Effects of Acetaminophen and Ibuprofen on Pulpal Anaesthesia Immediately after Pulpectomy of Primary Maxillary Molars

Introduction: This study aimed to evaluate the effects of acetaminophen and ibuprofen on pulpal anaesthesia immediately after pulpectomy of primary maxillary molars. Methods and Materials: In this placebo-controlled, double-blind clinical trial, 60 children (aged 5 to 9) were referred to the Department of Pediatric Dentistry, Yazd Dental School; for primary maxillary molar pulpectomy. Local anaesthesia and analgesic drugs were used for the pre-operative stage. A five-face scale was considered to evaluate pain reaction during the pulp therapy. Pain scores were determined when the dental procedure was complete. The Kruskal-Wallis and Mann-Whitney U tests were finally used at the confidence level of 95%. Results: Use of analgesics before pulpectomy in children can reduce pain score compared to placebo group (P<0.001) and increase the effectiveness of pulpal anesthesia. Additionally, ibuprofen exhibited lower pain scores compared to acetaminophen although the difference was not statistically significant. Conclusions: Pre-operative use of ibuprofen and acetaminophen might be a useful way to achieve analgesia during pulpectomy of primary maxillary molars in children.Keywords: Acetaminophen; Analgesia; Child; Ibuprofen; Pain; Pediatric Dentistry;  Pulpecto

The Effect of Er:YAG Laser Irradiation and Different Concentrations of Sodium Hypochlorite on Shear Bond Strength of Composite to Primary Teeth’s Dentin

Introduction: The aim of this study was to evaluate the effect of various concentrations of NaOCl on shear bond strength of composite resin to dentin of primary teeth, prepared with laser and bur.Methods: In this in vitro study, 48 primary molars were sectioned at mesiodistal direction and were randomly divided into 6 groups; G1: bur, G2: bur + NaOCl 2.5%, G3: bur + NaOCl 5.25%, G4: laser, G5: laser + NaOCl 2.5%, G6: laser + NaOCl 5.25%. One-Step Plus adhesive was applied after phosphoric acid gel and NaOCl over the dentin surfaces for all groups, and composite resin cylinders were bonded to the samples. After thermocycling, shear bond strengths of composite resin to dentin were measured and statistical analyses were done by means of t test and analysis of variance (ANOVA).Results: The mean shear bond strength showed no significant difference between the groups prepared with bur (13.82 ± 3.49) and laser (14.18 ± 3.65) (P > 0.05). The mean difference of shear bond strength between three groups G1, G2 and G3 and between G4, G5 and G6 were not statistically significant (P > 0.05). Scanning electron microscopy (SEM) figures showed an irregular surface in laser groups and fairly complete removal of smear layer from the orifices of the dentinal tubules, in the group in which NaOCl was used.Conclusion: The application of different concentrations of NaOCl does not significantly improve the bond strength in dentin surfaces prepared with laser or bur

Comparison of Micro-Leakage from Resin-Modified Glass Ionomer Restorations in Cavities Prepared by Er:YAG (Erbium-Doped Yttrium Aluminum Garnet) Laser and Conventional Method in Primary Teeth

Introduction: In recent years, significant developments have been taking place in caries removal and cavity preparation using laser in dentistry. As laser use is considered for cavity preparation, it is necessary to determine the quality of restoration margins. Glass ionomer cements have great applications for conservative restoration in the pediatric field.The purpose of this in vitro study was to compare resin-modified glass ionomer restorations micro-leakage in cavities prepared by Er:YAG (Erbium-Doped Yttrium Aluminum Garnet) laser irradiation and conventional method in primary teeth.Methods: This was an in vitro experimental study. Forty primary canine teeth were divided into 2 groups: group 1 represented cavities prepared by the no. 008 diamond bur, group 2 represented cavities prepared by Er:YAG laser. After cavity preparation, samples were restored by resin-modified glass ionomer. The teeth were thermocycled for 700 cycles, placed in 2% methylene blue for 24h and sectioned in the buccolingual direction. The degree of dye penetration was scored by 3 examiners. Data was analyzed using Mann-Whitney Test.Results: There was no statistical difference in micro-leakage between the two modes of cavity preparation (P=0.862)Conclusion: Since preparing conservative cavities is very important in pediatric dentistry, it is possible to use Er:YAG laser because of its novel and portable technology. However, further investigations of other restorative materials and other laser powers are required

Antibacterial Effect of Diode Laser in Pulpectomy of Primary Teeth

Introduction: Laser irradiation has been suggested as an adjunct to traditional methods of canal preparation but few studies are available on the antibacterial effect of diode laser in pulpectomy of primary teeth. The purpose of the present study is to investigate the antibacterial effect of diode laser in pulpectomy of primary teeth, in addition to define the optimal and harmless diode lasing conditions in the root canal.Methods: A total of 125 single rooted primary teeth were selected. After traditional canal cleaning, they were divided in 2 groups. Sixty-five specimens after culturing of Enterococcus faecalis into the canals, were divided in 3 groups: (1) traditional canal cleaning with 0.5% NaOCl irrigation, (2) method of group 1+ 1.5 W diode laser (980 nm, pulse), (3) without treatment (5 specimens). Then the specimens were cultured and after colony counting under light microscope, were statistically analyzed by Kruskal-Wallis and Mann-Whitney tests. For 60 specimens, temperature rise of apical and cervical parts of the external root surface were measured using 2 thermocouple type K, when radiating a 1.5 W diode laser into the canal.Results: In the first experiment, the diode laser group showed tmost reduction in bacterial count. And in the second experiment, the mean temperature rise of external root surface was less than the threshold of periodontal ligament (PDL) damage.Conclusion: Diode laser with a power output of 1.5 W, is effective in reduction of E. faecalis bacterial count without damaging periodontal structures

The Effect of Er:YAG Laser on Entroccocus faecalis Bacterium in the Pulpectomy of Anterior Primary Teeth

Introduction: Successful root canal therapy depends on the complete elimination of micro-organisms such as Entroccocus faecalis, which is impossible to achieve with the traditional methods. Lasers are recently introduced as a new method to solve the problem. The present study is planned and performed to examining the antibacterial effect of Er: YAG laser.Methods: Sixty extracted anterior primary teeth were prepared and sterilized. E. faecalis bacterium was cultured in canals. Samples were randomly divided into two groups. The first group was disinfected by NaOCl 5/25% and Er: YAG laser and the second group just by NaOCl 5/25%. Samples of canal contents were cultured and colony counts were calculated. The results were analyzed statistically by SPSS software and Mann Whitney test.Results: There was no significant difference between colony counts in both groups (P = 0.142). But the number of colonies in the first group was lower than in the second group.Conclusion: Although, Er: YAG laser cannot completely eliminate E. faecalis bacterium, its simultaneous use with NaOCl decreases E. faecalis

Microleakage of cervical cavities prepared by an Er:YAG laser or a high-speed handpiece, after restoration using resin composite

Objectives The purpose of this in vitro study was to evaluate the microleakage of cervical cavities prepared by Er:YAG laser or high-speed hand piece and bur.Methods This in vitro experimental study was performed on 40 sound permanent third molar teeth randomly assigned into two equal groups (n = 20). In the first group, high-speed hand piece and bur and in the second group Er:YAG laser was used to prepare class V cavities on the buccal or lingual surfaces. Filtek Z250 composite resin was used as the restorative material. The teeth were thermocycled for 1000 cycles, placed in 2% methylene blue solution for 24 hours, sectioned at the center of restoration and evaluated under a stereomicroscope at x40 magnification for microleakage. Data were analyzed using Mann-Whitney U test at 0.05 level of significance.Results There was no significant difference between the occlusal or gingival margin microleakage of cavities prepared with Er:YAG laser and high-speed hand piece (P = 0.445 and P = 0.758, respectively). However, the difference in the occlusal and gingival margins was significant within the high-speed hand piece (P = 0.042) and Er:YAG laser (P = 0.002) groups.Conclusion Cavity preparation by Er:YAG laser and high speed hand piece and bur is not significantly different in terms of microleakage

Evaluating the additive effect of Persica and chlorhexidine mouthwashes on oral health status of children receiving chemotherapy for their hematomalignancy : a randomized clinical trial

No definitive protocol has been introduced for treatment or prevention of chemotherapy induced mucositis. The aim of this study was to assess the additive effect of Persica and chlorhexidine on chemotherapy induced mucositis of children with hematomalignancies. This randomized clinical trial was performed on 44 children aged 6 to 12 years who were under a similar maintenance chemotherapy protocol for their hematomalignancies. The clinician instructed oral hygiene cares to the patients and their parents and the severity of the mucositis and oral health status of patients were evaluated according to Oral Assessment Guide index. Then, the patients were randomly assigned to one of two experimental groups and were instructed to rinse either with Persica oral drops or normal saline, twice a day for two weeks. Subsequently, the patients in both groups were educated to rinse with chlorhexidine for 30 seconds and avoid eating for an hour. Second and third oral examinations were performed on the 8th and 15th day using the same questionnaire. Comparing severity of mucositis and oral health status of patients did not show any significant difference between treatment groups in either of examination sessions (p>0.05). However, both treatment groups showed statistically significant oral health improvement, in terms of mucositis, plaque accumulation and gingival condition, in 14 days following mouthrinses administration (p<0.05). Both mouth-rinse combinations were effective on mucositis, plaque and gingival status of children receiving chemotherapy. However, Persica does not seem to pose additional effect on chlorhexidine in decreasing severity of chemotherapy induced mucositis

The Relationship between Temperament and Dental Anxiety in Children Aged 6 to 11 Referred to Yazd Dental School

Introduction: Dental anxiety is one of the complications of dental treatments in children and it is affected by many factors such as gender, age, and temperament. Therefore, the present study aimed to determine the relationship between children's temperament and dental anxiety in children aged 6 to 11 years referred to Yazd Dental School.Materials and Methods: This is a descriptive-analytical cross-sectional study in which 152 children aged 6 to 11 years were studied who referred to the pediatric dentistry department of the Faculty of Dentistry, Shahid Sadoughi University of Yazd, Iran in 2021. The data were collected using EAS (Emotion, Activity, sociability) temperament questionnaire and also MCDAS (Modified Child Dental Anxiety Scale) anxiety questionnaire. Finally, the relationship between the score of temperament dimensions and that of pediatric dental anxiety was analyzed by the Pearson correlation coefficient test using SPSS software. The significance level was considered at 0.05.Results: A significant correlation was observed between dental anxiety score and emotional score (P-value=0. 012, r=0. 203). This relationship was also significant and positive between dental anxiety and shyness score (P-value=0. 004, r=0. 232). Dental anxiety and dimensions like physical activity and sociability were negatively and significantly related (P-value=0. 031, r=-0. 175 and P-value=0. 048, r=-0. 161, respectively. A regression model was used to estimate the anxiety score using the scores of different mood dimensions. The result is R2=0. 1 which means 10% of the changes in the dependent variable is explained by the regression model. In this model, only the temperament dimension of emotion is effective in the anxiety score.Conclusion: According to the results of this study, decreasing the score in emotional and shyness dimensions and increasing the score in physical activity and sociability can reduce the dental anxiety of children during dental treatment. The regression model confirmed the effect of the emotional dimensions in increasing the anxiety score which can be achieved by psychologists and creating appropriate conditions and behaviors

Fluorescence devices for the detection of dental caries

BACKGROUND: Caries is one of the most prevalent and preventable conditions worldwide. If identified early enough then non‐invasive techniques can be applied, and therefore this review focusses on early caries involving the enamel surface of the tooth. The cornerstone of caries detection is a visual and tactile dental examination, however alternative methods of detection are available, and these include fluorescence‐based devices. There are three categories of fluorescence‐based device each primarily defined by the different wavelengths they exploit; we have labelled these groups as red, blue, and green fluorescence. These devices could support the visual examination for the detection and diagnosis of caries at an early stage of decay. OBJECTIVES: Our primary objectives were to estimate the diagnostic test accuracy of fluorescence‐based devices for the detection and diagnosis of enamel caries in children or adults. We planned to investigate the following potential sources of heterogeneity: tooth surface (occlusal, proximal, smooth surface or adjacent to a restoration); single point measurement devices versus imaging or surface assessment devices; and the prevalence of more severe disease in each study sample, at the level of caries into dentine. SEARCH METHODS: Cochrane Oral Health's Information Specialist undertook a search of the following databases: MEDLINE Ovid (1946 to 30 May 2019); Embase Ovid (1980 to 30 May 2019); US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov, to 30 May 2019); and the World Health Organization International Clinical Trials Registry Platform (to 30 May 2019). We studied reference lists as well as published systematic review articles. SELECTION CRITERIA: We included diagnostic accuracy study designs that compared a fluorescence‐based device with a reference standard. This included prospective studies that evaluated the diagnostic accuracy of single index tests and studies that directly compared two or more index tests. Studies that explicitly recruited participants with caries into dentine or frank cavitation were excluded. DATA COLLECTION AND ANALYSIS: Two review authors extracted data independently using a piloted study data extraction form based on the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS‐2). Sensitivity and specificity with 95% confidence intervals (CIs) were reported for each study. This information has been displayed as coupled forest plots and summary receiver operating characteristic (SROC) plots, displaying the sensitivity‐specificity points for each study. We estimated diagnostic accuracy using hierarchical summary receiver operating characteristic (HSROC) methods. We reported sensitivities at fixed values of specificity (median 0.78, upper quartile 0.90). MAIN RESULTS: We included a total of 133 studies, 55 did not report data in the 2 x 2 format and could not be included in the meta‐analysis. 79 studies which provided 114 datasets and evaluated 21,283 tooth surfaces were included in the meta‐analysis. There was a high risk of bias for the participant selection domain. The index test, reference standard, and flow and timing domains all showed a high proportion of studies to be at low risk of bias. Concerns regarding the applicability of the evidence were high or unclear for all domains, the highest proportion being seen in participant selection. Selective participant recruitment, poorly defined diagnostic thresholds, and in vitro studies being non‐generalisable to the clinical scenario of a routine dental examination were the main reasons for these findings. The dominance of in vitro studies also means that the information on how the results of these devices are used to support diagnosis, as opposed to pure detection, was extremely limited. There was substantial variability in the results which could not be explained by the different devices or dentition or other sources of heterogeneity that we investigated. The diagnostic odds ratio (DOR) was 14.12 (95% CI 11.17 to 17.84). The estimated sensitivity, at a fixed median specificity of 0.78, was 0.70 (95% CI 0.64 to 0.75). In a hypothetical cohort of 1000 tooth sites or surfaces, with a prevalence of enamel caries of 57%, obtained from the included studies, the estimated sensitivity of 0.70 and specificity of 0.78 would result in 171 missed tooth sites or surfaces with enamel caries (false negatives) and 95 incorrectly classed as having early caries (false positives). We used meta‐regression to compare the accuracy of the different devices for red fluorescence (84 datasets, 14,514 tooth sites), blue fluorescence (21 datasets, 3429 tooth sites), and green fluorescence (9 datasets, 3340 tooth sites) devices. Initially, we allowed threshold, shape, and accuracy to vary according to device type by including covariates in the model. Allowing consistency of shape, removal of the covariates for accuracy had only a negligible effect (Chi(2) = 3.91, degrees of freedom (df) = 2, P = 0.14). Despite the relatively large volume of evidence we rated the certainty of the evidence as low, downgraded two levels in total, for risk of bias due to limitations in the design and conduct of the included studies, indirectness arising from the high number of in vitro studies, and inconsistency due to the substantial variability of results. AUTHORS' CONCLUSIONS: There is considerable variation in the performance of these fluorescence‐based devices that could not be explained by the different wavelengths of the devices assessed, participant, or study characteristics. Blue and green fluorescence‐based devices appeared to outperform red fluorescence‐based devices but this difference was not supported by the results of a formal statistical comparison. The evidence base was considerable, but we were only able to include 79 studies out of 133 in the meta‐analysis as estimates of sensitivity or specificity values or both could not be extracted or derived. In terms of applicability, any future studies should be carried out in a clinical setting, where difficulties of caries assessment within the oral cavity include plaque, staining, and restorations. Other considerations include the potential of fluorescence devices to be used in combination with other technologies and comparative diagnostic accuracy studies

Effect of Diode Laser Irradiation Combined with Topical Fluoride on Enamel Microhardness of Primary Teeth.

Laser irradiation has been suggested as an adjunct to traditional caries prevention methods. But little is known about the cariostatic effect of diode laser and most studies available are on permanent teeth.The purpose of the present study was to investigate the effect of diode laser irradiation combined with topical fluoride on enamel surface microhardness.Forty-five primary teeth were used in this in vitro study. The teeth were sectioned to produce 90 slabs. The baseline Vickers microhardness number of each enamel surface was determined. The samples were randomly divided into 3 groups. Group 1: 5% NaF varnish, group 2: NaF varnish+ diode laser at 5 W power and group 3: NaF varnish+ diode laser at 7 W power. Then, the final microhardness number of each surface was again determined. The data were statistically analyzed by repeated measures ANOVA at 0.05 level of significance.In all 3 groups, microhardness number increased significantly after surface treatment (P0.05).The combined application of diode laser and topical fluoride varnish on enamel surface did not show any significant additional effect on enamel resistance to caries