Efficacy of preoperative ibuprofen on the success of inferior alveolar nerve block in patients with symptomatic irreversible pulpitis: a randomized clinical trial.

AIM: To evaluate the effect of preoperative oral ibuprofen (IBU) on the success of inferior alveolar nerve blocks (IANBs) with mepivacaine containing 1 : 100 000 epinephrine for patients with symptomatic irreversible pulpitis (SIP). METHODOLOGY: The present study was a double-blind, randomized, placebo-controlled clinical trial. The study included two study groups each consisting of 25 patients who exhibited symptomatic irreversible pulpitis of a mandibular posterior tooth. The patients presented prolonged moderate or severe pain (>10 s) after cold testing and indicated their pain scores on a Heft-Parker visual analogue scale. The patients received identically appearing capsules containing either 600 mg IBU (IBUg) or gelatin (placebo, PLAg) 1 h before administration of IANB with 2% mepivacaine containing 1 : 100 000 epinephrine. After 15 min, the anaesthetic blockade was assessed by a three-step examination (lip numbness, positive/negative response to cold testing and clinical discomfort during endodontic access). IANB success was defined as the absence of pain during any of these evaluations. The data were analysed using the chi-squared test. RESULTS: All of the patients reported moderate or severe pain before the preoperative procedure. Statistically significant differences were observed between the IBUg and PLAg (P < 0.05); the success rates for the IANB were 72% (IBUg) and 36% (PLAg). CONCLUSIONS: Preoperative oral administration of IBU significantly improved the efficacy of IANB in patients with symptomatic irreversible pulpitis.

Comparison of the antibacterial effect of modified 3-mix paste versus Ultrapex over anaerobic microorganisms from infected root canals of primary teeth: an in vitro study.

OBJECTIVE: The aim of this study was to evaluate in vitro the antimicrobial efficacy of a modified 3-mix paste and to compare it with an iodoform paste (Ultrapex) against anaerobic microorganisms isolated from root canals of infected or necrotic primary teeth. STUDY DESIGN: An in vitro experimental assay was performed over isolated and identified anaerobic microorganisms of 21 samples, in order to compare the antimicrobial ability of both root canal filling materials, using a disc-diffusion method. RESULTS: A total of 21 microbial samples (15 polymicrobial and 6 monomicrobial) were obtained, from which 19 different strains were identified. Modified 3-mix paste showed an excellent antimicrobial effect against most of both kinds of microbial samples, although some of them exhibited resistance; on the other hand, Ultrapex showed only minimal antimicrobial ability (null or low categories). Clostridium ramosum exhibited the most resistance to both materials. CONCLUSION: The bactericidal effect of the modified 3-mix paste was superior to Ultrapex, with a statistically significant difference, against anaerobic microorganisms isolated from infected root canals of primary teeth.

Effectiveness of oxidative potential water as an irrigant in pulpectomized primary teeth.

OBJECTIVE: The aim of this study was to evaluate the effectiveness of oxidative potential water (OPW) as an irrigating solution in reducing bacterial loading in necrotic pulpectomized primary teeth. STUDY DESIGN: Forty necrotic teeth were included, 20 irrigated with OPW (experimental group) and 20 with 1% NaOCl (control group); in both groups, 2 microbiological samples from within the canals were taken with a sterile paper point, the first before irrigation (immediately before opening the crown), and the second after instrumentation and final irrigation (before filling). All samples were evaluated by McFarland's scale. RESULTS: After the samples were analyzed before and after irrigation in the control group, there was a significant decrease in bacterial load, as in the experimental group (P < 0.0001). When both groups were compared post irrigation, no significant difference was observed (P = 0.1519). CONCLUSION: The OPW was as effective as the NaOCl and is suggested as an alternative for irrigating after pulpectomy of necrotic primary teeth.

Reduction in bacterial loading using 2% chlorhexidine gluconate as an irrigant in pulpectomized primary teeth: a preliminary report.

OBJECTIVE: The aim of this study was to evaluate the reduction in bacterial loading using 2% chlorhexidine gluconate as an irrigating solution in pulpectomized primary teeth. STUDY DESIGN: A randomized, controlled clinical trial was performed that included primary teeth with pulp necrosis. Forty necrotic teeth were included, 20 irrigated with 2% chlorhexidine gluconate (experimental group) and 20 with sterile saline solution (control group); in all cases, 2 microbiological samples from within the canals were taken with sterile paper points, the first after the canal opening and before the first irrigation, and the second after instrumentation and final irrigation, before filling. All samples were evaluated by McFarlands scale. RESULTS: The results were statistically analyzed by the Mann-Whitney U test. After analyzing samples before and after irrigation in the control group (saline), we found a significant decrease of bacterial load (P < 0.0002). The same occurred in the chlorhexidine group samples (P < 0.0001). When both groups were compared post-irrigation, a statistically significant difference was observed in favor of 2% chlorhexidine gluconate. CONCLUSION: Two percent chlorhexidine gluconate showed a greater reduction of intracanal bacterial loading compared with that observed with sterile saline solution. This irrigating solution is suggested as an alternative for pulpectomy of necrotic primary teeth.