Effects of endodontic treatment on salivary levels of CGRP and substance P: a pilot study.

OBJECTIVES: The aim of this study was to evaluate the effects of endodontic treatment on levels of substance P (SP) and calcitonin gene-related peptide (CGRP) in the saliva of patients with symptomatic apical periodontitis. MATERIALS AND METHODS: Twelve patients with mandibular molars with symptomatic apical periodontitis were enrolled in this study. An initial saliva sample was collected just before administration of anesthesia for root canal treatment, which was performed at the first visit. A second saliva sample was collected at a control visit 1 week after treatment. Salivary SP and CGRP levels were evaluated quantitatively using biochemical assays. The data were analyzed using Pearson correlation analysis, the paired samples t-test, and the Mann-Whitney U test (p = 0.05). RESULTS: The postoperative salivary level of SP was significantly lower than the preoperative level (p = 0.005). However, the postoperative salivary level of CGRP was similar to the preoperative level (p = 0.932). Visual analog scale (VAS) scores of patients' subjective pain were found to be positively correlated with salivary levels of SP (r = 0.421; p = 0.040). No statistically significant correlations were observed between salivary levels of CGRP and VAS scores for patients' subjective percussion tenderness (p = 0.533) or VAS scores for patients' subjective pain (p = 0.459). CONCLUSIONS: According to the results of the present study, salivary SP levels may be used as an objective indicator in the diagnosis and assessment of the degree of pain in endodontic diseases. TRIAL REGISTRATION: Thai Clinical Trials Registry Identifier: TCTR20161228001.

Acupuncture reduces the postoperative pain in teeth with symptomatic apical periodontitis: a preliminary randomized placebo-controlled prospective clinical trial.

OBJECTIVE: Endodontic treatment generally results in a wide range of postoperative pain intensity. The aim of this study was to investigate the effect of preoperative acupuncture on postoperative pain in molar teeth with symptomatic apical periodontitis. METHOD AND MATERIALS: Thirty patients having symptomatic apical periodontitis with a preoperative and percussion pain of visual analog scale (VAS) more than 60 were included in this study. The patients were randomly distributed into two groups; G1, real acupuncture; and G2, placebo (mock acupuncture). After 15 minutes of application, root canal treatment was performed. A logistic regression analysis was used to determine the variable(s) (group, age, gender, tooth number, preoperative pain, preoperative percussion pain, and radiographic status) that controls the postoperative pain significantly. Chi-square, Mann Whitney U, and independent t tests were performed to analyze the data, and the level of significance was set at .05 (P = .05). RESULTS: A regression analysis demonstrated that the group variable had the most significant effect on postoperative pain at day 1 (P = .003). Results showed that acupuncture reduced the preoperative and percussion pain levels significantly more than placebo group at all day intervals (P < .05). For postoperative pain at the 7-day follow-up, the pain ranged from "mild" to "no pain" in G1, compared with "moderate" to "minimal" in G2. Only one patient required postoperative analgesics in the acupuncture group compared to eight patients for placebo. CONCLUSIONS: Preoperative acupuncture can be beneficial in reducing postoperative pain in teeth with symptomatic apical periodontitis.

Comparative study of ProTaper gold, reciproc, and ProTaper universal for root canal preparation in severely curved root canals.

AIM: The aim of this study is to evaluate the root canal transportation, centering ability, and instrumentation times with the ProTaper Gold (Dentsply Tulsa Dental, Tulsa, OK, USA), Reciproc (VDW, Munich, Germany), and ProTaper Universal (Dentsply Maillefer, Ballaigues, Switzerland) using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Thirty mesial root canals of mandibular first molars with curvature angles of 35°-70° and radii of 2-6 mm were included in the study. Root canal instrumentation was performed up to F2 or R25. The instrumentation times were recorded. CBCT scanning was performed both pre- and post-instrumentation. Root canal transportation and the centering ratio were calculated for groups, and the data were analyzed using a one-way ANOVA and least significant difference post hoc tests for the instrumentation time, root canal transportation, and centering ratio at the 95% confidence level (P = 0.05). RESULTS: At 3, 5, and 7 mm levels, there was no significant difference in the root canal transportation and centering ratio among the groups (P > 0.05). There were significant differences between the Reciproc and ProTaper Universal groups in the instrumentation times (P < 0.05). CONCLUSION: Root canal transportation and the centering ratio with the ProTaper Gold were similar to those obtained with the ProTaper Universal and Reciproc.

Effect of instrument speed when used in reciprocating motion on root canal transportation and centering ability.

AIM: This study aims to evaluate the root canal transportation, centering ability, and instrumentation times after root canal preparation using reciprocating motion at 300 rotations per minute (rpm) and 600 rpm. MATERIALS AND METHODS: Twenty mesial root canals of mandibular first molars with curvature angles of 35°-70° and radii of 2-6 mm were included in the study. Root canal instrumentation was performed using R25 according to the manufacturer's instructions at 300 rpm or 600 rpm (n = 10). Cone-beam computed tomography scanning was performed both pre- and post-instrumentation. Root canal transportation and the centering ratio were calculated for both the groups, and the data were analyzed using independent sample t-test for the instrumentation time, root canal transportation, and centering ratio at the 95% confidence level (P = 0.05). RESULTS: At the three levels (3 mm, 5 mm, and 7 mm), there were no significant differences in centering ratio between the groups (P > 0.05). At 3 mm, 600 rpm resulted in more transportation than 300 rpm. However, there were no significant differences in the root canal transportation between the groups at 5 mm and 7 mm levels (P > 0.05). CONCLUSION: At the 3 mm level, 600 rpm resulted in more transportation than 300 rpm. However, centering ratio was similar at both 600 rpm and 300 rpm.