Novel cryotherapy technique for pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis- a randomized controlled trial.

OBJECTIVES: To assess the effect of cryotherapy on haemostasis, post-operative pain, and the outcome of full pulpotomy performed in mature permanent teeth with symptomatic irreversible pulpitis. MATERIALS AND METHODS: The study included sixty mature permanent mandibular molar teeth with symptomatic irreversible pulpitis and no periapical rarefaction. After coronal pulp tissue amputation, teeth were randomly allocated to one of two groups (n = 30 each). In group I (conventional pulpotomy), a sterile cotton pellet moistened with 2.5% NaOCl was used for haemostasis. In group II (cryotherapy), the pulp chamber was continuously lavaged with 2.50C normal saline solution for haemostasis using an indigenous portable cryotherapy irrigation unit. Following haemostasis, the pulp was capped with mineral trioxide aggregate and the tooth was restored with resin composite. The time taken to achieve haemostasis was recorded. Preoperative and 24, 48 and 72 h postoperative pain was measured using the Numerical Rating Scale. The pulpotomy outcome was assessed at the 12-month follow-up. Data were analyzed using Fischer's exact test, two-sample t-test, two-sample Wilcoxon rank-sum test, Friedman Test, and Wilcoxon Signed Rank Test. RESULTS: The cryotherapy group achieved haemostasis in less time (p < 0.05). There was a significant pain reduction at 24 and 48 h in the cryotherapy group when compared with the conventional pulpotomy group (P < 0.005). The overall success rate of pulpotomy after 12 months was 88% (n = 22) in both study groups(p < 0.05). CONCLUSIONS: Cryotherapy application reduces postoperative pain and has no adverse effect on the outcome of pulpotomy in permanent teeth with symptomatic irreversible pulpitis. CLINICAL RELEVANCE: The cryotherapy can be incorporated in pulpotomy protocol as an adjunct to minimize post-operative pain.

Response to Pulp Sensibility Tests after Full Pulpotomy in Permanent Mandibular Teeth with Symptomatic Irreversible Pulpitis: A Retrospective Data Analysis.

INTRODUCTION: This retrospective study analyzed the 12-month pulp sensibility (cold and electric) test response after mineral trioxide aggregate (MTA) full pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis. METHODS: The records of 120 subjects from 3 completed and 1 ongoing clinical study on MTA full pulpotomy were retrieved. Ninety-six first and second mandibular molar teeth with a diagnosis of symptomatic irreversible pulpitis that underwent a single-visit MTA full pulpotomy and had completed a 12-month clinical, radiographic, and pulp sensibility (cold and electric) test follow-up were included. The data were analyzed using the Fisher exact test, the Pearson chi-square test, and the McNemar test. The significance level was predetermined at P < .05. RESULTS: A higher percentage of teeth (94.7%) responded to the electric pulp test in comparison with the cold test (13.5%) (P < .05). Sex-based responses to the electric pulp test (P > .05) and the cold test were similar (P > .05). The age-based response was similar for the electric pulp test (P > .05) but was significant for the cold test (P < .05). The tooth quadrant (left and right), the tooth (mandibular first and second molar), and the location of restoration (proximal or occlusal) did not influence the response of either the electric pulp test (P > .05) or the cold test (P > .05). At the 1-year follow-up, all the teeth that were classified as clinically and radiographically successful responded to the electric pulp test; however, only 13 teeth responded to the cold test (P = .00). CONCLUSIONS: The majority (94.7%) of the teeth that underwent MTA full pulpotomy responded to the electric pulp test at a 1-year time interval.

Influence of occlusal and proximal caries on the outcome of full pulpotomy in permanent mandibular molar teeth with partial irreversible pulpitis: A prospective study.

AIM: To assess the influence of occlusal and proximal deep carious lesions on the outcome of full pulpotomy performed in mandibular teeth with pulpal diagnosis of symptomatic partial irreversible pulpitis. METHODOLOGY: Eighty deep carious mandibular molar teeth with clinical and radiographic diagnosis of symptomatic partial irreversible pulpitis without periapical rarefaction from patients of either gender between the age of 16-35 years were included. Depending upon the location of deep carious lesion, the teeth were distributed equally into occlusal (n = 40) and proximal caries groups (n = 40). Full pulpotomy was performed under local anaesthesia and aseptic conditions. The pulp tissue was removed until the root canal orifices, and 2.5% sodium hypochlorite (NaOCl) was applied to arrest pulpal bleeding. Mineral trioxide aggregate (MTA) was compacted over the radicular pulp. Teeth were restored with resin-modified glass ionomer cement (RMGIC) and bulk-fill composite resin. Pre- and post-operative pain was assessed at 24, 48 and 72 h using a 11-point Numerical Rating Scale (NRS). Patients were followed at 6 and 12 months for clinical and radiographic evaluation. Asymptomatic teeth without any radiographic evidence of periapical rarefaction were considered successful. The data were analysed using the Shapiro-Wilk W test, two-sample Wilcoxon rank-sum test, Pearson chi-square test, Fisher's exact test and Kappa coefficient. The significance level was predetermined at p < .05. RESULT: An intergroup comparison revealed that the pre- and post-operative pain scores at 24, 48 and 72 h were not significantly different (p > .05). At the end of follow-up period (12 months), success of full pulpotomy in occlusal and proximal caries group was 95% and 92.5%, respectively (p = .644). For both groups, the combined success rate of full pulpotomy was 93.75%. CONCLUSION: The site of carious lesions (i.e., occlusal or proximal) did not affect the clinical and radiographic outcome of full pulpotomy performed in mature permanent mandibular teeth with symptomatic partial irreversible pulpitis.

Influence of preoperative degree of tooth loosening and thickness of wire on the rigidity of wire composite splint.

Context: A wire composite splint (WCS) is most commonly used in clinical practice for the management of luxation dental injuries (LDIs). Wire thickness and adhesive point dimensions influence the rigidity of WCS. However, the influence of presplint tooth mobility on the rigidity of splint is not yet addressed. Aim: The aim of this study is to identify the optimal thickness of WCS that achieves physiologic mobility in teeth with varying degrees of loosening (DoL) in a simulated LDI model. Settings and Design: In vitro study. Materials and Methods: Three typodont models with resin teeth were used. Right central incisor (Tooth 11) was simulated as an injured tooth and adjacent right lateral and left central incisor teeth (12 and21) acted as uninjured teeth. Each typodont model was modified to reproduce DoL 1, 2, and 3 in tooth 11 and categorized as Groups I, II, and III, respectively. The simulated injured tooth 11 was splinted with adjacent teeth 12 and 21 using 0.3, 0.5, and 0.8 mm WCS. Postsplinting DoL was assessed with Periotest. Statistical Analysis Used: Two-way ANOVA and post hoc Tukey test were used for intragroup and intergroup comparisons of pre- and postsplinting Periotest values (PTVs). Friedman's two-way ANOVA and Kruskal-Wallis test were used for the intragroup and intergroup comparison of splint effect. Results: Irrespective of the thickness of WCS, the postsplint PTVs corresponding to DoL 0 for simulated injured right central incisor tooth (11) were not achieved in Groups II and III. In three study groups, there was no statistically significant difference in the splint effect produced by 0.3 mm versus 0.5 mm WCS or 0.5 mm versus 0.8 mm WCS for tooth 11. Conclusions: The postsplint DoL for a luxated tooth is affected by both the degree of presplint tooth mobility and the thickness of the wire.

Green silver-nanoparticle-based dual sensor for toxic Hg(II) ions.

The present study focuses on the utilization of green silver nanoparticles, as they are preferred for sensing applications due to their environmentally friendly nature. We have examined the optical and electrochemical sensing behavior of silver nanoparticles from Agaricus bisporus (AgNP-AB) towards Hg(II) ions. The AgNP-AB was prepared by microwave reactor. The synthesized AgNP was used for the sensing of Hg(II) ions without the use of modifiers or further sophisticated instrumentation. The synthesized nanoparticles were successfully characterized by different techniques. AgNP-AB leads to aggregation with the addition of Hg(II) ions in aqueous medium, and develops a color change from brown to black which leads to the formation of AgNP-AB-Hg(II) complex. Moreover, the metal sensing ability of AgNP has been explored using electrochemical studies. AgNP-AB modified platinum electrode (AgNP-AB/PE) was developed for the fast sensing of toxic Hg(II) ions. The sensor exhibits a good limit of detection at 2.1 × 10-6 M. The sensitivity of AgNP-AB/PE towards Hg(II) ions was analyzed with various metal ions. The sensing skill of the developed system was successfully checked with real water samples from Vembanade Lake, Kumarakom, Kerala. AgNP from A. bisporus is highly versatile and promising for different environmental applications.