Single Root Canal Research Articles

The Effect of Silver Nanoparticles on Bond Strength of Calcium Silicate-Based Sealer: An In Vitro Study

The aim of this study was to evaluate the bond strength of the calcium silicate-based sealer (CSS) modified with the silver nanoparticles (AgNPs) using the single-cone technique (SC) and the continuous wave condensation (CWC) technique, measured by a universal testing machine. The AgNPs and the modified sealers were characterized by scanning electron microscopy and transmission electron microscopy. One hundred single-rooted extracted human permanent teeth with a single root canal were cleaned and shaped with a Protaper Next system. The teeth were randomly divided into four groups (n = 25) as follows: Group 1, canals were obturated using the SC technique with TotalFill® BC Sealer. Group 2, canals were obturated using the SC technique with TotalFill® BC Sealer mixed with AgNPs. Group 3, canals were obturated using the CWC technique with TotalFill® HiFlow BC Sealer. Group 4, canals were obturated using the CWC technique with TotalFill® HiFlow BC Sealer mixed with AgNPs. After two weeks, 1 mm-thick dentin slices were cut and exposed to a push-out bond strength test using a universal testing machine. Specimens were examined under a digital microscope to determine the mode of failure. Statistical analysis was performed using ANOVA and Tukey multiple comparison tests (p < 0.05). The nanoparticle characterization revealed a spherical morphology with no obvious aggregations. The results showed that group 4 had the highest dislodgement resistance compared to all groups (p < 0.05). Group 4 was significantly higher in push-out bond strength value than group 1 (p < 0.001) and group 3 (p < 0.003), but not significantly higher than group 2. Cohesive failure was the most prevalent failure mode among all groups. It can be concluded that the incorporation of silver nanoparticles into the calcium silicate-based sealer significantly increased the bond strength. The warm obturation approach demonstrated significantly higher resistance to dislodgment as compared to the single-cone technique.

Efficacy of Endodontic Cryotherapy in Alleviating Post-Treatment Pain after Single-Visit RCT: A Randomized Study

ABSTRACT Aim: This study aims to assess whether endodontic cryotherapy can effectively lower discomfort after a single root canal visit. Material and Method: Thirty-six patients aged 18–32 years requiring single-visit root canal treatment (RCT) were divided into three groups at random, with twelve people in each: group 1 (control group), group 2 (normal saline), and group 3 (cold saline). After root canal therapy was finished, group 1 got no further treatment, group 2 got standard saline irrigation at room temperature, and group 3 got cold saline irrigation at 35.6–41°F. A visual analog scale (VAS) was used to measure pain after 6, 12, 24, and 48 hours after therapy. Result: Preliminary results indicated a marked reduction in pain in group 3 relative to groups 1 and 2 at 6, 12, and 24 hours post-treatment (P < 0.05). At 48 hours, pain levels had significantly diminished across all groups, with group 3 consistently exhibiting the lowest VAS scores. Conclusion: Endodontic cryotherapy using cold saline irrigation shows significant efficacy in reducing post-treatment pain after single-visit RCT when compared to normal saline and no additional intervention. These findings suggest that integrating cryotherapy could be a valuable adjunct in endodontic pain management.

Comparing Filling Techniques in Molars with Single Root Canals

Comparing Filling Techniques in Molars with Single Root Canals

Antimicrobial efficacy of 2% chlorhexidine gel, triphala, and Azadirachta indica as intracanal medicaments against Enterococcus faecalis: A randomized clinical trial

Abstract Context: Concerns about adverse reactions and the development of antibiotic resistance have prompted an alternative treatment strategy that utilizes traditional medicinal herbs. Aim: This randomized control trial assessed the antimicrobial efficacy of 2% chlorhexidine (CHX) gel, Triphala, and Azadirachta indica as intracanal medicaments against Enterococcus faecalis. Materials and Methods: Forty patients with nonvital teeth and single root canals were selected (n = 10). Following the initial access opening, the first microbial samples (S1) were collected using paper points. Second microbial samples (S2) were collected following the chemo-mechanical preparation and 1 week after introducing the intracanal medicaments. Group I: 2% CHX, Group II: A. indica, Group III: Triphala, and Group IV: Calcium hydroxide (Ca(OH)2). S1 and S2 samples were collected, and bacterial growth was observed using the colony-forming unit (CFU) count. Statistical Analysis: Comparison of the difference in CFU count among four groups was performed using one-way ANOVA test (P < 0.05) followed by post hoc Tukey test. Results: Reduction in CFU count postmedication S2 from S1 in each group was statistically significant. Percentage reduction in CFU count was highest in Triphala group followed by A. indica and 2% CHX group. Percentage reduction in CFU count was least in Ca(OH)2 group. The post hoc pairwise comparison of % reduction in CFU count among four groups showed that the percent reduction was highest in Triphala group. Conclusion: Triphala has considerable antimicrobial efficacy against E. faecalis.

Evaluation of root and root canal morphology in maxillary premolar teeth: A cone-beam computed tomography study using two classification systems in a Japanese population

Background/purposeInadequate knowledge increases the risk of overlooking root canals and causing procedural errors that can lead to root canal treatment failure. This study aimed to analyze the root and root canal morphology in maxillary premolar teeth using two classification systems assessed by cone-beam computed tomography (CBCT) in a large Japanese population. Materials and methodsThis study evaluated 1443 maxillary teeth including 726 first and 717 s premolars, from 642 Japanese individuals aged 16–84 years. CBCT images were analyzed according to the Vertucci and Ahmed classification systems, focusing on the root and root canal morphology. Variations were analyzed based on gender and age using the chi-square test (P < 0.05). ResultsMaxillary first premolars were predominantly single-rooted (64.9%) and had two root canals (86.2%). Females exhibited a higher prevalence of single-rooted (71.0%) compared to males (49.8%) (P < 0.05). Additionally, single root canals occurred significantly more frequently in females (14.0%) than in males (7.5%) (P < 0.05). Maxillary second premolars mostly had a single root (97.8%) with a single root canal (72.1%). The frequency of second premolars with two root canals significantly increased with age (P < 0.001). The three-rooted configuration occurred in 1.2% and 0.3% of the first and second premolars, respectively. ConclusionMaxillary premolars in a Japanese population showed significant anatomical variations, highlighting the importance of understanding anatomical characteristics specific to age and gender. Ahmed's system provides a more comprehensive description of the morphological variations.

Effect of long-acting supplementary local anesthetic on intra and post operative pain in single visit root canal treatment: a randomized control trial

Effect of long-acting supplementary local anesthetic on intra and post operative pain in single visit root canal treatment: a randomized control trial

A protocol for a comparative evaluation of the fracture resistance of endodontically treated teeth reinforced with Cention N, resin-modified glass ionomer cement (RMGIC) and short fiber reinforced flowable composite as an intraorifice barrier.

Endodontic treatment is the most common method for resolving pulpal and periapical pathology. However, various studies have reported that almost 11%-13% of all teeth that undergo extraction after endodontic treatment show the presence of cracks, craze lines, and vertical root fractures. Teeth with inadequate post endodontic restoration are more prone to fracture and coronal leakage, resulting in the diffusion of oral fluids, bacteria, bacterial products, and possibly root canal treatment failure. Furthermore, studies have advocated the use of endodontically treated teeth with restorative materials that have a similar or higher elastic modulus than the tooth for providing stiffness against forces that cause root fracture. Intraorifice barriers made of restorative materials that can bond to radicular dentin could thus be used to reinforce the radicular dentin while also preventing coronal microleakage. Although the sealing ability of intraorifice barriers has been widely compared in the literature, there have been few studies on the strengthening effect of the materials used in the study as intraorifice barriers when placed into the root canal. As a result, the current in vitro study aims to assess the effect of various materials as intraorifice barriers (Cention N, Resin modified glass ionomer cement, and short fiber reinforced flowable composite) on the force required fracture teeth after root canal treatment. This in vitro study will be done on extracted human mandibular premolars with single root canal where after doing root canal treatment 2-3 mm obturating material would be replaced by intra orifice barriers (Cention N, resin modified glass ionomer cement [RMGIC], and short fiber reinforced flowable composite). The force required to fracture teeth will be calculated using universal testing machine.

Postoperative Pain Following Single Visit Root Canal Treatment With Reciproc Blue And Hyflex EDM Instrumentation; A Prospective Randomized Clinical Trial

Objective: Single file systems with continuous rotation or reciprocation produced with many new technologies promising in terms of postoperative pain. The aim of this study was to investigate the efficacy of using novel Reciproc Blue (RBlue) and HyFlex EDM (HEDM) files on postoperative pain after single visit root canal treatment. Materials and Methods: 72 patients with asymptomatic pulp necrosis in mandibular molar and premolar teeth were included. The root canals were prepared using HEDM (n=29) or RBlue (n=28) and hand-instruments (n=15) in single visit. Pain presence using verbal rating scale (VRS) and analgesic intake were recorded after 24h, 48h, 72h and 7 days. Results: Postoperative pain at 24h and 48h was statistically higher at RBlue group than HEDM and control groups (p0.05).There was no difference between groups in terms of analgesic intake (p&gt;0.05). RBlue files were associated with higher incidence of postoperative pain and higher VRS scores than HEDM and hand-instruments. Conclusion: RBlue files working with reciprocating motion caused much more postoperative pain than HEDM files and manual files.

Enhancing Precision in Endodontic Procedures: An In vitro Investigation of Magnification and Enhanced Visualization

ABSTRACT Background: Endodontic procedures require precise manipulation and visualization to achieve optimal treatment outcomes. Magnification and enhanced visualization tools, such as dental loupes and dental operating microscopes (DOMs), have been introduced to enhance precision in endodontic practice. Materials and Methods: Extracted human teeth with single-rooted canals were divided into two groups: a control group without magnification and an experimental group with magnification and enhanced visualization. Endodontic procedures, including access cavity preparation, cleaning, shaping, and obturation, were performed on both groups. The experimental group utilized either dental loupes or a DOM for enhanced visualization. Treatment outcomes were assessed based on predefined criteria, including the quality of access cavity preparation, canal cleanliness, shaping, and obturation. Scores were assigned to each criterion to quantify treatment precision. Results: The use of magnification and enhanced visualization significantly improved precision in endodontic procedures compared to the control group. Access cavity preparation in the experimental group resulted in more conservative tooth structure removal and improved visualization of canal orifices. Canal cleanliness, shaping, and obturation were markedly superior in the experimental group, with higher scores indicating better precision. The experimental group also exhibited a reduced incidence of procedural errors and complications compared to the control group. Conclusion: Magnification and enhanced visualization tools, such as dental loupes and DOMs, enhance precision in endodontic procedures.

Comparing Warm and Cold Gutta-Percha Techniques for Root Canal Filling: An In Vitro Study

ABSTRACT Background: Gutta-percha is commonly used in endodontic therapy for obturating root canals after cleaning and shaping procedures. Warm and cold gutta-percha techniques are two common methods employed for obturation, each with its own advantages and limitations. Materials and Methods: Twenty extracted human teeth with single-rooted canals were selected and divided into two groups: warm gutta-percha obturation and cold gutta-percha obturation. In the warm gutta-percha group, gutta-percha was heated to a predetermined temperature using a warm gutta-percha heating device and injected into the root canal using a heated carrier. In the cold gutta-percha group, gutta-percha was applied directly to the root canal without prior heating. Root canal obturation quality was assessed using radiographic imaging to evaluate the presence of voids, completeness of obturation, and adaptation to the canal walls. Micro-computed tomography (micro-CT) analysis was also performed to quantify the volume of obturating material and assess the three-dimensional distribution of gutta-percha within the root canal space. Results: Both warm and cold gutta-percha techniques demonstrated effective obturation of root canals, with comparable outcomes in terms of void formation, completeness of obturation, and adaptation to canal walls. However, micro-CT analysis revealed differences in the volume and distribution of gutta-percha within the root canal space. Warm gutta-percha obturation exhibited more uniform distribution of gutta-percha material and higher volumetric filling compared to cold gutta-percha obturation. Additionally, the warm gutta-percha technique demonstrated superior flowability and adaptation to irregularities within the root canal system. Conclusion: In this in vitro study, warm gutta-percha obturation demonstrated advantages over cold gutta-percha obturation in terms of volumetric filling, distribution within the root canal space, and adaptation to canal irregularities.

Association between the irrigation-agitation techniques and Periapical Healing of large periapical lesions: a Randomized Controlled Trial

ObjectivesThe aim of this study was to evaluate the effects of manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), and laser-activated irrigation (shock wave-enhanced emission photoacoustic streaming (SWEEPS)) on the periapical healing of large periapical lesions following nonsurgical root canal treatment.Materials and methodsA total of fifty-six systemically healthy patients with a mandibular single-rooted tooth with periapical lesions of endodontic origin and a periapical index score of 3 or higher were included in the study. Before the treatment procedures, lesion volumes were determined volumetrically using cone–beam computed tomography (CBCT). Patients were randomized into treatment (MDA, PUI, SWEEPS) and control groups (n = 14). Root canal treatment and irrigation procedures were performed by a calibrated postgraduate operator and completed at one visit. For routine follow-up, clinical and radiographic evaluations were performed by a blinded evaluator using periapical (PA) radiographs according to Molven’s criteria at 3, 6, and 9 months. At 12 months, lesion volumes were quantified volumetrically using CBCT (ITK-SNAP). The data were statistically analyzed with the Wilcoxon test. The significance level was set at p < 0.05.ResultsIn all groups, the mean lesion volume after treatment was significantly smaller than the mean volume before treatment (p = 0.001). Among the 56 teeth, 11 teeth were ‘totally healed’, and 39 teeth were ‘reduced’ on PA radiographs. No ‘enlargement’ was detected in any group. On CBCT, the lesion volume decreased in the following order: LAI-SWEEPS (86.9%) > PUI (85.4%) > MDA (80.4%) > control (74.5%), with no statistically significant difference (p > 0.05).ConclusionsDespite the limitations of the present study, although a greater percentage of healing was observed in the LAI-SWEEPS and PUI groups, irrigation procedures had no statistically significant effect on the healing of periapical lesions with a single root canal at the 12-month follow-up. On the other hand, the outcome may change in multirooted teeth with curved and complex root canal systems.Clinical relevanceIn the short term and in single-canal teeth, advanced irrigation agitation methods such as laser and ultrasonic did not make a difference in healing other than manual irrigation agitation.

Worldwide Prevalence of Single-rooted with a Single Root Canal and Four-rooted Configurations in Maxillary Molars: A Multi-center Cross-sectional Study with Meta-analysis

IntroductionTo evaluate the prevalence of single root with a single root canal and four-root configurations in the maxillary first and second molars, and analyze how geographic region, ethnicity, sex, and age impact these outcomes. MethodsResearchers from 44 nations examined 26,400 maxillary molars using cone-beam computed tomography scans to gather data on the proportions of single roots with single canals and four-root configurations. All observers underwent prior calibration regarding the step-by-step assessment protocol and anatomical concepts to ensure consistent evaluations across all assessed locations. Tests were conducted to evaluate the intraobserver and interobserver reliability. Demographic data including ethnicity, gender, and age were collected for each participant. The potential impact of imaging voxel size and field-of-view on bias was also assessed. The primary results were depicted as odds ratios and untransformed proportion forest plots with 95% confidence intervals. Additionally, a meta-analysis was performed to compare various subgroups and identify sources of variation among them. Statistical significance was set at 5%. ResultsThe prevalence of single-rooted with a single canal and four-rooted configurations in the maxillary first molar was 0.16% and 0.28%, respectively, while in the maxillary second molar, it was 2.56% and 0.83%. Males tended to exhibit lower percentages of single roots with a single canal (P < .05) and higher percentages of four-rooted configurations (P > .05) in the second molar, whereas the African subgroup displayed lower proportions for both configurations. Additionally, in both teeth, single roots with a single canal were more prevalent among older patients. Voxel size and field-of-view did not significantly influence the results (P > .05). ConclusionsThe proportions of single-rooted with a single canal and four-rooted configurations were low, and demographic factors such as geographic region, ethnicity, sex, and age may have influenced the outcomes for the maxillary second molar.

The Effect of Surface Properties of Different Types of Post Materials on Fracture Type

Introduction and Aim Considering the advantages and disadvantages of different clinical situations, the surface characteristics of the post materials significantly affect the connection of the post material with dentin. In this study, the surface properties of PEEK posts, which are not yet widely used as post materials, were examined in terms of their effects on dentin bonding. Method 66 extracted upper central incisor-type human teeth that had undergone canal treatment with single and straight root canals were used. Posts were produced ) (n=11) from metal, fiber, and PEEK materials to form six groups (CP-0, CP-1, FP-0, FP-1, PP-0, and PP-1). The surface roughness of each post was examined by using a tactile profilometer. Zirconium full crowns, compatible with the central maxillary incisor anatomy, were produced for 66 samples with completed post-core production and polymerized using dual-cure resin cement (Monobond plus Vivadent). Subsequently, the samples were subjected to fracture strength testing at a 135-degree angle to the long axis of the tooth from the palatal side of the zirconium crown at a speed of 0.02 cm/min using a universal testing machine. After the test, the samples were classified into three groups based on the type of fracture: adhesive, cohesive, and mixed. One-way ANOVA and Pearson’s chi-squared tests were used for statistical analysis. Results The surface roughness value of the PEEK post group (1.42 ± 0.21) was significantly lower than that of the metal and fiber post groups. Although no significant difference was found in terms of the fracture type, the adhesive failure rate was higher in the PEEK post group (P

Effect of Chitosan Irrigant and Lubricating Gel on Bond Strength of Resin Sealer to Radicular Dentin: An In Vitro Study.

The adhesive strength of sealers to dentin is influenced by various factors, and the presence of a smear layer is among the critical variables. Chitosan, known for its dentin compatibility, has previously demonstrated a reduction in dentin change and resin sealer bond strength comparable to ethylenediaminetetraacetic acid (EDTA) when used as an irrigant and final rinse. The study investigates the impact of chitosan, used as both a lubricating gel and final rinse, on the push-out bond strength of resin sealer. Forty single-rooted premolar teeth, each with a fully formed root and a single root canal, were collected post-extraction. During canal preparation, 1 mlsodium hypochlorite (3%) was used for irrigation at every change ofinstrument, followed by applying specific chelating gel and final rinse for each experimental group. The groups included: Group 1 (17% EDTA chelating gel, final rinse with saline), Group 2 (17% EDTA chelating gel, final rinse with 17% EDTA solution), Group 3 (chitosan chelating gel, final rinse with saline solution), and Group 4 (chitosan chelating gel, final rinse with 0.2% chitosan solution), 10 specimens in each group.After obturation, specimens were sealed and incubated for a week at 37°C with 100% humidity. The universal testing machine was used for push-out tests, and specimens were examined using a scanning electron microscope (SEM) to identify various types of bond failure. Among the four groups, Group 2 exhibited the highest mean push-out bond strength (7.33 ± 0.26 MPa), followed by Group 4 (5.33 ± 0.25 MPa), Group 1 (4.61 ± 0.30 MPa), and Group 3 (2.94 ± 0.32 MPa). The variations in bond strength suggest a notable impact of the chelating agents and final rinse solutions on the resin sealer's interaction with dentin. The study concludes that the use of EDTA as both a lubricating gel and a final rinse significantly enhances push-out bond strength, outperforming chitosan in this study. Groups with saline as the final rinse (Group 1 and Group 3) exhibited the least bond strength, highlighting the importance of the final rinse in root canal therapy.

Successful Root Canal Re-treatment of the Second Mandibular Premolar with type III of Vertucci Classification

Knowledge of the root canal system plays a significant role in avoiding the failure of root canal treatment. Premolar teeth may have several anatomical variations in their root canal system. A dentist must understand these root canal systems and their variation to conduct the appropriate treatment. The mandibular second premolar usually consists of a single root with a single root canal. The incidence of lower premolars with two or more root canals varied between 1.2% and 34%. This study aims to evaluate the success of root canal re-treatment of mandibular second premolars with type III Vertucci’s Classification. Case report: A 28-year-old woman visited our dental hospital with a pain sensation in her lower left premolar tooth. The subjective examination revealed that she had experienced pulp capping and root canal treatment last year. However, she felt pain and uncomfortable feeling on that treated tooth. A radiograph examination showed a radiopaque area from the crown edge to half of the root. The radiolucent area from the half tooth to the apical region showed root canal branching. The diagnosis for this tooth was previously treated teeth, asymptomatic apical periodontitis with type III of Vertucci’s Classification. Root Canal Treatment was done using crown down preparation technique and obturation with warm vertical condensation followed by class II composite resin composite as a temporary filling. Results showed that after three months of evaluation, the retreated-tooth condition kept showing good condition without any complaints, pain, or clinical abnormalities, suggesting it could function properly.

Evaluation of Different Root Canal Sealers on Post Operative Pain in Single Visit RCT – A Comparative Study

ABSTRACT Aim: To evaluate and compare three different root canal sealers (Endo-Sequence BC, Bio Root RCS and Zinc Oxide Eugenol) on post operative pain in single visit root canal therapies. Material and Methodology: 60 subjects with age ranging from 18-60 years were randomly selected depending upon the inclusion criteria. The subjects were then divided into three groups with 20 patients in each. In all the patients’ single visit root canal treatment was done followed by obturation using different sealers. In Group I Endo- Sequence sealer was used, in Group II Bio-Root RCS and in Group III Zinc Oxide Eugenol sealers were used respectively. Results: statistically significant results were obtained on comparing the efficacy of three groups with Group I proving to be much effect among the three. Conclusion: within the limitation of the study it can be concluded that though all the sealers were effective in reducing post-operative pain, patients with Endo Sequence BC sealers evaluated statistically significant results.

ProTaper universal retreatment retreatment potential in oval-shaped canals filled with different obturation techniques-A micro-computed tomography study.

The objective of this in vitro micro-computed tomography investigation is to assess the efficacy of the ProTaper Universal Retreatment System in retreating oval-shaped root canals filled with three obturation procedures. Thirty-six lower incisors with a single oval root canal were prepared using XP-Endo Shaper up to size 30/0.04, and allocated into three equal groups based on the filling technique: Group 1: Warm vertical condensation technique; Group 2: GuttaCore obturators; Group 3: Cold lateral condensation technique. All samples were further retreated using the ProTaper Universal Retreatment system. Micro-CT analysis was performed before and after the retreatment procedure. Statistical analysis was performed with a significance level of 0.05. Data analysis was conducted using the Kolmogorov-Smirnov and Kruskal-Wallis H tests. The best performance of the files was achieved when the removal of the filling in the entire canal was considered. However, this outcome was not statistically significant when compared with the other observed root canal levels. The retreatment procedure could not ensure thorough cleanliness of the canal walls from filling remnants, regardless of the obturation technique and observational level. The ProTaper Universal Retreatment system used for the removal of gutta-percha and sealer in oval-shaped root canals demonstrated equal effectiveness, regardless of the obturation technique used.

In vitro effects of Er: YAG laser-activated photodynamic therapy on Enterococcus faecalis in root canal treatment

ObjectivePhotodynamic therapy (PDT) plays an important role for root canal disinfection. Nevertheless, the effect of photosensitizers penetrating dentin tubules is limited, which ultimately impedes the disinfection effect of PDT. The study implements an Er: YAG laser to activate methylene blue, the photosensitizer, to determine the bactericidal impact of PDT on Enterococcus faecalis in vitro root canals. MethodsWe obtained 53 single root canal teeth with intact roots, standardized the root to 9 mm. The root canals were prepared using ProTaper rotary files. Subsequently, the teeth were sterilized, and Enterococcus faecalis was cultured for 3 weeks in vitro using brain heart infusion (BHI). The model of Enterococcus faecalis root canal infection of teeth was constructed by observing Enterococcus faecalis through electron microscope scanning. The teeth were randomly allocated to five treatment groups (n = 10): control, NaOCl, NaOCl + Er: YAG, PDT, and PDT + Er: YAG. Following treatment, the number of colony forming units (CFU)/ml was assessed for each group. Statistical analysis was conducted using one-way ANOVA, with post-hoc analysis using Tukey's test for multiple comparisons. ResultsThe colony counts in the remaining groups were significantly lower compared to the control group (P<0.001). Using PDT alone had the least impact on reducing colonies, while using PDT and Er: YAG laser together resulted in a significant reduction in colony counts (P<0.001). There was no significant difference in colony counts reduction between the NaOCl + Er: YAG group and the PDT + Er: YAG group (P = 1.000). ConclusionsThe combination of Er: YAG laser and PDT significantly enhanced the bactericidal efficacy of PDT against Enterococcus faecalis in root canals. It had a similar impact on eliminating Enterococcus faecalis when compared to the effect of using Er: YAG laser and NaOCl.

A protocol for a comparative evaluation of the fracture resistance of endodontically treated teeth reinforced with Cention N, resin-modified glass ionomer cement (RMGIC) and short fiber reinforced flowable composite as an intraorifice barrier

Background: Endodontic treatment is the most common method for resolving pulpal and periapical pathology. However, various studies have reported that almost 11%–13% of all teeth that undergo extraction after endodontic treatment show the presence of cracks, craze lines, and vertical root fractures. Teeth with inadequate post endodontic restoration are more prone to fracture and coronal leakage, resulting in the diffusion of oral fluids, bacteria, bacterial products, and possibly root canal treatment failure. Furthermore, studies have advocated the use of endodontically treated teeth with restorative materials that have a similar or higher elastic modulus than the tooth for providing stiffness against forces that cause root fracture. Intraorifice barriers made of restorative materials that can bond to radicular dentin could thus be used to reinforce the radicular dentin while also preventing coronal microleakage. Although the sealing ability of intraorifice barriers has been widely compared in the literature, there have been few studies on the strengthening effect of the materials used in the study as intraorifice barriers when placed into the root canal. As a result, the current in vitro study aims to assess the effect of various materials as intraorifice barriers (Cention N, Resin modified glass ionomer cement, and short fiber reinforced flowable composite) on the force required fracture teeth after root canal treatment. Methods: This in vitro study will be done on extracted human mandibular premolars with single root canal where after doing root canal treatment 2-3 mm obturating material would be replaced by intra orifice barriers (Cention N, resin modified glass ionomer cement [RMGIC], and short fiber reinforced flowable composite). The force required to fracture teeth will be calculated using universal testing machine.

Comparative evaluation of effect of intracanal cryotherapy and corticosteroid solution on post endodontic pain in single visit root canal treatment.

Post-operative pain after endodontic treatment is a common occurrence, and its prevalence is mostly high immediately after treatment, decreasing in one day and reportedly reaching minimal levels 7 days after treatment. This research focuses on the final flushing of the root canal with different irrigating solutions to reduce its occurrence. Aim: To compare and evaluate the effect of delivering three intracanal irrigants - saline at room temperature, saline at 2.5oC, and intracanal dexamethasone as final irrigant on postoperative pain after a single visit endodontics. This randomized double-blinded parallel clinical trial was conducted on patients requiring a single appointment root canal treatment, with a pain level of 4 or higher on the visual analogue scale (VAS). According to the final irrigating solution, all patients were randomly allocated into three groups of 15 each: 0.9% physiological saline (Group 1), 2.5oC cold saline (Group 2), and 2ml Dexamethasone (Group 3). Patients were instructed to complete VAS to determine their post-operative scores at 6hrs, 12hrs, and 24hrs following the treatment. In all groups, mean VAS scores decreased significantly from baseline to 6hr and 12hr, with lower scores at 24 hours. Post-hoc analysis revealed no significant distinction in the mean VAS scores between 12 hours to 24 hours. Lower pain scores are observed in the dexamethasone group, followed by cryotherapy which performed better than saline at room temperature. Final flushing with dexamethasone solution and cryotherapy is effective, safe, and a well-tolerated strategy to minimize postoperative pain after single visit endodontics. Key words:Intracanal cryotherapy, Cold saline, Dexamethasone, Postoperative pain, Visual analogue scale.