Post-instrumentation pain after the use of either Mtwo or the SAF system: a randomized controlled clinical trial.

AIM: This randomized controlled trial compared the incidence of post-instrumentation pain associated with Mtwo rotary NiTi files and the self-adjusting file system following canal shaping and cleaning. METHODOLOGY: Following sample size estimation, a total of 130 patients were randomized into two groups based on selection criteria [group Mtwo and group SAF (self-adjusting file)]. Root canal treatment was carried out in two appointments. The teeth were endodontically treated with the appropriate allotted systems following the similar clinical parameters. Patients were asked to rate the intensity of pre-instrumentation and post-instrumentation pain (at 2, 4, 6, 8, 24, 48 h) using the VAS score. The Kruskal-Wallis test was carried out for the overall comparisons of the two systems. The Friedman test was used to compare between time-points with each system. Subgroup analyses for independent variables (gender, pulp status and diagnosis) used the Mann-Whitney test and Wilcoxon signed ranks test (P < 0.05). RESULTS: No significant difference was found between the two groups with respect to post-instrumentation pain. Teeth with pulpal necrosis had significant pain at 8 h compared with teeth with vital pulps (P = 0.04). Teeth with vital pulps in the SAF group had significantly less post-instrumentation pain compared with those in the Mtwo group at 6 h (P = 0.042). Patients who had teeth with nonvital pulps in the SAF group experienced more post-instrumentation pain at 8 h (P = 0.017) and 24 h (P = 0.005). CONCLUSION: The incidence of post-instrumentation pain at different time intervals in patients undergoing root canal treatment was similar for both the self-adjusting file and Mtwo file systems.

Apical Extrusion of Irrigants in Immature Permanent Teeth by Using EndoVac and Needle Irrigation: An In Vitro Study.

OBJECTIVE: Immature teeth have a large apical opening and thin divergent or parallel dentinal walls; hence, with conventional needle irrigation there is a very high possibility of extrusion. This study was done to compare the apical extrusion of NaOCl in an immature root delivered using EndoVac and needle irrigation. MATERIALS AND METHODS: Eighty freshly extracted maxillary central incisors were decoronated followed by access cavity preparation. Modified organotypic protocol was performed to create an open apex; then, the samples were divided into four groups (n=20): EndoVac Microcannula (group I), EndoVac Macrocannula (group II), NaviTip irrigation needle (group III) and Max-i-Probe Irrigating needle (group IV); 9.0 ml of 3% sodium hypochlorite was delivered slowly over a period of 60 seconds. Extruded irrigants were collected in a vial and analysed statistically. RESULTS: Group I, group III and group IV showed 100% extrusion (20/20) but group II showed only 40% extrusion (8/20). The difference in this respect between group II and other groups was statistically significant (P<0.001). With regards to the volume of extrusion, group II had only 0.23 ml of extruded irrigant. Group I extruded 7.53ml of the irrigant. Group III and group IV extruded the entire volume of irrigant delivered. CONCLUSION: EndoVac Macrocannula resulted in the least extrusion of irrigant in immature teeth when compared to EndoVac Microcannula and conventional needle irrigation.

Volumetric analysis of root canal fillings in primary teeth using spiral computed tomography: an in vitro study.

PURPOSE: The purpose of this study was to volumetrically analyze the efficacy of root canal fillings in primary teeth using spiral computed tomography (CT). METHODS: Root canals in 30 primary maxillary and mandibular molars were instrumented with K files to size 30, and the volumes of the canals were then measured using spiral CT. The teeth were randomly divided into 3 groups of 10 each, and 18 of the canals in each group were evaluated with spiral CT after obturation with zinc oxide eugenol paste, Metapex and Vitapex. The filled volume in each canal was mea- sured using spiral CT, and the percentage of obturated volume (POV) was calculated. The pre- and post-mean canal volume values within each group and the POV of the 3 groups were statistically analyzed using one-way analysis of variance and paired t tests. RESULTS: Filler voids were seen in all groups, but there was a statistically significant difference (P <.001) in the calculated POV. Vitapex showed 95% POV compared to Metapex (88%) and ZOE (84%). CONCLUSION: Voids were seen in all 3 filling materials. Vitapex showed the maximum percentage of obturated volume among the 3 groups.