Reduction of postendodontic pain after one-visit root canal treatment using three irrigating regimens with different temperature.

OBJECTIVE: The aim of this clinical trial was to assess whether controlled irrigation with three different irrigation regimens with different temperature would result in reduction of post-endodontic pain after one-visit root canal treatment (RCT). MATERIALS AND METHODS: A total of 240 (129 females and 111 male) aged 18 - 65 years were referred and integrated in this clinical trial, All patients presented with a vital maxillary or mandibular molar, premolar or front teeth designated for conventional root canal treatment for prosthetic reasons detected with only vital pulps. All canals were cleaned and shaped with Reciproc instruments, and were used with a micro motor (VDW, Munich Germany). Final irrigation was done with cold (4°C, 2.5°C, and room temperature) 17% EDTA and 10 mL of cold saline solution. RESULTS: A total of 240 of 279 patients (129 females and 111 male) aged 18 - 65 years were referred and integrated in this clinical trial, whereas 29 were rejected as not completing the requirements needed. All patients presented with a vital maxillary or mandibular molar, premolar, or front teeth designated for intentional endodontic RCT for prosthetic reasons. No statistically significant difference (P > 0.05) among the groups was found regarding degree or duration of pain. There was no statistically significant difference (P > 0.05) among the 4oC and 2.5oC groups. CONCLUSION: The approach in both selecting the patients participating in the study and analyzing the data in this randomized clinical trial allows us to conclude that cryotherapy is an aid of clinical procedures to clean and shape the canals to reduce the occurrence of postendodontic pain and the need for medication in patients presenting with a diagnosis of vital pulp.

Comparison of working length determination with radiographs and four electronic apex locators.

AIM: To evaluate the accuracy of the Root ZX, Elements-Diagnostic, Precision AL and Raypex 5 electronic apex locators when compared to radiographs for locating the apical constriction. METHODOLOGY: The apical constriction of 693 canals in 245 maxillary and mandibular teeth was located in vivo with four electronic apex locators (EALs) and radiographically. After extraction the actual location of the apical constriction was determined visually and with magnification. A paired samples t-test, X2 test and a repeated measure anova at the 0.05 level of significance were used to determine differences between the groups. RESULTS: For anterior teeth, the Root ZX, Elements, Precision AL, Raypex 5 and radiographs located the apical constriction 89.09%, 83.63%, 85.45%, 81.81% and 32.72% of the time, respectively. For premolar teeth, the Root ZX, Elements, Precision AL, Raypex 5 and radiographs located the apical constriction 75%, 61.60%, 64.28%, 61.60% and 32.14% of the time, respectively. For molar teeth, the Root ZX, Elements, Precision AL, Raypex 5 and radiographs located the apical constriction 69.01%, 50.49%, 65.40%, 43.93% and 14.59% of the time, respectively. There was no statistically significant difference between the four EALs (P = 0.05). CONCLUSION: Measuring the location of the apical constriction using the four apex locators was more accurate than radiographs and would reduce the risk of instrumenting and filling beyond the apical foramen.

Comparison of working length determination with radiographs and two electronic apex locators.

AIM: To evaluate the accuracy of the Root ZX and Elements-Diagnostic electronic apex locators when compared with radiographs for locating the canal terminus or minor foramen. METHODOLOGY: The canal terminus of 482 canals in 160 maxillary and mandibular teeth was located in vivo with both locators and radiographically. After extraction, the actual location of the minor foramen was determined visually and with magnification. A paired samples t-test, chi-square test and a repeated measure anova at the 0.05 level of significance were used to determine differences between the groups. RESULTS: The Root ZX located the minor foramen correctly 68% of the time in anterior and premolar teeth, and 58% of the time in molar teeth. The Elements-Diagnostic located the minor foramen correctly 58% of the time in anterior and premolar teeth and 49% of the time in molar teeth. Radiographs located the minor foramen correctly 20% of the time in anterior and premolar teeth and 11% of the time in molar teeth. There was no statistically significant difference between the two locators, but there was a significant difference between them and radiographs. For all teeth, the measurements made by the apex locators were within +/-0.5 mm of the minor foramen 100% of the time, whereas for the radiographs, the measurements were within this range only 15% of the time. This difference was significant (P = 0.05). CONCLUSION: Measuring the location of the minor foramen using the two apex locators was more accurate than radiographs and would reduce the risk of instrumenting and filling beyond the apical foramen.