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Hamza EM, Abd El Aziz TM, Obeid MF. The influence of intraoral cryotherapy on postoperative pain and substance P in symptomatic apical periodontitis: randomized clinical study. Sci Rep 2024; 14:13890. [PMID: 38880787 PMCID: PMC11180658 DOI: 10.1038/s41598-024-64071-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 06/05/2024] [Indexed: 06/18/2024] Open
Abstract
Cryotherapy is widely utilized in medicine, particularly for pain management. This randomized clinical trial aimed to assess the effect of intraoral cold pack application (cryotherapy) on postoperative pain (POP) and the level of Substance P (SP) in patients with symptomatic apical periodontitis (SAP). Enrolled patients were randomly assigned to either cryotherapy or control group. After adequate anesthesia, access cavity, and biomechanical preparation of the root canal system were completed, the first apical fluid (AF) sample (S1) was obtained. A custom-made intraoral ice-gel pack was applied for 30 min in the cryotherapy group, while no intervention was performed in the control group. The second AF sample (S2) was collected 30 min later in both groups. Patients were asked to complete the Visual Analogue Scale (VAS) questionnaire to assess their POP. Quantification of SP in AF samples was performed using the enzyme-linked immunosorbent assay (ELISA) test. Data were analyzed statistically, revealing a significant reduction in POP and SP levels in the cryotherapy group compared to the control group (P ≤ 0.05). Furthermore, a moderate positive correlation was observed between SP levels and POP (P ≤ 0.05). In conclusion, intraoral cryotherapy represents a simple and cost-effective option for controlling POP and reducing inflammation levels in patients with SAP.
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Affiliation(s)
- Esraa Mohammed Hamza
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, 2 sixth of October St., Hadayek Al-Ahram-Haram, Giza, Cairo, Egypt.
| | - Tarek Mustafa Abd El Aziz
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, 2 sixth of October St., Hadayek Al-Ahram-Haram, Giza, Cairo, Egypt
| | - Maram Farouk Obeid
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, 2 sixth of October St., Hadayek Al-Ahram-Haram, Giza, Cairo, Egypt.
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Nunes LP, Nunes GP, Ferrisse TM, Strazzi-Sahyon HB, Dezan-Júnior E, Cintra LTA, Sivieri-Araujo G. A systematic review and meta-analysis on the effects of phototherapy on postoperative pain in conventional endodontic reintervention. Clin Oral Investig 2024; 28:232. [PMID: 38556608 DOI: 10.1007/s00784-024-05623-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/17/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES This systematic review and meta-analysis (SRM) aimed to evaluate the efficacy of laser phototherapy (LPT) on the reduction in postoperative pain (PP) of endodontic origin after conventional/non-surgical reintervention of root canals. METHODS This SRM was registered with PROSPERO (CRD42021243500) and followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Meta-analysis was conducted using R software with the "META" package, the mean difference (MD) measure of effect was calculated, and the fixed effect model was applied with a 95% confidence interval (CI). The Cochrane collaboration scale was used to assess the risk of bias and the GRADE tool to assess the quality of evidence. RESULTS Initially, 1028 articles were found, and five articles were included. Most studies were classified as "low" risk of bias. Of the five clinical studies, four showed a significant decrease in PP after endodontic reintervention in the LPT groups compared to the control group, especially in the first four days after the intervention. In symptomatic teeth with multiple roots, LPT led to less PP at 24 h (MD -0.52 [-1.03; -0.02] p = .04). However, no significant difference between the groups was found at 48 and 72 h (p > .05). The certainty of the evidence was classified as low. CONCLUSION Despite the limitations of this SRM, LPT was shown to be a promising alternative for reducing and controlling PP in conventional endodontic reintervention. CLINICAL SIGNIFICANCE The use of LPT in endodontic reintervention may be a safe and promising alternative to clinically efficacious agent for use in the management of PP in this procedure.
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Affiliation(s)
- Larissa Pereira Nunes
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio, Araçatuba, SP, Brazil
| | - Gabriel Pereira Nunes
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio, Araçatuba, SP, Brazil.
| | - Túlio Morandin Ferrisse
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Eloi Dezan-Júnior
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio, Araçatuba, SP, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio, Araçatuba, SP, Brazil
| | - Gustavo Sivieri-Araujo
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio, Araçatuba, SP, Brazil
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Baris SD, Turkyilmaz A, Derici MK. Effects of Nd: YAG laser on tumour necrosis factor-alpha, interleukin-1beta and interferon-gamma levels in teeth with apical periodontitis: A clinical study. AUST ENDOD J 2023; 49:657-664. [PMID: 37746745 DOI: 10.1111/aej.12799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/20/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023]
Abstract
This study aimed to evaluate the levels of tumour necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β) and interferon-gamma (IFN-γ) with asymptomatic apical periodontitis (AP). A total of 60 participants were randomly divided into two groups: the conventional irrigation (control) and the Nd: YAG laser irradiation. The interstitial fluids were obtained after root canal cleaning (day 0) and 1 week later (day 7). The TNF-α, IL-1β and IFN-γ levels were assayed using the enzyme-linked immunosorbent assay. The Mann-Whitney U, continuity correction chi-square, Pearson chi-square and Fisher exact tests were used. An increased level of cytokines on day 7 in the control group was observed, without statistically significant differences (p > 0.05). All cytokine levels decreased over time in the laser group. Only the IL-1β level showed a significant difference (p < 0.05). Nd: YAG irradiation has a positive effect on decreasing the proinflammatory cytokine level and may help to control infection in teeth with AP.
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Affiliation(s)
- Sevda Durust Baris
- Department of Endodontics, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey
| | - Ali Turkyilmaz
- Department of Endodontics, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey
| | - Mehmet Kursat Derici
- Department of Medical Pharmacology, Gulhane Faculty of Medicine, University of Health Science, Ankara, Turkey
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Ismail HH, Obeid M, Hassanien E. Efficiency of diode laser in control of post-endodontic pain: a randomized controlled trial. Clin Oral Investig 2023; 27:2797-2804. [PMID: 36662285 PMCID: PMC10264274 DOI: 10.1007/s00784-023-04864-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/10/2023] [Indexed: 01/21/2023]
Abstract
OBJECTIVES As post-endodontic pain control is one of the main targeted addressed in endodontics, our aim was delignated to compare two different methods for low-level laser application utilizing diode laser: low-level laser therapy (LLLT) and laser-activated irrigation (LAI) in the control of post-endodontic pain. MATERIALS AND SUBJECTS A total of 180 patients received single-visit root canal treatment; they were randomly allocated into 3 equal groups. Group I received LAI, group II received LLLT, and group III served as control with normal root canal treatment and mock laser intervention (ML group). Postoperative pain was recorded using visual analogue scale (VAS) after 24, 48, and 72 h. Data were tabulated and statistically analyzed. RESULTS At 24 h, there was a statistically significant difference between median pain scores in the three groups (P value < 0.001) with ML group scored highest score followed by LAI and then LLLT group. At 48 h, there was a statistically significant difference between the three groups (P value < 0.001), with ML group scoring highest median pain scores while LLLT and LAI showed statistical insignificant scores. At 72 h, there was no statistically significant difference between the 3 groups (P value = 0.179). CONCLUSION LLLT is superior to LAI and ML group in the control of immediate postoperative pain after 24 h while after 48 h both LAI and LLLT were equally effective, but they still showed significant differences when compared to ML group. CLINICAL RELEVANCE Diode laser can be used by clinicians as it decreases the post-endodontic pain in patients with symptomatic apical periodontitis undergoing endodontic treatment.
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Affiliation(s)
- Hend H Ismail
- Dept of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Maram Obeid
- Dept of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
| | - Ehab Hassanien
- Dept of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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Yong J, Gröger S, Wu Z, Ruf S, Ye Y, Chen X. Photobiomodulation Therapy and Pulp-Regenerative Endodontics: A Narrative Review. Bioengineering (Basel) 2023; 10:bioengineering10030371. [PMID: 36978762 PMCID: PMC10045842 DOI: 10.3390/bioengineering10030371] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
Regenerative endodontic procedures (REPs) were used to recover the dental pulp’s vitality in order to avoid the undesirable outcomes of conventional endodontic treatment and to promote dentinal formation, especially for immature permanent teeth. Photobiomodulation therapy (PBMT) exhibits photobiological and photochemical effects for improving the root canal’s environmental conditions by compensating for oxidative stress and increasing the blood supply to implanted stem cells and improving their survival. Basic research has revealed that PBMT can modulate human dental pulp stem cells’ (hDPSCs) differentiation, proliferation, and activity, and subsequent tissue activation. However, many unclear points still remain regarding the mechanisms of action induced by PBMT in REPs. Therefore, in this review, we present the applications of laser and PBMT irradiation to the procedures of REPs and in endodontics. In addition, the effects of PBMT on the regenerative processes of hDPSCs are reviewed from biochemical and cytological perspectives on the basis of the available literature. Furthermore, we consider the feasibility of treatment in which PBMT irradiation is applied to stem cells, including dental pulp stem cells, and we discuss research that has reported on its effect.
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Affiliation(s)
- Jiawen Yong
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310003, China
- Department of Orthodontics, Faculty of Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany
| | - Sabine Gröger
- Department of Orthodontics, Faculty of Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany
| | - Zuping Wu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310003, China
| | - Sabine Ruf
- Department of Orthodontics, Faculty of Medicine, Justus Liebig University Giessen, 35392 Giessen, Germany
| | - Yuer Ye
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310003, China
| | - Xiaoyan Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310003, China
- Correspondence:
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Huang Q, Li Z, Lyu P, Zhou X, Fan Y. Current Applications and Future Directions of Lasers in Endodontics: A Narrative Review. Bioengineering (Basel) 2023; 10:bioengineering10030296. [PMID: 36978686 PMCID: PMC10044917 DOI: 10.3390/bioengineering10030296] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 03/02/2023] Open
Abstract
The utilization of lasers has been regarded as a novel technique for the purposes of clinical use in the dental field. Recently, numerous studies have been conducted on the potential applications of laser therapy in endodontics. Moreover, due to their ablation, penetrability, and disinfection capabilities, lasers have performed well with respect to endodontic treatments, including root canal treatment, vital pulp therapy (pulp capping and pulpotomy), dentinal hypersensitivity treatment, and management of dental pain related to pulp and periradicular disease. In particular, the superiorities of laser-aided pulp therapy are emphasized through condensed clinical controlled trials, and histological studies, in this review. Moreover, the ingenious use of laser applications with respect to aiding in the acceleration of root development and the extraction of foreign matters (i.e., broken files and fiber posts) in canals has quickly become the cutting-edge trend of current research. This review offers a summary and discussion of the current literature on all the aforementioned laser applications. Moreover, the characteristics of laser devices, including erbium lasers, neodymium-doped lasers, CO2 lasers, and diode lasers, are detailed and discussed here, providing useful references for laser application in endodontics. We also focus on the different wavelengths with respect to the lasers that are applied in endodontics. High-power lasers perform well as operative instruments; in addition, low-level lasers lead to the regulation of pulp inflammation, and the promotion of pulp healing. This narrative review provides a summary of the advanced applications of lasers in conjunction with various devices in the practice of endodontics, and aims to inspire innovative perspectives on lasers in the context of the treatment of dental diseases, especially pulp diseases, in the future.
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Madarati AA, Sammani AMN, Alnazzawi AA, Alrahlah A, Pedullà E. Efficiency of reciprocating systems reciprocated at different angles in removing root-canals fillings with an MTA-type sealer: an Ex-vivo study. BMC Oral Health 2022; 22:357. [PMID: 35978330 PMCID: PMC9387022 DOI: 10.1186/s12903-022-02390-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/10/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND There have been no reports on the impact of different reciprocating angles on retreatment performance of reciprocating files. This ex-vivo study compared the efficiency of three reciprocating systems in removing MTA-type sealer-based filling materials and investigated the influence of different reciprocating angles on their retreatment ability. METHODS 140 root-canals were instrumented to a 35 apical size and filled with an MTA-type sealer and gutta-percha cones. Samples were scanned by micro-computed-tomography and the root-canals fillings volumes were measured. Samples were divided into 7 groups according to the reciprocating angles at which the WaveOne-Gold (WOG), Reciproc-Blue (RB) and R-Motion (RM) systems were reciprocated to remove the root-canals' fillings. The WOG-150/30, WOG-90/30, RB-150/30, RB-90/30, RM-150/30 and RM-90/30 groups in which the systems were reciprocated at 150/30 and 90/30 (counterclockwise/clockwise) angles. In the RB-270/30 group the RB system was reciprocated at 270/30 angles. Samples were re-scanned and the remaining filling materials' (RFMs) volumes were measured. The percentage of the RFMs volume and its mean value for each group were calculated and data were statistically analysed at 0.05 significance level. RESULTS The WOG system resulted in less RFMs (2.24%) when reciprocated at 90/30 angles compared to that resulted from the 150/30 angles (4.96%) [P = 0.002]. The RB system reciprocated at 90/30 angles resulted in less RFMs (2.67%) compared to that resulted from the 270/30 angles (6.64%) [P = 0.001]. The RFMs after using RM system reciprocated at 90/30 (6.02%) and 150/30 (7.61%) were greater than those of WOG (2.24 and 4.96%) and RB (2.67 and 4.34%) reciprocated at the same angles (P < 0.05). The longest time required to remove the filling materials was recorded with the RB-270/30 group (6.06 min) [P = 0.00]. The times required when the WOG, RB and RM files reciprocated at 90/30 angles (3.59, 3 and 3.05 mins, respectively) were shorter than those when files were reciprocated at 150/30 angles (5.25, 4.98 and 3.67 min, respectively) [P < 0.05]. CONCLUSIONS The WOG and RB systems removed more MTA-type sealer-based root-canals fillings than the RM system. Lower counterclockwise reciprocating angles improve the retreatment ability of reciprocating systems, especially the WOG system and can reduce the time required for retreatment procedures.
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Affiliation(s)
- Ahmad A. Madarati
- grid.412892.40000 0004 1754 9358Restorative Dental Sciences Department, College of Dentistry, Taibah University, Madina, Kingdom of Saudi Arabia ,Present Address: Riyadh (12252), Kingdom of Saudi Arabia
| | - Aya M. N. Sammani
- grid.412892.40000 0004 1754 9358Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Madina, Kingdom of Saudi Arabia
| | - Ahmad A. Alnazzawi
- grid.412892.40000 0004 1754 9358Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Madina, Kingdom of Saudi Arabia
| | - Ali Alrahlah
- grid.56302.320000 0004 1773 5396Restorative Dental Sciences Department, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Eugenio Pedullà
- grid.8158.40000 0004 1757 1969Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
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Protocol for the clinical practice of photodynamic therapy in endodontics: assessment of guideline quality using the AGREE II instrument. Photodiagnosis Photodyn Ther 2022; 38:102835. [PMID: 35367387 DOI: 10.1016/j.pdpdt.2022.102835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/01/2022] [Accepted: 03/28/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND The choice of parameters in Photodynamic Therapy for endodontic treatment, such as wavelength, energy, application time, and number of sessions can vary based on the characteristics of the procedure and the patient. Providing information supported by scientific evidence in an accessible way to clinicians who are unfamiliar with the literature is necessary. Thus, this study aimed to synthesize a clinical protocol for the use of photodynamic therapy in endodontics in permanent teeth. METHODS Protocols with high methodological quality were identified using a literature search and the Appraisal of Guidelines Research and Evaluation Instrument (AGREE II), a validated tool for assessing quality. The recommendations of these studies were synthesized and submitted to a group of experts for evaluation and adaptation, and consensus was assessed using the Delphi methodology. RESULTS The analysis of the literature on the application of antimicrobial photodynamic therapy in endodontics showed that clinical trials with good levels of evidence and clinical recommendations have been reported previously, with two studies identified as having a clinical recommendation level of A1A and an evidence level of A. CONCLUSION The written protocol was considered to be satisfactory and as having appropriate content validity during the second round of evaluation by the experts. The studies included in this research were predominantly explanatory in nature, highlighting the need for pragmatic designs to increase the degree of clinical applicability.
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Bansal N, Ismail PS, AlMogbel A, Priya R, Mattigatti S, Nara A, AlMutairi F. An in vitro comparative assessment of manual hand file, rotary protaper ni-ti, erbium:yttrium–aluminum–garnet laser, canal brush, and ultrasound methods for smear layer removal. Ann Afr Med 2022; 21:244-249. [DOI: 10.4103/aam.aam_115_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Evaluation of postoperative pain/discomfort after intracanal use of Nd:YAG and diode lasers in patients with symptomatic irreversible pulpitis and asymptomatic necrotic pulps: a randomized control trial. Clin Oral Investig 2021; 25:2737-2744. [PMID: 33409689 DOI: 10.1007/s00784-020-03588-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 09/15/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study aimed to investigate the ability of the diode and Nd:YAG lasers to decrease postoperative pain/discomfort after intracanal application in vital and devital endodontic cases. MATERIAL AND METHODS One hundred two patients with symptomatic irreversible pulpitis and asymptomatic necrotic pulps were selected and randomly divided into three groups. After chemomechanical preparation, Nd:YAG and diode laser was applied to first and second groups for final treatment of the root canals. In the control group, no further disinfection protocol was performed upon traditional procedures. Then all the teeth were obturated in the same appointment. Pre- and postoperative pain were recorded using the VAS at 0, 12th, 24th, 48th, and 72nd hours following the treatment Kruskal-Wallis and Dunn test. RESULTS VAS scores were significantly the most at 12-h period compared with other time periods after treatment for all groups. There was no significant difference among Nd:YAG laser, diode laser, and control groups in non-vital cases (p > 0.05). In vital cases, Nd:YAG laser group represented significantly fewer scores compared with diode laser and control groups at 48-h period (p < 0.05). CONCLUSIONS The processes involving the use of Nd:YAG and diode lasers after chemomechanical preparation was found to be equivalent in terms of postoperative pain intensity after completion of treatment in one session both in vital or non-vital cases except in vital cases in Nd:YAG group at 48 h. CLINICAL RELEVANCE Adjunct clinical use of Nd:YAG or diode lasers to traditional chemomechanical preparation did not cause any improvement or deterioration on postoperative discomfort and pain in patients with symptomatic irreversible pulpitis and asymptomatic necrotic pulps.
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Postoperative pain in endodontic retreatment of one visit versus multiple visits: a systematic review and meta-analysis of randomized controlled trials. Clin Oral Investig 2021; 25:455-468. [PMID: 33399930 DOI: 10.1007/s00784-020-03767-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 12/23/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The aim of this systematic review and meta-analysis (SRM) was to assess the postoperative pain (PP) after non-surgical endodontic retreatment (NSER) in a one visit compared to multiple visits. The PICO question used was "Does NSER in patients with unsatisfactory endodontic treatment in a one-visit visit have a similar PP to that of NSER in multiple visits?" MATERIALS AND METHODS This systematic review followed PRISMA and was registered in PROSPERO (CRD42019136700). Searches were performed in the PubMed/MEDLINE, Scopus, and the Cochrane Library databases for articles published until September 2020. The eligible criteria were randomized clinical trials (RCTs). The meta-analysis was based on the Mantel-Haenszel. The PP after the retreatment was analyzed using a dichotomous outcome, measured according to risk ratio (RR) when p < 0.05. The Cochrane scale was used to assess risk of bias, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. RESULTS Four studies were included. In general analysis without considering intensity, one-visit NSER presented lower PP than the multiple visits only for 1 and 30 days [(RR = 0.67; CI: 0.48 to 0.93; p = 0.02), and (RR = 0.09; CI: 0.01 to 0.66; p = 0.02)], respectively. Regarding sub-analysis considering the intensity, one visit present lower mild PP when compared with multiple visits [(RR = 0.54; CI: 0.30, 0.96; p = 0.04); (RR = 0.33; CI: 0.12, 0.88; p = 0.03); and (RR = 0.12; CI: 0.02, 0.86; p = 0.03)], respectively. However, sub-analysis for moderate and severe PP showed no significant difference, independently of period evaluated (p > 0.05). Regarding the risk of bias analysis, a low risk was observed for most domains, except allocation that was considered unclear, while the certainty of evidence for each analysis was considered low. CONCLUSION Within the limitations of study, the one and multiple visit can be considered adequate, because both present a similar occurrence of PP, except for mild pain. However, due to the low number of studies, further well conducted and standardized RCTs are needed to reassess these results. CLINICAL RELEVANCE Both therapies of endodontic retreatment can be considered in clinical practice. Therefore, the endodontist must consider the patient's individual characteristics and experience to consider the best treatment approach.
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Zhan C, Huang M, Yang X, Hou J. Dental nerves: a neglected mediator of pulpitis. Int Endod J 2020; 54:85-99. [PMID: 32880979 DOI: 10.1111/iej.13400] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 08/26/2020] [Indexed: 12/18/2022]
Abstract
As one of the most densely innervated tissues, the dental pulp contains abundant nerve fibres, including sensory, sympathetic and parasympathetic nerve fibres. Studies in animal models and human patients with pulpitis have revealed distinct alterations in protein expression and histological appearance in all types of dental nerve fibres. Various molecules secreted by neurons, such as classical neurotransmitters, neuropeptides and amino acids, not only contribute to the induction, sensitization and maintenance of tooth pain, but also regulate non-neuronal cells, including fibroblasts, odontoblasts, immune cells and vascular endothelial cells. Dental nerves are particularly important for the microcirculatory and immune responses in pulpitis via their release of a variety of functional substances. Further, nerve fibres are found to be involved in dental soft and hard tissue repair. Thus, understanding how dental nerves participate in pulpitis could have important clinical ramifications for endodontic treatment. In this review, the roles of dental nerves in regulating pulpal inflammatory processes are highlighted and their implications for future research on this topic are discussed.
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Affiliation(s)
- C Zhan
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - M Huang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - X Yang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - J Hou
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Systematic Review on the Role of Lasers in Endodontic Therapy: Valuable Adjunct Treatment? Dent J (Basel) 2020; 8:dj8030063. [PMID: 32630217 PMCID: PMC7559699 DOI: 10.3390/dj8030063] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/19/2020] [Accepted: 06/28/2020] [Indexed: 12/16/2022] Open
Abstract
(1) Background: Adjunctive instruments, such as lasers have been investigated to address the risk of failure of endodontic therapy due to the complexity of the root canal system. Lasers have been used therapeutically, in direct irradiation of the root canals or adjunct to irrigants placed into the canals, in combination with a photosensitizer (antimicrobial photodynamic therapy) and in pain management (photobiomodulation). The purpose of this systematic review was to evaluate the evidence in clinical use within these three areas of therapy. (2) Methods: PubMed, Cochrane and Scopus search engines were used to identify human clinical trials regarding the use of lasers in endodontic therapy. (3) Results: After applying the keywords and additional filters, inclusion and exclusion criteria, the initial number of 1486 articles was reduced to 17. It was revealed that almost all studies (14/17) presented a statistically significant improved outcome in laser-assisted endodontic therapy, with the remaining three not showing any adverse effects. (4) Conclusions: The use of laser photonic energy of appropriate delivered parameters can be proposed as useful adjunctive when considering optimal treatment modalities in orthograde endodontics. Additionally, a tendency of research towards pain modulation in this field is developing.
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Vahdatinia F, Gholami L, Karkehabadi H, Fekrazad R. Photobiomodulation in Endodontic, Restorative, and Prosthetic Dentistry: A Review of the Literature. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:869-886. [PMID: 31873065 DOI: 10.1089/photob.2019.4707] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To provide a review of the literature about the photobiomodulation therapy (PBMT) dental treatment protocols in endodontic, restorative, and prosthetic dentistry based on validated clinical studies published so far. More specifically, this study was carried out to carefully review therapeutic protocol of PBMT in clinical studies and their conclusions. Background data: The importance of using low-power lasers and photobiomodulation (PBM) is increasing in dentistry mainly due to their painless and noninvasive function. However, lack of sufficient clinical studies has led to unclear results regarding PBMT in dentistry, and also lack of an available precise protocol for clinicians. Moreover, scarcity of clinical studies in this area has made conduction of a precise systematic review study difficult. Methods: In our study, published clinical studies up to April 2019 were reviewed from library sources, Google Scholar, PubMed and Medline, Elsevier, Embase, Cochrane, Scopus, and Web of science (ISI). Inclusion criteria included those presented in clinical trials and case report/case series, language (English), and studies available in full text. Exclusion criterion was in vitro studies. Results: In general, findings of clinical studies have shown that PBMT can have a significant role in reducing postoperative dental pain, increasing depth of anesthesia, improving tooth hypersensitivity, reducing inflammation of the tissue, and helping wound healing. Conclusions: A review of clinical studies showed that the use of alternative or adjunctive PBMT is of great importance in controlling postoperative pain after endodontic treatments. In addition, evidence suggests that different parameters of light can be efficient in the treatment of tooth hypersensitivity. Nevertheless, lack of sufficient clinical studies and reliable results do not allow introducing a precise treatment protocol.
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Affiliation(s)
- Farshid Vahdatinia
- Dental Implants Research Center, Hamadan University of Medical Sciences, Hamandan, Iran
| | - Leila Gholami
- Department of Periodontology, Hamadan University of Medical Sciences, Hamandan, Iran
| | | | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran.,International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Bamini L, Anand Sherwood I, Abbott PV, Uthandakalaipandian R, Velu V. Influence of anti-inflammatory irrigant on substance P expression for single-visit root canal treatment of teeth with irreversible pulpitis. AUST ENDOD J 2019; 46:73-81. [PMID: 31270901 DOI: 10.1111/aej.12353] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2019] [Indexed: 11/28/2022]
Abstract
One of the main objectives of root canal treatment is to alleviate the pain associated with irreversibly inflamed pulps. However, some patients may have moderate to severe pain following treatment. The aim of this study was to compare and assess the effect of ketorolac tromethamine on substance P expression in the pulp and periapical tissues when used as a root canal irrigant for single-visit root canal treatment in teeth with irreversible pulpitis. Thirty-six patients were randomly allotted to three irrigant groups - saline (n = 14), 3% sodium hypochlorite (n = 11) and ketorolac tromethamine (n = 11). Pulp blood samples (S1) were collected on gaining access to the pulp, and periapical blood samples (S2) were collected after root canal preparation. Quantification of substance P was done by ELISA test. The ketorolac tromethamine group had greater reduction in substance P expression (S2). Post-operative pain levels were not significantly influenced by the different root canal irrigants.
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Affiliation(s)
- Lavanya Bamini
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences, Madurai, India
| | - I Anand Sherwood
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences, Madurai, India
| | - Paul V Abbott
- University of Western Australia, Perth, Western Australia, Australia
| | - Ramesh Uthandakalaipandian
- Department of Molecular Biology, School of Biological Sciences, Madurai Kamaraj University, Madurai, India
| | - Vijay Velu
- Department of Molecular Biology, School of Biological Sciences, Madurai Kamaraj University, Madurai, India
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Arslan H, Köseoğlu S, Doğanay Yildiz E, Arabaci T, Savran L, Yildiz DA, Veyisoğlu G. Effect of intracanal diode laser application and low-level laser therapy on CGRP change. Braz Oral Res 2019; 32:e125. [PMID: 30892373 DOI: 10.1590/1807-3107bor-2018.vol32.0125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 11/05/2018] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to investigate the effect of a placebo, intracanal diode laser application, and low-level laser therapy (LLLT) on the change of the total amount of calcitonin gene-related peptide (CGRP) in the gingival crevicular fluid (GCF) (split-mouth study design). GCF sampling was performed on a contralateral tooth and experimental tooth (root canal-treated tooth) of thirty-nine patients. The patients were divided into three groups (n = 13), as follows: placebo (mock laser application), intracanal laser application, and LLLT. GCF sampling was repeated at the same sites (experimental and control teeth) one week after root canal treatment. The data were analyzed using the Pearson's correlation analysis and the independent-samples t-tests (p=0.05). In the placebo group, the total CGRP level changes in the GCF before and after treatment was significantly higher for experimental teeth than for control teeth (p<0.05). However, there was no significant difference between experimental and control teeth in the intracanal laser application and LLLT groups (p > 0.05). Intracanal laser application and low-level laser therapy have immunomodulation effects linked to the modulation of the total amount of CGRP in the GCF.
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Affiliation(s)
- Hakan Arslan
- Atatürk University, Faculty of Dentistry, Department of Endodontics, Erzurum, Turkey
| | - Serhat Köseoğlu
- Sağlık Bilimleri University, Faculty of Dentistry,Department of Periodontology, Istanbul, Turkey
| | - Ezgi Doğanay Yildiz
- Kırıkkale University, Faculty of Dentistry, Department of Endodontics, Kırıkkale, Turkey
| | - Taner Arabaci
- Atatürk University, Faculty of Dentistry, Department of Periodontology, Erzurum, Turkey
| | - Levent Savran
- Izmir Katip Celebi University, Faculty of Dentistry, Department of Periodontology, Izmir, Turkey
| | - Dursun Anıl Yildiz
- Atatürk University, Faculty of Dentistry, Department of Periodontology, Erzurum, Turkey
| | - Gözde Veyisoğlu
- Başkent University, Faculty of Dentistry, Department of Periodontology, Ankara, Turkey
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17
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Effect of Low-level Laser Therapy on Postoperative Pain in Molars with Symptomatic Apical Periodontitis: A Randomized Placebo-controlled Clinical Trial. J Endod 2018; 44:1610-1615. [DOI: 10.1016/j.joen.2018.07.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 06/27/2018] [Accepted: 07/02/2018] [Indexed: 11/17/2022]
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18
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Doğanay Yıldız E, Arslan H, Köseoğlu S, Arabacı T, Yıldız DA, Savran L. The effect of photobiomodulation on total amount of substance P in gingival crevicular fluid: placebo-controlled randomized clinical trial. Lasers Med Sci 2018; 34:517-523. [DOI: 10.1007/s10103-018-2625-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 08/20/2018] [Indexed: 12/21/2022]
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Rahman SU, Mosca RC, Govindool Reddy S, Nunez SC, Andreana S, Mang TS, Arany PR. Learning from clinical phenotypes: Low-dose biophotonics therapies in oral diseases. Oral Dis 2018; 24:261-276. [DOI: 10.1111/odi.12796] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 10/06/2017] [Accepted: 10/09/2017] [Indexed: 01/03/2023]
Affiliation(s)
- SU Rahman
- Oral Biology; School of Dental Medicine; University at Buffalo; Buffalo NY USA
| | - RC Mosca
- Oral Biology; School of Dental Medicine; University at Buffalo; Buffalo NY USA
- Energetic and Nuclear Research Institute; Radiation Technology Center; São Paulo Brazil
| | - S Govindool Reddy
- Oral Biology; School of Dental Medicine; University at Buffalo; Buffalo NY USA
| | - SC Nunez
- Biomedical Engineering and Bioengineering; Universidade Brasil; São Paulo Brazil
| | - S Andreana
- Restorative and Implant Dentistry; School of Dental Medicine; University at Buffalo; Buffalo NY USA
| | - TS Mang
- Oral and Maxillofacial Surgery; School of Dental Medicine; University at Buffalo; Buffalo NY USA
| | - PR Arany
- Oral Biology; School of Dental Medicine; University at Buffalo; Buffalo NY USA
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Seifi M, Matini NS. Laser Surgery of Soft Tissue in Orthodontics: Review of the Clinical Trials. J Lasers Med Sci 2017; 8:S1-S6. [PMID: 29263776 DOI: 10.15171/jlms.2017.s1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Introduction: Recently, a wide variety of procedures have been done by laser application in orthodontics. Apart from the mentioned range of various treatments, laser has become a tool for many soft tissue surgeries as an alternative to conventional scalpel-based technique during orthodontic treatments in the management of soft tissue. Due to scarce information in the latter subject, this study was designed in order to include clinical trials that included soft tissue ablation by laser in orthodontics. Methods: Literature was searched based on PubMed and Google Scholar databases in 5 years (2010-2015) with English language restriction and clinical trial design. Studies that performed soft tissue application of laser during orthodontic treatment were extracted by the authors. Results: Only eight studies met the inclusion criteria. No significant difference was found between laser ablation and conventional scalpel technique in the matter of treatment outcome. However, few issues remained to clarify the differences in the mentioned procedures. Conclusion: Laser performance can be recommended in case of preceding less bleeding and discomfort during surgical procedure. There are still quandaries among clinical application of scalpel-based surgery in aesthetic region with bracket-bonded teeth. Precaution and knowledge regarding the characteristics of laser beam such as wavelength, frequency, power and timing is extremely needed.
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Affiliation(s)
- Massoud Seifi
- Tayebi Research Center, Marquette University, Wisconsin, USA.,Dentofacial Deformities Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Negin-Sadat Matini
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Bıçakcı H, Çapar İD, Genç S, İhtiyar A, Sütçü R. Influence of Rotary Instrumentation with Continuous Irrigation on Pain and Neuropeptide Release Levels: A Randomized Clinical Trial. J Endod 2017; 42:1613-1619. [PMID: 27788771 DOI: 10.1016/j.joen.2016.08.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 08/03/2016] [Accepted: 08/11/2016] [Indexed: 01/24/2023]
Abstract
INTRODUCTION The first objective was to determine correlation among various experimental and clinical pain measurement procedures. The second objective was to evaluate the influence of rotary instrumentation with continuous irrigation on pain and neuropeptide release levels. METHODS Forty patients who had preoperative pain at the levels of 3-8 on the visual analogue scale were included. Gingival crevicular fluid (GCF) samples were collected. Patients were randomly assigned to 2 treatment groups, the standard preparation group and the preparation with continuous irrigation group. Apical fluid samples (AFS) were collected after instrumentation. In the second visit, the patients' pain levels were recorded, and GCF and AFS were obtained. Substance P, calcitonin-gene related peptide (CGRP), interleukin (IL)-1β, and IL-10 levels were analyzed from the GCF and AFS samples. For comparison between groups, the Mann-Whitney test was used (P < .05). RESULTS In terms of clinical data, no significant difference was detected in the first and second sessions between groups. The IL-10 level obtained from AFS significantly decreased in the second session in both groups (P < .001). Visual analogue scale scores of spontaneous pain correlated with percussion pain positively (r = 0.718, P < .001). CGRP (GCF) (second session) and IL-10 (GCF) (second session) positively correlated with percussion pain (r = 0.425, P < .01) (r = 0.379, P < .05). CONCLUSIONS Rotary preparation with continuous irrigation has not been more effective than the standard preparation method for reducing pain. Because of determination of the correlation between CGRP and IL-10 with percussion pain, these neuropeptides can be used in further studies.
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Affiliation(s)
| | | | - Selin Genç
- Department of Periodontology, Faculty of Dentistry, İzmir Katip Çelebi University, İzmir, Turkey
| | - Alperen İhtiyar
- Department of Biochemistry and Clinical Biochemistry, School of Medicine, İzmir Katip Çelebi University, İzmir, Turkey
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Ramalho KM, de Souza LMP, Tortamano IP, Adde CA, Rocha RG, de Paula Eduardo C. A randomized placebo-blind study of the effect of low power laser on pain caused by irreversible pulpitis. Lasers Med Sci 2016; 31:1899-1905. [DOI: 10.1007/s10103-016-2068-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 09/05/2016] [Indexed: 10/20/2022]
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23
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da Costa Lima GA, Aguiar CM, Câmara AC, Alves LC, dos Santos FAB, do Nascimento AE. Comparison of Smear Layer Removal Using the Nd:YAG Laser, Ultrasound, ProTaper Universal System, and CanalBrush Methods: An In Vitro Study. J Endod 2015; 41:400-4. [DOI: 10.1016/j.joen.2014.11.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 07/31/2014] [Accepted: 11/04/2014] [Indexed: 11/25/2022]
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