventional endodontic treatment. Knowledge of this uncommon dental condition may assist dentists to adequately diagnose and manage these cases. Extraction should not be considered the first-line treatment option when sufficient root length is available to attempt endodontic treatment. Referral for medical evaluation is recommended to rule out systemic diseases which may mimic this condition.
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Affiliation(s)
- Glynn Dale Buchanan
- Department of Odontology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Sheree Tredoux
- Department of Odontology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Chane Nel
- Department of Oral Biology and Oral Pathology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Mohamed Yasin Gamieldien
- Department of Maxillofacial and Oral Surgery, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Munoz-Sanchez ML, Linas N, Decerle N, Nicolas E, Hennequin M, Cousson PY. A Combination of Full Pulpotomy and Chairside CAD/CAM Endocrown to Treat Teeth with Deep Carious Lesions and Pulpitis in a Single Session: A Preliminary Study. Int J Environ Res Public Health 2020; 17:ijerph17176340. [PMID: 32878168 PMCID: PMC7503687 DOI: 10.3390/ijerph17176340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 12/17/2022]
Abstract
A higher chance of carrying out a successful full pulpotomy may depend on whether the coronal restoration can be completed within a single appointment. The development of chairside CAD/CAM (Computer Aided Design and Manufacturing) technology has made it possible to carry out indirect restoration of endodontically treated teeth in a single session. This study aimed to evaluate the long-term outcome of a full pulpotomy with Biodentine™ immediately covered with a chairside CAD/CAM endocrown on teeth affected by pulpitis and deep carious lesions. The investigation involved a cohort of 30 molars that were treated by pulpotomy and CAD/CAM endocrown. Clinical and radiological examinations were scheduled at 1, 6, and 12 months postoperatively. Overall, all treatments were effective at any time during the follow-up. The results of this study need to be confirmed with a longer-term follow-up to allow for comparison with the literature. This original combination of endodontic and restorative treatments provides an Endo-prosthetic continuum in a single session, with the objective of long-term success in terms of tooth health.
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Affiliation(s)
- Marie-Laure Munoz-Sanchez
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (N.L.); (N.D.); (E.N.); (P.-Y.C.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
| | - Natacha Linas
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (N.L.); (N.D.); (E.N.); (P.-Y.C.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
| | - Nicolas Decerle
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (N.L.); (N.D.); (E.N.); (P.-Y.C.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
| | - Emmanuel Nicolas
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (N.L.); (N.D.); (E.N.); (P.-Y.C.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
| | - Martine Hennequin
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (N.L.); (N.D.); (E.N.); (P.-Y.C.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
- Correspondence:
| | - Pierre-Yves Cousson
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (N.L.); (N.D.); (E.N.); (P.-Y.C.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
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27
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Shu Y, Luo YJ. [Curative effect of warm gutta-percha filling technique combined with different sealers in root canal filling]. Shanghai Kou Qiang Yi Xue 2018; 27:645-648. [PMID: 30899949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE To evaluate the clinical curative effect of warm gutta-percha filling technique combined with different sealers in root canal filling. METHODS Ninety-five patients with pulpitis who underwent root canal filling from June 2015 to June 2017 were selected. They were randomly divided into group A (n=30), group B (n=33) and group C(n=32). Group A was treated with warm gutta-percha filling technique + iRoot SP, group B was treated with warm gutta-percha filling technique + AH plus, and group C was treated with warm gutta-percha filling technique + Vitapex. The quality of root canal filling at 7 days after surgery was compared among the three groups, and the pain degree was assessed. Statistical analysis was performed using SPSS 19.0 software package. RESULTS There was no significant difference in the rate of suitable filling among the three groups (P>0.05). The rates of level 1 pain in group A and group B (6.7% and 6.1%) were significantly lower than that in group C (28.1%) (P<0.05). CONCLUSIONS The root canal sealing effects of warm gutta-percha filling technique combined with iRoot SP or AH plus or Vitapex are good. However, compared with Vitapex, iRoot SP and AH plus can relieve symptoms of pain after root canal treatment more effectively. They are suggested as the preferred sealers in root canal filling.
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Affiliation(s)
- Yi Shu
- Department of Oral Medicine,Deyang Stomatological Hospital. Deyang 618000, Sichuan Province,China. E-mail:
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28
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Milani AS, Froughreyhani M, Rahimi S, Zand V, Jafarabadi MA. Volume of Anesthetic Agents and IANB Success: A Systematic Review. Anesth Prog 2018; 65:16-23. [PMID: 29509518 PMCID: PMC5841477 DOI: 10.2344/anpr-65-01-03] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 03/16/2017] [Indexed: 12/24/2022] Open
Abstract
The aim of this study was to provide an evidence-based answer to the question: "Is 3.6-mL volume of an anesthetic agent more effective than 1.8-mL volume in providing anesthesia for mandibular molars?" Following formulation of research question and keyword selection, a comprehensive search of the following databases was conducted: Cochrane library, PubMed, Scopus, Google Scholar, ProQuest, and Clinicaltrials.gov. Three-phase eligibility appraisal and quality assessment of the studies were carried out by 2 independent reviewers. To reduce clinical heterogeneity, the included studies were divided into 2 groups: studies on healthy teeth and studies on teeth with pulpitis. The data of included studies were statistically combined through meta-analysis using a fixed-effects model. A total of 20,778 records were initially retrieved from the search. Following screening and eligibility assessment, 8 studies met the eligibility criteria and were included for qualitative synthesis. Of those, 5 studies were qualified for meta-analysis. In the irreversible pulpitis group, increasing the volume of anesthetic agent from 1.8 to 3.6 mL significantly increased the success rate of inferior alveolar nerve block (risk ratio = 2.45, 95% CI: 1.67-3.59, p < .001). However, there was insufficient evidence to draw a conclusion regarding healthy teeth.
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Affiliation(s)
- Amin Salem Milani
- Assistant Professor, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Froughreyhani
- Associate Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeed Rahimi
- Professor of Endodontics, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Zand
- Associate Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Associate Professor of Biostatistics, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
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29
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Saba K, Maxood A, Abdullah S, Riaz A, Uddin S. Comparison of frequency of pain in root canal treatment using sodium hypochlorite and chlorhexidine as root canal irrigants. J PAK MED ASSOC 2018; 68:1334-1338. [PMID: 30317260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To compare the frequency of pain in root canal treatment using sodium hypochlorite and chlorhexidine as root canal irrigants. METHODS The cross-sectional study was carried out from January to June 2016 at the Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan, and comprised patients aged 18-40 years with irreversible pulpitis involving a posterior tooth. The patients were divided into two equal groups, with Group-I receiving 2% chlorhexidine, and Group-II receiving 5.25% sodium hypochlorite. Following the use of the irrigants, the selected teeth were evaluated for pain at 72 hours using Visual Analogue Scale. RESULTS There were 60 patients divided into groups of 30(50%) each. The overall mean age was 27.97±5.9 years. There were 32 (53.3%) females and 28 (46.6%) males. The mean post-operative pain score was 1.70±1.9 in Group-I and 1.90 ± 2.3 in Group-II (p=0.5). In Group-I, 25(83.3%) patients had no pain while in Group-II, 20(66.7%) had no pain (p=0.1). CONCLUSIONS There was no difference in post-operative pain at 72 hours between 2% chlorhexidine and 5.25% sodium hypochlorite when used as irrigants.
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Affiliation(s)
- Kiran Saba
- Shaheed Zulfiqar Ali Bhutto Medical University, PIMS, Islamabad
| | - Anser Maxood
- Shaheed Zulfiqar Ali Bhutto Medical University, PIMS, Islamabad
| | - Saeeda Abdullah
- Shaheed Zulfiqar Ali Bhutto Medical University, PIMS, Islamabad
| | - Amna Riaz
- Shaheed Zulfiqar Ali Bhutto Medical University, PIMS, Islamabad
| | - Shahab Uddin
- Shaheed Zulfiqar Ali Bhutto Medical University, PIMS, Islamabad
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30
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Kovach I, Buniatian K, Makarevych A, Verbyts'ka A, Gargin V. INFLUENCE OF TRICALCIUM SILICATE ON COURSE OF TRAUMATIC PULPITIS. Georgian Med News 2018:130-134. [PMID: 29697396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The use of Tricalcium Silicate (TS) as an odontotropic preparation makes it possible to create a hermetic crown restoration with a high degree of adhesion. However, the use of TS silicate by direct pulp capping remains disputable. The aim of this study was to determine the effects of TS on course of traumatic pulpitis by detection of morpho-functional peculiarities of changes in pulp tissue. We performed experimental investigation (on rabbits, males, aging three-month) for study of the morpho-functional changes of the pulp tissues with modeling of traumatic pulpitis and direct pulp capping with TS preparation (8 animals, investigated group) and calcium hydroxide (Calasept, NORDISKA DENTAL) preparation (8 animals, comparison group). After 2nd and 6th weeks tissues of tooth were fixed in 10% formalin with performing routine proceeding after decalcification and making histological slides which were investigated. Manifestations of protective adaptive mechanisms have been revealed in the form of inflammatory process two weeks after the injury in the pulp tissue with its resolution six weeks after performing of direct pulp capping with TS with replacement of necrotic area by connective tissue with their delimitation from viable pulp tissue against a background of intensive formation of capillaries. Morphometric study proved dynamical changes of vascular number cross-sections per 1 mm2 from 69.31±4.76 (2 weeks) to 47.38±4.12 (6 weeks) with 49.2±3.47 vascular density in intact group. Cellular density of odontoblasts as changed from 3.92±1.03 x103 per 1 mm2 (2 weeks) to 7.49±1.51 x103 per 1 mm2 (6 weeks) with 8.3±1.02 x103 per 1 mm2 cellular density in intact group. Thus it can be argued that the use of TS as a material for direct pulp capping promotes more active regeneration processes.
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Affiliation(s)
- I Kovach
- State Establishment "Dnipropetrovsk Medical Academy", Kharkiv National Medical University, Ukraine
| | - K Buniatian
- State Establishment "Dnipropetrovsk Medical Academy", Kharkiv National Medical University, Ukraine
| | - A Makarevych
- State Establishment "Dnipropetrovsk Medical Academy", Kharkiv National Medical University, Ukraine
| | - A Verbyts'ka
- State Establishment "Dnipropetrovsk Medical Academy", Kharkiv National Medical University, Ukraine
| | - V Gargin
- State Establishment "Dnipropetrovsk Medical Academy", Kharkiv National Medical University, Ukraine
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31
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Fu S, Zhang Y, Song WB. [Clinical evaluations of transitional treatment of pulpitis during pregnancy in 60 female patients]. Shanghai Kou Qiang Yi Xue 2018; 27:68-72. [PMID: 29946646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE The present study was aimed to clinically evaluate transitional treatment of pulpitis during pregnancy. METHODS Sixty pregnant women with pulpitis were divided into the first, second and third trimester. They were anesthetized locally using STA system combined with psychological intervention during treatment. The teeth were given one-appointment root canal preparation and filled with vitapex pasta. Normal obturation of the root canal was conducted after delivery. The effects of dental treatment, pregnancy outcomes and neonatal health status were observed. Data of the survey were analyzed by SPSS 20.0 software package, including Student's t test and chi-square test. RESULTS The symptoms of pulpitis were significantly improved 24h after treatment,and the effective rate was 96.7%. The difference of VAS before and after treatment was statistically significant (P<0.05). Patients had no discomfort till the end of pregnancy,and the success rate was 98.3%. No adverse pregnancy outcomes were observed after treatment during different periods of pregnancy. Neonatal health was good. Significant differences were not found in birth gestational age, body weight, malformations, and neonatal complications between three treatment periods (P>0.05). CONCLUSIONS Transitional treatment of pulpitis during pregnancy is a safe and effective procedure and worthy of wide use clinically.
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Affiliation(s)
- Shuang Fu
- College of Stomatology, Qingdao University. Qingdao 266071, Shandong Province, China. E-mail:
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32
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Chompu-inwai P, Simprasert S, Chuveera P, Nirunsittirat A, Sastraruji T, Srisuwan T. Effect of Nitrous Oxide on Pulpal Anesthesia: A Preliminary Study. Anesth Prog 2018; 65:156-161. [PMID: 30235437 PMCID: PMC6148698 DOI: 10.2344/anpr-65-02-08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 08/13/2017] [Indexed: 12/28/2022] Open
Abstract
To compare the success of perceived pulpal anesthesia between groups using nitrous oxide/oxygen (N2O/O2) and oxygen (O2) in children premedicated with ibuprofen with symptomatic irreversible pulpitis permanent teeth. Thirty-three children (mean age 10.4 ± 1.9 years) with 33 symptomatic irreversible pulpitis permanent teeth were included in this preliminary study. All children were premedicated with ibuprofen and randomly assigned to receive either N2O/O2 (17 participants) or O2 (16 participants). Four percent articaine with epinephrine 1:100,000 was administered, and vital pulp therapy was performed. Children used the Wong-Baker FACES Pain Rating Scale (WBFPS) to report their pain at baseline as well as during carious dentin removal, pulpal exposure, and pulpal tissue removal steps. The success was determined when the reported WBFPS score was ≤4. The chi-square test was used to compare the success between both groups. The success of pulpal anesthesia was 71% (12/17) and 19% (3/16) in the N2O/O2 and O2 groups, respectively. The success in the N2O/O2 group was 52% higher than that in the O2 group (confidence interval = 22.9% to 80.7%; significant difference p = .003). From the result of this preliminary study, N2O/O2 significantly increased the success of perceived pulpal anesthesia in children premedicated with ibuprofen with symptomatic irreversible pulpitis permanent teeth. However, further study with a larger sample is required to confirm this result.
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Affiliation(s)
- Papimon Chompu-inwai
- Division of Pediatric Dentistry, Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Sophon Simprasert
- Former postgraduate student in pediatric dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Patchanee Chuveera
- Department of Family and Community Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Areerat Nirunsittirat
- Department of Family and Community Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Thanapat Sastraruji
- Dental Research Center, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Tanida Srisuwan
- Division of Endodontics, Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
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33
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Liu J, Shi CS. [Comparative study of pain releasing effect of two approaches to acute pulpitis in the night emergency]. Shanghai Kou Qiang Yi Xue 2017; 26:669-671. [PMID: 29691569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE To compare the clinical effect of 2 methods for acute pulpitis in the night emergency. METHODS Two hundred and twenty-three patients with acute pulpitis were randomly divided into experimental group (107 cases) and control group (109 cases). Patients in the experimental group was enclosed formaldehyde cresol (FC) with CAVITON-GC after removal of crown pulp, while patients in the control group was treated with open drainage. Pain releasing effect was evaluated and analyzed 2 days after treatment.The data were analysed by t test and χ2 test with SPSS19.0 software package. RESULTS The average pain index of the experimental group was 1.23, which was lower than that of the control group (3.58), the difference was significant (P<0.05). The treatment efficiency was 93.46% in the experimental group, significantly higher than that in the control group (77.98%, P<0.05). CONCLUSIONS Treatment in the experimental group is more effective to relieve pain than simple drainage in the control group.
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Affiliation(s)
- Jian Liu
- Department of Stomatology, People's Hospital of Taizhou City. Taizhou 225300, Jiangsu Province, China. E-mail:
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Wang W, Wang PL, Xie NN, Wu C, Liu ZX. [Outcome of one-visit and multiple-visit root canal treatment for cracked tooth with pulpitis: a meta analysis]. Shanghai Kou Qiang Yi Xue 2017; 26:672-679. [PMID: 29691570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE To compare the treatment effect between one-visit and multiple-visit endodontic treatment for cracked tooth with pulpitis. METHODS The literatures published before 2016-06-01 regarding to one-visit and multiple-visit root canal treatment for cracked tooth with pulpitis were searched through MEDLINE, CNKI, VIP, Wanfang Database et al. Then the included studies were chosen according to the inclusion criteria. Collection of features, quality evaluation and analysis of treatment effect, follow-up results (half year/1 year) and postoperative pain of the included studies were analyzed using Stata/SE12.1 software. RESULTS A total of 24 Chinese literatures were included and no eligible foreign literatures were found. There were 3065 cases including 1608 with one-visit endodontic treatment and 1457 with multiple-visit endodontic treatment. Meta analysis showed that the effective rate (96.90%) and follow-up success rate (94.90%,94.60%) of one-visit endodontic treatment were significantly higher than multiple-visit one (84.00%,81.40%,89.00%),while there was no significant difference in postoperative pain [RR=0.96,95%CI (0.82,1.13)].The results did not change after sensitivity analysis. However,there were some differences in assignment methods and operations details among the literatures. CONCLUSIONS The existing limited evidences show that one-visit endodontic treatment has higher effective rate than multiple-visit endodontic treatment and its postoperative pain is acceptable. However, more standard randomized controlled trials are needed.
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Affiliation(s)
- Wen Wang
- Xuzhou Stomatological Hospital. Xuzhou 221003, Jiangsu Province, China. E-mail:
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Kérourédan O, Jallon L, Perez P, Germain C, Péli JF, Oriez D, Fricain JC, Arrivé E, Devillard R. Efficacy of orally administered prednisolone versus partial endodontic treatment on pain reduction in emergency care of acute irreversible pulpitis of mandibular molars: study protocol for a randomized controlled trial. Trials 2017; 18:141. [PMID: 28351379 PMCID: PMC5371272 DOI: 10.1186/s13063-017-1883-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 03/07/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Irreversible pulpitis is a highly painful inflammatory condition of the dental pulp which represents a common dental emergency. Recommended care is partial endodontic treatment. The dental literature reports major difficulties in achieving adequate analgesia to perform this emergency treatment, especially in the case of mandibular molars. In current practice, short-course, orally administered corticotherapy is used for the management of oral pain of inflammatory origin. The efficacy of intraosseous local steroid injections for irreversible pulpitis in mandibular molars has already been demonstrated but resulted in local comorbidities. Oral administration of short-course prednisolone is simple and safe but its efficacy to manage pain caused by irreversible pulpitis has not yet been demonstrated. This trial aims to evaluate the noninferiority of short-course, orally administered corticotherapy versus partial endodontic treatment for the emergency care of irreversible pulpitis in mandibular molars. METHODS/DESIGN This study is a noninferiority, open-label, randomized controlled clinical trial conducted at the Bordeaux University Hospital. One hundred and twenty subjects will be randomized in two 1:1 parallel arms: the intervention arm will receive one oral dose of prednisolone (1 mg/kg) during the emergency visit, followed by one morning dose each day for 3 days and the reference arm will receive partial endodontic treatment. Both groups will receive planned complete endodontic treatment 72 h after enrollment. The primary outcome is the proportion of patients with pain intensity below 5 on a Numeric Scale 24 h after the emergency visit. Secondary outcomes include comfort during care, the number of injected anesthetic cartridges when performing complete endodontic treatment, the number of antalgic drugs and the number of patients coming back for consultation after 72 h. DISCUSSION This randomized trial will assess the ability of short-term corticotherapy to reduce pain in irreversible pulpitis as a simple and rapid alternative to partial endodontic treatment and to enable planning of endodontic treatment in optimal analgesic conditions. TRIAL REGISTRATION ClinicalTrials.gov, identifier: NCT02629042 . Registered on 7 December 2015. (Version n°1.1 28 July 2015).
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Affiliation(s)
- Olivia Kérourédan
- CHU de Bordeaux, Pôle d’Odontologie et de Santé Buccale, 33000 Bordeaux, France
- INSERM, Bioingénierie Tissulaire, U1026, 33076 Bordeaux, France
- Université de Bordeaux, UFR des Sciences Odontologiques, 33082 Bordeaux, France
| | - Léonard Jallon
- CHU de Bordeaux, Pôle d’Odontologie et de Santé Buccale, 33000 Bordeaux, France
- Université de Bordeaux, UFR des Sciences Odontologiques, 33082 Bordeaux, France
| | - Paul Perez
- CHU de Bordeaux, USMR, Pôle Santé publique, 33076 Bordeaux, France
| | | | - Jean-François Péli
- CHU de Bordeaux, Pôle d’Odontologie et de Santé Buccale, 33000 Bordeaux, France
- Université de Bordeaux, UFR des Sciences Odontologiques, 33082 Bordeaux, France
| | - Dominique Oriez
- CHU de Bordeaux, Pôle d’Odontologie et de Santé Buccale, 33000 Bordeaux, France
- Université de Bordeaux, UFR des Sciences Odontologiques, 33082 Bordeaux, France
| | - Jean-Christophe Fricain
- CHU de Bordeaux, Pôle d’Odontologie et de Santé Buccale, 33000 Bordeaux, France
- INSERM, Bioingénierie Tissulaire, U1026, 33076 Bordeaux, France
- Université de Bordeaux, UFR des Sciences Odontologiques, 33082 Bordeaux, France
| | - Elise Arrivé
- CHU de Bordeaux, Pôle d’Odontologie et de Santé Buccale, 33000 Bordeaux, France
- Université de Bordeaux, UFR des Sciences Odontologiques, 33082 Bordeaux, France
- INSERM, ISPED, Centre INSERM U-897-Epidemiologie-Biostatistique, Bordeaux Cedex, 33076 France
| | - Raphaël Devillard
- CHU de Bordeaux, Pôle d’Odontologie et de Santé Buccale, 33000 Bordeaux, France
- INSERM, Bioingénierie Tissulaire, U1026, 33076 Bordeaux, France
- Université de Bordeaux, UFR des Sciences Odontologiques, 33082 Bordeaux, France
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Peng CF, Zhao YM, Yang Y, Liu H, Qin M. [Retrospective analysis of pulp revascularization in immature permanent teeth with diffuse pulpitis]. Zhonghua Kou Qiang Yi Xue Za Zhi 2017; 52:10-15. [PMID: 28072988 DOI: 10.3760/cma.j.issn.1002-0098.2017.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Objective: To evaluate the treatment effectiveness of revascularization in immature permanent teeth with diffuse pulpitis and to provide an alternative approach for the treatment of these teeth. Methods: Clinical and radiographic data were collected from 17 immature permanent teeth which were diagnosed as diffuse pulpitis and with their pulp extirpated at Emergency Department of Peking University School and Hospital of Stomatology. All these teeth were treated using pulp revascularization at Department of Pediatric Dentistry. Clinical success rate was then evaluated based on the clinical and radiographic findings. The increase of root length and dentin wall thickness of the revascularized teeth and the contralateral control teeth were measured and compared according to the preoperative and recall periapical radiographs. Results: The average follow-uptime is (25.8±9.9) months (12-46 months). Totally 13 out of the 17 teeth showed normal clinical and radiographic manifestation and achieved the increasein root length and dentin wall thickness. They met criteria for success treatment. The rest 4 out of the 17 teeth also showed root length and dentin wall thickness increaseand apical foramen closure. However, periapical inflammations were observed during 12 to 36 monthfollow-ups. These cases were recognized as failed. In all the17 teeth, the increase of root length and dentin wall thickness was not significantly different between the revascularized teeth and the contralateral control teeth (P>0.05). Conclusions: Pulp revascularization in young permanent teeth with diffuse pulpitis resulted in similar clinical outcomes in root development and root canal wall formation compared with the contralateral control teeth. However, reinfection might occur during long-term follow-up.
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Affiliation(s)
- C F Peng
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Y M Zhao
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Y Yang
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - H Liu
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - M Qin
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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Abstract
BACKGROUND Root canal treatment (RoCT), or endodontic treatment, is a common procedure in dentistry. The main indications for RoCT are irreversible pulpitis and necrosis of the dental pulp caused by carious processes, tooth cracks or chips, or dental trauma. Successful RoCT is characterised by an absence of symptoms (i.e. pain) and clinical signs (i.e. swelling and sinus tract) in teeth without radiographic evidence of periodontal involvement (i.e. normal periodontal ligament). The success of RoCT depends on a number of variables related to the preoperative condition of the tooth, as well as the endodontic procedures. This review updates the previous version published in 2007. OBJECTIVES To determine whether completion of root canal treatment (RoCT) in a single visit or over two or more visits, with or without medication, makes any difference in term of effectiveness or complications. SEARCH METHODS We searched the following electronic databases: Cochrane Oral Health's Trials Register (to 14 June 2016), Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2016, Issue 5), MEDLINE Ovid (1946 to 14 June 2016), and Embase Ovid (1980 to 14 June 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 14 June 2016. We did not place any restrictions on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs of people needing RoCT. We excluded surgical endodontic treatment. The outcomes of interest were tooth extraction for endodontic problems; radiological failure after at least one year, i.e. periapical radiolucency; postoperative pain; swelling or flare-up; painkiller use; sinus track or fistula formation; and complications (composite outcome including any adverse event). DATA COLLECTION AND ANALYSIS We collected data using a specially designed extraction form. We contacted trial authors for further details where these were unclear. We assessed the risk of bias in the studies using the Cochrane tool and we assessed the quality of the body of evidence using GRADE criteria. When valid and relevant data were collected, we undertook a meta-analysis of the data using the random-effects model. For dichotomous outcomes, we calculated risk ratios (RRs) and 95% confidence intervals (CIs). For continuous data, we calculated mean differences (MDs) and 95% CIs. We examined potential sources of heterogeneity. We conducted subgroup analyses for necrotic and vital teeth. MAIN RESULTS We included 25 RCTs in the review, with a total of 3780 participants, of whom we analysed 3751. We judged three studies to be at low risk of bias, 14 at high risk, and eight as unclear.Only one study reported data on tooth extraction due to endodontic problems. This study found no difference between treatment in one visit or treatment over multiple visits (1/117 single-visit participants lost a tooth versus 2/103 multiple-visit participants; odds ratio (OR) 0.44, 95% confidence interval (CI) 0.04 to 4.78; very low-quality evidence).We found no evidence of a difference between single-visit and multiple-visit treatment in terms of radiological failure (risk ratio (RR) 0.91, 95% CI 0.68 to 1.21; 1493 participants, 11 studies, I2 = 18%; low-quality evidence); immediate postoperative pain (dichotomous outcome) (RR 0.99, 95% CI 0.84 to 1.17; 1560 participants, 9 studies, I2 = 33%; moderate-quality evidence); swelling or flare-up incidence (RR 1.36, 95% CI 0.66 to 2.81; 281 participants, 4 studies, I2 = 0%; low-quality evidence); sinus tract or fistula formation (RR 0.98, 95% CI 0.15 to 6.48; 345 participants, 2 studies, I2 = 0%; low-quality evidence); or complications (RR 0.92, 95% CI 0.77 to 1.11; 1686 participants, 10 studies, I2 = 18%; moderate-quality evidence).The studies suggested people undergoing RoCT in a single visit may be more likely to experience pain in the first week than those whose RoCT was over multiple visits (RR 1.50, 95% CI 0.99 to 2.28; 1383 participants, 8 studies, I2 = 54%), though the quality of the evidence for this finding is low.Moderate-quality evidence showed people undergoing RoCT in a single visit were more likely to use painkillers than those receiving treatment over multiple visits (RR 2.35, 95% CI 1.60 to 3.45; 648 participants, 4 studies, I2 = 0%). AUTHORS' CONCLUSIONS There is no evidence to suggest that one treatment regimen (single-visit or multiple-visit root canal treatment) is better than the other. Neither can prevent all short- and long-term complications. On the basis of the available evidence, it seems likely that the benefit of a single-visit treatment, in terms of time and convenience, for both patient and dentist, has the cost of a higher frequency of late postoperative pain (and as a consequence, painkiller use).
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Affiliation(s)
- Maddalena Manfredi
- University of ParmaPolo Clinico di Odontostomatologia, SBiBiT DepartmentVia Gramsci, 14ParmaItaly43100
| | | | - Massimo Gagliani
- DMCO San PaoloClinica OdontoiatricaVia Beldiletto 1MilanItaly20142
| | - Giovanni Lodi
- Università degli Studi di MilanoDipartimento di Scienze Biomediche, Chirurgiche e OdontoiatricheVia Beldiletto 1/3MilanItaly20142
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Cao Y, Bogen G, Lim J, Shon WJ, Kang MK. Bioceramic Materials and the Changing Concepts in Vital Pulp Therapy. J Calif Dent Assoc 2016; 44:278-290. [PMID: 27290822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Vital pulp therapy (VPT) is devised to preserve and maintain vitality of pulpally involved teeth challenged by a variety of intraoral conditions. Notable progress has been made in this field due to a better understanding of pulp physiology, improved clinical protocols and advanced bioceramic materials paired with adhesive technology. With focused case selection, conservative VPT can provide reliable treatment options for permanent teeth diagnosed with normal pulps or reversible pulpitis.
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Chen HT, Wang WY, Wang J, Liang YP, Wang XT, Hou GM, Ji AP. [Risk assessment of different grades of hypertension during the treatment of patients with acute pulpitis]. Beijing Da Xue Xue Bao Yi Xue Ban 2016; 48:89-93. [PMID: 26885915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To evaluate the vital signs changes, influence factors in different grades of hypertension patients during the treatment of acute pulpitis, in order to obtain the risk prevention measures. METHODS In this study, 90 different grades of hypertension patients with acute pulpitis were recruited from February 2014 to February 2015 in the Department of Oral Emergency, Peking University School and Hospital of Stomatology. The information about the patients'general health, oral treatment, life signs of change information was collected. Patients were divided into high risk group, middle risk group, and low risk group (30 patients for each group). RESULTS (1) Compared with the preoperative, systolic blood pressure (90%), diastolic blood pressure (80%), heart rate increase (100%) were increased in the high risk group. The increase rates of the middle risk group and the low risk group were significantly lower than those of the high risk group (P<0.01). At the same time, the systolic blood pressure of 1/4 (26.7%) patients in high risk group increased more than 20 mmHg (1 mmHg=0.133 kPa), and the diastolic blood pressure of 2/5 patients in high risk group increased more than 10 mmHg, the difference was statistically significant compared with the other two groups (P<0.05). (2) Compared with the preoperative, the average increase of the maximum peak were increased [systolic blood pressure (18.0 ± 1.5) mmHg, diastolic blood pressure (8.0 ± 1.7) mmHg], the mean of heart rate changes [(7.0 ± 0.3) beats per minute] was also increased in the high risk group, while these two indicators were decreased in the low risk group and the middle risk group. The electrocardiogram (ECG) was changed in 6 cases during the treatment in the high risk group. No significantly changed were observed in the low risk group and the middle risk group. (3) Compared the risk assessment in preoperative with that in postoperative, in the middle risk group, 23 cases were evaluated as medium risk in final evaluation, 6 as low risk, and 1 as high risk (risk assessment increased); in the high risk group, 20 cases were evaluated as high risk, 7 as very high risk, and 3 as medium risk (risk assessment decreased). CONCLUSION Oral treatment is very safe for patients with hypertension, but the risk factor, target organ damage, and complications will also increase the risk of cardiovascular events in elderly patients during the acute pulpitis treatment. Dentist should take some measures to avoid the risks.
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Affiliation(s)
- Hong-tao Chen
- Department of Oral Emergency, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Wen-ying Wang
- Department of Oral Emergency, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Jin Wang
- Department of Oral Emergency, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Ya-ping Liang
- Department of Oral Emergency, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Xiao-ting Wang
- Department of Oral Emergency, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Guang-min Hou
- Department of Oral Emergency, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Ai-ping Ji
- Department of Oral Emergency, Peking University School and Hospital of Stomatology, Beijing 100081, China
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Chompu-inwai P, Boonsongsawat K, Sastraruji T, Sophasri T, Mankaen S, Nondon S, Tunlek S, Katwong S. Three Incomplete Caries Removal Techniques Compared Over Two Years in Primary Molars with Asymptomatic Deep Caries or Reversible Pulpitis. Pediatr Dent 2015; 37:41-48. [PMID: 26531075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE To directly compare the survival rates of three incomplete caries removal techniques that differed in the amount of caries removal and the base material used. METHODS Ninety-six primary molars with asymptomatic deep caries or reversible pulpitis were randomly assigned to three groups: (1) indirect pulp treatment (IPT); (2) minimal caries removal with both resin-modified glass ionomer base material and luting cement (MCRB/L); and (3) minimal caries removal with only resin-modified glass ionomer luting cement (MCRL). The treatments were followed clinically and radiographically for two years. RESULTS The two-year survival probabilities in the IPT, MCRB/L, and MCRL groups were 0.90 (95 percent confidence interval [CI] equals 0.73 to 0.97), 0.93 (95 percent CI equals 0.76 to 0.98), and 0.77 (95 percent CI equals 0.58 to 0.89), respectively. There was no significant difference in the two-year survival probabilities of the three studied groups (generalized Wilcoxon P=.07). CONCLUSIONS Following two years, neither the amount of caries removal nor the base material affected the success of incomplete caries removal treatment. However, minimal caries removal with MCRB/L presented the highest survival rate among the tested groups and resulted in no incidence of pulp exposure.
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Affiliation(s)
- Papimon Chompu-inwai
- Division of Pediatric Dentistry, Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand.
| | | | - Thanapat Sastraruji
- Dental Research Center, the Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
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Tang Y, Du R. [The effect of dental health instruction before treatment on anxiety of patients with acute pulpitis]. Shanghai Kou Qiang Yi Xue 2015; 24:483-485. [PMID: 26383577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE To evaluate the effect of dental health instruction before treatment on dental anxiety of patients with acute pulpitis. METHODS One hundred and fifty-four patients with acute pulpitis treated in our department from July 2011 to June 2013, and aged from 19 years to 64 years, were selected. They were randomly divided into experimental group and control group. Seventy-eight patients of the experimental group accepted dental health instruction before treatment, while 76 cases in the control group received regular treatment. Two questionaires of dental anxiety were proceeded to both groups respectively before treatment. The data was analyzed for Student's t test and Chi-square test using SPSS12.0 software package. RESULTS Dental anxiety (DA) points of the experimental group after dental health instruction were significantly lower than that before treatment (t=4.1346, P<0.01). DA points of the experimental group after dental health instruction were significantly lower than that of the control group (t=6.2784, P<0.01). The acceptability of the experimental group towards the first treatment was significantly higher than of the control group. The completion rate of the following treatment of the experimental group was also significantly higher than that of the control group. CONCLUSIONS Dental health instruction to patients with acute pulpitis before treatment are helpful to reduce the pressure and relieve the anxiety during the treatment, so that the patients will complete the first and the following treatment successfully.
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Affiliation(s)
- Yu Tang
- Department of General Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China.E-mail:
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Middleton G, Diogenes A. CAT OF THE MONTH. Preemptive Nonsteroidal Anti-inflammatory Drugs Increases the Success Rate of Inferior Alveolar Nerve Blocks in Mandibular Posterior Teeth with Symptomatic Irreversible Pulpitis UT CAT #2807. Tex Dent J 2015; 132:358. [PMID: 26357807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Brosnan MG, Natarajan AK, Campbell JM, Drummond BK. Management of the pulp in primary teeth--an update. N Z Dent J 2014; 110:119-123. [PMID: 25597190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Management of the pulpal tissue in primary teeth is a clinical challenge facing dental practitioners on a regular basis. This article reviews the most common treatments used at the present time in the management of the pulp in deciduous teeth. It gives an overview of treatment options and the indications and contra-indications for the different treatment modalities. The evidence behind the medicaments used, their actions and success rates are discussed. Practical guidelines for choosing to retain or extract deciduous teeth and management of the primary tooth pulp with different clinical presentations are discussed. Areas of future research are highlighted.
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Affiliation(s)
- M G Brosnan
- Department or Oral sciences, University of Otago, Dunedin
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Cassim I. A novel use of the Reciproc R25 Endodontic file for root canal obturation. SADJ 2014; 69:458-462. [PMID: 26506798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Pai ARV, Babu VM, Kundabala M. The role of hemisection in the prosthetic management of a distal extension ridge--a case report. ACTA ACUST UNITED AC 2014; 41:514-6. [PMID: 25195483 DOI: 10.12968/denu.2014.41.6.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED This case report illustrates the use of hemisection to minimize the distal extension span. The LR6 was the only molar next to a distal extension of the lower Kennedy's Class II ridge. Its unrestorable distal root was removed and its mesial portion was retained to serve as an effective antagonist and abutment tooth and lessen the extent of right distal extension. CLINICAL RELEVANCE Regarding the prosthetic rehabilitation of distal extensions, hemisection can be advantageous and offered as an alternative to other treatment modalities.
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Abstract
AIM To report cases with morphologic variations in mandibular premolars. BACKGROUND Mandibular premolars have earned the reputation for having aberrant anatomy. The occurrence of three canals with three separate (type V, Vertucci) foramina in mandibular premolars is very rare. In this report, three cases are presented involving the root canal treatment of mandibular premolars with three different root and canal configurations. The present report also emphasizes the use of the dental operating microscope to enhance visualization. CASE DESCRIPTION Correlation between radiographic findings, use of dental operating microscope and knowledge of aberrant anatomy helps to identify, locate and treat the aberrant anatomy of the tooth. CLINICAL SIGNIFICANCE The treatment was successful as all canals were identified and filled and also as evidenced by relief of symptoms. CONCLUSION Success is largely dependent on the use of magnification, which aided in identifying the location of the three individual root canal orifices; thus emphasizing the need to familiarize ourselves with dental microscopy, to obtain maximal anatomic information in endodontic practice.
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Affiliation(s)
- Anuj Bhardwaj
- Senior Lecturer, Department of Conservative Dentistry and Endodontics Modern Dental College and Research Centre, Indore, Madhya Pradesh, India, e-mail:
| | - Jojo Kottoor
- Senior Lecturer, Department of Conservative Dentistry and Endodontics, Mar Baselios Dental College, Kothamangalam, Kerala, India
| | - Denzil Valerian Albequerque
- Senior Lecturer, Department of Conservative Dentistry and Endodontics, Terna Dental College, Navi Mumbai, Maharashtra, India
| | - Natanasabapathy Velmurugan
- Professor and Head, Department of Conservative Dentistry and Endodontics Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India
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Abstract
Dentigerous cysts are uncommon, yet are being reported with increasing frequency in the veterinary literature. Dentigerous cysts are a type of benign odontogenic cyst associated with impacted teeth, most commonly the mandibular first premolar tooth. Significant bone destruction can occur secondary to the expansion of a dentigerous cyst. The expanding cyst can lead to pathology of neighboring teeth, which can include external root resorption or pulpitis. Intraoral dental radiographs are imperative to properly assess the presence and extent of a dentigerous cyst, as well as the status of the neighboring teeth. This case report describes treatment for dentigerous cyst including cyst lining curettage, mandibular bone regeneration, and endodontic therapy for a canine tooth with irreversible pulpitis.
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Agarwal R, Chaudhry K, Yeluri R, Singh C, Munshi AK. Alternative approach to management of early loss of second primary molar: a clinical case report. J Calif Dent Assoc 2014; 42:327-330. [PMID: 25087351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Preservation of space after premature loss of the second primary molar is essential to prevent mesial drifting of the permanent first molar. Various modifications of distal shoe space maintainers, which have been documented, are all nonfunctional in nature. This paper describes an innovative design of a functional distal shoe space maintainer that is intended to overcome the disadvantages of conventional non-functional space maintainers and that does not hamper the periodontal status of the abutment tooth.
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Tavassoli-Hojjati S, Kameli S, Rahimian-Emam S, Ahmadyar M, Asgary S. Calcium enriched mixture cement for primary molars exhibiting root perforations and extensive root resorption: report of three cases. Pediatr Dent 2014; 36:23E-27E. [PMID: 24717704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In primary molars with root perforations of endodontic origin, tooth extraction and space maintainer are recommended. Calcium-enriched mixture (CEM) cement is a new biomaterial demonstrating favorable sealability/biocompatibility. This report presents a novel treatment modality for cases of primary molar teeth with root perforations associated with a periodontal lesion due to extensive inflammatory root resorption, whereby CEM was used as a perforation repair/pulpotomy biomaterial. Three cases of primary molar root perforations due to inflammatory resorption were selected; all cases were associated with furcal lesions of endodontic origin. Pulp chambers were accessed/irrigated with NaOCl; the root canal orifices were filled with CEM and restored with stainless steel crowns. Clinical/radiographic examinations up to 17 months revealed that all teeth were functional and free of signs/symptoms of infection and all had complete bone healing. Further trials are suggested to confirm CEM use for management of root perforations in primary molars exhibiting root perforation.
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Affiliation(s)
- Sara Tavassoli-Hojjati
- Assistant professor, Research Center, the Department of Pediatric Dentistry, Dental School, Shahed University, Tehran, Iran
| | - Somayeh Kameli
- Researcher, the Department of Pediatric Dentistry, Dental School, Shahed University, Tehran, Iran
| | - Sara Rahimian-Emam
- Researcher, the Department of Pediatric Dentistry, Dental School, Shahed University, Tehran, Iran
| | - Maryam Ahmadyar
- Researcher, Dental Research Center, the Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Asgary
- Head of Iranian Center for Endodontic Research, the Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Petrikas AZ, Zakharova EL, Ol'khovskaia EB, Chestnykh EV. [Tooth decay complications incidence]. Stomatologiia (Mosk) 2014; 93:19-20. [PMID: 24576961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The aim of the article is to assess the quality of endodontic therapy and estimate further treatment needs. 900 orthopantomograms of 442 men and 458 women (aged 18-70) without any clinical manifestations of endodontic pathology were examined for endodontic treatment. 1,170 patients (41%) had additional intraoral radiographs taken for assessment of their periapical status. 2,852 (13.8%) of the 20,724 teeth examined had periapical lesions and/or root fillings. 2,503 of the 2,853 teeth were endodontically treated, only 1,011 of them (40.4%) having all their root canals obturated. 612 (41.3%) of the 1,492 (59.6%) teeth with inadequate root canal fillings hat a healthy apical periodontium. Of the 1,229 teeth to be endodontically treated 349 teeth required primary treatment, 880 required retreatment.
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