Comparison of diflunisal and an aspirin-codeine combination in the management of patients having one-visit endodontic therapy.

One hundred seventy-nine patients with asymptomatic or mildly symptomatic endodontic disease had single-visit therapy and were given either diflunisal (n = 94) or aspirin with codeine (n = 85) to control posttreatment pain. In this open-label, randomized study, diflunisal was judged superior to the aspirin-codeine combination in all major categories evaluated. Of patients receiving diflunisal, 93.6% needed the medication for only one day. In contrast, 77.7% of patients receiving aspirin with codeine needed the medication for only one day. Almost 64% of patients receiving diflunisal needed only one dose, while 32.9% of patients using aspirin with codeine needed only one dose. Four or more doses were required by 5.3% of patients receiving diflunisal and by 23.5% of patients receiving the aspirin-codeine combination. In patients receiving diflunisal, 20.2% experienced side effects. In contrast, 29.4% of patients receiving aspirin with codeine reported side effects. Thirty-five percent of patients receiving diflunisal rated the analgesic as excellent; 5.3% rated it as fair or poor. In contrast, 12.9% of patients receiving aspirin with codeine rated the analgesic combination as excellent; another 12.9% rated it as fair or poor. Diflunisal was found to be generally effective and well-tolerated, and superior to aspirin with codeine in the management of pain from endodontic treatment.

A diagnostic case involving an incisive canal cyst.

An incisive canal cyst was misdiagnosed as an endodontic lesion. The patient's chief complaint was pain on mastication with increasing intensity for the last 2 days. The single original periapical radiograph revealed a well-circumscribed radiolucency related to the apex of the maxillary right central incisor. The patient was referred with a request for endodontic therapy. A subsequent angled radiograph revealed an interroot location of the lesion, and pulp testing showed a normal response. The patient was then referred for surgical treatment. Following removal of the lesion, the histopathologic examination confirmed the diagnosis of an incisive canal cyst. One-year follow-up showed complete healing and maintained tooth vitality, and the patient was asymptomatic.

Tissue reactions to endodontic materials implanted in the mandibles of guinea pigs.

Teflon, Intermediate Restorative Material, and Prisma VLC Dycal were implanted in the mandibles of 16 guinea pigs. After experimental periods of 4 and 12 weeks, the animals were killed and tissue sections were prepared. No severe inflammatory response was noted in any of the groups except for a persistence of moderate inflammation in the poorly condensed Teflon group. Bone apposition occurred in the Prisma VLC Dycal group; none-to-mild inflammation and a thin fibrous capsule characterized the IRM group; and the Teflon group had a thick fibrous encapsulation except for samples where the Teflon material appeared to be poorly condensed and dispersed into the bony tissue. In areas where the teflon was loosely condensed, chronic inflammation and active phagocytosis were seen along the surface of the material.