The effectiveness of prophylactic etodolac on post-endodontic pain

The purpose of this study was to determine if prophylactic oral administration of etodolac would significantly reduce post-endodontic pain, when compared to ibuprofen and a placebo.;Thirty-six patients requiring conventional root canal therapy consented to single blind oral administration of either 400 mg of etodolac, 600 mg of ibuprofen, or a placebo, prior to conventional root canal therapy. Pain evaluation was completed on a pain survey that consisted of visual analog scales at the following time intervals; initial, immediately after, 4 hours, 8 hours, 12 hours, 24 hours, 48 hours, and 72 hours after initiation of root canal therapy.;A significant difference was found for ibuprofen\u27s ability to reduce post-endodontic pain at 4 and 8 hours after initiation of root canal therapy, when compared to etodolac and a placebo (4 Hours P-value = 0.0111; 8 Hours P-value = 0.0397). A significant difference was also found for the periapical diagnosis and the need for additional medication after completion of root canal therapy (P-value = 0.0077)

Systematic Review Of The Published Literature On Success And Failure Rates Of Nonsurgical Endodontic Treatment

Purpose: The aim of this study was to conduct a systematic review of the literature on treatment results in non-surgical Endodontic therapy. This included researching and defining inclusion and exclusion criteria and applying these criteria to identified relevant publications. The overall goal was to analyze the available literature and synthesize these results in an effort to inform the profession on the success and failure rates in non-surgical root canal therapy. Materials and Methods: Inclusion and exclusion criteria were established in an effort to systemically review and formulate an evidence-based understanding of treatment results in non-surgical root canal therapy. A comprehensive literature search was conducted using using PubMed and the Cochrane database using the search terms root canal therapy, apical periodontitis, success, failure, and treatment outcome and was restricted to January 2009 through December 2011. Articles were reviewed and analyzed according to the inclusion/exclusion criteria. Results: A review of the abstracts for these 330 publications resulted in 51 publications articles to be examined more closely for relevance and inclusion. From this, no publication met all defined inclusion/exclusion criteria. Discussion: Defining a set of criteria for how success is defined in practice is vital to the field of Endodontics. It is important to define, establish and incorporate a standardized methodology in the way research is conducted on Endodontic treatment results. This is necessary for the application of research to the practice of evidence-based Endodontics

Nanodiamond-Gutta Percha Composite Biomaterials for Root Canal Therapy.

Root canal therapy (RCT) represents a standard of treatment that addresses infected pulp tissue in teeth and protects against future infection. RCT involves removing dental pulp comprising blood vessels and nerve tissue, decontaminating residually infected tissue through biomechanical instrumentation, and root canal obturation using a filler material to replace the space that was previously composed of dental pulp. Gutta percha (GP) is typically used as the filler material, as it is malleable, inert, and biocompatible. While filling the root canal space with GP is the standard of care for endodontic therapies, it has exhibited limitations including leakage, root canal reinfection, and poor mechanical properties. To address these challenges, clinicians have explored the use of alternative root filling materials other than GP. Among the classes of materials that are being explored as novel endodontic therapy platforms, nanodiamonds (NDs) may offer unique advantages due to their favorable properties, particularly for dental applications. These include versatile faceted surface chemistry, biocompatibility, and their role in improving mechanical properties, among others. This study developed a ND-embedded GP (NDGP) that was functionalized with amoxicillin, a broad-spectrum antibiotic commonly used for endodontic infection. Comprehensive materials characterization confirmed improved mechanical properties of NDGP over unmodified GP. In addition, digital radiography and microcomputed tomography imaging demonstrated that obturation of root canals with NDGP could be achieved using clinically relevant techniques. Furthermore, bacterial growth inhibition assays confirmed drug functionality of NDGP functionalized with amoxicillin. This study demonstrates a promising path toward NDGP implementation in future endodontic therapy for improved treatment outcomes

Subcutaneous emphysema during root canal therapy: endodontic accident by sodium hypoclorite

Cervicofacial subcutaneous emphysema is defined as the abnormal introduction of air in the subcutaneous tissues of the head and neck. It is mainly caused by trauma, head and neck surgery, general anesthesia, and coughing or habitual performance of Valsalva manoeuvre. The occurrence of subcutaneous emphysema after dental treatment is rare, and diffusion of gas into the mediastinum is much rarer, especially when the procedure is a nonsurgical treatment. Presented here is a case of subcutaneous emphysema that occurred after sodium hypochlorite irrigation during endodontic treatment, and the description of its etiologies and prevention during nonsurgical endodontic treatment. Endodontic success can be essentially achieved via good debridement of a root canal, and an ideal endodontic irrigant is effective in removing the smear layer, opening the dentinal tubules, and producing a clean surface for closer obturation

Median mental sinus in twins

Sinus on the chin can be the result of a chronic apical abscess due to pulp necrosis of a mandibular anterior tooth. The tooth is usually asymptomatic, and a dental cause is therefore not apparent to the patient or the unsuspecting clinician. Not infrequently, the patient may seek treatment from a dermatologist or general surgeon instead of a dentist. Excision and repair of the fistula may be carried out with subsequent breakdown because the dental pathology is not removed. This paper reports the presence of median mental sinus of dental origin in twins. One case healed following root canal therapy while the other required both root canal therapy and surgery to eliminate the infection

Outcomes of Primary Endodontic Therapy Provided by Endodontic Specialists Compared with Other Providers

Introduction The objective of this study was to compare the outcomes of initial nonsurgical root canal therapy for different tooth types provided by both endodontists and other providers. Methods By using an insurance company database, 487,476 initial nonsurgical root canal therapy procedures were followed from the time of treatment to the presence of an untoward event indicated by Current Dental Terminology codes for retreatment, apical surgery, or extraction. Population demographics were computed for provider type and tooth location. Kaplan-Meier survival estimates were calculated for 1, 5, and 10 years. Hazard ratios for provider type and tooth location were calculated by using the Cox proportional hazards model. Results The survival of all teeth collectively was 98% at 1 year, 92% at 5 years, and 86% at 10 years. Significant differences in survival on the basis of provider type were noted for molars at 5 years and for all tooth types at 10 years. The greatest difference discovered was 5% higher survival rate at 10 years for molars treated by endodontists. A hazard ratio of 1.394 was found when comparing other providers\u27 success with that of endodontists within this 10-year molar group. Conclusions These findings show that survival rates of endodontically treated teeth are high at 10 years after treatment regardless of provider type. Molars treated by endodontists after 10 years have significantly higher survival rates than molars treated by non-endodontists

The Incidence of Root Canal Therapy or Extraction after Orthodontic Treatment: A Ten-Year Retrospective Study

INTRODUCTION: The impact of orthodontic treatment on anterior teeth specifically in relation to root canal therapy and extraction has not been previously described. The objective of this study was to evaluate the incidence of root canal therapy and extraction after orthodontic treatment in the anterior permanent dentition.Methods: We analyzed insurance claims and enrollment data for individuals enrolled with Delta Dental of Wisconsin from 2008 to 2017. A total of 63,720 teeth from 5310 patients who had Delta Dental insurance at age 10 were included in the study. The Cox Regression model was used to analyze the effect of the predictor variables, including orthodontic treatment on the survival of anterior teeth. The survival time was defined as the time from when patients turned ten years old to when extraction/root canal occurred. Teeth without an adverse event were censored at the end of continuous insurance coverage. All dental treatment procedures were identified using CDT codes (Code on Dental Procedures and Nomenclature).Results: Out of 63,720 teeth, only 1910 (2.9%) teeth of 1184 unique subjects had a root canal and 54 (.08%) had an extraction. The majority of root canals and extractions occurred in the maxillary teeth, specifically the central incisors. In addition, males were more at risk of extraction or root canal therapy than females (Female vs Male HR =0.650 p \u3c0.05). Cox regression showed that there is no added risk of extraction or root canal after the start of orthodontic treatment compared to before orthodontic treatment (after vs before orthodontics HR 1.105 p\u3e0.05).Conclusions: Orthodontic therapy is a safe and effective treatment modality for malocclusion and may not be directly associated with an increased risk of root canal therapy or extraction. The risk of endodontic treatment or extraction is considerably higher in males compared to females and is more likely to occur on the permanent maxillary central incisors compared to other anterior teeth

Do we know enough about root-canal therapy?

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Evaluation of apical foramen distance in relation to the anatomical apex of mandibular molars by cone-beam computed tomography (CBCT) in a selected Iranian population

Introduction: Knowledge of the internal anatomy and apical foramen of a tooth has always been a fundamental prerequisite for root canal therapy. Aim of the present study was to evaluate the distance of apical foramen in relation to the anatomical apex of mandibular molars by cone beam computed tomography (CBCT) in a selected Iranian population. Material & Methods: In this cross- sectional study, 97 CBCT images of 25-50 years old patients were evaluated .the teeth were assessed in coronal plan. Results: Average (±SD) distance from apical foramen to the anatomical apex in the mesio-buccal and mesio-lingual, distal canal were [0.938 (±0.294)mm], [0.964 (±0.315)mm] and [0.982 (±0.322)mm] respectively. No statistical difference was found between right and left quadrant. Conclusion: This study demonstrated that 1mm distance from radiographic apex in mandibular molars could be appropriate for root canal therapy