Acute dental pain elevates salivary oxytocin in women: a risk factor during pregnancy.

Irreversible pulpitis is an acute, brief, and painful condition. Oxytocin, cortisol, and secretory immunoglobulin A (sIgA) are released by the body in response to pain and emotional stress. The aim of this study was to investigate the expression of salivary cortisol, sIgA, and oxytocin among patients with irreversible pulpitis. This was an ethically approved case-control study comparing 90 cases of irreversible pulpitis and 40 healthy individuals. Five study groups were established: nonpregnant female pulpitis, pregnant female pulpitis, male pulpitis, healthy (nonpregnant) female control, and healthy male control. Pregnant women in the first trimester were enrolled in the study. Participants received both clinical and radiographic examinations, completed a simple questionnaire related to food intake, habits, and anxiety, and their pain levels were recorded on a visual analog scale in which 0 represented no pain and 10 represented the worst possible pain. Unstimulated saliva samples were collected to measure oxytocin, sIgA, and cortisol levels. Dental pulp specimens were obtained and stained with hematoxylin and eosin to evaluate the agreement between clinical and histologic pulpal diagnoses. The statistical analysis included analysis of variance and Tukey tests. The majority of patients (37%) recorded a score of 8 (severe pain) on the visual analog scale, while a score of 10 (worst possible pain) was recorded only by pregnant women (3%). There was no statistically significant difference among healthy subjects for all salivary samples. Oxytocin levels increased significantly in nonpregnant (P < 0.5) and pregnant (P < 0.001) women with pulpitis. Cortisol (P < 0.01) and sIgA (P < 0.001) levels were significantly elevated only in pregnant women with pulpitis. The results of the present study indicate that acute dental pain during pregnancy can be considered as a pregnancy risk factor because of the resulting elevated oxytocin and cortisol levels.

Comparison of the antimicrobial effects of six different intracanal medicaments on Enterococcus Faecalis

Aim: to investigate the antimicrobial effects of six different intracanal medicaments on Enterococcus faecalis. Material & Methods: An agar well diffusion test was used to determine the efficacy of the experimental medicaments in removing E. faecalis (ATCC 29212). Medicaments were divided into 7 groups; calcium hydroxide (Ca(OH)2) with saline, Ca(OH)2 with anaesthetic solution, Ca(OH)2 with propylene glycol, commercially available premixed Ca(OH)2 paste, chlorhexidine gluconate gel, triple antibiotic paste (metronidazole, ciprofloxacin, doxicycline) with propylen glycol and talk powder with saline as negative control group. The diameters of the growth inhibition zones for each group were measured after 24 and 48 hours. Differences between groups were analysed using Kruskal-Wallis and Mann-Whitney U tests, and intragroup differences were analysed using Wilcoxon sign test. Results: Diameter of the inhibition zone observed for the triple antibiotic paste was significantly larger (p<0.01) and the diameter of the inhibition zone observed for the chlorhexidine gluconate gel was significantly smaller in comparison to the other tested medicaments (p<0.05). Conclusion: All of the tested medicaments were found to be effective on E. faecalis. However the results suggest that the triple antibiotic paste would be the preferred medicament against E. faecalis as it has the greatest antibacterial effect among the tested medicaments.

Radiologic Assessment of Periapical Health: Comparison of 3 Different Index Systems.

INTRODUCTION: The aim of this study was to evaluate observer variations and observer reproducibility in the interpretation of periapical health using the Strindberg system, the periapical index (PAI), and the probability index for radiologic assessment of periapical health. METHODS: Four observers read digital periapical images to evaluate the periapical health of 200 root-filled teeth. Each observer evaluated a tooth twice by using the Strindberg system, twice by using the PAI, and twice by using the probability index. Each observation session was held at 1-month intervals. Three scores were used for the evaluations conducted by using the Strindberg system. Both the PAI and the probability index were considered on 5-point scales and were also dichotomized. SPSS for Windows 15.0 software (SPSS Inc, Chicago, IL) was used for data analysis, and intra- and interobserver agreements were described by using kappa statistics. RESULTS: The average kappa values of intra- and interobserver agreement calculated for the Strindberg system were 0.53 and 0.36, respectively. The corresponding average kappa values were calculated as 0.48 and 0.39 for the PAI and 0.45 and 0.30 for the probability index. The highest mean proportion values of intra- and interobserver agreement were observed for the dichotomization of the PAI (88.9% and 87.0%, respectively) followed by the dichotomization of the probability index (86.8% and 82.9%, respectively). CONCLUSIONS: The Strindberg system has lower intraobserver variation compared with the PAI and the probability index, whereas PAI has lower interobserver variation compared with the Strindberg system and the probability index. The dichotomization of the PAI and the probability index provided higher intra- and interobserver agreement values in the radiologic assessment of periapical health.

Effect of Storage Temperature on the Shelf Life of Self-adhesive Resin Cements.

PURPOSE: To compare the bonding performance of three new self-adhesive resin cements to human dentin after storage under two different conditions. MATERIALS AND METHODS: Buccal, lingual, mesial, and distal dentin surfaces of 36 human molars were abraded to directly below the enamel with #600 SiC papers. The teeth were divided into two main test groups. In the first test group (FT), the cements were kept in a refrigerator (6 ± 2°C) for three months and then used for the test. The remainder of the cements was kept at a constant room temperature of 19 ± 2°C for an additional three months, and then used again for the second test group (ST). Each test group comprised 6 teeth and 24 dentin sections. The cements Clearfil SA (CSA), G-Cem (GC), and Bis-Cem (BC) were applied to the surfaces according to the manufacturers' recommendations. After application of the cements to the flat dentin surfaces and light curing, shear bond strengths were determined at a crosshead speed of 0.5 mm/min. Bond strengths were then calculated and expressed in MPa. Data were analyzed with Kruskal-Wallis and Wilcoxon Signed Rank tests. To investigate the cement/ dentin interfaces using SEM, the buccal surfaces of three additional teeth were used for each test group. RESULTS: The bond strength values of cement groups were significantly different for the FT and ST groups (p < 0.01). GC showed the highest bond strength values of all materials. There was a difference between the bond strength values of the two testing periods for all materials (p < 0.01). Bond strengths significantly decreased after storage at room temperature. CONCLUSION: Storage temperatures considerably affect the shelf life of self-adhesive resin cements.