Efficacy of IANB and Gow-Gates Techniques in Mandibular Molars with Symptomatic Irreversible Pulpitis: A Prospective Randomized Double Blind Clinical Study.

INTRODUCTION: The aim of the present study was to compare the efficacy of the inferior alveolar nerve block (IANB) and Gow-Gates techniques in mandibular molars with symptomatic irreversible pulpitis. METHODS AND MATERIALS: In this randomised, double-blind clinical trial, 80 patients referred to Mashhad Dental School, were randomly divided into two groups: IANB and Gow-Gates anaesthetic techniques using 2% lidocaine with 1:100000 epinephrine. After injection, if pain during caries/dentin removal and access cavity preparation was reported in each group, the patients once again were randomly allocated to receive buccal or lingual supplementary infiltration. Pain severity was evaluated using a visual analogue scale. The rates of positive aspiration and changes in heart rate were compared between the IANB and Gow-Gates. Paired and individual t-tests and the Mann-Whitney U-test were used to compare the reduction in pain severity. The level of significance was set at 0.05. RESULTS: The success rates of anaesthesia in the Gow-Gates and IANB techniques were 50% and 42.5%, respectively with no significant difference (P=0.562). Supplementary infiltrations significantly reduced pain severity in all subgroups (P<0.05). Lingual infiltration resulted in a significantly greater reduction in pain severity in the IANB group than in the Gow-Gates group (P<0.05). No significant difference in heart rate or positive aspiration results was observed between groups (P>0.05). CONCLUSIONS: In the present study, the efficacy of the IANB and Gow-Gates techniques was comparable in mandibular molars with symptomatic irreversible pulpitis. Supplementary buccal and lingual infiltration significantly reduced pain severity.

Mandibular First Premolars with One Root and Three Canals: A Case Series.

The possibility of extra canals in mandibular premolars is quite low; however, it must be taken into account in clinical and radiographic evaluations during root canal treatment. This case series describes the presence of one root and three canals in mandibular premolars in three patients. The case series underlines the importance of complete knowledge about root canal morphology and possible variations to increase the ability of clinicians to treat difficult cases.

Endodontic management of a mandibular first molar with four canals in a distal root by using cone-beam computed tomography: a case report.

BACKGROUND: Aberrations in the root canal anatomy are clinically challenging for clinicians. Mandibular first molars usually have 2 roots and 3 or 4 canals, but various combinations may exist. A distal root with three canals is rare and its incidence in literature is about 0.2 - 3%. As a diagnostic tool, cone-beam computed tomography (CBCT) may be a better choice for diagnosis of extra roots or canals comparing to conventional radiography. METHODS: An endodontic management of a mandibular first molar with six canals was performed. CBCT was used to confirm the diagnosis and to understand the morphology of the canals. RESULTS: Evaluation of the axial and coronal slices of CBCT images confirmed the presence of 2 roots and 6 canals. The distal root had four distinct root canal orifices with two apical foramens, being described as type XIV canal configuration. CONCLUSIONS: Dentists should be aware of unexpected canal morphology when performing endodontic treatment. The present case demonstrated the use of CBCT in diagnosis and negotiation of extra canals in a mandibular first molar.

Use of fluid filtration method to evaluate the effect of master cone size on the apical seal of severely curved root canals.

The apical third of most root canals shows some degree of curvature, which is important in cleaning/shaping and obturation during root canal treatment. The present study evaluated the effect of master cone size on the apical seal of severely curved root canals. Thirty-eight mesial roots of human mandibular first molars were prepared using the crown-down technique. All samples were mature roots with closed apices, had no carious lesions or resorption, and had a canal curvature of > 45º to 60º. Two samples were used as a negative and positive control to evaluate the fluid filtration equipment, and the remaining 36 samples were equally divided into groups A, B, and C based on master cone size, namely, gutta-percha #20, #25, and #30, respectively. The fluid filtration method was used to evaluate microleakage. No significant difference in microleakage was observed among groups (P = 0.31). In conclusion, an increase in master cone size up to #30 does not significantly influence apical microleakage.

The Effect of Blood on Apical Microleakage of Epiphany and AH26: An In Vitro Study.

UNLABELLED:   INTRODUCTION: Blood contamination of the canal during preparation can be a major problem in endodontics; this may result in apical microleakage. The aim of this in vitro study was to evaluate the effect of blood on apical microleakage of a resin-based root canal sealer (AH26) and a polymer-based root canal sealer (Epiphany). MATERIALS AND METHODS: In this experimental study, 50 decoronated central incisors and canine teeth were prepared by RaCe rotary system and randomly divided into 4 groups (n=10). Groups A1 and A2 were obturated by Epiphany/Resilon and AH26/Gutta-percha, respectively. The obturations were performed with a single cone technique after drying root canals. In B1 and B2 groups, the test groups, 0.02cc citrated human blood was injected into dried root canals and they were obturated in the same manner. Ten specimens were served as positive and negative controls (n=5).The apical leakage was measured by means of a computerized fluid filtration method after 1 day and 3 weeks. The data was analyzed by One-Sample Kolmogorov-Smirnov, Independent Sample t-test and univariate analysis. Statistical significances were preset at α=0.05. RESULTS: There was no significant difference in apical microleakage of the two sealers after 1 day and 3 weeks in dry and blood environment (P>0.05). Sealer and environment had no interaction (P>0.05). CONCLUSION: Blood contamination has no significant effect on the apical microleakage of Epiphny and AH26.