Effect of Premedication with Indomethacin and Ibuprofen on Postoperative Endodontic Pain: A Clinical Trial

Introduction: Post-endodontic pain is one of the main problems for both patients and dentists. The purpose of this study was to compare the effectiveness of premedication with indomethacin and ibuprofen for management of postoperative endodontic pain. Methods and Materials: In this clinical trial, mandibular molars with irreversible pulpitis were endodontically treated in 66 patients. The medicines were prepared similarly in the form of capsules containing 400 mg ibuprofen (group A), 25 mg indomethacin (group B) and placebo (group C). The patients were given one capsule 1 h before the start of treatment. Patients recorded their pain measured by a visual analogue scale (VAS) at medication time, during treatment and 8, 12 and 24 h after treatment. The data were analyzed using the chi-square, repeated measures ANOVA, paired t-test, Tamhane and Pearson correlation coefficient. Results: Ibuprofen and indomethacin significantly reduced the postoperative pain in comparison with placebo during treatment and 8 h after treatment; however, there were no significant differences between them 12 and 24 h after treatment. Conclusion: Premedication with ibuprofen and indomethacin can effectively control short term post-operative pain; the lower incidence of side effects and greater analgesic power of ibuprofen make it a superior choice.Keywords: Ibuprofen; Indomethacin; Irreversible Pulpitis; Non-Steroidal Anti-Inflammatory Drugs; Post-Endodontic Pai

Cytotoxicity of Cold Ceramic compared with MTA and IRM

INTRODUCTION: Biocompatibility is a desirable feature for root-end filling materials. In this study we aimed to compare a new material called cold ceramic (CC) with intermediate restorative material (IRM) and mineral trioxide aggregate (MTA) using Methyl-tetrazolium bromide (MTT) assay. MATERIALS AND METHODS: The materials were tested in fresh and set states: (n=108). The cytotoxicity was compared using L929 fibroblasts as an indicator; tested materials were eluted with culture medium according to ISO: 109935 standard. Distilled water and culture medium served as positive and negative controls, respectively (n=36). The results were evaluated at 1, 24 hours and 7 days. Data were statistically analyzed by one-way ANOVA for each time interval and material status and t-tests. RESULTS: The cytotoxicity of the tested materials were statistically different at the various time intervals (P<0.001). IRM was the most cytotoxic root-end filling material (P<0.001), MTA demonstrated the least cytotoxicity followed by CC.  CONCLUSION: Despite displaying the greatest cytotoxicity, IRM is approved by the American Food and Drug Administration (FDA). Cold ceramic had significantly lower cytotoxicity compared to IRM, in all but one subgroup. Further investigations are required to assess the clinical applicability of this novel material

Clinical and Radiographic Evaluation of Procedural Accidents and Errors during Root Canal Therapy

INTRODUCTION: Root canal therapy (RCT)_like other dental practices_ can be accompanied with some accidents or unpredictable conditions that are called "procedural accidents". Having the knowledge about these accidents and their etiology is essential to have RCT completion and to prevent the repeat of these accidents. This study was designed to evaluate accidents occurring during RCT in patients referred to endodontic department of Shahid Beheshti dental school during 2002. MATERIALS AND METHODS: This study was conducted via descriptive method. Data were collected from observation, clinical examination and oral radiographs, and were recorded in questionnaires, 150 cases from the patients referred to endodontic department were selected randomly and different observed RCT errors were analyzed by SPSS software. The Chi-square and Fisher exact tests were used for analysis. RESULTS: The study showed that 101 patients (67.3%) had one type of RCT errors, and remaining (32.7%) were error free. From the errors studied the most prevalent were "void" which was observed in 41 patients (27.3%), and "ledge" in 39 patients (26%) respectively. The prevalence of other accidents were underfilling in 35 patients (23.3%), poor shaping in 30 patients (20%), overfilling in 23 patients (15.3%), transportation in 13 patients (8.7%), zipping in 3 patients (2%), gouging in 1 patients (0.7%), and strip perforation in 1 patients (0.7%), while no case of broken instruments, vertical fracture, furcation and cervical perforation was observed. CONCLUSION: The most prevalent errors were found in instrumentation and obturation steps, therefore more care and attention must be paid to instructor observation and the education of these stages

Comparing the sealing properties of mineral trioxide aggregate and an experimental ceramic based root end filling material in different environments

Background: An apical seal is an important factor in achieving success in surgical endodontics. Aim: The purpose of this study was to compare the sealing properties of mineral trioxide aggregate (MTA) with a new ceramic based root end filling material (Cold Ceramic) in different environments. Materials and Methods: One hundred teeth were selected. The root canals were instrumented and obturated. Except for the apical 2 mm, the root surfaces were sealed. After root resection, 3 mm depth root-end cavities were prepared. For each material, roots were divided into 3 equal subgroups and the root-end filling was done in different environments (dry, saliva contaminated, blood contaminated). Five roots served as positive and 5 roots as negative controls. Samples were immersed in 2% methylene blue dye. Roots were sectioned longitudinally and examined under stereomicroscope to record the extension of dye penetration. Results: All experimental groups demonstrated dye penetration. The lowest linear leakage was seen in Cold Ceramic blood contaminated group while the highest leakage was observed in MTA blood contaminated group. The linear dye penetration of both MTA and Cold Ceramic (CC) groups did not show any significant differences among different environments. Also, the difference between MTA and CC was not significant in dry and saliva contaminated subgroups. Only the difference between dye penetration of MTA and CC in blood contaminated subgroups showed significant difference ( P = 0.008). Conclusion: The sealing property of this ceramic based root end filling material (Cold Ceramic) is better than MTA in blood contaminated condition and at least similar to MTA in other conditions

The effect of ovalbumin on orthodontic induced root resorption

Background: This randomized trial was undertaken to investigate the effect of experimentally induced allergy on orthodontic induced root resorption. Materials and Methods: A total of 30 Wistar rats were divided randomly into test and control groups. Starting from the first 3 days, the rats in the test group were injected intra-peritoneally by 2 mg ovalbumin as allergen and 0.5 mg Alume as adjuvant. Afterward only allergen was injected once a week. The control group was injected by normal saline. After 21 days, Wistar immunoglobulin E was measured and peripheral matured eosinophil was counted. A total of 50 g nickel-titanium closed coil spring was ligated between right incisor and first molar. All animals were sacrificed after 14 days. The mesial root of the right and left first molar was dissected in a horizontal plane. The specimens were divided into four groups considering whether force and/or ovalbumin was applied or not. Root resorption was measured and compared among these groups. Repeated measures analysis of variance (ANOVA), and Bonferoni tests were used to analyze the data. The level of significance was determined at 0.05. Results: In general, the differences were insignificant (P > 0.05). As the only exception, the group in which both ovalbumin and force were applied had significantly more root resorption than the group in which neither force nor ovalbumin was applied (P < 0.001). Conclusion: Allergy may increase the susceptibility to root resorption. Application of light force, periodical monitoring of root resorption and control of allergy are advisable