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Abbas B, Ahsin E, Asghar S, Habib F, Ishaq H, Um Min Allah N. Effect of the Irrigation Agitation Technique on Postoperative Pain in Teeth With Symptomatic Irreversible Pulpitis. Cureus 2024; 16:e61331. [PMID: 38947708 PMCID: PMC11213831 DOI: 10.7759/cureus.61331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2024] [Indexed: 07/02/2024] Open
Abstract
Introduction Irrigation of the root canal system is a vital step in endodontic treatment aimed at disinfecting the canal. The efficacy of irrigation can be improved by various irrigation agitation methods. One such novel method of interest is the manual dynamic agitation (MDA) technique. However, the effect of MDA on postoperative pain as compared to needle irrigation (NI) with sodium hypochlorite has been scarcely explored. This study aimed to compare the effects of NI and MDA techniques on postoperative pain in teeth with symptomatic irreversible pulpitis. Materials and methods This quasi-experimental study was conducted at the Department of Operative and Paediatric Dentistry, Fauji Foundation Dental Hospital, over four months after gaining ethical approval. One hundred and sixty-eight participants diagnosed with symptomatic irreversible pulpitis were enrolled in the study through the purposive sampling technique. The participants were divided into two groups based on the irrigation technique used: Group A (NI) and Group B (MDA). Postoperative pain was recorded after six hours, 24 hours, 48 hours, and seven days using the 0-100mm visual analog scale (VAS). The VAS scores were compared using an independent sample t-test. Results Out of 168 participants, 48.2% were in Group A and 51.2% in Group B. The study found that VAS pain scores for Group B (MDA) were significantly lower at six hours, 24 hours, 48 hours, and seven days as compared to Group A (NI), with a p-value less than 0.001. Conclusion This study shows that the MDA technique leads to decreased postoperative pain both immediately after endodontic treatment and a week later as compared to the NI technique. Hence, the use of MDA can aid in controlling postendodontic pain and, therefore, ensure smoother recovery and increased patient satisfaction.
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Affiliation(s)
- Beenish Abbas
- Pediatric Dentistry, Foundation University Islamabad, Islamabad, PAK
| | - Emaan Ahsin
- Pediatric Dentistry, Foundation University Islamabad, Islamabad, PAK
| | - Summiya Asghar
- Pediatric Dentistry, Foundation University Islamabad, Islamabad, PAK
| | - Faiza Habib
- Pediatric Dentistry, Foundation University Islamabad, Islamabad, PAK
| | - Hina Ishaq
- Pediatric Dentistry, Foundation University Islamabad, Islamabad, PAK
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Fahim SZ, Ghali RM, Hashem AA, Farid MM. The efficacy of 2780 nm Er,Cr;YSGG and 940 nm Diode Laser in root canal disinfection: A randomized clinical trial. Clin Oral Investig 2024; 28:175. [PMID: 38403667 PMCID: PMC10894764 DOI: 10.1007/s00784-024-05563-z] [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: 12/06/2023] [Accepted: 02/14/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES Effective disinfection of the root canals is the cornerstone of successful endodontic treatment. Diminishing the microbial load within the root canal system is crucial for healing in endodontically treated teeth. The aim of this study was to evaluate the effect of 2780 nm Er,Cr:YSGG and 940 nm diode lasers on the eradication of microorganisms from single-rooted teeth with asymptomatic apical periodontitis. MATERIALS AND METHODS Thirty participants conforming to the inclusion criteria were randomly divided into 3 groups according to the disinfection protocol used; Conventional group: 2.5% Sodium Hypochlorite (NaOCl) and 17% EDTA solution NaOCl/EDTA, Dual laser group: 2780 nm Erbium, chromium: yttrium scandium-gallium-garnet (Er,Cr:YSGG) laser and 940 nm diode laser Er,CrYSGG/Diode, and Combined group: 17% EDTA and 940 nm diode laser EDTA/Diode. Bacterial samples were collected before and after intervention. The collected data were statistically analyzed using Friedman's test and Kruskal-Wallis test (P ≤ 0.05). RESULTS The results of the study showed that both dual laser Er,CrYSGG/Diode and combined laser EDTA/Diode groups showed significantly less mean Log10 CFU/ml of aerobic and anaerobic bacterial counts than the conventional NaOCl/EDTA group. CONCLUSIONS In this study we evaluated in vivo the bactericidal efficacy of three disinfection protocols for endodontic treatment of single-rooted teeth with apical periodontitis. The results indicated that both dual laser Er,CrYSGG/Diode and combined laser EDTA/Diode groups provide superior bactericidal effect compared to the conventional NaOCl/EDTA group. CLINICAL RELEVANCE The integration of lasers into root canal disinfection protocols has demonstrated significant bacterial reduction which might promote healing and long-term success.
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Affiliation(s)
- Sara Zakaria Fahim
- Faculty of Dentistry, Department of Oral Medicine, Periodontology, Diagnosis and Radiology, Future University, Cairo, Egypt.
| | - Rami Maher Ghali
- Faculty of Dentistry, Department of Prosthodontics, Ain Shams University, Cairo, Egypt
| | - Ahmed A Hashem
- Ain Shams University, Faculty of Dentistry, Endodontic Department, Cairo, Egypt
- Cleveland Dental Institute, Cleveland, OH, USA
| | - Mary Medhat Farid
- Faculty of Dentistry, Department of Oral and Maxillofacial, Radiology, Ain Shams University, Cairo, Egypt
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Nouroloyouni A, Safavi Hir F, Farhang R, Noorolouny S, Salem Milani A, Alyali R. Evaluating In Vitro Performance of a Novel Stainless Steel Rotary System (Gentlefile) Based on Debris Extrusion and Instrumentation Time. BIOMED RESEARCH INTERNATIONAL 2023; 2023:9945236. [PMID: 37936828 PMCID: PMC10627714 DOI: 10.1155/2023/9945236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 11/09/2023]
Abstract
The new Gentlefile (GF) system, made of stainless steel and developed by MedicNRG in Kibbutz Afikim, Israel, claims to have advantages over traditional nickel-titanium files. However, research has shown that nickel-titanium files are mechanically superior due to their increased flexibility, cutting efficiency, and ability to maintain canal anatomy with less risk of procedural errors. This study compared the amount of debris extrusion and the time required for root canal instrumentation using GF versus the nickel-titanium ProTaper Universal (PTU) system and a manual step-back (MSB) stainless steel technique. This in vitro experimental study utilized 66 extracted human single-canal mandibular premolars with mature apices and root curvature of less than 10 degrees. The teeth were randomly divided into three groups (n = 22) and standardized for working length before being placed in preweighed vials. Group 1 was instrumented with PTU, Group 2 with GF, and Group 3 with the MSB technique. Extruded debris was collected in the vials, dried in an incubator, and weighed using the same scale. The change in weight indicates the debris amount. Instrumentation time was recorded using a stopwatch. The normal distribution of data was assessed using the Kolmogorov-Smirnov test. The groups were then compared regarding the amount of extruded debris and instrumentation time using the Kruskal-Wallis test and one-way ANOVA, followed by the Games-Howell test, respectively (alpha = 0.05). No significant difference in apical debris extrusion was found among the three groups (P > 0.05). However, a significant difference in instrumentation time was detected between the groups (P < 0.05). MSB instrumentation took significantly longer than both the PTU (P = 0.001) and GF (P = 0.001) systems. The GF system did not demonstrate reduced apical debris extrusion or faster instrumentation time compared to PTU. MSB had the longest instrumentation time compared to the other techniques.
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Affiliation(s)
- Ahmad Nouroloyouni
- Department of Endodontics, School of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
| | - Fatemeh Safavi Hir
- Department of Endodontics, School of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
| | - Robab Farhang
- Department of Endodontics, School of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
| | - Sara Noorolouny
- Department of Pediatric Dentistry, School of Dentistry, Ardabil University of Medical Science, Ardabil, Iran
| | - Amin Salem Milani
- Department of Endodontics, School of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Rashin Alyali
- Department of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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Meyfarth SRS, Tavares JDS, Guimarães LDS, Silva EAB, Gaio DC, Ecker MB, Brancher JA, Küchler EC, Silva-Sousa AC, de Sousa-Neto MD, Antunes LAA, Antunes LS. Association between single-nucleotide polymorphisms in serotonin receptor 2A and melatonin receptor 1A genes and pain after root canal treatment. Int Endod J 2023; 56:1077-1091. [PMID: 37323077 DOI: 10.1111/iej.13946] [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: 02/06/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/17/2023]
Abstract
AIM This study aimed to investigate whether single-nucleotide polymorphisms (SNPs) in the genes encoding 5-HTR2A (5-Hydroxytryptamine (serotonin) receptor 2A) and MTNR1A (melatonin receptor 1A) may contribute to postoperative pain perception after root canal treatment. We hypothesised that SNPs in HTR2A and MTNR1A genes were associated with postoperative pain after root canal treatment. METHODOLOGY This genetic cohort study enrolled patients with single-rooted teeth diagnosed with pulp necrosis and asymptomatic apical periodontitis before root canal treatment. Root canal treatment was performed in one session using a standardized protocol. Postoperative pain and tenderness were assessed using a visual analogue scale (recorded every day for 7 days and on the 14th and 30th days after root canal treatment). Genomic DNA was extracted from saliva and used to genotype the SNPs in HTR2A (rs4941573 and rs6313) and MTNR1A (rs6553010, rs6847693 and rs13140012) using real-time polymerase chain reaction. Genotypes were compared using univariate and multivariate Poisson regression with generalized estimating equations (p < .05). RESULTS In total, 108 patients were enrolled in this study. The SNPs rs6553010 (MTNR1A), rs4941573 and rs6313 (HTR2A) were associated with an increased risk of developing pain after root canal treatment (p < .05). CONCLUSIONS This study suggests that SNPs in HTR2A and MTNR1A influence pain response after root canal treatment.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Alice Corrêa Silva-Sousa
- Restorative Dentistry Department, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Manoel Damião de Sousa-Neto
- Restorative Dentistry Department, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Lívia Azeredo Alves Antunes
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Niterói, Brazil
- Clinical Research Unit, Fluminense Federal University, Rio de Janeiro, Brazil
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Nova Friburgo, Brazil
- Specific Formation Department, School of Dentistry of Nova Friburgo, Fluminense Federal University, Rio de Janeiro, Brazil
| | - Leonardo Santos Antunes
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Niterói, Brazil
- Clinical Research Unit, Fluminense Federal University, Rio de Janeiro, Brazil
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Nova Friburgo, Brazil
- Specific Formation Department, School of Dentistry of Nova Friburgo, Fluminense Federal University, Rio de Janeiro, Brazil
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Agrawal A, Agrawal N, Biswas K, Vasisth D, Almutairi N, Alotaibi BB, Patel B, Singh R. Evaluation of the Impact of Different Instrumentation Techniques on the Incidence of Postoperative Pain in Patients Undergoing Root Canal Treatment. Cureus 2023; 15:e42736. [PMID: 37654945 PMCID: PMC10467327 DOI: 10.7759/cureus.42736] [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: 07/01/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Postoperative pain is a common concern in root canal treatment, and the choice of instrumentation technique can significantly impact patient comfort. This study aimed to evaluate the impact of different instrumentation techniques on the incidence of postoperative pain in patients undergoing root canal treatment. METHODS A randomized controlled trial was conducted on 208 patients randomly assigned to four groups: step-back preparation, crown-down preparation, hybrid technique, and conventional instrumentation. Pain intensity was assessed using a verbal rating scale (VRS) at six, 12, 24, 48, and 72 hours postoperatively. Data were analyzed using appropriate statistical methods. RESULTS The mean pain scores and standard deviations (SDs) were calculated for each instrumentation technique at different time intervals. At six hours, the step-back preparation group reported a mean pain score of 2.3 (SD = 0.8), the crown-down preparation group had a score of 2.8 (SD = 0.9), the hybrid technique group had a score of 2.5 (SD = 0.7), and the conventional instrumentation group had a score of 3.1 (SD = 0.1). The differences in pain scores between the groups were statistically significant at all time intervals (p < 0.05). CONCLUSION The choice of instrumentation technique significantly influenced the incidence of postoperative pain in root canal treatment. The step-back preparation technique was associated with lower pain intensity than the crown-down preparation, hybrid technique, and conventional instrumentation. These findings highlight the importance of considering the instrumentation technique to optimize patient comfort during and after root canal treatment.
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Affiliation(s)
- Ankita Agrawal
- Department of Endodontics and Conservative Dentistry, Buddha Institute of Dental Sciences and Hospital, Patna, IND
| | - Neha Agrawal
- Department of Dentistry, Government Medical College, Mahasamund, IND
| | - Krishna Biswas
- Department of Conservative Dentistry and Endodontics, All India Institute of Medical Sciences, Guwahati, IND
| | - Diwakar Vasisth
- Department of Dental and Maxillofacial Surgery, Lady Hardinge Medical College and Hospital, Delhi, IND
| | - Nawaf Almutairi
- Department of Conservative Dental Science and Endodontics, Qassim University, Buraidah, SAU
| | - Badi B Alotaibi
- Department of Conservative Dental Science, Qassim University, Buraidah, SAU
| | - Bhumika Patel
- Department of Oral Medicine and Radiology, Howard University, Washington, DC, USA
| | - Ramanpal Singh
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Bilaspur, IND
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Kumar U, Parmar P, Vashisht R, Tandon N, Kaur CK. Incidence of postoperative pain after using single continuous, single reciprocating, and full sequence continuous rotary file system: a prospective randomized clinical trial. J Dent Anesth Pain Med 2023; 23:91-99. [PMID: 37034837 PMCID: PMC10079766 DOI: 10.17245/jdapm.2023.23.2.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 04/07/2023] Open
Abstract
Background Extrusion of debris is a major factor that results in postoperative pain during root canal treatment with various instruments and instrumentation techniques. Therefore, instrumentation techniques that extrude minimal debris into the periapical area while reducing pain are desirable. This study aimed to compare the incidence of postoperative pain and intake of analgesic medication (frequency and quantity) after endodontic treatment of mandibular posterior teeth using two single files and full-sequence continuous rotary systems with different kinematic motions. Methods Thirty-five of 105 patients were assigned equally to three groups according to the instrumentation system used: ProTaper Next (PN) X2, 25/06 (Dentsply, Maillefer, Ballaigues, Switzerland), One Shape (OS), #0.25/06 (Micro Mega, Besancon, France), and Wave One Gold (WG), Red - #0.25, 0.07 (Dentsply, Maillefer, Ballaigues, Switzerland). Five specialists were included in this study design; each professional prepared 21 teeth, and randomly selected 7 per instrument system. The VAS sheet ranging from 0 to 10 was used to record the initial and postoperative pains at 24, 48, and 72 h, and 7th day after single visit endodontic treatment in mandibular premolars and molars with a diagnosis of asymptomatic irreversible pulpitis with or without apical periodontitis. Postoperatively, an analgesic, ibuprofen 400 mg was administered for intolerable pain at a dose of 1 tablet for 6 h. The patients were asked over the telephone regarding postoperative pain at intervals of 24, 48, and 72 h, and 7th day using a visual analogue scale. Result There were no statistically significant differences among the PN, OS, and WG systems (P > 0.05) with regard to the incidence of postoperative pain at any of the four time points assessed. Conclusion The intensity of postoperative pain, frequency, and analgesic intake were similar across all three types of instrument systems; however, the reciprocating single file (WG) was associated with less postoperative pain than the full sequence continuous rotary file.
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Affiliation(s)
- Umesh Kumar
- Unit of Conservative Dentistry & Endodontics, Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Pragnesh Parmar
- Unit of Conservative Dentistry & Endodontics, Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Ruchi Vashisht
- Unit of Conservative Dentistry & Endodontics, Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Namita Tandon
- Unit of Conservative Dentistry & Endodontics, Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Charan Kamal Kaur
- Unit of Conservative Dentistry & Endodontics, Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
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