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Medicina (Kaunas, Lithuania) Dec 2023Silver diamine fluoride (SDF) has been incorporated into the treatment of dental caries in children, mainly in countries with high caries prevalence. In Europe,...
Silver diamine fluoride (SDF) has been incorporated into the treatment of dental caries in children, mainly in countries with high caries prevalence. In Europe, however, SDF started to gain popularity during the COVID-19 pandemic. This study aimed to investigate the efficacy of SDF and to evaluate dentists'/parents' acceptance of SDF use in paediatric patients treated in a German university setting. A retrospective analysis of all patients treated with SDF between 2017 and 2020 was carried out. Only teeth with no reported clinical/radiographic evidence of irreversible pulpal inflammation were included. The outcome measures were success, minor failures (caries progression, reversible pulpitis) and major failures (irreversible pulpitis, abscess). The treatment acceptance by dentists and the parents of SDF-treated children was cross-sectionally evaluated using questionnaires. Descriptive statistics and Kaplan-Meier survival analysis were performed. A total of 93 patients (mean age 5.3 ± 2.9 years) with 455 treated teeth (418 primary/91.9%; 37 permanent/8.1%) were included and followed up for up to 24 months (19.9 ± 10.5 months). SDF was used for dental caries (98.2%) and hypersensitivity relief on MIH teeth (1.8%). Most teeth did not show any failure (total success 84.2%). A total of 5 teeth (1.1%) showed minor failures, and 67 teeth (14.7%) showed major failures ( = 0.001). Success/failure rates were not affected by patient compliance, gender, dentition, or operator ( > 0.05). In total, 30 questionnaires were collected from parents (mean age 36.8 ± 6.4 years). SDF was applied on anterior ( = 2/6.7%), posterior ( = 15/50%) and anterior/posterior teeth ( = 13/43.3%). At the 1-week follow-up, 80% of parents noticed black teeth discoloration. Treatment satisfaction was higher for posterior (95.2%) than for anterior teeth (36.4%; < 0.001). In the 27 responses from clinicians, SDF was generally considered a viable option in paediatric dentistry ( = 23; 85%). : SDF was found to be effective and well-accepted by parents and dentists for caries inactivation in a paediatric dentistry German university setting.
Topics: Humans; Child; Child, Preschool; Adult; Cariostatic Agents; Cross-Sectional Studies; Pediatric Dentistry; Pulpitis; Dental Caries; Pandemics; Retrospective Studies; Abscess; Quaternary Ammonium Compounds; Fluorides, Topical; Silver Compounds
PubMed: 38276050
DOI: 10.3390/medicina60010016 -
International Journal of Clinical... Nov 2023Single-visit pulpectomy (SVP) protocol with rotary files is highly recommended for the treatment of teeth with irreversible pulpitis. Various rotary endodontic files...
Comparative Evaluation of Single Rotary File System and Sequential Multi-file Rotary Systems on Time for Biomechanical Preparation and Obturation Quality in Single-visit Pulpectomy Protocol: A Double-blind Randomized Clinical Trial.
BACKGROUND
Single-visit pulpectomy (SVP) protocol with rotary files is highly recommended for the treatment of teeth with irreversible pulpitis. Various rotary endodontic files specially designed for use in the pediatric population are available. The aim is to clinically assess the parameters related to the time required for biomechanical preparation (T) and quality of filling using a single file system vs a sequential multi-file system in infected primary mandibular molars.
MATERIALS AND METHODS
A total of 45 infected primary molars were allocated to three groups (two experimental groups ( = 15) and a control group. The first experimental group was instrumented using NiTi K-Flex files, the second group with a single file rotary system with variably variable (VV) taper, and the third with a sequential multi-file system with constant taper. Biomechanical preparation time was recorded and standardized digital radiograph (RVG) were taken pre- and postinstrumentation. The data recorded was sent for statistical analysis.
CONCLUSION
There is a substantial reduction of T in primary molars using single file VV taper and multi-sequential file constant taper. Obturation time for all three file systems was comparable and there were no differences between the three file systems used ( > 0.05). Multi-sequential file constant taper files showed a higher probability of optimal obturations and minimal voids followed by NiTi "K-Flex" files and single file system but the difference was nonsignificant ( > 0.05). However, using a rotary in primary teeth results in better canal shape, and less T leading to a better quality of treatment in less time.
HOW TO CITE THIS ARTICLE
Shetty B, Singh R, Patil V, Comparative Evaluation of Single Rotary File System and Sequential Multi-file Rotary Systems on Time for Biomechanical Preparation and Obturation Quality in Single-visit Pulpectomy Protocol: A Double-blind Randomized Clinical Trial. Int J Clin Pediatr Dent 2023;16(S-3):S247-S252.
PubMed: 38268640
DOI: 10.5005/jp-journals-10005-2685 -
Scientific Reports Jan 2024This cohort study evaluated the long-term success/survival of vital pulp therapies (VPTs) after carious pulp exposure in adult teeth. Additionally, factors influencing...
This cohort study evaluated the long-term success/survival of vital pulp therapies (VPTs) after carious pulp exposure in adult teeth. Additionally, factors influencing long-term success were identified. Teeth treated during 2011-2022 in a private clinic were studied with clinical/radiographic follow-ups. Data included patient demographics, tooth specifics, and treatment details. Outcomes were classified as success/failure based on clinical/radiographic findings, with tooth functionality determining the survival rate. Encompassing 1149 patients and 1257 VPT-treated teeth, the average monitoring period was 42.2 months. Overall VPTs' survival and success rates were 99.1% and 91.6%, respectively. Success rates for 768 direct pulp cappings, 217 miniature pulpotomies, and 272 full pulpotomies were 91.9%, 92.6%, and 90.1%, respectively (P > 0.05). Influencing factors included symptomatic irreversible pulpitis (SIP; HR 1.974, 95% CI 1.242-3.137; P = 0.004), radiographic signs of apical periodontitis (AP; HR 2.983, 95% CI 1.961-4.540; P < 0.001), restoration type (HR 2.263, 95%CI 1.423-3.600; P = 0.001), and restoration surfaces (HR 1.401, 95%CI 1.034-1.899; P = 0.030). This study concludes that VPT techniques consistently exhibit high long-term success/survival rates in treating carious pulp exposures. Critical predictors include initial clinical signs of SIP/AP, caries extent, and use of composite restorations.
Topics: Adult; Humans; Cohort Studies; Retrospective Studies; Dental Care; Pulpotomy; Ambulatory Care Facilities
PubMed: 38267594
DOI: 10.1038/s41598-024-52654-8 -
Experimental and Therapeutic Medicine Feb 2024Cluster of differentiation (CD)44 is a marker of dental pulp stem cells and is involved in odontoblast differentiation and calcification. Chemokine-like receptor 1...
Cluster of differentiation (CD)44 is a marker of dental pulp stem cells and is involved in odontoblast differentiation and calcification. Chemokine-like receptor 1 (CMKLR1), also known as chemerin receptor 23 (ChemR23) is also expressed in odontoblasts and dental pulp stem cells and is involved in inflammation suppression and tooth regeneration. Resolvin E1, a bioactive lipid, is a CMKLR1 ligand that mediates the chemerin-CMKLR1 interaction and suppresses pulpal inflammation. The present study clarified the intracellular and tissue localization of CD44 and CMKLR1 by immunohistochemical staining of normal pulp and pulp with pulpitis from 12-week-old male Wistar rat teeth or human teeth. In addition, the localization of CD44 and CMKLR1 in human dental pulp stem cells was observed by immunofluorescence staining. The present study also examined the involvement of resolvin E1 in inhibiting inflammation and calcification by western blotting. CD44- and CMKLR1-positive cells were confirmed in the odontoblast layer in normal dental pulp of rats and humans. CD44 was mainly localized in the cell membrane and CMKLR1 was mainly found in the cytoplasm of human dental pulp stem cells. CMKLR1 was also confirmed in the odontoblast layer in rats and humans with pulpitis but CD44 was not present. Following treatment of dental pulp stem cells with lipoteichoic acid, which imitates Gram-positive bacterial infection, resolvin E1 did not suppress the expression of cyclooxygenase-2 or of the odontoblast differentiation marker, dentin sialophosphoprotein. Furthermore, resolvin E1 induced the differentiation of dental pulp stem cells into odontoblasts even in the presence of the inflammatory stimulus.
PubMed: 38264427
DOI: 10.3892/etm.2023.12363 -
Bioinformation 2023Endodontic pain, a common complication after root canal treatment, affects 2.5% to 60% of patients. Therefore, it is of interest to compare apical negative pressure...
Endodontic pain, a common complication after root canal treatment, affects 2.5% to 60% of patients. Therefore, it is of interest to compare apical negative pressure irrigation (EndoVac) with conventional needle irrigation to assess their impact on postoperative pain in permanent anterior teeth with symptomatic irreversible pulpitis. Fifty patients were randomly assigned to either the EndoVac or needle irrigation group. Pre and post-operative pain levels were assessed using a Visual Analog Scale and the amount of Ibuprofen taken was recorded. At 12-, 24-, and 48-hour intervals, the EndoVac group reported significantly less pain than the needle irrigation group. The needle irrigation group also required more Ibuprofen. The apical negative pressure irrigation system (EndoVac) resulted in significantly less postoperative pain and reduced the need for analgesic medication than the conventional needle irrigation protocol.
PubMed: 38250540
DOI: 10.6026/973206300191129 -
Journal of the Indian Society of... Oct 2023Inferior alveolar nerve block (IANB) is considered the cornerstone in achieving anesthesia for mandibular molars. However, failure of routine lignocaine IANB to achieve... (Randomized Controlled Trial)
Randomized Controlled Trial
CONTEXT
Inferior alveolar nerve block (IANB) is considered the cornerstone in achieving anesthesia for mandibular molars. However, failure of routine lignocaine IANB to achieve profound anesthesia of the pulp has been reported in patients with molar incisor hypomineralization (MIH). Articaine 4% with epinephrine 1:100,000 has proven to provide total pain relief during most dental procedures.
AIMS
This study aimed to assess and compare the pain perception level in children using Visual Analog Scale (VAS) during root canal treatment after administering 4% articaine buccal infiltration (BI), 4% articaine IANB, and 2% lignocaine IANB.
SUBJECTS AND METHODS
Twenty-seven children aged 8-12 years, requiring root canal treatment of mandibular first permanent molars with MIH were randomly allocated into three groups - 4% articaine (1:100,000 epinephrine) BI, 4% articaine (1:100,000 epinephrine) IANB, and 2% lignocaine IANB. The efficacy of the anesthetic was determined by rating the pain perception of the child using a VAS.
STATISTICAL ANALYSIS USED
The scores marked by the children on the VAS were recorded and were statistically analyzed. Data were entered into Microsoft excel data sheet and were analyzed using SPSS for Windows version 17.0.
RESULTS
Patients anesthetized with 4% articaine IANB presented lesser pain scores compared to IANB with 2% lidocaine and 4% articaine BI on access opening and instrumentation of the root canals.
CONCLUSION
4% articaine IANB has better anesthetic efficacy than 4% articaine BI and 2% lignocaine IANB in anesthetising mandibular first permanent molars with MIH.
Topics: Child; Humans; Carticaine; Lidocaine; Anesthetics, Local; Dental Pulp Cavity; Molar Hypomineralization; Pulpitis; Nerve Block; Epinephrine; Anesthesia, Dental; Pain; Mandibular Nerve; Double-Blind Method
PubMed: 38235818
DOI: 10.4103/jisppd.jisppd_375_23 -
BMC Oral Health Jan 2024This study aimed to assess the influence of continuous rotation and reciprocation kinematics on postoperative pain (POP) levels and substance P (SP) levels in patients... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
This study aimed to assess the influence of continuous rotation and reciprocation kinematics on postoperative pain (POP) levels and substance P (SP) levels in patients diagnosed with irreversible pulpitis and symptomatic apical periodontitis (SAP).
MATERIALS AND SUBJECTS
A total of twenty patients were randomly assigned into two groups: Continuous Rotation Group (CRG) (n = 10), subjected to mechanical preparation with the EdgeEndox7 rotary system (Albuquerque, NM, USA), and Reciprocation Group (RG) (n = 10), treated with the EdgeOne Fire reciprocating system (Albuquerque, NM, USA). Apical fluid (AF) samples were collected, and SP levels were quantified through radioimmunoassay. POP was assessed using the Numerical Rating Scale (NRS) at various time intervals (preoperatively, 6 h, 12 h, 24 h, 48 h, and 72 h). Data were statistically analyzed utilizing the independent t-test, Mann-Whitney U test, Friedman's test, and Nemenyi post hoc test.
RESULTS
There was a significant increase in SP levels in the reciprocating group compared to the continuous rotation group (P ≤ 0.05). Additionally, patients in the reciprocating group reported significantly higher POP levels (P ≤ 0.05) at all measured intervals (6 h, 12 h, 24 h, and 48 h), with both groups exhibiting similar pain level reductions at the 72-hour mark.
CONCLUSION
Our findings suggest that continuous rotation kinematics in root canal preparation leads to a considerable reduction in SP expression and POP.
TRIAL REGISTRATION
The study protocol was retrospectively registered on the www.
CLINICALTRIALS
gov database (NCT06081335) at (13/10/2023) after the approval of the Ethics Committee, Faculty of Dentistry, Ain Shams University (FDASU-RecIM012135).
Topics: Humans; Substance P; Biomechanical Phenomena; Root Canal Preparation; Pulpitis; Pain, Postoperative
PubMed: 38233887
DOI: 10.1186/s12903-024-03882-x -
Iranian Endodontic Journal 2024This non-randomized clinical trial investigated the outcomes of full pulpotomy in adult molars with irreversible pulpitis, comparing those with calcified and...
INTRODUCTION
This non-randomized clinical trial investigated the outcomes of full pulpotomy in adult molars with irreversible pulpitis, comparing those with calcified and non-calcified pulp chambers over 6 and 12 months.
MATERIALS AND METHODS
A total of 101 adult permanent molars with irreversible pulpitis, in individuals over 12 years old, were categorized based on pulp chamber calcification observed in radiographic images by two endodontists. Subsequently, full pulpotomy procedures were performed, achieving hemostasis, and applying a 2 mm layer of calcium-enriched mixture (CEM) cement as a pulp covering agent. After 48 hours, the setting of the CEM cement was verified, followed by the application of a layer of resin-modified glass-ionomer. The tooth was then restored using amalgam. Clinical and radiographic evaluations were conducted at 6-month and 1-year follow-ups by blinded endodontists. Success rates were compared using Fisher's exact test and logistic regression tests with a significance level of 0.05.
RESULTS
Among the 97 patients with 6-month and 1-year follow-ups, all achieved clinical success. Radiographic success rates were 99% at 6 months and 96.9% at 1 year, regardless of pulp calcification. In the 6-month follow-up, success rates were 98.07% for non-calcified pulp chambers and 100% for calcified pulp chambers. At the 1-year follow-up, success rates were 96.1% and 97.8%, respectively. Statistical analysis showed no significant difference in radiographic success rate between the two groups at both follow-ups (>0.05).
CONCLUSIONS
Full pulpotomy using CEM cement is a successful treatment for adult permanent teeth with calcified and non-calcified pulp chambers presenting signs and symptoms of irreversible pulpitis up to a 1-year follow-up. This study provides compelling evidence that vital pulp therapy can be effectively employed in the pulpotomy of calcified teeth, at least in the short term.
PubMed: 38223838
DOI: 10.22037/iej.v19i1.43894 -
Iranian Endodontic Journal 2024This study investigates the influence of root length in mandibular molars with irreversible pulpitis on the success of supplemental intraligamentary injection following...
INTRODUCTION
This study investigates the influence of root length in mandibular molars with irreversible pulpitis on the success of supplemental intraligamentary injection following an inferior alveolar nerve (IAN) block. Various factors, including anatomical location, tooth type, and anesthetic solution, may affect supplemental anesthesia success.
MATERIALS AND METHODS
A total of 251 patients diagnosed with irreversible pulpitis in mandibular first or second molars underwent buccal infiltration anesthesia (4% articaine with 1:100,000 epinephrine) after IAN block injection (3% prilocaine and 0.03 IU/mL of felypressin). Fifty patients experiencing pain during access cavity preparation received supplemental intraligamentary injection (0.3 mL of 2% lidocaine with 1:80,000 epinephrine) at each mesial and distal line angle. The root length of treated teeth was recorded using an apex locator. Data analysis involved independent t-tests, Chi-square tests, and logistic regression.
RESULTS
Successful supplemental intraligamentary injection was observed in 21 (42%) out of 50 patients. No significant correlation was found between the mean length of mesiobuccal (=0.61), mesiolingual (=0.34), or distal (=0.60) canals of mandibular molars and the injection's success. Logistic regression analysis, however, revealed a significant impact of mesiolingual canal length on the success rate [OR 0.09 (0.01-0.79), =0.030].
CONCLUSION
The root length of mandibular first and second molars does not significantly affect the success of supplemental intraligamentary injection.
PubMed: 38223836
DOI: 10.22037/iej.v19i1.42660 -
European Endodontic Journal Aug 2023The purpose of this prospective, randomized clinical trial was to evaluate the effect of cooling a 2% lidocaine solution with 1: 200,000 epinephrine, administered as a... (Randomized Controlled Trial)
Randomized Controlled Trial
Effect of Cooling of Lidocaine with Epinephrine on the Anesthetic Success of Supplementary Intraligamentary Injection after a Failed Primary Inferior Alveolar Nerve Block: A Randomized Controlled Trial.
OBJECTIVE
The purpose of this prospective, randomized clinical trial was to evaluate the effect of cooling a 2% lidocaine solution with 1: 200,000 epinephrine, administered as a supplementary intraligamentary injection to overcome a failed primary inferior alveolar nerve block (IANB).
METHODS
The study was preceded by a pilot study to evaluate the anesthetic efficacy of plain lidocaine solutions given as intraligamentary injections. In the subsequent randomized clinical trial, one hundred and thirty-eight patients received IANB with 2% lidocaine with 1: 80,000 epinephrine for endodontic man- agement of a mandibular molar with symptomatic irreversible pulpitis. Eighty-eight patients reported pain greater than 54 mm on a visual analog scale (Heft-Parker VAS) were categorized as unsuccessful anesthesia. These patients received either of the following intraligamentary injections: 2% lidocaine with 1: 200,000 epinephrine at room temperature; or 2% lidocaine with 1: 200,000 epinephrine at 4°C. Anes- thetic success was again evaluated after re-initiation of the endodontic treatment. The heart rates of the patients were measured using a finger pulse oximeter. The categorical success rates were statistically analyzed with the Pearson chi-square test at 5% significance levels. The heart rate measurements were analyzed using a t-test.
RESULTS
The intraligamentary injections with anesthetic solutions at room temperature presented a suc- cess rate of 59.1%, while the injections with a solution at 4°C gave a success rate of 52.27%. There were no significant differences between the success rates of the groups (χ2=0.41, p=0.52). Regarding the heart rates, there were no differences between the two solutions at baseline (T=1.2, p=0.2) or after injections (T=0.64, p=0.52).
CONCLUSION
Reducing the temperature of 2% lidocaine with 1: 200,000 epinephrine to 4°C does not affect the anesthetic efficacy of supplemental intraligamentary injections, given after a failed primary IANB. (EEJ-2023-03-044).
Topics: Humans; Anesthetics, Local; Epinephrine; Lidocaine; Mandibular Nerve; Nerve Block; Pilot Projects; Prospective Studies
PubMed: 38219038
DOI: 10.14744/eej.2023.41275