A comparative study on anti-hyperalgesia effect of MTA and Ketoprofen in inflammatory pain

INTRODUCTION: Mineral trioxide aggregate (MTA) is an endodontic material with different clinical applications e.g. root-end filling, pulp capping and perforation repair.  It has been reported to possess antimicrobial and antifungal activities. The aim of this study was to examine the effect of White MTA on formalin-induced hyperalgesia in a rat with inflammatory pain. MATERIALS AND METHODS: Inflammatory pain was induced by subcutaneous (SC) injection of formalin (40 µL, 2.5%) into the rat upper lip. The nociceptive behavioral responses i.e. shaking of the lower jaw and face rubbing were quantified. 40 µL of eugenol (50 mg/kg), WMTA (20 mg/0.2 mL) or ketoprofen were injected solely or in combination with formalin 2.5% and the behavioral responses were compared with those observed after formalin treatment alone. One-way ANOVA, Tukey were used for analysis of data. RESULTS: Formalin 2.5% provoked a biphasic nociceptive response, with an early and short lasting first tonic phase followed by a second phase. Solely SC injection of either WMTA or ketoprofen (a non steroidal anti-inflammatory drug) did not stimulate any significant nociceptive behaviour. However, injection of eugenol (a pain relieving agent) induced the early phase not the tonic phase of nociceptive response. WMTA, eugenol or ketoprofen injection 20 min before formalin injection attenuated the first phase but somehow prevented the induction of the second phase of nociceptive responses which were produced by formalin. Behavioural nociceptive responses including shaking of the lower jaw and face rubbing were significantly reduced when the subject was pretreated with either WMTA or ketoprofen (P<0.001). CONCLUSION: In this study, WMTA induced pain reduction by suppression of the formalin-induced nociceptive response

In Vitro Comparison of Pushout Bond Strength of ProRoot MTA, Biodentine and TheraCal

One problem encountered in vital pulp therapy is the dislodgment of biomaterial as the result of the application of mechanical condensation forces for the final restoration of the cavity or occlusal loads. In this in vitro, experimental study, 90 denti

Canal Transportation and Centering Ability of ProTaper and SafeSider in Preparation of Curved Root Canals: A CBCT Evaluation

Introduction: Maintaining the original central canal path is an important parameter in efficient root canal preparation. Instruments causing minimal changes in original canal path are preferred for this purpose. This study sought to compare canal transportation and centering ability of ProTaper and SafeSider instruments in curved mesiobuccal root canals of mandibular first molars using cone beam computed tomography (CBCT). Materials and Methods: In this experimental study, 30 mesiobuccal root canals of extracted human mandibular first molars with 20° to 40° curvature were randomly divided into two groups (n=15). After mounting in putty, preoperative CBCT scans were obtained of teeth. Root canals in group A were shaped using S1, S2, F1 and F2 of ProTaper system. Root canals in group B were instrumented to size 25 using SafeSider system according to the manufacturers’ instructions. Postoperative CBCT scans were then obtained. The distance between the external root surface and internal canal wall was measured at the mesial and distal at 1, 3 and 7 mm from the apex. The values measured on primary and secondary CBCT scans were compared to assess possible changes in original central canal path and canal transportation. Data were compared using the t-test and repeated measure ANOVA. Results: ProTaper and SafeSider were significantly different in terms of canal transportation and centering ability, and ProTaper was significantly superior to SafeSider in this respect (P<0.001). Conclusion: ProTaper (in contrast to SafeSider) is well capable of maintaining the original central canal path with the least amount of transportation.Keywords: Canal Transportation; Cone-beam Computed Tomography; ProTaper; Root Canal Preparation; SafeSide

Onset and duration of 2% lidocaine as inferior alveolar nerve block versus buccal/lingual infiltration of 4% articaine in mandibular second molars: Clinical trial study

BACKGROUND AND AIM: The effectiveness of buccal or lingual (B/L) infiltration of 4% articaine as supplemental injection for pulp anesthesia of mandibular teeth was confirmed in previous studies. However, this study was aimed to compare the effectiveness of 2% lidocaine as inferior alveolar nerve block (IANB) versus B/L infiltration of 4% articaine for pulp anesthesia, as primary injection in mandibular second molars. METHODS: Thirty adult volunteers ranging from 18 to 40 years old with no systemic disease or medicine intake were included in this split-mouth, double-blind, randomized clinical trial study. Each mandibular side of included subjects was allocated randomly to control group (IANB using 2% lidocaine and 1/80000 epinephrine using direct technique) and B/L infiltration group using 4% articaine (Septanest; Septodont, Saint-Maur-des-Fosses, France). After obtaining base line sensitivity, electric pulp testing (EPT) was done at 5, 8, 11, 15, 20, 25, 30, 45, 60, 75, and 90 minutes post injections. The data were analyzed using chi-square test. RESULTS: The success rate of anesthesia for IANB group was 83.3% (25 of 30 subjects) and 30% (9 of 30 subjects) for B/L infiltration group, and the difference between the groups was statistically significant (P = 0.0005). The mean onset time of pulp anesthesia for IANB group was 22.6 ± 30.9 minutes and 65.5 ± 38.0 for B/L infiltration group, and the difference between the groups was statistically significant (P = 0.0001). The mean duration time of pulp anesthesia for IANB group was 53.0 ± 27.4 minutes and 10.6 ± 17.2 for B/L infiltration group, and the difference between the groups was statistically significant (P = 0.0001). CONCLUSION: The results indicated that IANB using 2% lidocaine was more successful than B/L infiltration of 4% articaine in onset and duration of pulp anesthesia of mandibular second molars as primary injections. KEYWORDS: Articaine; Lidocaine; Local Anesthesia; Molar; Inferior Alveolar Nerve; Volunteer

In vitro effect of XP-Endo finisher on the amount of residual debris and smear layer on the root canal walls

Background: A successful endodontic treatment depends on efficient cleaning and shaping and effective irrigation of root canals. The irrigating solution may not be effective in some areas in the canal. The manufacturer of XP-Endo finisher claims that it can effectively clean the root canals with complex morphology. This study aimed to assess the effect of XP-Endo finisher on the amount of residual debris and smear layer on the root canal walls of mandibular second premolars. Materials and Methods: In this In vitro study Fifty extracted mandibular second premolars with a root curvature <20° were collected. Root canals were prepared using BioRaCe rotary system. The root canals were in contact with the file and different irrigating solutions for 1 min. The teeth were then randomly divided into four experimental (n = 10) and one positive control group as follows: (1) XPF + saline, (2) XPF + ethylenediaminetetraacetic acid (EDTA), (3) XPF + sodium hypochlorite (NaOCl), (4) XPF + EDTA + NaOCl and (control) EDTA + NaOCl. The teeth were longitudinally sectioned into two halves and the amount of debris and smear layer remaining in the coronal, middle, and apical thirds of the roots was quantified and scored under an electron microscope. The Kruskal–Wallis test was used to compare the groups, and P < 0.05 was considered statistically significant. Results: The highest mean amount of residual debris (2.9 ± 1.13) was noted in XPF + saline group (P < 0.05). XPF + saline and XPF + NaOCl (3.8 ± 0.60) had the lowest efficacy for smear layer removal (P < 0.05) with no significant within-group difference. No significant difference was noted between Groups 2, 3, and 4 with the positive control group regarding debris removal. Groups 2 and 4 had no significant difference with the positive control group regarding smear layer removal. Conclusion: Use of XP-Endo finisher has no superiority to the standard protocol for the use of irrigating solutions (EDTA + NaOCl) for debris and smear layer removal, but in some cases, such as second appointment of regeneration treatment we cannot use NaOCl because of its destructive effects on stem cells; thus, we can benefit from the synergistic effects of XPF and EDTA for better smear layer removal

Comparative antibacterial efficacy of endemic Satureja Khuzistanica Jamzad essential oil, sodium hypochlorite and chlorhexidine gluconate solutions as root canal irrigations

Background: The aim of this study was to compare the antibacterial efficacy of endemic Satureja Khuzistanica Jamzad (SKJ) essential oil as root canal irrigation versus 2.5% sodium hypochlorite and 2% chlorhexidine gluconate. Methods : In current in vitro experimental study, fifty four single-rooted teeth were randomly divided into 6 groups of 9 samples: 2.5% sodium hypochlorite (NaOCl), 2% chlorhexidine gluconate (CHX), 0.31 mg/ml SKJ, 0.62 mg/ml SKJ, positive and negative controls. Each tooth was instrumented, sealed and autoclaved. Then, test groups were inoculated with E. faecalis, treated with irrigation solution and viable bacterial counts in intracanal dentin chips were determined. Utilizing SPSS 18 software, collected data were analyzed by Kruskal-Wallis one way analysis of variance (P = 0.05). Results: 99.94 % and 99.50% reduction in bacteria load after 5 min treatment with NaOCl and CHX were detected, respectively. Similarly, 99.97% and 99.96% reduction in bacterial counts were observed after 5 min application of 0.62 mg/ml and 0.31 mg/ml SKJ essential. No significant differences were detected among the four irrigation solutions (P = 0.755). Conclusion: SKJ essential oil with the minimum inhibitory concentration (MIC) of 0.31 mg/ml could be an effective antibacterial irrigation solution

Pulp capping materials modulate the balance between inflammation and regeneration

International audienceThe interrelations between inflammation and regeneration are of particular significance within the dental pulp tissue inextensible environment. Recent data have demonstrated the pulp capacity to respond to insults by initiating an inflammatory reaction and dentin pulp regeneration. Different study models have been developed in vitro and in vivo to investigate the initial steps of pulp inflammation and regeneration. These include endothelial cell interaction with inflammatory cells, stem cell interaction with pulp fibroblasts, migration chambers to study cell recruitment and entire human tooth culture model. Using these models, the pulp has been shown to possess an inherent anti-inflammatory potential and a high regeneration capacity in all teeth and at all ages. The same models were used to investigate the effects of tricalcium silicate-based pulp capping materials, which were found to modulate the pulp anti-inflammatory potential and regeneration capacity. Among these, resin-containing materials such as TheraCal ® shift the pulp response towards the inflamma-tory reaction while altering the regeneration process. On the opposite, resin-free materials such as Biodentine TM have an anti-inflammatory potential and induce the pulp regeneration capacity. This knowledge contradicts the new tendency of developing resin-based calcium silicate hybrid materials for direct pulp capping. Additionally, it would allow investigating the modulatory effects of newly released pulp capping materials on the balance between tissue inflammation and regeneration. It would also set the basis for developing future capping materials targeting these processes

Dental Pulp Response to RetroMTA after Partial Pulpotomy in Permanent Human Teeth

International audienceIntroduction: A lack of information exists regarding the efficacy of RetroMTA (BioMTA, Seoul, Korea) directly applied on the pulp in vital pulp therapy. This study was designed to examine the clinical efficacy of Retro-MTA compared with ProRoot mineral trioxide aggregate (MTA) (Dentsply Tulsa Dental, Tulsa, OK) for partial pul-potomy.Methods: Partial pulpotomy was performed in 22 healthy human maxillary and mandibular third molars planned for extraction. The teeth were randomly divided into 2 groups (n = 11) and underwent partial pulpotomy with RetroMTA and ProRoot MTA as the control. The teeth were then restored with glass ionomer cement. Clinical and electric pulp tests were performed after 1 and 8 weeks. The teeth were radiographed and extracted at 8 weeks. Histologic sections were prepared and analyzed for pulp inflammation and dentinal bridge formation. Data were analyzed using the Mann-Whitney U test.Results: Clinical examination after 1 and 8 weeks showed no sensitivity to heat, cold, or palpation in the ProRoot MTA and RetroMTA groups. Periapical ra-diographs taken before the extraction of teeth showed no evidence of periapical pathology. Electric pulp testing revealed no sensitivity. Data comparisons using the Mann-Whitney U test showed no significant difference between the materials with regard to the pulp inflammation type, intensity and extension (P = .3), or bridge continuity (P = .12). However, these data revealed a significant difference between the 2 materials in pulp morphology (P < .05) and bridge thickness (P < .01).Conclusions: This is the first work to evaluate a Retro-MTA histologic outcome in partial pulpotomy in human permanent teeth. It shows pulp disorganization, an absence of inflammation, and discontinuous mineraliza-tion, which may represent a potential drawback with RetroMTA in this indication. (J Endod 2018;-:1-5