Application of Laser in Oral Surgery

In this review collected from the literature on usage of laser in oral minor surgery based on a Medline search in the time period between the years: 2008 and 2013, the most current evidence on laser-assisted oral minor surgery is going to be surveyed

Cytotoxicity of Endodontic Irrigants on Human Periodontal Ligament Cells

Introduction: Root canal irrigation has an extremely important role in the success of endodontic treatment. During endodontic treatment, the irrigants will be in contact with pulpal and periapical tissues. The purpose of this study was to clarify the potential toxicological implications of NaOCl, EDTA, MTAD, CHX and QMix on periapical and periodontal tissues. Methods and Materials: Cytotoxicity of solutions was evaluated on cultured human periodontal ligament (hPDL) that were carefully removed from the middle third of premolar roots. Cytotoxicity of the materials was assessed after 1, 5 and 15 min of exposure using the Mosmann’s Tetrazolium Toxicity (MTT) assay. Optical density of the solution was read at 540-690 nm wavelength. The intensity of color generated correlated with the percentage of viable cells. Data were statistically analyzed using repeated measures ANOVA followed by Bonferroni test. Results: The mean percentage of viable cells in all experimental groups was significantly different from sterile saline groups at all time points (P<0.0001). The mean percentage of viable cells significantly decreased over time in MTAD and NaOCl groups. The lowest and highest cytotoxicity belonged to MTAD and EDTA groups, respectively at all the time points (P<0.05). Conclusion: MTAD had the lowest cytotoxicity compared to NaOCl, CHX, QMix and EDTA. These impacts have been time dependent. These irrigation fluids may cause unfavorable effects on vital tissues. Keywords: Cytotoxicity Test; MTT Tetrazolium; Periodontal Ligament; Root Canal Irrigant

The Effect of Smear Layer on Antimicrobial Efficacy of Three Root Canal Irrigants

Introduction: One of the main goals of endodontic treatment is to decrease the harboring bacteria within the root canal system and dentinal tubules. This experimental study attempted to investigate the antibacterial efficacy of three root canal irrigants in the presence and absence of smear layer (SL). Methods and Materials: A total of 210 sound extracted human single-rooted teeth were prepared. After creating the SL and its removal in half of the samples, they were infected with Candida albicans (C. albicans) and Actinomyces israelii (A. israelii). A total of 180 specimen were used to assess the antimicrobial efficacy of the three irrigants in presence and absence of SL, 24 specimen were placed in the positive and negative controls, 2 samples were utilized for scanning electron microscopy (SEM) analysis and 2 were used for Gram staining. Then, they were exposed to irrigants including 2.61% sodium hypochlorite (NaOCl), 0.2% chlorhexidine gluconate (CHX) and 1% povidone-iodine (PI) for 5, 30 and 60 min. Presence/absence of test microorganisms was determined by incubation of specimens in test tubes containing brain-heart infusion (BHI) broth and then measuring the colony forming units (CFU) on BHI agar. A cumulative logistic model was used to analyze the ordinal response. Results: The 2.61% solution of NaOCl was significantly more effective than 0.2% CHX and the latter was more efficient than 1% PI for decreasing fungal and microbial infection of dentinal tubules in the presence and absence of SL. Conclusion: The presence of smear layer decreased the efficacy of antimicrobial irrigants. The minimum time required for elimination of fungal/microbial infection was 30 min.Keywords: Actinomyces israelii; Candida albicans; Chlorhexidine; Povidone-Iodine; Smear Layer; Sodium Hypochlorit

Evaluation of Pulp Tissue Following Direct Pulp Capping with Propolis versus Calcium Hydroxide: A Clinical Trial

Objectives Direct pulp capping may result in formation of a dentinal bridge and preservation of pulp vitality. This randomized controlled clinical trial sought to histologically assess and compare pulp tissue following pulp capping with propolis and calcium hydroxide. Methods In A cavity was prepared at the center of the occlusal surface of 10 third molars scheduled for extraction by using a cylindrical bur. The pulp chamber was exposed with a round bur. Samples were randomly divided into two groups (5 teeth in each group). The first group underwent direct pulp capping with propolis and the second group with calcium hydroxide. Auto-polymerizing glass ionomer was then applied to seal the cavity. The teeth were extracted after 45 days, and histologically evaluated. The obtained data were analyzed using the Fisher’s exact test. Results The quality (P=0.048) and quantity (P=0.008) of dentinal bridge were significantly different between the two groups. Propolis resulted in formation of a continuous dentinal bridge with irregular tubular dentin; whereas, calcium hydroxide resulted in formation of osteodentin (low quality dentin). Conclusion Propolis induced the formation of tubular dentin with higher quality compared with calcium hydroxide

Physical Properties and Chemical Characterization of Two Experimental Epoxy Resin Root Canal Sealers

Introduction: The aim of this in vitro study was to evaluate the setting time, flow, film thickness, solubility, radiopacity and characterization analysis of three epoxy resin based sealers including two experimental sealers and AH-26. Methods and Materials: Five samples of each material were evaluated for setting time, flow, film thickness, solubility and radiopacity according to ISO 6876 Standard. Characterization of sealers was performed under the scanning electron microscopy (SEM), X-ray energy dispersive spectroscopy, X-ray diffraction (XRD) and Fourier transform infrared (FTIR) spectroscopy. Statistical evaluation was performed using the Kruskal-Wallis test. Results: In this study, AH-26 showed more radiopacity and flow compared to two other experimental sealers (P<0.05). However, both sealers had lower setting time than AH-26 (P<0.05). No statistical differences were found regarding film thickness, solubility and radiopacity (P>0.05). The characterization analysis exhibited relatively similar microstructure of AH-26 sealer to the experimental root canal sealers. Conclusion: According to the result of this study, all tested root canal sealers had acceptable properties based on ISO 6876 standard criteria.Keywords: Epoxy Resin; Fourier Transform Infrared; Root Canal Sealer; Scanning Electron Microscopy; X-Ray Energy Dispersive Spectroscopy

Cytotoxicity of Two Experimental Epoxy Resin-Based Sealers

Introduction: Many endodontic sealers are available, but search for the ideal sealer continues. This study aimed to assess the cytotoxicity of two experimental endodontic sealers in comparison with AH-26 resin sealer. Methods and Materials: This in vitro study was conducted on conventional and experimental root canal sealers: AH-26, an epoxy resin experimental sealer A (ES-A) composed of calcium tungstate, zirconium oxide, aerosil, bismuth oxide, titanium oxide, hexamine and an epoxy resin and experimental sealer B (ES-B) with compositions similar to ES-A except for the presence of imidazoline as a catalyst. The experimental sealers containing nano-particles were mixed with 37.5% of an epoxy resin. The extraction of five samples of each experimental sealer (A, B) and AH-26 sealer were subjected to MTT assay in the form of set and fresh at 1, 24 and 72 h with 1, 10, 100% dilution according to the International Standard ISO:10993-2012. Data were analyzed using the one-way ANOVA. Results: The set ES-A had the least cytotoxicity from the first hour but the cytotoxicity of ES-B and AH-26 extraction decreased over time. In fresh form, except for 100% concentration, ES-A showed the least cytotoxicity compared to the other two sealers. Conclusion: All three sealers had high cytotoxicity in 100% concentration but had low cytotoxicity in 10% and 1% concentrations.Keywords: Cytotoxicity; Endodontics; Epoxy Resin; Seale

Evaluation of Chemical and Physical Properties of an Experimental Endodontic Sealer in Comparison with AH-26 and AH-Plus

Introduction: This study aimed to assess the physical and chemical properties of an experimental endodontic resin sealer (Resil) compared with AH-26 and AH-Plus.  Methods and Materials: In this in vitro experimental study, dimensional stability (by measurement of length; n=5), pH (using a pH meter; n=5), and antibacterial activity (by agar diffusion test; n=8) of Resil, AH-26 and AH-Plus were evaluated and compared using one-way ANOVA and Tukey’s test. Results: All three groups showed significant expansion from day 1 to day 30 (P<0.05). The difference in the mean dimensional changes between the AH-Plus and experimental sealer was significant (P=0.020). Two hours after mixing, the pH of experimental sealer (Resil) was significantly lower than that of AH-Plus (P<0.001) and higher than that of AH-26 (P<0.001). Antibacterial activity of the experimental sealer before and after setting was significantly higher than that of the other two sealers (P<0.001). Conclusion: The results of this in vitro study showed that the experimental sealer had dimensional changes greater than the other two sealers. It had an alkaline pH, and showed superior antibacterial activity compared with AH-26 and AH-Plus. It may be possible to use this sealer in the clinic after animal studies because an epoxy resin based sealer with lower price and more appropriate properties is favorable

Efficacy of Different Ibuprofen Formulations with Two Prescription Methods on Post Endodontic Pain of Teeth with Irreversible Pulpitis: A Randomized Clinical Trial

Introduction: Pain management during root canal therapy and after that is of great importance in endodontics. This study aimed to compare the effect of two non-steroidal anti-inflammatory drugs (NSAIDs); ibuprofen and ibuprofen lysine with two methods of prescription on pain after single-visit root canal treatment of first and second mandibular molar teeth with irreversible pulpitis. Materials and Methods: This randomized study recruited subjects experiencing moderate to severe pain from a tooth diagnosed with symptomatic irreversible pulpitis (n = 120). Subjects were randomized to receive 400 mg ibuprofen acid or 400 mg ibuprofen lysine regularly or on demand. The primary objective was to measure changes in pain scores at post-operative time frames of 6, 12, 18, 24, 48 and 72 hours after the root canal treatment on a 0-10 numerical rating scale (NRS).  Independent T-test, Non-parametric Kruskal-Wallis Test and Friedman Test were used to analyze the data. Results:  Kruskal-Wallis analysis showed a significant difference in NRS score between on-demand ibuprofen group and regular ibuprofen group and also between regular ibuprofen lysine group and regular ibuprofen group at 6 hours after the treatment (P<0.05). But no remarkable difference was observed in the recorded mean pain intensity of four study groups in the other time frames (P>0.05). Conclusions: Based on this randomized clinical trial, there was no significant difference in the pain intensity of patients using ibuprofen and ibuprofen lysine. Additionally, there was no significant difference in the degree of pain between the on-demand and regular groups, despite the fact that patients in the on-demand group used less medications. Due to the multiple negative effects of NSAIDs, it would be wise to prescribe ibuprofen on demand

Irrigants in endodontic treatment

The aim of root canal treatment is to remove virulence factors from this system. Cleaning and shaping of the root canal are at the outmost importance in endodontic treatment. Canal irrigation during the process of cleaning and shaping can lead to the elimination of microorganism, which are not removable through physical methods. Moreover, during the preparation of root canal, manually and by rotary instruments, the smear layer is created that must be eliminated by irrigants. In the present review article, irrigants were investigated in terms of chemical and biological features and their effective and safe ways of usage, along with some information that have been proposed on recent developments of root canal solutions. Furthermore, this topic has been studied regarding its effect on microorganisms and smear layer. In the present article, a review has been conducted through libraries, PubMed, ISI Web of science, Scopus websites, and Google using keywords such as endodontic treatment, intracanal irrigant, anti-bacterial, chlorhexidine, smear layer, and sodium hypochlorite. Diff erent materials have been introduced as root canal irrigants. Although sodium hypochlorite is the most common material used in the endodontic treatment against root canal microorganism, it has certain disadvantages and limitations and could not entirely remove the smear layer. Therefore, there is no irrigant that is capable of providing all the features of an appropriate irrigant individually. To remove the smear layer, ethylene diamine tetra acetic acid is required as the final rinse. High-density sodium hypochlorite (NaOCl) is more effective than 1 and 2% solutions. In order to eliminate the microorganisms of the root canal and the smear layer, it is suggested to use two or more detergents with a proper frequency. Using chlorhexidine as the final detergent creates a lasting impact

Case Report Inferior Alveolar Nerve Paresthesia Related to Apical Periodontitis of Mandibular Third Molar

Abstract: Paresthesia of the inferior alveolar nerve (IAN) as the result of preapical inflammation or endodontic treatment is a rare but serious occurrence. The following case report describes the diagnosis and management of paresthesia related to an endodontic periodical lesion of a mandibular third molar