Comparison of the efficiency and effectiveness of various techniques for removal of fiber posts.

A study was conducted to determine the efficiency and effectiveness of several techniques for fiber post removal. Four groups of 20 mandibular premolars were endodontically treated and obturated. Post spaces were prepared for the following post systems: ParaPost XH, ParaPost Fiber White, Luscent Anchors, and Aestheti-Plus. After cementation, 10 posts of each group were removed with their corresponding manufacturer's removal kit and the other 10 removed with diamond burs and ultrasonics. Removal times were recorded and the teeth were sectioned vertically and microscopically analyzed for removal effectiveness based on a 0 to 5 point scale. Removal kits removed Luscent Anchors the fastest (mean = 3.9 min) and most effectively (mean = 2.6), while Aestheti-Plus posts were removed the slowest (mean = 7.3 min) and least effectively (mean = 3.4). Diamonds and ultrasonics required an average of 10 additional minutes for each fiber post system removal, yet removal effectiveness improved half a point. The results suggest recommended removal kits were significantly more efficient, while diamonds and ultrasonics were more effective. Removal kits could be enhanced with subsequent ultrasonic instrumentation to remove remaining fibers and cement.

Effect of sublingual triazolam on the success of inferior alveolar nerve block in patients with irreversible pulpitis.

The purpose of this prospective, randomized, double-blind, placebo-controlled study was to determine the effect of the administration of sublingual triazolam on the success of the inferior alveolar nerve (IAN) block in patients experiencing irreversible pulpitis. Fifty-eight emergency patients diagnosed with irreversible pulpitis of a mandibular posterior tooth randomly received, in a double-blind manner, an identical sublingual tablet of either 0.25 mg of triazolam or a placebo 30 minutes before administration of a conventional IAN block. Access was begun 15 minutes after completion of the IAN block, and all patients had profound lip numbness. Success was defined as no or mild pain (visual analog scale recordings) on access or initial instrumentation. The success rate for the IAN block was 43% with triazolam and 57% with the placebo, with no significant difference (P = .43) between the 2 groups. For mandibular posterior teeth, triazolam in a sublingual dose of 0.25 mg did not result in an increase in success of the IAN block in patients with irreversible pulpitis. Therefore, when using conscious sedation, profound local anesthesia is still required to eliminate the sensation of pain during endodontic treatment for patients with irreversible pulpitis.