Postoperative pain intensity after using different instrumentation techniques: a randomized clinical study

Postoperative pain is a frequent complication associated with root canal treatment, especially during apical instrumentation of tooth with preexisting periradicular inflammation Objectives The aim of this clinical study was to evaluate the influence of the instrumentation techniques on the incidence and intensity of postoperative pain in single-visit root canal treatment. Material and Methods Ninety patients with single root/canal and non-vital pulps were included. The patients were assigned into 3 groups according to root canal instrumentation technique used; modified step-back, reciprocal, and rotational techniques. Root canal treatment was carried out in a single visit and the severity of postoperative pain was assessed via 4-point pain intensity scale. All the participants were called through the phone at 12, 24 and 48 h to obtain the pain scores. Data were analyzed through the Kruskal–Wallis test. Results There was significant difference between all groups (

Evaluation of Postoperative Pain After Using Different File Systems: A Randomized Clinical Study

Objectives: This study evaluated the effect of instrumentation techniques on the postoperative pain after single-visit root canal treatment. Materials and Methods: Sixty patients having an indication of endodontic treatment were included. Only single rooted teeth were selected The patients were randomly divided into 2 groups. In group 1; the root canals were instrumented using ProTaper Next instruments with rotational motion, in group 2 TF Adaptive instruments with adaptive motion were used during instrumentation. Treatments were completed in a single appointment. Postoperative pain questionnaires were scored by patients using a four-point pain intensity scale for 12, 24, and 48 hours. Mann Whitney-U, Friedman and Wilcoxon tests were used for analyzing the final data. Results: The comparison of time intervals between groups demonstrated no difference between both groups (p>.05). In both groups, the postoperative pain values of 12h time period were significantly higher than both other periods, and significant difference was found between 24h and 48h time periods (p<0.05). The postoperative pain values of 48h time period were significantly lower than the other two time periods (p<0.05). Conclusions: Both instrumentation techniques caused postoperative pain. The pain scores indicated that both techniques caused limited discomfort associated with slight pain which did not require any additional treatment and medication

Evaluation of the surface alterations of the different nikel-titanium files which used in retreatments for removing the root canal filling materials

Bu çalışmanın amacı tekrarlayan tedavilerde kullanılan döner nikel titanyum eğelerin üç ve beşinci kullanım sonrası yüzey değişikliklerinin incelenmesidir. Ayrıca %2 lik sodyum hipokloritin, kloroform solüsyonunun ve sterilizasyon işlemlerinin tekrarlayan tedavilerde kullanılan döner nikel titanyum eğelerin yüzeylerine etkisi incelenmiştir. Bu çalışma için Protaper retreatment eğeleri, R-endo eğeleri ve Mtwo retreatment eğeleri kullanılmıştır. Üst çene birinci büyük azı dişlerine ait palatinal kökler guta perka ve Ah 26 ile dolduruldu ve iki ay sonra bu eğe sistemleri ile retreatment işlemleri uygulandı. Kullanılmamış, üç ve beş kez kullanılmış, NaOCl ve kloroform solüsyonunda bekletilmiş ve sterilizasyon işlemleri görmüş NiTi döner eğelerin yüzey değişiklikleri atomik kuvvet mikroskou ve tarama elektron mikroskobu ile incelendi. RMS ve Depth değerleri ve üç boyutlu görüntüler elde edildi. SEM incelemesi ile eğelerin çeşitli büyütmelerde görüntüleri ve EDX ile eğe yüzeyinin kimyasal kompozisyonu hakkında veriler elde edildi. RMS ve Depth değerleri tüm üç eğe sisteminde de üç ve beş kullanım sonrasında anlamlı bozulmalar olduğunu gösterdi. Üç ve beş kullanım sonrasında SEM incelemelerinde çatlaklar, hasarlar ve spiral yapıda bozulmalar görüldü. Ek olarak, Mtwo 15 eğesi beşinci kullanımdan sonra bozuldu. AFM verileri 2%NaOCl solüsyonunun NiTi döner eğeleri üzerinde anlamlı yüzey bozuklukları oluştuğunu göstermiştir. AFM ve SEM verileri kloroform solüsyonu ve sterilizasyon işlemlerinin yüzey anlamlı bozukluklarına yol açmadığını göstermiştir. EDX verileri, bütün çalışma grupları için, meydana gelen bozulmaların fiziksel olduğunu, eğelerin yüzeylerinde herhangi kimyasal bir bozulmaya rastlanmadığını göstermiştir. Sonuç olarak; Protaper retreatment, R-endo ve Mtwo retreatment eğelerinde kullanıma bağlı olarak yüzey bozuklukları görülmüştür. Klinisyenler, retreatment işlemlerinde özellikle üçüncü kullanımdan sonra kırılma riskini göz önünde bulundurmalıdırlar.The aim of this study was to evaluate the surface changes of nickel titanium rotary retreatment files after three and five times of use. Furthermore, effects of 2% sodium hypochlorite and chloroform solutions and sterilization procedures on the NiTi rotary retreatment surfaces were investigated. Protaper Retreatment files, R-endo files and Mtwo retreatment files were used for this study. The palatinal roots of maxillary first molar teeth were obturated with gutta percha and Ah26. After two months, retreatment procedures were performed with these retreatment file systems. Surface changes of NiTi rotary files which untreated, used for three and five times, embedded in NaOCl, chloroform and the files which were execuded sterilization procedures were investigated with atomic force microscopy and scanning electron microscopy. The RMS and Depth values, and three dimensional images were obtained. The surface of retreatment files were observed with SEM at various magnificaitons. EDX data was obtained to assess chemical composition of NiTi file surfaces. RMS and Depth values showed that all three NiTi rotary retreatment file systems showed significant deteriorations after three and five times of use. Cracks, damages and spiral construction deteriorations were detected on SEM images after three and five times of use. Furthermore, Mtwo 15 file was broken off after five times of use. AFM data indicated that 2% NaOCl caused significant surface deteriorations on NiTi rotary files. AFM and SEM evaluation showed that chloroform solution and sterilization procedures didn t cause significant surface deteriorations. EDX data indicated that in all study groups; all changes occured physically, no chemical changes occured on NiTi rotary NiTi files. In conclusion, Protaper retreatment, R-endo and Mtwo retreatment files showed surface damages depending on retreatment procedures. Clinicians have to consider that retreatment files always have a tendency to break off when used for three times

Efficacy of XP-Endo Finisher and Passive Ultrasonic Irrigation on Modified Triple Antibiotic Paste Removal

Objectives: The aim of this study was to compare conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI), and XP-endo Finisher (XPF) techniques in terms of modified triple antibiotic paste (mTAP) removal.Materials and Methods: A total of 30 mandibular premolars were instrumented to a size F3 file. A mixture of mTAP was prepared by mixing 3 antibiotics, including 250 mg ciprofloxacin, 250 mg metronidazole, and 150 mg clindamycin, with 1 ml distilled water and applied into the root canals. The teeth were allocated into 3 equal groups, irrigation/agitation was performed and teeth were divided into two halves. The removal of mTAP was evaluated with a scanning electron microscope by using the 4 grade scoring system.Results: In the apical thirds, significant difference was found between PUI and CNI groups (p<0.05), whilst no significant difference was found among the other irrigation activation regimens (p> 0.05). No statistically significant difference was found between all groups in the middle third. In the coronal thirds, XPF removed significantly more mTAP than the CNI group (p<0.05). However, no difference was recorded among other groups (p>0.05). Conclusions: Passive ultrasonic irrigation and XPF file agitation demonstrated superior efficacy in removing mTAP from root canals compared to CNI

Elektronik apex bulucu cihazların düşük ve tam dolu pil/şarj durumlarının karşılaştırılması

Amaç: Bu çalışmanın amacı Root ZX mini ve Raypex 6 elektronik apex bulucu cihazların (EAB) düşük ve tam dolu pil/şarj durumlarının kanal boyu ölçümündeki etkinliklerinin karşılaştırılmasıdır. Gereç ve Yöntem: Bu çalışmada kök ucu gelişimi tamamlanmış 27 adet daimi alt çene keser diş kullanıldı. Giriş kaviteleri hazırlandı ve tüm örnekler numaralandırıldı. 10 numara K tipi eğe kök kanalı içerisine ucu apikal foramende görülünceye dek yerleştirildi ve gerçek kök kanal boyu belirlendi. Pil ile çalışan Root ZX mini ve şarj edilebilir özellikte olan Raypex 6 EAB cihazları üretici firma talimatlarına göre kullanıldı. Elektronik çalışma boyutu tespiti ilk olarak tam dolu ardından da düşük pil/şarj seviyesine sahip Root ZX mini ve Raypex 6 cihazları ile yapıldı. Gruplar arasındaki farklılıkların kıyaslanması Kruskal-Wallis istatistiksel analizi ile yapıldı. Bulgular: Raypex 6 ile yapılan ölçümlerde tam dolu ve düşük şarj seviyeleri arasında istatistiksel olarak anlamlı bir fark bulunmamıştır. Root ZX ve Raypex 6'nın tam dolu pil/şarj seviyeleri arasında anlamlı bir fark bulunmamıştır. Düşük pil seviyesindeki Root ZX mini ile diğer deney grupları arasında ise istatistiksel olarak anlamlı bir fark ortaya çıkmıştır(p< 0.05). Sonuç: Root ZX mini düşük pil seviyesinde farklı ölçümlere yol açmıştır ancak pil ile çalışan ve şarjlı elektronik apeks bulucu cihazları ile elektronik kanal boyu ölçümünde hem düşük hem de tam dolu pil/şarj seviyelerinde ±1 mm tolerans aralığı için kabul edilebilir ölçümler elde edilmiştirAim: The aim of this in vitro study was to compare the accuracy of Root ZX mini and Raypex 6 electronic apex locators (EAL) in low versus full battery/charge conditions. Material and methods: Twenty-seven extracted human mandibular incisor teeth with mature apices were used in this study. Access cavities were prepared and all specimens were numbered. #10 K file was introduced into the root canal until its tip was visualized at the apical foramen and the actual working length (AWL) was determined..The EALs; battery-powered Root ZX mini (J. Morita Corp, Tokyo, Japan) and rechargeble Raypex 6 (VDW, Munich, Germany) manufacturers’ instructions. The electronic working length (EWL) measurement differences with Root ZX mini and Raypex 6 in low and full battery/chargeconditions were compared among the groups. Statistical analyses were performed by the Kruskal–Wallis test.Results: No significant difference was observed between low and full charge condition of Raypex 6 groups. Although there was no significant difference between Root ZX with full battery and Raypex 6 with full charge conditions, contrary root ZX mini with low battery showed significant differences in comparison with the other groups (p< 0.05).Conclusion: Although the low battery condition of the EAL may cause deviations in measurements, the accuracy of the both battery powered and charged EALs presents acceptable results in low and full battery/charge conditions within the ±1 mm tolerance range. Nevertheless the low battery condition of the EAL may cause deviations in measurement

Effect of glide path preparation on apical debris extrusion of rotary and reciprocating single-file systems: OneShape versus WaveOne

Objectives: To assess the effect of glide path on the amount of apically extruded debris after instrumentation with WaveOne and OneShape. Materials &amp; Methods: Forty-eight extracted human mandibular incisors were assigned to 4&nbsp;groups. In groups&nbsp;1 and 2, preparation was completed with WaveOne, in groups&nbsp;3 and 4&nbsp;canals were prepared with OneShape. Before instrumentation, in groups&nbsp;1 and 3, glide path was created with PathFile 1, 2, and 3 at working length, whereas in groups&nbsp; 2 and 4, glide path was not performed. The weight of the extruded debris for each group was calculated by comparing the pre-&nbsp;and post-instrumentation weights of the eppendorf tubes. The time required for reaching full WL was also recorded. Data were analysed by Kruskal–Wallis and Mann–Whitney U tests. Results: There was no difference in the amount of debris extruded between the single file systems (P=0.234). Time required to reach full WL was significantly decreased by creating a glide path (P< 0.05). Conclusions: Creation of a glide path does not significantly affect the apically extruded debris.Objectives: To assess the effect of glide path on the amount of apically extruded debris after instrumentation with WaveOne and OneShape. Materials &amp; Methods: Forty-eight extracted human mandibular incisors were assigned to 4&nbsp;groups. In groups&nbsp;1 and 2, preparation was completed with WaveOne, in groups&nbsp;3 and 4&nbsp;canals were prepared with OneShape. Before instrumentation, in groups&nbsp;1 and 3, glide path was created with PathFile 1, 2, and 3 at working length, whereas in groups&nbsp; 2 and 4, glide path was not performed. The weight of the extruded debris for each group was calculated by comparing the pre-&nbsp;and post-instrumentation weights of the eppendorf tubes. The time required for reaching full WL was also recorded. Data were analysed by Kruskal–Wallis and Mann–Whitney U tests. Results: There was no difference in the amount of debris extruded between the single file systems (P=0.234). Time required to reach full WL was significantly decreased by creating a glide path (P< 0.05). Conclusions: Creation of a glide path does not significantly affect the apically extruded debris

Farklı preparasyon genişliklerinde iki elektronik apeks bulucu cihazın doğruluğunun değerlendirilmesi

Bu çalışmanın amacı iki farklı apeks bulucu cihazınfarklı preparasyon çaplarındaki doğruluğunun karşılaştırılmasıdır.GEREÇ VEYÖNTEM: Bu çalışma için çekilmiş 14 adet insanalt keser dişi kullanıldı. Dişlerin kronları mine-sement birleşiminden kesilerek uzaklaştırıldı. Kök kanalı içerisinde10 numaralı bir K-tipi eğe apikalden görülünceye kadarilerletildi ve elde edilen boy bir kumpas yardımıyla ölçüldü. Gerçek çalışma boyu için bu ölçümden 0.5 mm çıkarıldı ve kaydedildi. Dişler periodonsiyumu taklit etmekamacıyla aljinat içerisine gömüldü. Propex II ve Root ZXmini elektronik apeks bulucu cihaz ile ilk ölçümler (preparasyon öncesi) yapıldı ve kaydedildi. Daha sonra dişlerProTaper döner eğe sistemi ile F1 çapına kadar genişletildi. Elektonik apeks bulucu cihazlar ile tekrar ölçüm yapıldı. Son olarak kök kanalları F3 çapına kadar genişletildive çalışma boyları cihazlar ile bir kez daha ölçüldü. Eldeedilen bütün apeks bulucu cihaz verilerinin gerçek boylarla olan farkları hesaplandı. Gerçek boy ile preparasyonöncesi değerler ve sonrası değerler farkları hem elektronikapeks bulucu cihazlar için kendi içerinde ve hem de birbirleriyle t-testi kullanılarak istatistiksel olarak karşılaştırıldı.BULGULAR: Preparasyon öncesi ve diğer iki preparasyonçaplarında, Propex II ve Root ZX Mini elektronik apeks bulucu cihazlar arasında ve kendi içlerinde istatistiksel olarakanlamlı bir fark görülmedi (p>0.01).SONUÇ: Propex II ve Root ZX mini elektronik apeks bulucucihazların kök kanal tedavisi başlangıcında ve farklı preparasyon çaplarında birbirleri ile uyumlu sonuçlar verdiğigörüldü.The aim of this study was to compare the accuracy of two electronic apex locator devices after root canalpreparation at different sizes.MATERIALS ANDMETHOD: Fourteen extracted mandibular incisors were used in this study. Crowns were removed atthe cementoenamel junction. The actual canal length wasdetermined by introducing a size 10 K-file into the canaluntil the file tip became visible at the apical foramen andthen subtracting 0.5 mm from the measured length. Theteeth were embedded in alginate model. Initial (pre-operative) root canal length measurements were performed byusing Propex II and Root ZX mini electronic apex locators.Then, the root canals were prepared by using ProTaper rotary system to size F1. Working lengths were measuredagain by using the two electronic apex locators. Finally,the root canals were prepared to size F3 and the workinglengths were measured once more by using the same devices. Differences between the actual working length values and the electronic apex locator values (initial valuesand values obtained after F1 and F3 preparation sizes)were calculated and compared statistically using t-test.Comparisons were done both between the two devicesand within each device.RESULTS: No statisticall significant difference was foundbetween and within the readings of the Propex II and RootZX mini electronic apex locator devices for measurementsperformed at the different stages (p>0.01)CONCLUSION: Propex II and Root ZX Mini electronic apex locator devices exhibited comparable results at the beginning of the root canal treatment and at differentpreparation size

Comparison of nd:yag and diode laser irradiation during intracoronal bleaching with sodium perborate: color and raman spectroscopy analysis

WOS: 000349532300005PubMed: 25654643Objective: The aim of this study was to evaluate the color and enamel structure changes after intracoronal bleaching with sodium perborate under neodymium:yttrium-aluminum-garnet (Nd:YAG) and diode laser irradiation. Background data: Although some studies investigated the efficacy of laser irradiation during intracoronal bleaching, no study has been conducted to investigate the changes in both color and enamel structure during intracoronal bleaching with laser irradiation. Methods: Thirty-six extracted mandibular incisors were used. The root canals were prepared and filled with AH Plus and gutta-percha. Baseline color values and Raman spectra were obtained from all samples. The samples were randomly divided into three groups as follows: group 1, intracoronal bleaching with sodium perborate plus NdYAG laser irradiation; group 2, intracoronal bleaching with sodium perborate plus diode laser irradiation; and group 3, intracoronal bleaching with sodium perborate without any laser irradiation. Following the bleaching procedures, the final baseline color values and Raman spectra were obtained. The baseline and final values were statistically analyzed. Statistical analyses were performed with SPSS 18.0 software using Anova and the Kruskal-Wallis test. Results: There was a significant difference between the Nd:YAG laser and control groups (p0.05). Conclusions: Laser application, especially Nd:YAG laser irradiation, was able to increase the efficacy of intracoronal bleaching with sodium perborate. Laser irradiation significantly increased the bleaching efficacy without any changes in the enamel surface structure