Comparative evaluation of postoperative pain and periapical healing after root canal treatment using three different base endodontic sealers ? A randomized control clinical trial

The aim of the present study was to evaluate and compare the postoperative pain and periapical healing after root canal treatment using three different base endodontic sealers. Primary root canal treatment was initiated in 63 patients diagnosed with nec

ANALGESIC EFFECT OF PRE-EMPTIVE ORAL NSAIDS ON POST-ENDODONTIC PAIN LEVELS IN SINGLE VISIT ENDODONTICS -A SYSTEMATIC REVIEW

Background: Pre-emptive analgesia is an anti-nociceptive treatment which reduces the postoperative pain by preventing the processing of altered afferent input. As most of the patients present with pain preoperatively have higher levels of released local inflammatory mediators. Thus, pretreatment analgesia decreases the establishment of central sensitization, a mechanism by which spinal neurons increase their response to peripheral nociceptive impulse. Objective: This systematic review aims to compare and evaluate the postoperative pain levels and analgesic intake on preoperative oral administration of NSAIDs in single visit root canal treatment. Data Sources: The present review was done according to PRISMA guidelines and was registered in the PROSPERO (Centre for Reviews and Dissemination University of York; http://www.crd.york.ac.uk/PROSPERO). Registration number - CRD42020195775. The research question was formulated based on the PICO strategy. A comprehensive electronic literature search was conducted across PubMed/Medline, Scopus and Cochrane Database independently by two reviewers. Study Eligibility Criteria: Articles published from January 1990 to May 2019 that focused on preemptive strategies in single visit root canal treatment were included in the present review. Based on specified inclusion and exclusion criteria’s, the selected articles were subjected to quality assessment, and the risk of bias was evaluated. Methods: A total of 6 articles were included, out of which three were hand searched. The overall risk of bias of included studies was moderate, and the study limitations were high. Results: Among the studies included, Ibuprofen was considered as the best drug of choice in single visit endodontics. Limitations: The present review was assessing only the effectiveness of NSAIDs in single visit root canal treatment. But ideally comprehensive literature should search on effectiveness in both single and multiple visit root canal treatments. Conclusion: The present systematic review concluded that ibuprofen was considered to be an effective drug in single visit root canal treatment

A Review of Prolonged Post-COVID-19 Symptoms and Their Implications on Dental Management

The available data regarding the short and long-term consequences of COVID-19 is still insufficient. This narrative review aims to provide information on the prolonged COVID-19 symptoms in recovered patients and their implications during dental management. Additionally, this manuscript highlights the oral manifestations of COVID-19 and its management. A systematic search was conducted in PubMed, Embase, Cochrane Library and Web of Science databases, WHO and CDC websites, and grey literature was searched through Google Scholar. Clinical articles (clinical trials, case-reports, cohort, and cross-sectional studies) were included, reporting prolonged post-COVID-19 symptoms. Although COVID-19 is an infectious disease primarily affecting the lungs, its multi-organ involvement is responsible for several prolonged symptoms, including oral implications. In recovered patients with prolonged COVID-19 symptoms, considerations for providing dental treatment has to be made as they can present with assortment of symptoms. These prolonged post-COVID-19 symptoms can affect the delivery of the required dental treatment. Hence, the recommendations proposed in this narrative review can be a useful starting point to aid dental teams providing adequate care for such recovered patients

Tackling Local Anesthetic Failure in Endodontics

Achieving anesthesia in a hot tooth or tooth with inflamed pulp is challenging, especially during endodontic treatment. In the presence of symptomatic irreversible pulpitis, mainly in mandibular teeth, pose even more challenge to attain profound anesthesia. Tetradoxin resistant channel is a class of sodium channel that is found to be increased in such condition and is found to resist local anesthesia. The pH also determines the success of local anesthesia. In inflammatory conditions, the surrounding area\u27s pH, which eventually decreases the amount of base form of local anesthetic penetration into the nerve membrane, thereby causing anesthetic failure. In such conditions, the excitability threshold is reduced, leading to failure in achieving anesthesia. This chapter highlights and discusses the cause of anesthetic failure and its management in obtaining profound anesthesia during endodontic treatment

Evaluation of Root Canal Cleanliness on Using a Novel Irrigation Device with an Ultrasonic Activation Technique: An Ex Vivo Study

Root canal preparation generates inorganic and organic tissue debris. Various irrigation techniques are used to remove the smear layer from the root canal system. The present study aimed to evaluate canal cleanliness using a novel irrigation device with ultrasonic and manual irrigation in extracted teeth. Twenty-one freshly extracted single-rooted teeth with specified inclusion and exclusion criteria were collected for the present study. The specimens were prepared to a size using a rotary file to size 30 and 6% taper preparation. The specimens were then divided into three groups: group I, Manual irrigation group (n = 7), group II, Automated irrigation (n = 7), group III, Passive ultrasonic irrigation (n = 7). Following the experimental irrigation, the teeth were subjected to the scanning electron microscopy (SEM). Statistically significant reduction (p < 0.05) in both smear layer and debris scores were seen in group III as compared to the other groups. Based on Hülsmann’s scoring method, it was found that the automated root canal irrigation device showed better canal cleanliness when compared with the manual irrigation technique but was less effective than passive ultrasonic irrigation

Influence of Commonly Used Endodontic Irrigants on the Setting Time and Metal Composition of Various Base Endodontic Sealers

The present study aimed to evaluate if commonly used endodontic irrigants such as 3% sodium hypochlorite (NaOCl, Prime Dental, Thane, India), 2% chlorhexidine (CHX, Sigma-Aldrich Co., St. Louis, MO, USA), and 17% ethylenediaminetetraacetic acid (EDTA, Meta-Biomed Co. Ltd., Cheongju-si, South Korea) influenced the setting time and metal composition of different base endodontic sealers on exposure. AH Plus (Dentsply De Trey GmbH, Konstanz, Germany), Sealapex (SybronEndo, Orange, CA, USA), mineral trioxide aggregate (MTA) Fillapex (Angelus Soluções Odontológicas, Londrina, Brazil), and Tubli-Seal (Kerr Dental, Orange, CA, USA) were selected as the different base representatives of endodontic sealers. These sealers were exposed to 3% NaOCl, 2% CHX, and 17% EDTA, and the individual setting time of the sealers was analyzed. The samples were analyzed for heavy metal elements such as chromium (Cr), nickel (Ni), cobalt (Co), cadmium (Cd), arsenic (As), mercury (Hg), lead (Pb), and beryllium (Be) by using inductively coupled plasma mass spectrometry (ICP-MS) analysis. For statistical analysis, one-way ANOVA and post hoc Tukey's tests were used. All selected sealers showed variation in setting time post-exposure to different irrigants. MTA Fillapex had the shortest mean setting time (215.7 min, post-exposure at 187.3 min) (p < 0.05). Mean setting time was also affected for AH Plus (479.6 min, post-exposure at 423.9 min) (p < 0.05) and Tubli-Seal (514.7 min, post-exposure at 465.2 min) (p < 0.05). Sealapex showed the maximum reduction of setting time (864.8 min, post-exposure at 673.4 min) (p < 0.05). All tested sealers showed heavy metals (Cr, Ni, Co, Cd, As, Hg, and Pb) in their composition, and the quantities were influenced by interaction with different irrigants. The heavy metal Be was not seen in any of the samples. Sealapex showed the longest setting time in comparison to other test sealers. Heavy metals were most present in Sealapex, followed by AH Plus, Tubli-Seal, and MTA Fillapex. MTA Fillapex was seen to have the shortest setting time, and heavy metal composition was least affected on interaction with different commonly used endodontic irrigants. Further, this study provides significant insight into the influence of different endodontic irrigants on interaction with different base endodontic sealers, which has not been reported previously, and future studies should emphasize endodontic irrigant-sealer interactions and their possible effects in the long run.Sin financiación4.329 JCR (2020) Q1, 18/90 Polymer Science0.770 SJR (2020) Q1, 103/446 Chemistry (miscellaneous)No data IDR 2020UE

Monomer Elution from Three Resin Composites at Two Different Time Interval Using High Performance Liquid Chromatography—An In-Vitro Study

Esthetics, improved colour stability and ease of contour have made photo-activated resin based restorative materials being widely used in routine dental clinical practice. Perhaps improper and inadequate polymerization of resin based composite material might lead to elution of monomer. Thus, the aim of the current study was to quantify the monomer elution from three resin composites. The intended analysis was made using high performance liquid chromatography (HPLC) at two different time periods. Three different materials that were investigated in the current study included Swiss Tech resin composite (Group A), Ceram X (Group B) and Beautifil Injectable composite (Group C). Ten cylindrical samples were fabricated in each study group. In 75% wt of ethanol, the samples were ingressed immediately and stored at room temperature. A 0.5 mL of the samples was assessed at pre-defined time intervals at 24 h and 7th day. Later, assessment of the samples was performed with HPLC and the data was analyzed using statistical test. Bisphenol A-glycidyl methacrylate (Bis-GMA), Triethylene glycol dimethacrylate (TEGDMA), 2-hydroxyethyl methacrylate (HEMA) and Urethane dimethacrylate (UDMA) were quantified in the samples. When analyzing the release monomer, it was found that at the end of 24 h Bis-GMA was eluted more in the injectable resin composite whereas, TEGDMA was eluted from Swiss Tech and Ceram X resin composites. At the end of the 7th day it was evident that Bis-GMA was eluted maximum in all the three resin composites. Thus, monomer release was found to be evident among all three resin composites and it is of utmost important to be assessed in routine clinical practice

Preparation of a Novel Nanocomposite and Its Antibacterial Effectiveness against <i>Enterococcus faecalis</i>—An In Vitro Evaluation

The interest in the use of green-mediated synthesis of nanoparticles (NPs) is shown to have increased due to their biocompatibility and reduction of overall production costs. The current study aimed to evaluate a novel nanocomposite (NC) prepared by using a combination of zinc oxide, silver and chitosan with lemon extract as a cross-linking agent and assessed its antimicrobial effectiveness against Enterococcus faecalis (E. faecalis). The NPs and NC were prepared individually using a modification of previously established methods. Ananalys is of the physiochemical properties of the NC was conducted using ultraviolet-visible spectroscopy (UV-Vis) (Shimadzu Corporation, Kyoto, Japan). and transmission electron microscopy (TEM) imaging(HR-TEM; JEOL Ltd., Akishima-shi, Japan. The microbial reduction with this novel NC was evaluated by measuring the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) using a tube assay analytic technique. A time-kill assay analysis was conducted to evaluate the kinetic potential against E. faecalis at different time intervals. The novel NC showed a homogenous nanoparticle size under TEM imaging and under UV-Vis established an absorption range of 350–420 nm making it similar to its individual counterparts. The MIC and MIB were measured at 62.5 ± 20 mg/L (p p E. faecalis. Based on the achieved results, it was seen that the novel NC using a combination of silver, zinc oxide and chitosan showed improved antimicrobial action against E. faecalis compared with its individual components under laboratory conditions. A complete eradication of 108 log units of E. faecalis at 250 mg/L occurred after a total of 5 h. These preliminary results establish the use of lemon extract-mediated silver, zinc and chitosan-based NC had an antibacterial effectiveness against E. faecalis similar to the individual counterparts used for its production under laboratory conditions