Split-mouth Clinical Trial Research Articles

Antimicrobial photodynamic therapy (aPDT) with curcumin and LED, as an enhancement to scaling and root planing in the treatment of residual pockets in diabetic patients: A randomized and controlled split-mouth clinical trial.

Residual pockets represent a risk factor for periodontal disease progression. Diabetes Mellitus (DM) may impair prognosis after cause-related therapy, mainly due to the chronic hyperglycemia that negatively influences tissue repair. This study evaluated the clinical efficacy of antimicrobial photodynamic therapy (aPDT) with curcumin (CUR) solution (100 mg/L) and LED irradiation (465-485 nm), as an adjunctive therapy to scaling and root planing (SRP), in the treatment of residual pockets in type 2 diabetic patients. Individuals with type 2 DM and chronic periodontitis presenting at least one residual pocket per quadrant were selected (n = 25). In each patient, all residual pockets with probing depth (PD) ≥5 mm and bleeding on probing (BOP) were allocated to receive, according to quadrant: 1) SRP (SRP group); 2) SRP and irrigation with CUR solution (100 mg/L) (CUR group); 3) SRP and LED irradiation (InGaN, 465-485 nm, 0.78 cm², 78 mW, 100 mW/cm², 60 s) (LED group); 4) SRP, irrigation with CUR solution (100 mg/L), one minute of pre-irradiation, and LED irradiation (InGaN, 465-485 nm, 60 s) (aPDT group). Clinical parameters of PD, gingival recession (GR), clinical attachment level (CAL), BOP and visible plaque index (PI) were evaluated at baseline, three and six months post-therapies. Differences between the examination periods in each group were analyzed by Friedman's test for non-parametric data, while parametric data were submitted to analysis of variance (One-way ANOVA), followed by Tukey's test. Intergroup comparisons were performed by Kruskal-Wallis test. In an intergroup comparison, the mean values for PD, GR, CAL, BOP and PI were not different at baseline, three and six months (p > 0.05). The intragroup comparison evidenced reduction in PD and BOP in all treatment groups at three and six months (p < 0.05). Significant CAL gain was notable only for the aPDT and LED groups at three months in comparison to baseline data (p < 0.05). Treatment of residual pockets in patients with type 2 DM through association of SRP with aPDT (CUR solution 100 mg/L and LED irradiation) or LED irradiation may yield short-term (three months) clinical benefits regarding CAL gain.

Randomized clinical trial on indirect resin composite and ceramic laminate veneers: Up to 10-year findings

ObjectivesIn this randomized split-mouth clinical trial the survival rate and quality of survival of indirect resin composite and ceramic laminate veneers were evaluated. MethodsA total of 48 indirect resin composite (Estenia; n = 24) and ceramic laminate veneers (IPS Empress Esthetic; n = 24) were placed on maxillary anterior teeth. Veneer preparations with incisal overlap were performed using a mock up technique. Survival of the restoration was considered the primary outcome measure and reported using Kaplan-Meier statistics and survival curves compared by means of Log Rank (Mantel-Cox) test. After luting, restorations were evaluated by calibrated operators at baseline and every year thereafter, using modified USPHS criteria and compared by means of Mann-Whitney U test. ResultsIn total, 6 failures were observed, consisting of debonding (n = 3) and fracture (n = 3), all in the group of the indirect resin composite laminate veneers. Cumulative chance on survival after 10 years of the indirect resin composite and ceramic veneers was 75% (se 3,8%) and 100% respectively (p = 0.013). Of the surviving 42 laminate veneers, the variables ‘color match’ (p = 0.002), ‘surface roughness’ (p = 0.000), ‘fracture of the restoration’ (p = 0.028), and ‘wear of the restoration’ (p = 0.014), were significantly less favourable among the composite laminate veneers as well. ConclusionsThe ceramic veneers on maxillary anterior teeth in this study performed significantly better compared to the composite indirect laminate veneers after a decade, both in terms of survival rate and in terms of quality of the surviving restorations. Clinical RelevanceWhen indicated, anterior ceramic laminate veneers may be preferred over indirect composite laminate veneers.

Effects of topical application of 1% sodium alendronate gel in the surgical treatment of periodontal intrabony defects: A 6-month randomized controlled clinical trial.

Sodium alendronate (ALN) is an aminobisphosphonate and potent inhibitor of bone resorption. It has been suggested that ALN might be a promising carrier of biomolecules for periodontal bone repair. The aim of this randomized split-mouth clinical trial was to evaluate the effects of the topical application of 1% ALN gel in intrabony defects during the surgical treatment of patients with periodontitis. Sixty-four intrabony defects from 32 patients with periodontitis were randomly treated with either 1% ALN gel or placebo gel during periodontal surgeries. Full-mouth periodontal examination was performed at baseline and at 3 and 6 months after surgical treatment. Clinical attachment level (CAL), probing depth (PD), and bleeding on probing (BOP) were recorded as the clinical outcomes. Bone defects were evaluated by digital subtraction radiography (DSR) at baseline and 6 months post-treatment. Analyses were performed through Fisher, Kruskal-Wallis, and ANOVA tests and a generalized estimation equations method. Both ALN and placebo groups showed significant improvements in BOP, PD, and CAL after periodontal surgical procedures (P<0.001). Intergroup analysis showed significantly better outcomes in the ALN group with higher PD reduction and clinical attachment gain. DSR showed positive effects on periodontal bone repair strongly associated in the ALN group (P<0.001). Topical application of 1% ALN may be a promising and beneficial adjuvant for the treatment of intrabony defects during surgical periodontal therapy.

Diode laser versus electrocautery for inflammatory fibrous hyperplasia treatment: a split-mouth clinical trial

Diode laser versus electrocautery for inflammatory fibrous hyperplasia treatment: a split-mouth clinical trial

Randomized Prospective Clinical Trial of Class II Restorations Using Low-shrinkage Flowable Resin Composite.

The aim of this prospective, randomized, split-mouth clinical trial was to evaluate postoperative sensitivity, clinical performance, and interproximal contacts after using different restorative systems. Fifty-three subjects each received three class II restorations according to the restorative systems: conventional resin composite (PA: Peak Universal+Amelogen Plus, Ultradent), low-shrinkage flowable and nanoparticulate resin composites (ABF: Adper Single Bond 2+Filtek Bulk Fill Flow+Filtek Z350XT, 3M ESPE), and low-shrinkage flowable and microhybrid resin composites (XST: XP Bond+SDR+TPH3, Dentsply). Postoperative sensitivity was assessed at 24 hours, seven days, 90 days, and six months. The clinical performance and interproximal contacts were evaluated at baseline, six months, and one year. Friedman, Wilcoxon, Kruskal-Wallis, and Mann-Whitney tests were used to evaluate postoperative sensitivity and interproximal contacts. The equality test of two proportions and logistic regression analysis were used to assess the clinical performance. No statistically significant differences were observed among groups for postoperative sensitivity. The highest spontaneous sensitivity was reported at 24 hours. ABF was the only group that did not present a reduction in cold sensitivity. Color, marginal discoloration, and superficial staining showed differences among the groups. XST did not show superficial staining after one year. No differences were observed among groups in relation to interproximal contacts. XST resulted in the loss of interproximal contact after one year. Different types of restorative systems do not influence postoperative sensitivity; however, ABF maintained cold sensitivity over time. Marginal discoloration occurred for all groups but occurred earliest for PA. XST presented a reduction of interproximal contact after one year of evaluation.

Comparing the rotational control during canine retraction using two different bracket systems – Synergy and Self Ligating brackets – Split mouth study

Canine, being the cornerstone of the dental arches, shares an important role in oral functions, esthetics, arch shape and stability. With the new bracket systems that have come to light, which have reduced friction, there is not much literature on how much of a rotation control they have on the cuspids. Hence this study is conducted to compare the efficiency of two least frictional resistance offering brackets – Self-ligating and synergy brackets in terms of rotational control. The study was designed as a prospective randomized controlled split-mouth clinical trial, which included 16 subjects of ages 12-30 years, divided into two groups, left, and the right quadrants receiving Self Ligating and Synergy brackets based on simple randomization, along with a 19*25" SS wire and closed coil springs for individual canine retraction. The patients were reviewed every 21 days for four appointments, and records were taken for each review. Photographs were taken of the cast at every review, and the degree of canine rotation was measured and compared. The results indicate that there is no statistical difference between both the groups in the amount of canine rotation during individual canine retraction with a p-value greater than 0.05 at every interval. The results also indicate that there is a significant amount of canine rotation in Group 1 – Self-ligating brackets and Group 2 – Synergy brackets independently, when comparing T0 to every interval. Overall results show that there is no significant statistical difference between Synergy and Self-Ligating brackets in the amount of canine rotation during canine retraction. The mean or average amount of canine rotation for Group I Self-ligating was 3.32º ±6.55°. The mean or average amount of canine rotation for Group 2 Synergy was 4.08º ±3.85°.

Comparing the rate of retraction in canines in males and females

There are multiple factors that affect the treatment duration and the rate of canine retraction between males and females. A difference in the levels of calcitonin and the maintenance of the appliance by both genders varies the treatment duration. Hence this study was conducted to analyse the difference in the rate of canine retraction between males and females using two different bracket systems, synergy and self-ligating. The study was designed as a prospective randomized controlled split-mouth clinical trial, which included 16 subjects, 8 males and 8 females, of ages 12-30 years, divided into 2 groups, the left and the right quadrants receiving Self Ligating and Synergy brackets based on simple randomization, along with a 19*25" SS wire and closed coil springs for individual canine retraction. The patients were reviewed every 21 days for four appointments and records were taken for each review. Digital Vernier calliper was used to measure the amount of canine retraction, and statistical analysis was conducted. The values were calculated and tabulated, and independent ‘t' test was used to analyse the statistical difference. There was no significant statistical difference between the two genders. There are various factors that affect the rate of canine retraction and gender of the patient undergoing orthodontic treatment is one of them. With increased amounts of calcitonin in males, making the alveolar and basal bone denser when compared to women, would likely increase the treatment time in males, when compared to females. Hence this study was conducted to compare the difference and showed that there is no statistical difference between males and females in the rate of canine retraction.

Evaluation of topically applied probiotic treatment on localized aggressive periodontitis patients: A split mouth study

Aim: This study aims to evaluate clinically the effect of probiotic treatment on localized aggressive periodontitis patients. Subjects and methods: This study was designed as a randomized, controlled, split mouth clinical trial, carried out on localized aggressive periodontitis (LAP) which having almost two identical sites with clinical probing depth of ≥ 5 mm. Two contralateral sites were randomly divided into two groups, Group I: received conventional periodontal treatment, scaling and root planning combined with topical application of probiotic. Group II: received conventional periodontal treatment, scaling and root planning only. Patients were evaluated clinically using the following parameters: plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) and radiographically by radiographic bone density (pixel) at baseline, 3, 6, and 9 months. Results: Clinical and radiographic results of this study showed that: there were a significant reduction for assessed variables (Plaque Index, gingival index, probing pocket depth and clinical attachment level and significant increase in radiographic bone density in probiotic group compared to group II. Conclusion: Adjunctive use of topically applied probiotic appeared to be beneficial effect in localized aggressive periodontitis patients when compared with scaling and root planning alone.

The Effect of Piezosurgical Ridge Splitting and Osseodensification on The Primary Stability of The Implant in Narrow Ridge: (Comparative Randomized Controlled Split Mouth Clinical Trial)

Aim: This study aims to evaluate the effect of and compare between the piezosurgical ridge splitting and osseodensification in implant primary stability. Subjects and Methods: 28 implants were divided into two groups. Group I: 14 implants in sites received piezosurgery technique. Group II: 14 implants in sites received osseodensification technique. Then, all implants were evaluated clinically for primary stability after implant insertion by Osstell mentor magnetic resonance device and radiographically for peri-implant bone density. Results: unpaired t-test between the two groups showed moderate statistical significant difference in group II when compared with group I in both primary stability and bone density Conclusion: The primary stability in both piezosurgical ridge splitting and osseodensification techniques is within normal range but in favor of osseodensification technique suggesting that osseodensification enhance the bone density thereby improve the implant primary stability.

Non-surgical Periodontal Therapy With Adjunctive Topical Metronidazole + Piroxicam Gel Compared With Piroxicam Gel in the Treatment of Chronic Periodontitis

Background: Host modulation therapy represents a treatment concept in which drug therapies are applied as an adjunctive therapy to conventional periodontal treatments to counteract the destructive effects of the host inflammatory response. Methods: This is a randomized split-mouth clinical trial in which a total of 40 outpatients diagnosed with mild-moderate chronic periodontitis with at least two pairs of contralateral anatomically matching proximal tooth surfaces showing probing depth of ≥5 mm were enrolled. Full-mouth scaling and root planing (SRP) was performed for all patients and pockets larger than 5 mm were selected for application of the studied gels. The selected sites were randomly divided into group A (piroxicam + metronidazole) and group B (piroxicam). Recall appointments were scheduled every two weeks within 3 months. The periodontal parameters, assessed in the molar teeth, also recorded that changes in clinical parameters during the study. Results: A total of 34 patients, with mean age of 45.2±8.6 (range 32-60) years, none of whom developed unpleasant side effect, were enrolled. Plaque index was significantly higher in group A; further it was a statistically significant difference in Bleeding on probing levels in group A at the baseline to last interval recall while current study. The results exhibited significant reductions in pocket depth within 3 months when compared to the baseline values, while the combination adjunctive therapy was more effective to reduce pocket depth. Furthermore, both groups showed a statistically significant mean reduction in clinical attachment level (CAL), but in the test group A had a higher CAL gain than in the control group B (P=0.039). Conclusions: The use of a combination of drugs can help reduce the clinical signs of periodontal disease, therefore, by changing the patient’s health habits along with periodontal treatment, the mechanical treatment that a microbial plaque can be obtained, and then the use of piroxicam + metronidazole gel as a complementary therapy, the recovery process can be accelerated.

Efficacy of injectable platelet-rich plasma in reducing alveolar bone resorption following rapid maxillary expansion: A cone-beam computed tomography assessment in a randomized split-mouth controlled trial.

To evaluate the effectiveness of platelet-rich plasma (PRP) with its growth factors in minimizing the side effects of rapid maxillary expansion (RME) on the periodontal tissue of anchoring teeth using cone-beam computed tomography (CBCT). A randomized, split-mouth clinical trial was conducted on 18 patients aged 12-16 years (14 ± 1.65) with a skeletal maxillary constriction who underwent RME using a Hyrax appliance. The sample was randomly divided into two groups: intervention and control sides. PRP was prepared and injected on the buccal aspect of supporting teeth in the intervention group. High-resolution CBCT imaging (H-CBCT) was carried out preoperatively (T0) and after 3 months of retention (T1) to study the buccal bone plate thickness (BBPT) and buccal bone crest level (BBCL) of anchoring teeth. Changes induced by expansion were evaluated using paired sample t-test (P < .05). Results showed that there was no significant difference in BBPT and BBCL between the two groups after RME (P > .05). The prevalence of dehiscence and fenestrations was increased at (T1) in both groups and the percentage was higher in the PRP group. RME induced vertical and horizontal bone loss. PRP did not minimize alveolar defects after RME.

Hydrogen peroxide-based products alter inflammatory and tissue damage-related proteins in the gingival crevicular fluid of healthy volunteers: a randomized trial

Hydrogen peroxide (H2O2)-based products are effective in tooth whitening; however, their safety is controversial as they may harm patient tissues/cells. These effects are suggested to be concentration-dependent; nonetheless, to date, there are no reports on H2O2-mediated oxidative damage in the gingival tissue, and neither whether this can be detected in gingival crevicular fluid (GCF) samples. We hypothesize that H2O2 whitening products may cause collateral oxidative tissue damage following in office application. Therefore, H2O2 and nitric oxide (NO) levels were investigated in GCF samples obtained from patients undergoing dental bleaching with H2O2 at different concentrations, in a randomized, double-blind, split-mouth clinical trial. A proteomic analysis of these samples was also performed. H2O2-based whitening products promoted inflammation which was detected in GCF samples and lasted for longer following 35% H2O2 bleaching. This included time-dependent changes in NO levels and in the abundance of proteins associated with NO synthesis, oxidative stress, neutrophil regulation, nucleic acid damage, cell survival and/or tissue regeneration. Overall, H2O2-based products used in office promote inflammation irrespective of their concentration. As the inflammation caused by 35% H2O2 is longer, patients may benefit better from using lower concentrations of this bleaching product, as they may result in less tissue damage.

The effects of ozone therapy on periodontal therapy: A randomized placebo-controlled clinical trial.

The aim of this randomized split-mouth clinical trial was to evaluate the effects of ozone therapy on clinical and biochemical parameters of moderate to severe generalized periodontitis patients after non-surgical periodontal therapy. A total of 36 moderate to severe generalized periodontitis patients were included in the study. The patients were systemically healthy and 18 to 64years of age. Periodontal parameters, including plaque index (PI), gingival index (GI), probing depth (PD), percentage of bleeding on probing, percentage of pockets deeper than 5mm and clinical attachment level (CAL), and percentage of ≥3mm CAL, were evaluated at baseline and 3months following periodontal therapy. All participants were treated non-surgically. Topical gaseous ozone was applied into periodontal pockets twice a week for 2weeks during active periodontal therapy. Gingival crevicular fluid pentraxin-3 (PTX-3), interleukin-1β (IL-1β), and high sensitivity C-reactive protein (Hs-CRP) were evaluated. All statistical data were analyzed using SPSS software. Total of 36 participants completed the study (18 males, 18 females). PI, GI, PD, percentage of bleeding on probing, percentage of pockets deeper than 5mm and CAL, and percentage of ≥3mm CAL were improved, and there were no significant differences between the two sides. All inflammatory parameters, PTX-3, Hs-CRP, and IL-1, were reduced at 3-month follow-up. Only the decrease in PTX-3 levels between baseline and 3-month follow-up was statistically significant. Ozone therapy did not have any additional effect on periodontal parameters. All cytokines were reduced after periodontal therapy. Only PTX-3 levels were significantly lower at ozone sites compared to those at the control sites.

Influence of antimicrobial photodynamic therapy in carious lesion. Randomized split-mouth clinical trial in primary molars

The literature presents many studies regarding photodynamic antimicrobial therapy (aPDT). However, the great variety of protocols to be used can directly influence its effectiveness in reducing microorganisms. The aim of this randomized split-mouth clinical study was to evaluate the effect of aPDT in the reduction of Streptococcus mutans and their effect on restorations performed. Twenty children between 6 and 8 years old with active caries and dentin cavitation, located on the occlusal surface of homologous primary molars were included. The selective removal of carious tissue was performed in both molars, than one was subsequently restored and the other received aPDT treatment on the affected dentin with low intensity laser (InGaAlP) associated to 0.005% methylene blue photosensitizer before restoration. Dentin collections were performed only in the tooth submitted to aPDT in three moments: before and after selective caries removal and after application of aPDT. The restorations were analyzed after polishing and after 6 months using United States Public Health Service (USPHS) method. Data were analyzed using ANOVA with repeated measures and Bonferroni post-hoc test with a significance level of 5%. There was a significant reduction on the amount of microorganisms after selective caries removal (p = 0.04) and also after the application of aPDT (p = 0.01). The reduction of S. mutans CFU was of 76.4% after caries removal, but associated with aPDT was 92.6%. After 6 months of clinical evaluation, no difference between groups was found for retention, marginal adaptation, color, marginal discoloration, and secondary caries. aPDT can be used as an additional treatment against cariogenic microorganisms after selective caries removal without compromising composite resin restorations.

Split-mouth Randomised Clinical Trial on the Efficacy of GIC Sealant on Occlusal Surfaces of Primary Second Molar.

To evaluate the clinical performance of high viscosity GIC sealant applied with or without additional light curing in children with early childhood caries (ECC). A split-mouth clinical trial was conducted in a total of 111 3- to 5-year-old children with ECC. 180 pairs of non-carious primary second molars were selected and divided into two groups: study and control. On the basis of the application technique, selected teeth in the study group were further allotted to group A (sealant application with additional light curing) and group B (sealant application without additional light curing). Caries incidence was observed for 1 year in the anatomical pits and grooves, along with sealant retention and marginal discolouration at various intervals over the 1-year period. Group A (GIC sealant with additional light curing) (44.2%) showed sealant retention similar to that of group B (GIC sealant without additional light curing) (43.0%) (p = 0.885). Caries incidence was significantly higher in the control group (26%) than the sealant groups (1%) (p < 0.001). No marginal discolouration adjacent to the sealant was observed in either anatomical grooves or pits in both sealant groups for the duration of the study. Retention and caries prevention by high-viscosity GIC sealant applied with or without additional light curing was found to be similar. At the 12-month assessment, mean dmfs scores and caries incidence in primary second molars were higher in the control than in both study groups.

Radiographic comparison of density and height of posterior maxillary bone after open sinus lift surgery with and without PRF.

Background Expansion of maxillary sinus towards the alveolar crest due to tooth loss or horizontal‒vertical resorption of the alveolar bone decreases the available bone for the placement of dental implants in the posterior maxilla. The method suggested for placing implants with a standard length is the use of sinus lift surgery with autogenous bone graft or bone substitute materials. The aim of the present research, with split-mouth design, was radiographic comparison of the density and height of the posterior of maxillary bone after open sinus lift procedure with and without PRF. Materials and Methods. In this split-mouth clinical trial, 14 patients were evaluated, with complete or partial bilateral edentulism of the upper jaw. In each case, for the sinus lift surgery of the test side, PRF was used, while in the sinus lift surgery of the other side of the same patient no graft materials were used. After six months and before the second surgery, CBCT was used to evaluate bone density and height. Results All the 41 implants were osseointegrated and were clinically stable. The bone height was 1.42 mm higher in the PRF group than the group without PRF, which was statistically significant. The mean density of the bone formed around the dental implants in the PRF group was 52.85 units higher than that of the group without PRF, which was statistically significant. Conclusion Using PRF in sinus lift surgery might enhance the quantity and quality of bone formation.

The Effect of a Plasma With Platelet-rich Fibrin in Bone Regeneration and on Rate of Orthodontic Tooth Movement in Adolescents

The aim of this study was to evaluate the effect of platelet-rich fibrin (PRF), placed in extraction sockets, on bone regeneration and orthodontic tooth movement in adolescents. Fourty extraction sockets from twenty patients requiring extraction of first premolars based on their orthodontic treatment plan participated in this split-mouth clinical trial. Immediately, the teeth adjacent to the defects were pulled together by a NiTi closed-coil spring with constant force. The bone regeneration and the amount of orthodontic tooth movement was evaluated.

Assessment of anesthetic properties and pain during needleless jet injection anesthesia: a randomized clinical trial.

Pain due to administration of local anesthetics is the primary reason for patients' fear and anxiety, and various methods are used to minimize it. This study aimed to measure the degree of pain during administration of anesthesia and determine the latency time and duration of pulpal anesthesia using two anesthetic methods in the maxilla.Materials and Methods:A randomized, single-blind, split-mouth clinical trial was conducted with 41 volunteers who required class I restorations in the maxillary first molars. Local anesthesia was administered with a needleless jet injection system (experimental group) or with a carpule syringe (control) using a 30-gauge short needle. The method of anesthesia and laterality of the maxilla were randomized. A pulp electric tester measured the latency time and duration of anesthesia in the second molar. Visual analogue scale (VAS) was used to measure the degree of pain during the anesthetic method. Data were tabulated and then analyzed by a statistician. The t-test was used to analyze the differences between the groups for basal electrical stimulation. Duration of anesthesia and degree of pain were compared using the Mann-Whitney test. A 5% significance level was considered.Results:There was no statistical difference in the basal electrical stimulation threshold (mA) and degree of pain between the two methods of anesthesia (p>0.05). Latency time was 2 minutes for all subjects. The duration of pulpal anesthesia showed no statistical difference (minutes) between the two methods (p<0.001), with a longer duration for the traditional method of anesthesia (median of 40 minutes).Conclusions:The two anesthetics methods did not differ concerning the pain experienced during anesthesia. Latency lasted 2 minutes for all subjects; the traditional infiltration anesthesia resulted in a longer anesthetic duration compared with the needleless jet injection.

Is Biodentine, as successful as, mineral trioxide aggregate for pulpotomy of primary molars? A split-mouth clinical trial

Background Despite the clinical and radiographic success of mineral trioxide aggregate (MTA) pulpotomy in primary molars, it does not gain much clinicians acceptance regarding manipulation difficulties. Aim This study aims to assess success rates of Biodentine and MTA used as pulpotomy agents in human primary molars, both clinically and radiographically. Patients and methods A split-mouth controlled clinical trial was carried out on 21 healthy, 3–7-year old children, with 42 pairs (84 molars) of contralateral mandibular primary molars indicated for pulpotomy. One paired tooth in one side was designated to Biodentine (group 1) and the other side for MTA (group 2) as a pulp medicament. All pulpotomized teeth were finally restored with stainless-steel crowns. Patients were monitored clinically and radiographically at 1, 3, 6, and 12 months. Results For all the patients available for the follow up appointments, Biodentine and MTA showed 100% success rate both clinically and radiographically. Conclusion Biodentine and MTA are highly recommended as pulpotomy medicaments in primary molars.

Comparative evaluation of analgesic and anti-inflammatory efficacy of ibuprofen and traumeel after periodontal flap surgery: A randomized triple-blind clinical trial.

Background:Pain management after performing flap surgery is of paramount importance. Taking into consideration the side effects of nonsteroidal anti-inflammatory drugs (NSAIDs), and the advantages of homeopathic medication, the analgesic and anti-inflammatory properties of ibuprofen (NSAID) and traumeel (homeopathic AID) following flap surgery were evaluated.Materials and Methods:A randomized, triple-blinded, split-mouth clinical trial, with a sample size of 20 (age range of 20–60 years) was planned. Subjects included patients diagnosed with moderate chronic generalized periodontitis. Two quadrants for each subject were operated on, with an interval of 3 weeks. Random assignment of the operated quadrants to the following medication protocols was carried out by a third person: Ibuprofen, 600 mg and traumeel, 600 mg (up to three tablets) every 8 h for first 24 h and SOS (Si Opus Sit/if needed) thereafter for a period of 1 week as pain medication, respectively. After 1 week, sutures were removed. Primary outcomes were mean postoperative pain (modified visual analog scale) and number of tablets consumed in 1 week. The secondary outcome was postoperative tissue response. Any adverse effects were recorded.Results:Number of tablets consumed and pain perception was lower in traumeel compared to ibuprofen Group (P < 0.001). A better tissue response was shown by the group treated with traumeel as compared to the ibuprofen receiving group (P < 0.05). Three patients reported adverse drug reactions after consumption of ibuprofen.Conclusion:The present study suggested that while managing pain following flap surgery, traumeel was superior as compared to ibuprofen, with minimal or no side effects.