Prevalence of post-treatment pain after cleaning and shaping of the root canal system using manual step-back versus rotary nickel titanium.

To evaluate the effect of ProTaper rotary NiTi instrumentation technique on post-treatment pain at different time periods when compared with step-back technique, one hundred forty-six patients with 160 teeth participated in this study. All treated teeth (160) are having vital pulps and divided into two groups according to the canal instrumentation technique. Group (1) consisted of 80 teeth, cleaned and shaped with manual step-back technique using K-Flexo hand files. Group (2) was 80 teeth cleaned and shaped using ProTaper (NiTi) rotary files. Patients assessed post-treatment pain at 8 h, 24 h, and 48 h as none, mild, moderate, or severe. Evaluation of the two groups, according to the three post-treatment time period, was tabled as to the number of responses at each pain level at each interval. Comparisons were made by subjecting the collected data to a multiple- regression test. The results demonstrated that there were no statistically significant difference in post-treatment pain between the two groups at any time period P > 0.05.

Biochemical and histochemical analysis of the enzyme arylsulfatase in human lesions of endodontic origin.

Lesions of endodontic origin are areas of inflammatory response which occur as a result of untreated disease process within the root canal system. Lysosomal hydrolytic arylsulfatase A and B have been identified as major enzymes initiating and propagating bone loss by degrading chondroitin-4-sulfate. The purpose of this investigation was to examine human lesions of endodontic origin for the presence of arylsulfatase A and B. Fifteen periapical lesions were obtained at the time of periapical surgery. The lesions were analyzed for the presence of arylsulfatases using the spectrophotometer by monitoring the liberated 4-nitrocatechol at 515-nm wavelength. The same lesions were examined histochemically using the electron microscope. Five control samples from healthy periodontal ligament were evaluated in a similar manner. The results showed higher levels of arylsulfatase A in lesions than in control tissues, and marked activity of arylsulfatase B in lesions, whereas no activity of this enzyme was detected in the control specimen. Histochemically, all lesions showed positive staining for enzyme activity, whereas the controls were negative. These findings indicate that arylsulfatase A and B play a role in the pathogenesis of human lesions of endodontic origin.

Sealing ability of amalgam, super EBA cement, and MTA when used as retrograde filling materials.

OBJECTIVE: To compare apical microleakage of MTA following reverse retrograde root filling with that following amalgam and EBA retrofilling. DESIGN: Prospective random control trial. SETTING: It was conducted at the University of Jordan in 1998. MATERIALS AND METHODS: The root canals of 79 extracted teeth were instrumented and obturated with vertically condensed gutta-percha. Each tooth was apically resected and the apex was prepared ultrasonically to 3 mm depth and the root surface isolated with nail varnish. Teeth were divided randomly into three groups of 25 teeth each. First group was retrofilled with amalgam, second group with EBA and the third group with MTA. Following immersion in 1% methylene blue dye for 72 hours, the roots were sectioned and the depth of dye penetration was evaluated by a stereomicroscope at x10 magnification. INTERVENTIONS: Super EBA is a reinforced zinc oxide cement based on a mixture of 32% eugenol and 68% ethoxy benzoic acid (EBA). MTA is a mineral trioxide aggregate cement (MTA) based on a mixture of sterile water. MAIN OUTCOME MEASURES: The sealing effectiveness of the retrograde filling materials used in this study was determined by their ability to inhibit dye penetration. RESULTS: 56% of the group filled with amalgam and 20% of the group filled with EBA showed dye leakage beyond the retrofilling material whereas the MTA group showed none, two samples from MTA group were eliminated because of their fractured roots. The chi-squared test revealed a statistically significant difference among all three groups (P < 0.05). CONCLUSION: MTA cement provides a better seal than amalgam and EBA cement when used as retrograde filling, but the extrapolation of this result into a clinical practice may be questionable.

Five-year follow-up of successful intentional replantation.

Intentional replantation has been practised for many years as a treatment modality for pulpless teeth. Although the success ratio for intentional replantation is far below that for routine or surgical endodontics, one should consider this procedure as an alternative to tooth extraction. Two cases of mandibular second molars which were treated with intentional replantation and retrograde fillings are reported in this article. At the 5-year recall visit, the radiographs showed no evidence of pathological changes.