Endodontic Treatment Protocol Research Articles

The Impact of Silver Nanoparticles’ Size on Biofilm Eradication

IntroductionEfficient intracanal disinfection is required for a successful regenerative endodontic treatment. Thus, this study aimed to identify the silver nanoparticles’ (NPs) size (AgNPs) with the highest antibiofilm efficacy when mixed with calcium hydroxide [Ca(OH)2] to eradicate an in vitro endodontic biofilm. MethodsThe various sizes of AgNPs and mixtures were characterized by scanning electron microscopy, transmission electron microscopy, and ultraviolet-visible spectroscopy. A total of 168 dentin root segments were prepared, sterilized, and inoculated for 3 weeks with Actinomyces naeslundii and Fusobacterium nucleatum. Samples were randomly allocated to 4 experimental groups (n = 28/group): 2 nm AgNPs + 35% Ca(OH)2, 5 nm AgNPs + 35% Ca(OH)2, 10 nm AgNPs + 35% Ca(OH)2, and 35% Ca(OH)2 alone. Samples exposed to saline and triple antibiotic paste (TAP) acted as negative and positive control groups, respectively. After 1 and 2 weeks, samples were stained with LIVE/DEAD BacLight dye and examined under a confocal laser scanning microscope to determine the proportion of dead bacteria. ResultsThe characterization procedure revealed a spherical NP's structure with minor aggregations. Except for Ca(OH)2 group, all groups had significantly higher antibiofilm efficacy at 2 weeks. Both the 10 nm mixture (99.5%) and TAP (99.2%) exhibited the highest antibiofilm efficacy at 2 weeks and were not significantly different from one another (P > .05). No significant difference was noted between the 2 and 5 nm mixtures at 1 week (81% and 84%) and 2 weeks (89% and 91%). ConclusionThe 10 nm AgNPs (0.02%) + 35% Ca(OH)2 mixture exhibited the highest antibiofilm efficacy at 2 weeks compared to all other mixtures at both observation periods. Interestingly, the 10 nm mixture performed similarly to TAP at 2 weeks. Excluding Ca(OH)2 group, longer application significantly improved the antibiofilm efficacy of all tested medicaments. Clinical RelevanceThe 10 nm AgNPs + 35% Ca(OH)2 mixture revealed promising results as an intracanal medicament in the regenerative endodontic treatment protocol.

Effect of radiotherapy, immediate dentin sealing and irrigation simulating single- or two-visits endodontic treatment on the bond strength to pulp chamber dentin: an in vitro study.

This study aimed to evaluate the influence of radiotherapy and different endodontic treatment protocols on the bond strength to pulp chamber dentin. Eighty mandibular molars were randomly divided into two groups (n = 40): non-irradiated and irradiated (60Gy). The pulp chambers were sectioned, and each group was subdivided (n = 8), according to the endodontic treatment protocol: no treatment (Control); Single-visit; Two-visits; Immediate dentin sealing (IDS) + single-visit; and IDS + two-visits. Each endodontic treatment visit was simulated through irrigation with 2.5% NaOCl, 17% EDTA and distilled water. IDS was performed by actively applying two coats of a universal adhesive to the lateral walls of the pulp chamber. After, the pulp chambers were restored with resin composite and four sticks were obtained for microtensile test. In addition, the dentin of the pulp chamber roof was assessed for surface roughness, chemical composition, and topography after each treatment protocol. Two-way ANOVA, Tukey's post hoc, Mann-Whitney, Kruskal-Wallis and Dunn's post hoc were performed (α = 5%). The treatment protocol affected bond strength (p < 0.05), while the irradiation did not (p > 0.05). The control group presented the highest values (p < 0.05). The single-visit group demonstrated better performance compared to the other groups (p < 0.05), which did not differ from each other (p > 0.05) The use of IDS changed the surface roughness (p < 0.05), chemical composition (p < 0.05) and topography of the dentin. In conclusion, the treatment protocol influenced dentin adhesion, while irradiation did not.

МЕТОДИКА МЕДИЦИНСКОГО СОПРОВОЖДЕНИЯ ПАЦИЕНТОВ ПОСЛЕ ПРОВЕДЕНИЯ ДЕНТАЛЬНОЙ РЕПЛАНТАЦИИ

Modern dentistry is aimed at using minimally invasive interventions to preserve dentition. This fact determines the need for wider use of various types of tooth-preserving operations. In modern conditions, tooth-preserving operations are increasingly being carried out with a predictable successful outcome. Treatment of dental trauma involves complex endodontic or surgical treatment protocols. An important aspect in the rehabilitation of dental injuries is the development of clear diagnostic tactics both at the initial appointment and at all stages of treatment. We observed 127 patients from 2012 to 2022 with diagnoses: complete, incomplete tooth dislocation, uncomplicated or complicated by fractures of the coronal part of the teeth, men and women aged 18 to 40 years. The first group consisted of 66 people with traumatic dislocations of teeth, who sought medical help within 24 hours after the injury, who underwent tooth replantation surgery, endodontic treatment, a complex treatment developed aimed at stopping an acute inflammatory reaction of a post-traumatic nature, and carrying out the necessary splinting measures. The second group consisted of 61 people with traumatic dislocations of teeth who sought medical help after 24 hours or later. Patients in each group were divided into subgroups; in the control subgroups, traditional treatment and rehabilitation after dental replantation were carried out; in the main subgroups, the technique we developed using M-Chip nanomatrices and LED radiation was used. All patients underwent macrohistochemical examination and measurement of dentogingival attachment using a periodontal probe. The results of a macrohistochemical study 7 days after replantation showed that in groups 1b and 2b, whose patients received complex treatment according to the developed method, the area of inflammation of the mucogingival complex was smaller than in patients in groups 1a and 2a, who were treated according to the traditional method. Results of probing of the dentogingival attachment found that in groups 1b and 2b, whose patients received complex treatment using the developed method, the dentogingival attachment corresponds to normal indicators of a healthy periodontal complex than in patients in groups 1a and 2a, who were treated using the traditional method. The inclusion in the complex of rehabilitation measures after dental replantation surgery of drugs that have antiseptic, reparative, hemostatic and immunoadjuvant effects, using LED radiation, increases the effectiveness of these measures by 2-3 times.

ОСОБЕННОСТИ ЭНДОДОНТИЧЕСКОГО ЛЕЧЕНИЯ C УЧЕТОМ ВЫЯВЛЕННОЙ CANDIDA ALBICANS В СИСТЕМЕ КОРНЕВЫХ КАНАЛОВ

The subject of the study was to study the properties of basic means for irrigation and physical methods of influencing the microflora of the root canal system against identified Candida Albicans. The purpose of the work was to review and analyze the features of endodontic dental treatment, taking into account the identified Candida Albicans in the root canal system. A search was conducted in domestic publications and foreign sources for studies containing information on various methods of influencing root canal biofilms during endodontic treatment. A comparison was made of the activity of various irrigants and physical methods of root canal treatment in relation to the identified microflora containing bacteria such as yeast-like fungi of the genus Candida and others. Sodium hypochlorite solution (NaOCl) is a mandatory antiseptic agent included in the recommended endodontic treatment protocol used in modern dentistry. To achieve a successful result, we consider it necessary to perform high-quality mechanical treatment of root canals, competent selection of irrigants, as well as the use of additional physiotherapeutic methods (ultrasound or laser technologies). A bacterioscopic examination of the contents of the root canals was carried out for the presence of yeast-like fungi of the genus Candida. A temporary exposure of a suspension of the drug “Fluconazole” on a paper point was introduced into the root canals at the first stage of endodontic treatment, and the drug “Fluconazole” was prescribed orally at a dose of 150 mg on the first day. Then, in the absence of exudate or odor in the root canals, as well as confirmation by bacterioscopic examination of the absence of yeast-like fungi of the genus Candida, the root canals were filled with permanent material. But despite following all clinical recommendations, in some cases it is not possible to achieve the required effect due to the resistance of biofilms containing Candida albicans, Prevotella melaninogenica, Enterococcus faecalis, Bacteroides fragelis in the root canal system to the effects. Despite the wide variety of endodontic treatment methods and drugs for influencing representatives of the root canal microflora, it is not always possible to achieve complete elimination of biofilm during irrigation and medicinal or physical influence on them. It is especially important to look for ways to modify treatment and make it easier to use and accessible in order to avoid subsequent complications.

Comparison of the removal of intracanal medicaments used in regenerative endodontics from root canal system using needle, ultrasonic, sonic, and laser-activated irrigation systems

This study aimed to compare the syringe-needle irrigation (SNI), passive ultrasonic irrigation (PUI), EDDY, and shock wave–enhanced emission photoacoustic streaming (SWEEPS) techniques regarding calcium hydroxide and double antibiotic paste removal from the root canal in regenerative endodontic treatments. Eighty single-rooted human teeth were decoronated and enlarged up to #100 to stimulate the immature tooth model. Root canals were irrigated with 1.5% sodium hypochlorite followed by saline solution according to the regenerative endodontic treatment protocol. Dressed teeth were divided into 2 main groups regarding the used intracanal medicaments. Calcium hydroxide and double antibiotic paste were introduced to the canals, and teeth were stored for 3 weeks. Each medicament group was divided into 4 subgroups according to the activation techniques. Medicaments were removed using a 17% EDTA solution. Teeth were split longitudinally into two parts. The remaining medicaments were evaluated under a stereo microscope with a scoring system. Data were analyzed with the Kruskal-Wallis and Mann-Whitney U tests. Regardless of the used irrigation activation systems, there was no statistically significant difference between the removal of the CH and DAP from the root canal (P>0.05). While SWEEPS had the highest ability regarding the removal of intracanal medicaments, syringe-needle irrigation had the lowest (P<0.05). There was no statistically significant difference between PUI and EDDY (P>0.05). Complete removal of intracanal medicaments could not be achieved with any techniques. SWEEPS technology was more effective in removing intracanal medicaments in regenerative endodontic treatments compared to the sonic and ultrasonic irrigation activation systems.

Potential applications of the human amniotic membrane in endodontics: A case series of three different procedures

The human amniotic membrane (hAM) is the innermost placental membrane that protects and nourishes the growing fetus. While its use in various oral and maxillofacial procedures is abundant, application in endodontics is relatively new. The present case series describes the application of this therapeutic membrane in three different endodontic procedures – pulpotomy, revascularization, and root-end surgery. In case 1 (pulpotomy), the radicular pulp returned to its uninflamed state, and the patient became asymptomatic at follow-up. In case 2 (revascularization), the patient became asymptomatic; however, there was no increase in the root length and width even after 2 years of follow-up. In case 3, the osseous bone defect was healed entirely at the 6-month follow-up. The application of hAM in different endodontic treatment protocols seems appreciable. A potential limitation of its use has been described in this report. Further clinical trials are warranted to produce better evidence for the same.

Përdorimi i diod lazerit në mjekimin endodontik te periodontitet apikale kronike

The complete elimination of microorganisms from the root canal is difficult due to the complex anatomy of the canal, the microbial invasion of the dentinal tubules, and the for- mation of the intracanal biofilm, which gives rise to contin- uous apical periodontitis. The use of lasers in the treatment of caries complications has led to the improvement of various endodontic diagnoses. The aim is to provide clin- ical-radiological data on increasing the effectiveness and quality of endodontic treatment, using a diode laser with a wavelength of 980 nm and a laser power of 0.8–1.0 W in the radicular canals, in the treatment of chronic apical periodontitis. Materials and methods: Eighty-four patients aged between 20 and 70 years were treated, with a total number of teeth of 91; of these, 64 were mono radicular and 27 multi radicular. We divided the patients into two groups; where the first group was the control one, with 40 patients in which 30 single-root teeth and 11 multi- root teeth were selected and treated with the traditional method by performing chemical-mechanical processes. The second group, which was the study one, treated 44 patients from which 36 single-root teeth with chronic peri- odontitis with periapical destruction and 14 multi-root teeth were selected; in this group, in addition to the chemical-mechanical processes, was also applied the diode laser with a wavelength of 980 nm. The cases were observed clinically and radiologically in dynamics for a period of time ranging from 6 to 12 months. Results: We highlighted that the number of complications in chronic apical periodontitis was reduced to a large per- centage in the diode laser group (study group), which achieved 96 % success after 12 months and 4 % failure. As for the control group, there were many complications in the first 6 months and after 12 months, where the final result was 78.1% success, while complications were 21.9%. Conclusions: The quality of root canal treatment with the traditional endodontic treatment protocol has not been sufficient to achieve a clinical effect for a long time. Modification of this protocol by diode laser processing showed high-quality sterilization of canals and rapid reduction of de- structive focus by stimulating osteogenesis.

Investigation of the Effect of Bleaching on Discolored Teeth After Regenerative Treatment on Fracture Resistance of Teeth

Objective: This study aimed to evaluate the effect of bleaching discolored teeth after regenerative endodontic treatment on fracture resistance. Methods: Forty human maxillary incisors were selected for the study and were divided into four study groups (n=10). Group 1 was called the positive control group, and no treatment was applied. In Group 2; root canals were enlarged to size 6 peezo reamer bur to mimic an immature tooth. The disinfection protocol was performed according to the regenerative endodontic treatment protocol of the American Association of Endodontists. 3 mm thick mineral trioxide aggregate (MTA) was placed at the cementoenamel margin and restored with a temporary restorative material. The samples in group 3 were restored with glass ionomer and composite resin. In Group 4 bleaching was applied with 35% hydrogen peroxide bleaching agent to the samples before restoration with glass ionomer and composite resin. Then each group was applied to the cervical fracture resistance test with a universal testing machine. The fracture resistance values were recorded in Newtons (N), and the obtained data were analyzed statistically. Results: While the highest fracture strength was obtained in group 1 (1092 ±9.27N), the lowest fracture resistance was observed in group 2 (493.8 ±7.60N). The difference between all groups was statistically significant (p&amp;lt;0.05). Conclusion: 35% hydrogen peroxide bleaching agent application after regenerative endodontic treatment reduces fracture resistance of the tooth.

Protection of Pulp Viability with Minimally Invasive Endodontic Treatment Protocols

Protection of Pulp Viability with Minimally Invasive Endodontic Treatment Protocols

Protection of Pulp Viability with Minimally Invasive Endodontic Treatment Protocols

Protection of Pulp Viability with Minimally Invasive Endodontic Treatment Protocols

The standard protocols used for endodontic treatment among dental interns and general dental practitioners in the central region of Saudi Arabia

Background: The primary goal of endodontic therapy is to alleviate pain, prevent infection and re-infection, maintain the functionality of the teeth, and create an environment within the root canal system which allows the healing and continued maintenance of the health of the peri-radicular tissue. This study aims to gather information on routine endodontic treatment among dental interns and general practitioners (GDPs) in the central region of Saudi Arabia. Methodology: An e-questionnaire was distributed among dental interns and GDPs in Saudi Arabia (n = 150). The e-questionnaire questions covered the assessment of knowledge, attitude, and performance toward practicing the proper standards of endodontic treatment in their clinic. Data were analyzed using Statistical Package for the Social Sciences version 22, and the relationships between categorical variables were established using the chi-square test. Results: The response rate was 66%. 32% of the total respondents were female, and 68% were male. All respondents were Saudi, and most were GDPs 57% and 43% were dental interns. No significant difference was found between GDPs and dental interns regarding technique, instruments used, and knowledge related to endodontic treatment protocols (p-value &amp;gt; 0.05). Conclusion: This study highlights some minor points to consider to improve treatment quality provided by dental interns and GDPs for patients in the central region of Saudi Arabia. These include little knowledge regarding endodontic treatment standards that need to be fulfilled, either by educational courses or workshops and to stay updated regarding the protocols and instructions provided by, e.g., the Saudi association of endodontics, American association of endodontics, and other official societies related to endodontics.

Effect of Different Treatment Regimen and Types of Endodontic Sealers on Pain and Periapical Radiographic Changes

INTRODUCTION: The study aims as a pilot study to evaluate the effect of different treatment regimen and different types of endodontic sealers on pain and periapical radiographic changes was studied. MATERIALS AND METHODS: Forty patients in need of an endodontic root canal treatment on anterior teeth were selected and divided into two groups (20 patients each), according to the endodontic treatment protocol (single or multiple visits). Then, each group was subdivided into two subgroups according to sealer used 10 each (AH Plus Jet resin sealer, Total Fill Bioceramic Sealer). To record pain intensity of the patients at different intervals: 1, 2, 3, 7 days, a visual analog scale was used. Furthermore, patients were recalled after 1, 3, 6, 9 months to evaluate periapical radiographic changes. RESULTS: Showed that as regard pain assessment both tested endodontic sealers, as well as single or multiple visits have no statistically significant difference between pain values of patients during all the observation period from immediately post-operative, after 4, 12, 24, 48, 72 h as well as after 7 days (p &gt; 0.05). As regard lamina dura thickness, results showed that with both tested endodontic sealers as well as single or multiple visits, there was no statistically significant difference between lamina dura thickness of patients after 1 month, 3, 6 as well as after 9 months. CONCLUSIONS: Neither number of visits of endodontic treatment nor type of sealer used for obturation affects post-operative pain and thickness of lamina dura.

Evaluation of postoperative pain and periapical healing after single visit endodontic treatment using Rotary Ni-Ti system

Purpose: This study was designed to evaluate the postoperative pain and periapical healing after single and two visits endodontic treatment using twisted file adaptive “TF Adaptive” Ni-Ti rotary system. Subjects and Methods: Twenty patients requiring endodontic treatment for necrotic single rooted teeth with periapical lesion were enrolled in this study. The selected patients were divided into two groups (10 patients each) according to the number of visits; Group І: single visit endodontic treatment and Group ІІ: two visits endodontic treatment. The root canals were prepared using the TF Adaptive system. In group I the obturation was done by modified single-cone technique in a single visit, while in group II the obturation was done in the second visit. Evaluation of postoperative pain at 24, 48 and 72 hours after obturation and periapical healing after 6 and 12 months was done. Results: There was no statistical significant difference between the two groups either in postoperative pain or in the periapical healing.Conclusion: Single visit and two visits endodontic treatment protocols were comparable regarding the incidence of postoperative pain and periapical healing

КЛИНИЧЕСКИЙ ПРИМЕР ПРИМЕНЕНИЯ ГИДРОКИНЕТИЧЕСКОГО ЛАЗЕРА WATERLASE IPLUS С ДЛИНОЙ ВОЛНЫ 2780 НМ ПРИ ЛЕЧЕНИИ ГНОЙНОГО ПУЛЬПИТА

The article presents a clinical example demonstrating the tactics of using the hydrokinetic Er, Cr:YSGG laser Waterlase Iplus with a wavelength of 2780 nm in the treatment of purulent pulpitis. The authors were faced with the task of showing the elimination of microorganisms in the treatment of purulent pulpitis, as well as the long-term results of endodontic treatment, using a specific clinical example. Objective is to describe the clinical features and effectiveness of the use of the hydrokinetic Er, Cr:YSGG Waterlase Iplus laser with a wavelength of 2780 nm in the treatment of purulent pulpitis. The patient was treated in one visit, aqua destillata was used with irrigation solution, the root canals of the teeth were sterilized with a hydrokinetic Er, Cr:YSGG laser Waterlase Iplus with a wavelength of 2780 nm with the parameters: power-1.5 W, frequency-40 Hz, air-35%, water-25%. Bacteriological examination after mechanical and laser treatment showed antibacterial decontamination of the root canal system of the tooth. According to the X-ray examination, 6 months after the treatment, there was no inflammatory process in the periodontal tissues. The use of a hydrokinetic Er, Cr: YSGG laser with a wavelength of 2780 nm in the treatment of complicated forms of dental caries is a reliable alternative to traditional endodontic treatment protocols, allowing you to reduce the amount of irrigation solutions used, intra-channel pastes, as well as initiate faster rehabilitation of patients after treatment.

Assessment of Practice of Endodontic Treatment Protocols among General Dental Practitioners in Pokhara, Nepal

Introduction: Endodontics is specialty field, but the majority of endodontic treatment in Pokhara is provided by the general dental practitioners. The aim of this study was to assess the practice of endodontic treatment protocols among general dental practitioners in Pokhara, Nepal. &#x0D; Materials and Methods: A cross sectional questionnaire based study was conducted among all the general dental practitioners working in various government, private hospital and clinic of Pokhara. Information about the materials and techniques used in endodontic treatment was collected and descriptive statistical analysis was done. &#x0D; Results: Out of 89 respondents, only 82 completely filled the questionnaires which were included in the study. Most general dental practitioners (96.34%) regularly treat single rooted endodontic cases. Only 10.97% occasionally use rubber dam during endodontic treatment. Most general dental practitioners (96.34%) used radiographic technique for working length determination. Ninety two percent used stainless steel hand files and step back was the choice of technique by 90.24%. Sodium hypochlorite irrigation and calcium hydroxide intra canal medicaments were used by 93.9% and 98.78% of general dental practitioners respectively. 75.6% used zinc oxide eugenol as root canal sealer and 95.12% obturated root canals with lateral compaction technique. The common complication encountered was mid treatment pain. They seem to overuse antibiotics in cases requiring endodontic therapy. Only 52.43% used autoclave for sterilization of endodontic files. About 92.68% felt the need of further endodontic training and 74.39% preferred post graduate program. &#x0D; Conclusion: This study indicates that many general dental practitioners of Pokhara are not following well acknowledged endodontic quality guidelines; hence there is a need for further endodontic training.

Effect of endodontic treatment on periodontal healing of grade 3 endo-periodontal lesions without root damage in periodontally compromised patients\u2014a retrospective pilot study

ObjectivesThere is little evidence about the effect of different treatment protocols for grade 3 endo-periodontal lesions without root damage in patients with periodontitis according to the new classification of periodontal disease. The aim of this study is to evaluate the impact of endodontic treatment on the achievement of periodontal healing.Materials and methodsTeeth with the initial diagnosis endo-periodontal lesion without root damage grade 3, treated with a standardized endodontic treatment protocol, were included in this study. A retrospective analysis was performed to assess the impact on periodontal healing by evaluating probing pocket depth (PPD), clinical attachment gain (CAL), and periapical index score (PAI).ResultsNineteen teeth and 13 patients were included. A mean reduction of 3.19 ± 3.41 mm in PPD was recorded. The mean CAL gain was 2.33± 3.75 mm. Five teeth (45.4%) showed an improvement of PAI and were classified as treatment success.ConclusionsThe results failed to show a highly predictable treatment outcome for endo-periodontal lesion grade 3 without root damage in patients with periodontitis. However, endodontic therapy alone resulted in treatment success for some of the teeth, which would otherwise have had a poor prognosis.Clinical relevanceEndo-periodontal lesions can often be challenging for dentists in daily clinical practice. To date, there is not much evidence for practitioners to rely on. Therefore, this study aims to strengthen the evidence for the management and treatment of endo-periodontal lesions. Although the outcome is not highly predictable yet, teeth with the initial diagnosis endo-periodontal lesion without root damage grade 3 can benefit from an endodontic treatment.

Photodynamic therapy for endodontic treatment of primary teeth: A randomized controlled clinical trial.

This study aimed to evaluate the reduction in bacterial load following conventional endodontic treatment with and without antimicrobial photodynamic therapy (a-PDT) in primary teeth. Thirty primary anterior teeth with a diagnosis of pulp necrosis were selected. Patients were randomly allocated to two groups as follows: Group I, patients undergoing conventional root canal therapy (n = 15) and Group II, patients undergoing conventional root canal therapy combined with antimicrobial PDT (n = 15). For PDT, methylene blue, at a concentration of 0.005 %, was used as the photosensitizing agent, which was applied to the interior of the canal with a sterile paper cone for 3 min, followed by the administration of laser light for 40 s (wavelength: 660 nm, energy density: 4 J/cm², power: 100 mW), delivered in direct contact at the entrance to the root canal. Two microbiological samples of the intra-canal content were taken (one before and one immediately after treatment in both groups) using paper cones. Clinical follow-up involved the investigation of fistulas and mobility and was performed 1- and 3 months after treatment. Data were statistically analyzed. The reduction in bacterial load was 93 % in Group I and 99 % in Group II, with no statistically significant difference. Conventional treatment combined with antimicrobial PDT with parameters used in this study proved effective but presented equal efficacious capability to conventional endodontic treatment alone. The use of PDT has been studied in endodontic treatment protocols in permanent teeth. However, clinical trials in deciduous teeth are necessary for establishing the effectiveness and parameters of this application. The present study analyzes the results of PDT in the endodontic treatment of deciduous teeth.

A retrospective assessment of different endodontic treatment protocols.

BackgroundThe aim of this study was to assess the clinical impact of non-surgical root canal treatments (NSRCT) performed with different treatment protocols on the probability of tooth survival without untoward events and to identify predictors influencing the outcome.MethodsDuring the period from July 1999 to October 2016, 5,858 patients were identified in which 9,967 NSRCTs were performed. The treatments were followed up and divided into three groups. In Group 1 root canal treatment was performed with hand instruments, in Group 2 with multiple file rotary instruments and passive ultrasonic irrigation (PUI), and Group 3 was treated with Reciproc instruments and PUI. Untoward events were defined as orthograde retreatment, apicoectomy or extraction of the tooth after initial treatment. Weibull regression was used to analyse the data.ResultsA total of 9,938 cases could be included into the analyses. The results showed 5-years predicted survival rates without untoward events of 73.9% (95% CI [71.7%–76.1%]), 75.1% (95% CI [71.7%–78.0%]) and 78.4% (95% CI [75.1%–81.4%]) for study group 1 (N = 5,580), 2 (N = 1,700) and 3 (N = 2,658), respectively. The differences between Group 1 and 3 were statistically significant (p < 0.006). Higher age of the patient (per year increase) and number of earlier NSRCTs (per unit increase) reduce the survival without untoward events statistically significant (both p < 0.02), while treatment of premolars had a statistically significant lower hazard ratio [0.89 (95% CI [0.79–0.99]; p = 0.030)] compared to treatment of molars and anterior teeth. A higher number of supportive periodontal treatments (per unit increase) improved tooth survival without untoward events highly significant (p < 0.0001).DiscussionMore recent endodontic treatment protocols involving reciprocating instruments and PUI appear to be associated with higher tooth survival rates without untoward events compared to hand instruments.

Managing post endodontic treatment pain by eliminating occlusal contacts.

Data sources Forty-four adult patients (32 female : 12 males) with irreversible pulpitis with periapical periodontitis on a mandibular posterior tooth, who were undergoing a two-visit endodontic treatment protocol, were randomly divided into two groups. The intervention group (n = 22) had occlusal surface reduced on the treated tooth and a control group (n = 22) did not.Data The primary outcome was pain intensity after endodontic treament, which was measured on a visual-analogue-scale (VAS). This was measured 6, 12, 24 and 48 hours after the first visit, and 6, then 12 hours after the second visit.The study also investigated the proportion of patients who took post-operative analgesic tablets.Results Pain intensity 12 hours after the first and second visits were statistically significantly lower in the intervention group compared to the control group. The proportion of patients who recorded taking analgesics was not significantly different between the two groups.Conclusions Occlusal reduction seems to reduce levels of post root- treatment pain in posterior mandibular teeth 12 hours postopertively, but otherwise makes little difference.

Endodontic Tendencies in a Very-Low-Income Population Area of Northeastern Brazil.

Aim To gather information regarding endodontic treatment protocols and continuing education attendance of dentists in some cities located in Northeastern Brazil (Sergipe and Bahia States), a region that comprises a very-low-income population. Methods A questionnaire containing different questions (e.g., routine treatment protocols, the use of new technologies, time required to conclude the treatment, and attendance in an endodontic continuing education) was distributed to 250 dentists. The collected data were analyzed through descriptive statistics and Poisson regression (p < 0.05). Results A total of 199 dentists practicing endodontic treatment in the cities of Aracaju (n = 58), Salvador (n = 83), and towns of Estância (n = 8), Itabaiana (n = 16), Itabaianinha (n = 5), Lagarto (n = 10), Ribeirópolis (n = 3), Simão Dias (n = 6), and Tobias Barreto (n = 10) participated in this research. Most of the respondents have concluded their graduation in Dentistry in less than 10 years (62.3%), with nearly 75.4% of the sample having attended postgraduation education in the field. Regarding treatment protocols, the frequency for using rotary/reciprocating systems and for always using rubber dam isolation during root canal treatment (RCT) was 78% and 62%, respectively, which was also more prevalent among dentists who attended a continuous education program (p < 0.05). Lastly, the professionals who attended (p < 0.05) to a continuous education program in Endodontics were more frequently associated to performing incisors and molars RCT in one clinical appointment (p < 0.05).Conclusions The results of this survey indicated that even in an area where most of the population has low-income conditions, the professionals are seeking for knowledge by attending to postgraduation programs, following the new tendencies in Endodontics with most of the professionals having employed technological resources.