Postendodontic Pain after Pulpotomy or Root Canal Treatment in Mature Teeth with Carious Pulp Exposure: A Multicenter Randomized Controlled Trial.

This equivalence, randomized, clinical trial aimed to compare the postoperative pain of root canal therapy (RCT) with pulpotomy with mineral trioxide aggregate (PMTA) or calcium-enriched mixture (PCEM) in permanent mature teeth. In seven academic centers, 550 cariously exposed pulps were included and randomly allocated into PMTA (n = 188), PCEM (n = 194), or RCT (n = 168) arms. Preoperative "Pain Intensity" (PI) on Numerical Rating Scale and postoperative PIs until day 7 were recorded. Patients' demographic and pre-/intra-/postoperative factors/conditions were recorded/analysed. The arms were homogeneous in terms of demographics. The mean preoperative PIs were similar (P=0.998), the mean sum PIs recorded during 10 postoperative intervals were comparable (P=0.939), and the trend/changes in pain relief were parallel (P=0.821) in all study arms. The incidences of preoperative moderate-severe pain in RCT, PMTA, and PCEM arms were 56.5%, 55.7%, and 56.7%, which after 24 hours considerably decreased to 13.1%, 10.6%, and 12.9%, respectively (P=0.578). The time span of endodontic procedures was statistically different; RCT = 69.73, PMTA = 35.37, and PCEM = 33.62 minutes (P < 0.001). Patients with greater preoperative pain, symptomatic apical periodontitis, or presence of PDL widening suffered more pain (P=0.002, 0.035, and 0.023, resp.); however, other pre-/intra-/postoperative factors/conditions were comparable. Pulpotomy with MTA/CEM and RCT demonstrate comparable and effective postoperative pain relief.

Evaluation of the Dislodgement Resistance of a New Pozzolan-Based Cement (EndoSeal MTA) Compared to ProRoot MTA and Biodentine in the Presence and Absence of Blood.

INTRODUCTION: This in vitro study investigated the dislodgement resistance of EndoSeal MTA, a new pozzolan-containing calcium silicate-based material, in comparison with ProRoot MTA and Biodentine in the presence and absence of contamination with blood. METHODS: Standard furcal perforations were created in 180 human mandibular first molars. The teeth were randomly allocated to 12 groups of 15 each. ProRoot MTA, Biodentine, and EndoSeal MTA were used to repair the perforations. In half of the samples, the walls of the perforated areas were contaminated with blood, whereas saline was injected into the other half. A push-out test was performed using a universal testing machine after 24 hours or 7 days. To evaluate failure patterns, the samples were split into half and were examined under a stereomicroscope at a 20x magnification. Data were analyzed using three-way analysis of variance, Tukey test, and Student's t-test. RESULTS: At both time intervals and in the presence and absence of contamination with blood, ProRoot MTA and Biodentine had significantly higher retention values than EndoSeal MTA (p < 0.001). Contamination with blood had no effect on EndoSeal MTA; however, it negatively affected the dislodgement resistance of Biodentine at 24 hours and ProRoot MTA at both time intervals (p < 0.05). Time significantly affected only the bond strength of the uncontaminated groups (p > 0.001). The most common type of failure was mixed for ProRoot MTA and Biodentine, whereas it was cohesive for EndoSeal MTA. CONCLUSIONS: ProRoot MTA and Biodentine showed higher values of bond strength than EndoSeal MTA and may thus be better options for the repair of root perforations.

Dimensional stability of two solder index materials.

OBJECTIVES: This study aimed to compare the dimensional accuracy of two indexing materials, an acrylic resin (GC pattern resin) and a castable composite (Bredent). The effect of time lapse until investment was also investigated. MATERIALS AND METHODS: Two standardized brass dies 15 mm apart were prepared and then 20 identical coping-bar assemblies were designed and fabricated by a rapid prototyping device. Each bar was sectioned at the center, and indices were fabricated from an acrylic resin or castable composite (n = 10 per group). The distances between the reference points were measured with a digital microscope at ×80 magnifications at 15 min, 60 min, and 24 h after indexing. Data were statically analyzed using repeated-measure ANOVA (α = 0.05). RESULTS: The distance between the reference points without the coping being joined was considered as the baseline measurement (control group). The mean distance was 19.30 ± 0.04 mm between the reference points where the copings were not joined. When indexed with acrylic resin, the mean ± standard deviation (SD) dimensions were 19.27 ± 0.087 mm (15 min), 19.25 ± 0.09 mm (60 min), and 18.98 ± 0.1 mm (24 h). The mean ± SD dimensions for composite were 19.29 ± 0.087 mm (15 min), 19.28 ± 0.08 mm (60 min), and 19.26 ± 0.08 mm (24 h). All tested groups showed significant differences compared to the control group except when it was indexed with composite and where the distances were measured after 15 and 60 min (P > 0.05). CONCLUSIONS: The most accurate indexed-assemblies belonged to castable composite at 15 and 60 min.