Incidence of Postoperative Pain after Single Visit Root Canal Treatment using XP-endo Shaper, 2Shape and ProTaper Gold Rotary Systems: A Prospective Randomized Clinical Trial.

OBJECTIVE: To evaluate the incidence of postoperative pain, treatment time and analgesic intake after single visit endodontic treatment of mandibular molars using XP-endo Shaper, 2Shape and ProTaper Gold rotary systems. METHODS: 150 patients with irreversible pulpitis were scheduled for single visit root canal treatment. Teeth were randomly assigned to one of the three groups: ProTaper Gold (PTG; Dentsply Tulsa Dental Specialties, Johnson City, TN), 2Shape (2S; Micro-Mega, Besancon, Cedex, France) and XP-endo Shaper (XPES; FKG Dentaire, La Chaux-de-Fonds, Switzerland). Preoperative and postoperative pain was rated by the patients at the beginning of treatment and after 24, 48, 72 hours and 7 days on Heft Parker's visual analog scale (HP-VAS). RESULTS: Highest mean postoperative pain score was recorded in PTG (P<0.05), followed by 2S and XPES respectively at all time intervals. XPES exhibited maximum reduction from preoperative pain at 24 (48.67%) and 48 hours (96.90 %) with no pain at 72 hours. Treatment time was significantly least in XPES (P<0.05) followed by 2S and PTG; but no significant difference in analgesic intake was noted. CONCLUSION: XPES exhibited least postoperative pain at all time intervals and treatment time, followed by 2S and PTG rotary systems respectively. (EEJ-2022-04-053).

Stainless steel vs. titanium miniscrew implants: Evaluation of stability during retraction of maxillary and mandibular anterior teeth.

OBJECTIVES: This study was aimed to compare the stability of stainless steel and titanium miniscrew implants of the same diameter and length during en masse retraction of maxillary and mandibular anterior teeth. MATERIALS AND METHODS: Forty miniscrew implants (1.3 mm diameter and 8 mm length) were placed in 10 patients (20 titanium and 20 stainless steel). Stability was checked at insertion (T0), at one month (T1), and at sixth months (T2) and the amount of retraction was recorded in millimeters. RESULTS: Titanium and stainless steel implants were equally stable at the time of insertion. At T1, three titanium miniscrew implants showed grade 2 mobility, whereas seven stainless steel miniscrew implants showed grade 2 mobility. For T2, none of the titanium miniscrew implants had grade 2 mobility while four stainless steel miniscrew implants resulted in grade 2 mobility. Both had an equal frequency of grade 3 and grade 4 mobility. However, the difference in the stability was not statistically significant. No statistical significance was found when the amount of retraction achieved by titanium and stainless steel miniscrew implants was compared between the maxillary and mandibular arches. CONCLUSION: Both titanium and stainless steel miniscrew implants provide good anchorage and remain stable during en masse retraction of maxillary and mandibular anterior teeth. Thus, both miniscrews are clinically effective.

Dental Pulp Status of Posterior Teeth in Patients with Oral and Oropharyngeal Cancer Treated with Radiotherapy: 1-year Follow-up.

INTRODUCTION: Teeth may react negatively to pulp sensitivity testing in patients who have undergone radiotherapy. The aim of the current investigation was to evaluate the pulp sensibility of posterior teeth at 4, 6, and 12 months in patients who have undergone radiotherapy for oral and oropharyngeal malignancies. METHODS: Seventy-nine patients diagnosed with malignant oral and oropharyngeal cancer undergoing radiotherapy underwent cold thermal pulp sensitivity testing and electric pulp testing of 4 teeth, 1 from each quadrant. The results were recorded at 5 different time points (TPs): before radiotherapy (TP1), at the end of radiotherapy at 66-70 Gy (TP2), 4 months after the completion of radiotherapy (TP3), 6 months after the completion of radiotherapy (TP4), and 12 months after the completion of radiotherapy (TP5). RESULTS: All 288 teeth tested positive to cold thermal pulp sensitivity testing and electric pulp testing (EPT) at TP1 (100%). No tooth responded to the cold test (100%) at TP4 and TP5, and progressively higher EPT values were noted during the observation period. A statistically significant difference existed in the number of positive responses between different TPs. CONCLUSIONS: There was a progressive decrease in pulp sensibility from TP1 to TP5 in teeth of patients with oral and oropharyngeal cancer who underwent radiotherapy (66-70 Gy). No response to cold thermal tests was noted at TP4 (6 months) and TP5 (12 months), and teeth responded at increasingly higher EPT values from TP1 through TP5. This result was statistically significant.

Dental Pulp Status of Posterior Teeth in Patients with Oral and Oropharyngeal Cancer Treated with Concurrent Chemoradiotherapy.

INTRODUCTION: The absence of tooth sensitivity has been observed in patients who have undergone radiotherapy. The aim of this investigation was to evaluate the effects of concurrent chemoradiotherapy on the pulp status of posterior teeth in patients with malignant oral and oropharyngeal cancer. METHODS: Twenty-one patients diagnosed with malignant oral and oropharyngeal cancer undergoing concurrent chemoradiotherapy underwent cold thermal pulp sensitivity testing and electric pulp testing of 4 teeth, 1 from each quadrant, at 4 points in time (PT): before radiotherapy (PT1), after 30-35 Gy (PT2), at the end of radiotherapy at 66-70 Gy (PT3), and 4 months (PT4) after beginning radiotherapy. RESULTS: All 84 teeth tested positive to cold thermal pulp sensitivity testing at PT1 (100%) and 25 teeth at PT2. No tooth responded at PT3 and PT4 (100%). A statistically significant difference (P < .05) existed in the number of positive responses between different points in time. CONCLUSIONS: Radiotherapy decreased the number of teeth responding to pulp sensitivity testing after doses greater than 30-35 Gy.

Comparison of Preoperative Oral Ketorolac on Anesthetic Efficacy of Inferior Alveolar Nerve Block and Buccal and Lingual Infiltration with Articaine and Lidocaine in Patients with Irreversible Pulpitis: A Prospective, Randomized, Controlled, Double-blind Study.

INTRODUCTION: Irreversible pulpitis (IP) commonly results in decreased anesthetic efficacy of the inferior alveolar nerve block (IANB) for mandibular molar. It has been shown that supplementary buccal and/or lingual infiltration as well as premedication with ketorolac result in improved efficacy of the IANB. METHODS: One hundred fifty emergency patients who had their lower first or/and second molar diagnosed with IP participated in the study. All patients were randomly divided into 2 major IANB groups: 1 group received 4% articaine with 1:100,000 epinephrine, and the other group received 2% lidocaine with 1:80,000 epinephrine. Each group was further divided into 3 subgroups of 25 each: (1) buccal and lingual infiltration with articaine and lidocaine, respectively; (2) preoperative oral medication of ketorolac; and (3) preoperative oral medication of ketorolac followed by buccal and lingual infiltration with articaine and lidocaine, respectively. Endodontic access was initiated 15 minutes after solution deposition, and all patients were required to have profound lip numbness. Success of the anesthetic was defined as none or mild pain on endodontic access and initial instrumentation. RESULTS: Statistical analysis was performed using multiple-comparison analysis of variance (Kruskal-Wallis) and t tests. Articaine IANB with infiltrations plus oral ketorolac premedication significantly increased the success rate to 76%. The success rate after the administration of an articaine IANB with infiltration injections was 64%, whereas with lidocaine it was 32% (P < .05). CONCLUSIONS: Premedication with ketorolac significantly increases the anesthetic efficacy of articaine IANB plus infiltration in mandibular molars with IP.

Perioral age-related changes in smile dynamics along the vertical plane: a videographic cross-sectional study.

OBJECTIVE: To evaluate the changes in characteristics of perioral musculature at rest and when smiling, with respect to age and gender, measured along the vertical plane in a randomly selected sample of a North Indian population. MATERIALS AND METHODS: Perioral musculature of 195 subjects (divided into three age groups) was recorded using standardized videographic methods. Two frames of each subject-at rest and widest posed smile-were analyzed for a comprehensive list of parameters. Data was evaluated using SPSS version 16 software. Two-way analysis of variance and post hoc least significant difference tests were conducted. RESULTS: Significant observations were increased resting upper lip length for females; decreased upper lip thickness, maxillary incisor exposure, and lip elevation for males; and increased smiling upper lip length for both sexes. CONCLUSIONS: With age, the smile gets narrower vertically, especially for the male population. The pattern of change observed in the present study must be considered and incorporated during treatment planning to deliver healthier and long-lasting results to patients of all age groups.