Requiring Root Canal Treatment Research Articles

The efficacy of premixed bioceramic sealers versus standard sealers on root canal treatment outcome, extrusion rate and post-obturation pain: A systematic review and meta-analysis.

Limited evidence is available regarding the superior clinical properties of bioceramic sealers comparted with traditional standard sealers. This review aimed to answer the following research questions: 'In healthy patients requiring a root canal treatment (P), what is the efficacy of premixed bioceramic sealers (I) compared with traditional root canal epoxy resin-based sealers (C) in terms of survival, success rates (PICO1) sealer extrusion and resorption (PICO2) post-obturation pain (PICO3) (O)?' Authors independently searched three electronic databases: PubMed (including MEDLINE), Web of Science, Embase and Scopus up to 31 October 2023. This was accompanied by both grey literature and manual search. Detailed selection criteria were applied, namely mature permanent teeth requiring root canal treatment, premixed bioceramic sealer with gutta-percha as an intervention group, a standard filling technique as control group and full-text available in English. A random-effect meta-analysis was used to synthesize the body of evidence regarding the use of bioceramic sealers in root canal treatment and their impact on post-obturation pain. Effect sizes were represented as relative risks on a logarithmic scale for binary outcomes and as mean differences for continuous outcomes. A total of 941 articles were identified. Fifteen Comparative clinical studies were finally included. Eleven were randomized clinical trials, and four were prospective clinical trials with control group. The follow-up of these studies was not greater than 2 years. No publication bias was observed in any study. No significant differences were observed between the two groups in terms of survival and success rates. A small non-significant lower risk of extrusion was observed for bioceramics. A small, non-significantly lower post-operative-pain within 24-h was observed when bioceramics were used. The majority of current evidence shows inconsistencies in reporting and is of short-term duration. Robust prospective long-term trials are needed in this area to better support future recommendations. This systematic review is the first to analyse several clinical outcomes using premixed sealers. Included studies differed in terms of clinical protocol and operator expertise, but reported a similar outcome when comparing bioceramic versus standard sealers. Tooth survival, treatment outcome, post-operative pain and periapical extrusion were similar and presented no significant differences between the two sealer types. PROSPERO database (CRD42023449151).

Effect of Occlusal Reduction on Postoperative Pain during Root Canal Treatment in Teeth with Symptomatic Apical Periodontitis

INTRODUCTION: Pain management after root canal treatment is a very important issue in clinical practice. Occlusal reduction has been widely used after root canal treatment to reduce post treatment pain and flare up. The purpose of this study was to evaluate the effect of occlusal reduction on postoperative pain in teeth with symptomatic apical periodontitis. MATERIALS AND METHODS: Seventy mandibular molar teeth with symptomatic apical periodontitis requiring root canal treatment were included in this study. Each patient who met the inclusion criteria had a serial number allocated, ranging from 1 to 70. The patients were divided into two groups i.e, occlusal reduction group and without occlusal reduction group according to the odd and even numbers on the list. After administration of local anesthesia, the root canals were instrumented, and an intracanal calcium hydroxide dressing was placed. Following confirmation with articulating paper, occlusal reduction group received a 2 mm reduction in occlusal contacts. Preoperative pain before start of the procedure and postoperative pain 6 days after instrumentation were recorded on visual analogue scale. Data was evaluated by chi-square test and Man Whitney U test with p-value <0.05 considered as statistically significant. RESULTS: There was no significant difference in postoperative pain between two groups (p>0.05) after root canal preparation. CONCLUSIONS: Occlusal surface reduction did not provide any further reduction in postoperative pain for teeth with symptomatic apical periodontitis compared with no occlusal reduction

Indications for root canal treatment following traumatic dental injuries to permanent teeth.

The dental pulp may respond favourably or unfavourably to traumatic dental injuries. The most serious unfavourable responses are pulp necrosis and infection of the root canal system. These cause apical periodontitis and/or external inflammatory resorption of the tooth. The following injuries require root canal treatment as part of their emergency management-(A) complicated crown fractures (but some may be suitable for conservative pulp treatments, such as pulp capping, partial pulpotomy or pulpotomy), (B) complicated crown-root fractures, (C) supra-crestal coronal third root fractures and (D) injuries where pulp necrosis is predictable or highly likely to occur AND where there has been damage to the root surface and/or periodontal ligament with the aim of preventing external inflammatory resorption. This latter group of injuries are avulsion, intrusion, lateral luxation with a crown fracture, extrusion with a crown fracture (all in fully developed teeth) plus avulsion with a crown fracture and intrusion with a crown fracture (both in incompletely developed teeth). All other injuries should not have root canal treatment commenced as part of the emergency management, but they must be reviewed regularly to monitor the pulp for any adverse changes to its status, particularly pulp necrosis and infection of the root canal system.

Reliability of clinical examination methods for postoperative pain after primary root canal treatment

Background/purposeClinical test results may have lower reliability due to the varying range of test stimulation or patient subjectiveness. This study aimed to verify a reliable clinical test method by comparing pain intensity levels of a tooth at rest, during function, and after the clinical tests of percussion and chewing. Materials and methodsA total of 36 asymptomatic necrotic teeth that required root canal treatment, one in each patient, were included. All treatment procedures were performed in a single visit by an experienced endodontist. Patients were asked to mark their pain levels on a vertical visual analog scale (VAS) while the relevant tooth was at rest and during function 24 h after the treatment. In addition, patients marked their pain levels after the clinical tests of percussion and chewing. Finally, the pain levels were compared using Pearson's correlation for the reliability of the test methods at a significance level of 95%. ResultsThe postoperative pain levels measured during the clinical tests and functions were significantly higher than the pain levels at rest (P < 0.05). The pain levels after percussion tests were significantly higher than that during the function and chewing tests (P < 0.05). Pain intensity during the function was simulated with a higher correlation when using the chewing strip method rather than the percussion method. ConclusionThe bite test using the chewing strips as a pain intensity assessment can mimic the actual postoperative pain experience, whereas the percussion test fails to provide the accuracy of this pain experience.

Comparative evaluation of the depth of penetration and postoperative pain associated with the use of continuous chelation using HEBP and standard irrigation protocol in the endodontic treatment of adult permanent nonvital teeth: A randomized controlled trial

ABSTRACT Aim: To evaluate and compare the apical depth of penetration and postoperative pain associated with the use of 9% 1-Hydroxyethylidene-1, 1-Bisphosphonate (HEBP) along with 3% sodium hypochlorite (NaOCl) as continuous chelation and standard irrigation protocol in endodontic treatment of adult permanent nonvital teeth. Methods: In this parallel arm double-blind single-center randomized controlled trial, standard irrigation protocol was compared to continuous chelation protocol (HEBP/NaOCl combination) with respect to the apical depth of penetration of irrigant and the postoperative pain. Forty-six patients aged between 18 and 45 years presenting with nonvital teeth requiring root canal treatment were randomly divided into two groups (n = 23) based on irrigation regime. After the final irrigation protocol, the apical depth of penetration of the irrigant was evaluated using a radiovisiography and radiopaque dye. Postoperative pain levels were evaluated at 6 h and 24 h after treatment using the numerical rating scale. Results: The results revealed that there was no statistically significant difference between the two groups in terms of the apical depth of penetration of the irrigant. While, with respect to postoperative pain, a statistically significant difference was found between the two groups at 24 h, with lower pain values observed in the continuous chelation group. Conclusion: The use of soft chelating agents like HEBP in continuous chelation has the apical depth of penetration comparable to that of ethylenediaminetetraacetic acid (EDTA) in standard irrigation protocol with lower postoperative pain at 24 h. Therefore, HEBP with NaOCl in continuous chelation can be seen as a viable, economical, and less technique-sensitive alternative to the use of EDTA for an effective three-dimensional disinfection of the root canal system up to the apical third of the root, which can be easily incorporated into daily clinical practice.

Comparison of postoperative pain reduction following laser, ultrasonic activation and conventional needle irrigation after root canal treatment - A randomized clinical trial.

To compare the incidence of postoperative pain and analgesic intake on the administration of passive ultrasonic irrigation (PUI) using IrriSafeTM, laser-activated irrigation (LAI) using Er:Cr: YSGG in comparison to conventional needle irrigation (CNI) in participants diagnosed with symptomatic irreversible pulpitis (SIP). In this randomised double-blinded parallel trial, 75 participants requiring root canal treatment in mandibular first molars diagnosed with SIP were enrolled. A 10 cm visual analogue scale (VAS) was used for pain assessment and patients presented with a preoperative pain score of 5 cm and above were only selected. After biomechanical preparation, the final irrigation protocols varied based on the irrigation protocol employed. In CNI, intracanal irrigation was conducted without agitation using a 31G side vented needle. In PUI, irrigant activation was conducted using IrriSafeTM and in LAI, irrigant activation was conducted using a pulsed Er:Cr: YSGG (2940 nm) laser with radial firing tip (RFT - 2). The pain scores and analgesic intake were assessed postoperatively after obturation at 6, 24 and 48 h. A significant reduction in postoperative pain levels and analgesic intake was seen among all groups at assessed time intervals (p<0.05). Overall, mean postoperative pain scores and analgesic intake were CNI>LAI>PUI (p<0.05) respectively. Participants diagnosed with SIP receiving PUI and LAI showed low and comparable levels of postoperative pain scores. Based on the analgesic intake, PUI showed the least analgesic intake when compared to LAI and CNI respectively. Key words:Endodontics, Root canal irrigants, Postoperative Pain, Passive ultrasonic activation, Laser ultrasonic activation.

Factors associated with postoperative signs and symptoms in teeth with periapical lesion: a longitudinal study.

This study aimed to evaluate the association of the variables age, gender, arch position, tooth length, root canal amplitude, and periapical lesion size with the occurrence of postoperative signs and symptoms (pain, tenderness, and edema) and the use of postoperative analgesics following root canal treatment with foraminal enlargement in single-rooted teeth with apical periodontitis. This prospective longitudinal study included 105 patients requiring root canal treatment of maxillary or mandibular single-rooted teeth with periapical lesion. After root canal treatment in a single session, pain intensity and tenderness were recorded daily for 7 days and on days 14 and 30. Edema was evaluated by two independent evaluators within 48 h, 72 h, and 7 days after treatment. Ordinal and logistic regressions were performed (p < 0.05). Female gender (beta = 1.02; p < 0.01), mandibular teeth (beta = 25.50; p < 0.01), medium root canal amplitude (beta = 0.93; p = 0.03), and edema (beta = 1.88; p < 0.01) were associated with increased postoperative pain and tenderness, while the use of analgesics (beta = -1.82; p < 0.01) and time in days (beta = -0.23; p < 0.01) were associated with a decrease in these signs and symptoms. Edema was considered a risk factor for analgesic requirement (Odds Ratio [OR] = 61.46; p < 0.01). Factors such as gender, arch position, and root canal amplitude were associated with postoperative signs and symptoms. The use of analgesics was more required in edema and was associated with decreased pain.

The use of electrodermal activity in pulpal diagnosis and dental pain assessment.

To explore whether electrodermal activity (EDA) can serve as a complementary tool for pulpal diagnosis (Aim 1) and an objective metric to assess dental pain before and after local anaesthesia (Aim 2). A total of 53 subjects (189 teeth) and 14 subjects (14 teeth) were recruited for Aim 1 and Aim 2, respectively. We recorded EDA using commercially available devices, PowerLab and Galvanic Skin Response (GSR) Amplifier, in conjunction with cold and electric pulp testing (EPT). Participants rated their level of sensation on a 0-10 visual analogue scale (VAS) after each test. We recorded EPT-stimulated EDA activity before and after the administration of local anaesthesia for participants who required root canal treatment (RCT) due to painful pulpitis. The raw data were converted to the time-varying index of sympathetic activity (TVSymp), a sensitive and specific parameter of EDA. Statistical analysis was performed using Python 3.6 and its Scikit-post hoc library. Electrodermal activity was upregulated by the stimuli of cold and EPT testing in the normal pulp. TVSymp signals were significantly increased in vital pulp compared to necrotic pulp by both cold test and EPT. Teeth that exhibited intensive sensitivity to cold with or without lingering pain had increased peak numbers of TVSymp than teeth with mild sensation to cold. Pre- and post-anaesthesia EDA activity and VAS scores were recorded in patients with painful pulpitis. Post-anaesthesia EDA signals were significantly lower compared to pre-anaesthesia levels. Approximately 71% of patients (10 of 14 patients) experienced no pain during treatment and reported VAS score of 0 or 1. The majority of patients (10 of 14) showed a reduction of TVSymp after the administration of anaesthesia. Two of three patients who experienced increased pain during RCT (post-treatment VAS > pre-treatment VAS) exhibited increased post-anaesthesia TVSymp. Our data show promising results for using EDA in pulpal diagnosis and for assessing dental pain. Whilst our testing was limited to subjects who had adequate communication skills, our future goal is to be able to use this technology to aid in the endodontic diagnosis of patients who have limited communication ability.

Characteristics of Cracked Teeth with Reversible Pulpitis After Orthodontic Banding—A Prospective Cohort Study

IntroductionCracked teeth with reversible pulpitis can be managed with orthodontic bands in the interim before definitive restorations. The aim of this study was to determine short-term outcomes of these teeth following orthodontic band placement. The time taken for definitive pulp diagnoses after orthodontic band placement and associated prognostic factors was also analyzed. MethodsOne hundred twenty-five patients with a cracked tooth with reversible pulpitis each were recruited. Preoperative data including patient and tooth factors were collected. Cracked teeth were banded and reviewed until symptoms resolved before referral for coronal coverage. Kaplan-Meier and Cox analyses were performed to analyze pulp survival of these teeth. Prognostic factors were investigated using Pearson's chi-square and Student's t-test. ResultsOne hundred twenty-two cracked teeth were analyzed. One hundred thirteen (92.6%) teeth had the pulpitis resolved within 2 months (median 40.0; interquartile range 28–61). The median time taken for progression to irreversible pulpitis or pulp necrosis for teeth that required root canal treatment was 3 months (median 90.0; interquartile range 68–110). No prognostic factors were associated with the resolution of pulpal symptoms. However, higher preoperative triggered pain scores (P < .05, hazards ratio 1.547) and absence of a distal marginal ridge crack (P < .05, hazards ratio 0.638) were correlated with a longer duration before definitive pulp diagnoses. ConclusionFollowing orthodontic band placement, a normal pulp diagnosis was achieved in 92.6% of cracked teeth with preoperative reversible pulpitis. Definitive pulp diagnoses could be determined in approximately 2 months. Teeth with higher preoperative triggered pain scores may require a longer review period.

Effect of Ultrasonic and Diode Laser Irrigation Activation on Post-operative Pain and Microbial Reduction in Single Visit Endodontic Treatment of Necrotic Mandibular Molars

Aim: To clinically evaluate the effect of continuous ultrasonic and diode laser 810 wave length irrigation activation techniques on postoperative pain and bacterial reduction in single visit endodontic treatment of mandibular molars.&#x0D; Material and methods: Forty patients requiring root canal treatment therapy for necrotic mandibular molars teeth were included in this study with age ranges between 20 and 45 years. In all cases, single visit endodontic treatment was carried out using Revo-S rotary file system in crown down sequence. NaOCl 2.5% irrigation solution was used during treatment. Patients were randomly and equally assigned into two groups according to irrigation technique. Group (1): conventional syringe irrigation and group (2): continuous ultrasonic irrigation. Each group was subdivided into two sub groups (n = 10); subgroup 1A (conventional syringe irrigation with no laser), subgroup 1B (conventional syringe irrigation with diode laser), subgroup 2A (continuous ultrasonic irrigation with no laser) and subgroup 2B (continuous ultrasonic irrigation with diode laser).&#x0D; Postoperative pain evaluation was done using Visual Analogue Scale (VAS) at 6, 12, 24, 36, 48 hours and 7 days postoperatively. Microbiological detection of bacterial reduction was done by taking Samples (S1 and S2) for bacterial cultures. S1 after finishing access cavity and before mechanical preparation and S2 after finishing mechanical preparation and irrigation activation and before obturation. Samples were cultured on blood agar and determined as colony forming units (CFU/mL). Microbiological bacterial reduction was calculated accordingly. Statistical analyses were analyzed using the Mann-Whitney U test. The significance level was set at p &lt; 0.05.&#x0D; Results: In all sub groups, postoperative pain decreased by time in all time intervals but pain was significantly lower in subgroup (2B) (continuous ultrasonic irrigation with diode laser) than subgroup (1A) (conventional syringe irrigation with no laser) in all time interval. Microbiological results showed the highest bacterial reduction was in subgroup (2B) (continuous ultrasonic irrigation with diode laser) and least bacterial reduction was in subgroup (1A) (conventional syringe irrigation with no laser).&#x0D; Conclusion: Using diode laser and continuous ultrasonic irrigation activation techniques as adjunctive methods showed improvement in postoperative pain records and enhanced bacterial reduction in root canal therapy.&#x0D; Keywords: Continuous ultrasonic irrigation, diode laser 810, post-operative pain, bacterial reduction, single visit endodontic treatment.

Apical periodontitis after intense bruxism

BackgroundBruxism is known to cause masticatory muscle pain, temporomandibular joint pain, headaches, mechanical tooth wear, prosthodontic complications and cracked teeth. Less known to the practitioner, and described only experimentally in literature, is that bruxism can also damage the pulp. To our knowledge, this is the first known clinical case of a patient developing apical periodontitis due to bruxism.Case presentationThis article presents the case and successful treatment of a 28-year-old healthy male patient with apical periodontitis on teeth 36 and 46 requiring root canal treatment after an intense phase of bruxism. Due to an unclear diagnosis, treatment had been delayed.ConclusionsIncomprehensible tooth pain can be the result of bruxism. Practitioners need to be informed that intense bruxism can possibly lead to apical periodontitis. It is important, therefore, that a thorough anamnesis is collected and taken into account during diagnostics.

Rapid prototyping-assisted tooth autotransplantation is associated with a reduced root canal treatment rate: a retrospective cohort study

BackgroundAutotransplantation is a beneficial treatment with a high success rate for young patients. However, most adult patients require root canal treatment (RCT) of the donor teeth after the autotransplantation procedure, which causes a prolonged treatment time and additional expenses and increases the rate of future tooth fracture. Rapid prototyping (RP)-assisted autotransplantation shortens the extra-alveolar time and enables a superior clinical outcome. However, no cohort studies of the application of this method on adult populations have been reported.MethodsThis study is a retrospective cohort study. All patients underwent autotransplantation from 2012 to 2020 in the Kaohsiung and Chia-Yi branches of Chang Gung Memorial Hospital, and the procedure and clinical outcomes were analysed. Differences in clinical outcomes, age, sex, extra-alveolar time, fixation method, and RCT rate were compared between the two groups.ResultsWe enrolled 21 patients, 13 treated using the conventional method and 8 treated using the RP-based technique. The RCT rates of the conventional group and RP group were 92.3% and 59%, respectively. The mean age of the two groups was significantly different (28.8 ± 10 vs. 21.6 ± 2.1); after performing subgroup analysis by excluding all of the patients aged > 40 years, we found that the RCT rates were still significantly different (91.0% vs. 50%). The mean extra-alveolar time was 43 s in the RP group, and the autotransplantation survival rate in both groups was 100%.ConclusionsRapid prototyping-assisted autotransplantation was successfully adopted for all patients in our study population. By shortening the extra-alveolar time, only 50% of the patients required a root canal treatment with a 100% autotransplantation survival rate.Trial Registration : Retrospectively registered.

Radioimaging in the Evaluation of the Therapeutic Effect of the Vegetable Extract Obtained from Epilobium Parviflorum Schreb

For years, apical microleakage has been considered the main factor in endodontic failure therapy. Sealing abilities and antibacterial properties of root canal sealers and intracanal medicaments between appointments have been recognized as important factors for the success of endodontic treatment. Background: Apical periodontitis (AP) is an inflammatory disease around the apex of a tooth root. The microorganisms reach the pulp by dentinal tubules especially when there is an open cavity after a coronal fracture and the pulp is in contact with the septic oral environment. The aim of the study was to evaluate the dynamics of healing by recording periapical index (PAI), after two appointment endodontic procedure with commercial or experimental intracanal medicament. Methods: A total of 40 patients with primary chronic apical periodontitis requiring root canal treatment were assigned randomly into four groups according to the teeth medicated with dehydrated plant extract, calcium hydroxide, calcium hydroxide mixed with chlorhexidine (CHX) gel 2%, Walkhoff paste and obturated on a second visit, 7 days later. Patients were recalled at intervals of 3, 6, and 12 months to evaluate the treated teeth both clinically and radiographically for periapical healing. A 5-score scale PAI was used to evaluate stages of the periapical healing on a periapical radiography using a Kodak Dental imaging software provided by the radio-imagistic center. Results: Radiological evaluation revealed that the experimental intracanal medicament had a cumulative positive healing capacity by reducing the PAI as well as all resorbable pastes used in endodontic conventional therapy. Conclusions: The results suggest that the vegetable dry extract obtained from Epilobium parviflorum Schreb can be used as an inter-appointment medication among with the root canal filling for the positive effect on apical healing quantified by reducing the PAI.

Assessment of sCD14 levels in patients with endodontic pathology requiring root canal treatment

Assessment of sCD14 levels in patients with endodontic pathology requiring root canal treatment

Perfil microbiano de los conductos radiculares de dientes con infección pulpar en ghaneses

Introduction: Pulpal and periapical infections are initiated by microorganisms when they gain access to the dental pulp. The success of root canal treatment principally depends on the eradication of the micro-organisms in the root canal system. The aim of this study was to evaluate the viable microbial profile of root canals with various stages of infection in Ghanaians. Material and Methods: Forty-four consecutive patients with sixty teeth referred to the Restorative Dentistry Clinic requiring root canal treatment were recruited. Root canal samples were collected from the teeth with sterile paper points. The samples were processed and subjected to microbial analysis and identification using Matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry (MS). Results: A total of 259 isolates were recovered from the 60 infected root canals, belonging to twenty different microbial genera. Out of the 259 microbial species isolated, only two were Candida albicans, a fungi; 257 (99.2%) were bacterial isolates belonging to 19 genera. The 19 genera encompassed 53 bacterial species, out of which 26 (49.1%) were identified as facultative anaerobes, 15 (28.3 %.) as obligate anaerobes and 12 (22.6%) were aerobes. Streptococcus species (Streptococcus oralis, Streptococcus mitis, Streptococcus mutans and Streptococcus constellatus) were the most predominant isolates, followed by Prevotella sp, Actinomyces sp, Enterococcus faecalis and Rothia sp respectively. Conclusion: The findings of this study show that infected root canals are polymicrobial in nature. The determination of the microbial profile aids in understanding the pathogenesis of pulpal and periradicular infections and helps in choosing effective antimicrobial irrigation and medicament for root canal treatment.

Does bidirectional splinting improve outcomes in cracked teeth with reversible pulpitis?

Aim To investigate the success rate of 'bidirectional' splinting - both internal and external - of teeth with longitudinal cracks and reversible pulpitis, as well as to identify any signs or symptoms that could give a prognostic indication of success.Design Cohort study.Cohort selection Thirty-four teeth from 33 patients visiting the Department of Conservative Dentistry at the Yonsei University Dental Hospital, Seoul, South Korea, between June 2016 and November 2017, diagnosed with longitudinal cracked teeth with reversible pulpitis. Teeth with signs of pulp necrosis, irreversible pulpitis or other types of longitudinal cracks were excluded.Data analysis These teeth were treated by a systematic protocol of initial external splinting with a metal band, crack removal and internal splinting with composite resin, placement of a temporary crown, before a final permanent crown. Symptoms and vitality were assessed at every stage and root canal treatment provided where deemed necessary. The teeth were then followed up for up to four years to assess tooth survival and pulp vitality.Results Accounting for five dropouts during the treatment protocol, 29 teeth reached at least a one-year recall. Of these, 21 (72%) had pulp survival, eight (28%) had required root canal treatment - six of those before final crown cementation - and zero teeth required extraction (100% survival rate). Cracked teeth without initial tenderness to percussion showed a 94% pulp survival rate, while those with tenderness had only a 46% pulp survival rate.Conclusions A systematic approach to treating cracked teeth with reversible pulpitis should be utilised to maintain tooth vitality and survival. Using a bidirectional splinting method provides good outcomes for these teeth. Tenderness to percussion is a significant prognostic indicator of pulp vitality and whether root canal treatment should be initiated.

SOS teeth with advanced caries and sociodemographic indicators, health-related habits and dental attendance patterns: data from the Dental, Oral, Medical Epidemiological (DOME) nationwide records-based study

Background"SOS teeth" are teeth that need to be treated first, and represent dental teeth with deep caries seen clinically and radiographically which may require root canal treatment or extraction. The aims of the present research were to study the associations of SOS teeth with: socio-demographic parameters, dental attendance patterns, health-related habits among young to middle-aged adults.MethodsThis cross-sectional records-based research analyzed data from the Dental, Oral, Medical Epidemiological (DOME) repository that captures comprehensive socio-demographic, medical, and dental databases of a nationwide sample of 132,529 records of dental attendees to military dental clinics for 1 year aged 18 to 50 years.ResultsSOS teeth had a significant positive association in the multivariate analysis with male sex [OR 1.137, 95% Confidence Interval (CI): 1.079–1.199], rural versus urban Jewish locality [OR 1.748 (1.082–2.825)], and consumption of sweetened beverages [OR 1.415 (1.337–1.496)]. SOS teeth retained significant negative associations (protective parameter) with academic [OR 0.647 (0.592–0.708)] and technicians (OR 0.616 (0.556–0.682)] compared to high school education, high [OR 0.437 (0.401–0.476)], and medium (OR 0.648 (0.598–0.702)] versus low socio-economic status, urban non-Jewish versus urban Jewish locality [OR 0.746 (0.693–0.802)], Asia (OR 0.658 (0.452–0.959)], North America (OR 0.539 (0.442–0.658)] and Israel [OR 0.735 (0.686–0.788)] versus western Europe birth countries.ConclusionsHealth authorities should be familiar with this profile of the patient who is vulnerable to SOS teeth and formulate policies and allow the appropriate implementation of strategies in those in high-risk populations.

Effect of photobiomodulation on post-operative symptoms in teeth with asymptomatic apical periodontitis treated with foraminal enlargement: A randomized clinical trial.

To assess the efficacy of photobiomodulation in reducing post-operative symptoms and use of analgesics in teeth with asymptomatic apical periodontitis treated with foraminal enlargement in a single visit. This prospective double-blind, controlled, superiority, randomized clinical trial enrolled 70 patients requiring root canal treatment of one single-rooted tooth with asymptomatic apical periodontitis. The participants were randomized into one of the following two groups: 35 patients in the control group (C.G) - root canal treatment with foraminal enlargement, without any additional treatment and 35 patients in the photobiomodulation group (PBM.G) - root canal treatment with foraminal enlargement associated with photobiomodulation (antimicrobial photodynamic therapy and low-level laser therapy). The outcome variables were post-operative pain, tenderness, oedema and the use of analgesics. Pain intensity was measured using a visual analogue scale (recorded every day for 7days, then the 14th and 30th days after root canal treatment). Facial oedema was assessed subjectively by two independent evaluators using photographs taken by one of the researchers at 48h, 72h and 7days after the procedures. Data were tabulated and analysed using the Mann-Whitney U, Chi-Square, Fisher`s Exact, Student T and Ordinal Logistic Regression by Generalized Estimating Equations tests in SPSS software. There were no significant differences in post-operative pain and tenderness between the groups at any observation period (p>.05). Photobiomodulation (beta=-0.77 / p=.01), time (beta=-0.23 / p<.01), and male gender (beta=-1.20 / p<.01) were associated with decreased post-operative pain. Only time (beta: -0.10; p<.01) and male gender (beta: -1.04; p<.01) were associated with decreased tenderness. For oedema and use of analgesics, there was no difference between the groups (p>.05). Photobiomodulation had no significant effect on post-operative pain, tenderness, oedema and the use of analgesics after root canal treatment with foraminal enlargement, in single-rooted teeth treated in a single visit. Register of Clinical Trials: NCT03704857. Research Ethics Committee: no 2.353.996 / CAAE 74185417.9.0000.5626.

Assessment of post-operative pain with use of rotary and conventional root canal instruments in single and multiple visit root canal treatment

Aim: To compare the post-operative pain after the use of rotary and conventional root canal instruments in single and multiple visit root canal treatment Materials and Method: 168 patients requiring Root Canal Treatment [RCT] in maxillary and mandibular 1st molar were involved in the study. On the basis of vitality and radiographic features two groups were made, multiple visit (Group A n=72), single visit (Group B n=96). Then the patients were randomly divided into 4 subgroups. Subgroup I n=36 (multiple visit conventional RCT), Subgroup II n=36 (multiple visit rotary RCT), Subgroup III n=48 (single visit Conventional RCT) and Subgroup IV n=48 (single visit rotary RCT). In subgroup I &amp; Subgroup III Canal preparation was done with stainless steel K files in step back manner. In subgroup II &amp; Subgroup IV, rotary Protaper Next was used. Irrigation was done with 3 % NaOCl and Ethylenediamine tetraacetic acid (EDTA) alternatively followed by obturation. The postobturation pain was recorded at 6hr, 12hr, 24hr, 1 week using visual analogue scale. Statistical Analysis was done using Tukey HSD Post Hoc Test and ANOVA Test. Results: Within 24 hours there was statistically significant difference between the groups (p&lt; 0.05) but after 7 days no statistically significant difference was there (p&gt;0.05). Conclusion: Patients in the groups either in single and multiple visit experience less postobturation pain if the canal preparation was done with the rotary files at all the time intervals (6hrs, 12hrs, 24hrs ) but after 7 days no statistical difference was found.

Comparison of the Effects of a Bioceramic and Conventional Resin-Based Sealers on Postoperative Pain after Nonsurgical Root Canal Treatment: A Randomized Controlled Clinical Study.

Background: This clinical trial aimed to compare the effects of bioceramic sealer and resin-based sealer on the incidence and intensity of postoperative pain. Methods: Patients with anterior teeth or premolars requiring root canal treatment were assigned to group 1 (n = 51). Those with molars requiring treatment were assigned to group 2 (n = 57). In groups 1En and 2En, root canals were obturated with Endoseal MTA using the single-cone technique. In groups 1AH and 2AH, the sealer used was AH Plus with the continuous wave technique. On the day of canal filling, each patient was instructed to indicate their pain intensity over the 7 day postoperative period, at rest and, while biting, using a visual analog scale. Results: There was no significant difference in the incidence or intensity of postoperative pain between the Endoseal MTA and AH Plus groups during the 7 day postoperative period (p > 0.05). Less time was needed to seal the root canals with Endoseal MTA, especially in group 2 (p < 0.05). Conclusions: Endoseal MTA and AH Plus had similar effects on the incidence and intensity of postoperative pain. The obturation time was shorter when using Endoseal MTA compared to AH Plus.