Pain assessment following endodontic treatment using two automated systems compared to manual treatment in primary molars

Background. Root canal treatment in primary teeth is quite difficult and time-consuming, especially canal preparation. Pain is the most common negative outcome following root canal treatment, occurring hours or days after treatment. It is an unpleasant experience for both the patient and the dentist. Objectives. The objective of this study was to assess the severity and duration of pain following the endo-dontic treatment of primary molars with the use of rotary and reciprocating preparation systems compared to the traditional manual method. Material and methods. The research sample consisted of 157 asymptomatic primary lower second molars with non-vital pulp that were indicated for root canal treatment. The patients were randomly divided into 3 groups: in the 1st group, the molars (n = 52) were prepared using the manual method; in the 2nd group (n = 53), a reciprocating automated preparation system (WaveOne®) was used; and in the 3rd group (n = 52), a rotary preparation system (ProTaper Next®) was used. Pain assessment was carried out after 6, 12, 24, 48, and 72 h, and after 1 week, using a four-face facial pain scale. Results. The manual method provided a higher pain score through 6, 12 and 24 h (p < 0.05) as compared to the 2 automated preparation systems. The intensity of pain did not vary between the 2 machine preparation systems after 6, 12, 24, and 48 h (p > 0.05). There were no differences between the 3 methods after 72 h and after 1 week (p > 0.05). Conclusions. The manual method caused more pain than the other 2 preparation systems, but there was no difference between the 2 automated methods. Automated root canal preparation systems could be used to reduce the intensity of postoperative pain after the endodontic treatment of primary teeth. © 2021 by Wroclaw Medical University

A Comparative Clinical Radiological Study using Platelet Rich Fibrin and MTA in Pulpotomy of First Permanent Immature Molars

Introduction: Maintaining a vital pulp of immature permanent teeth is an essential and important requirement for dentin formation. Every effort must be made to preserve the vitality of teeth with incomplete apices to maintain the physiological apex generation process as much as possible. Pulpotomy is considered as one of the successful procedures to maintain that process in immature teeth. Aim: To evaluate the treatment success of pulpotomy of first immature molars with irreversible pulpitis using Platelet-Rich Fibrin (PRF) or Mineral Trioxide Aggregate (MTA), monitoring the teeth for 1 year. Materials and Methods: A randomised clinical and radiological double-blinded evaluation was conducted in the Department of Paediatric Dentistry at Damascus University. The research sample consisted of 24 first permanent immature molars in 20 children between age group of 6-8 years. Each of them had at least one first permanent immature molar with irreversible pulpitis. The research sample was randomly divided into two equal groups according to the treatment method: 1) pulpotomy with PRF; and 2) pulpotomy using MTA. Treatment were evaluated through periodic reviews and clinical and radiological examinations of the treated teeth by three specialists to assess treatment success. The treatment outcome was determined in terms of success or failure during two study periods (after six months and after one year), McNemar's and Chi-square tests were applied using IBM SPSS v. 20.0. The significance level was set at p0.05. After analysing the results statistically using McNemar's test, it was observed that the treatment success rate after one year (50%, n=6) was lesser than that after six months (100%, n=12) in the MTA treatment group (p=0.031*). In the treatment group using PRF, no significant difference (p=0.125) were observed in the success or failure of treatment between the two studied time periods (after six months and one year). Overall, the success rate of MTA was slightly higher than the success rate of PRF at the two study time periods (after six months and one year), the difference however was not statistically significant. Conclusion: Performing first immature molar pulpotomy using MTA had a slightly higher success rate than PRF pulpotomy