ledermix and Toothache

The purpose of this research is to investigate the frequency of endodontic flare-ups using a visual analogue scale. Definitions of flare-ups vary widely as does their reported frequency. A flare-up was defined as an increase of 20 or more points on the visual analogue scale for a given tooth, within the periods of 4 h and 24 h after the initial treatment appointment. The data from a previous study were used to determine the incidence of flare-ups after using three modalities (Ledermix, calcium hydroxide and no medication) to manage patients presenting for relief of pain of endodontic origin. A statistical analysis showed that there were no significant differences in flare-up rates at both the 4-h and 24-h periods between the three modalities. Further research is required using the above definition of a flare-up and standardising treatment protocols.

Topics: Analysis of Variance; Calcium Hydroxide; Demeclocycline; Drug Combinations; Humans; Pain Measurement; Recurrence; Root Canal Irrigants; Toothache; Triamcinolone Acetonide

The purpose of this research is to investigate the frequency of endodontic flare-ups using a visual analogue scale. Definitions of flare-ups vary widely as does their reported frequency. A flare-up was defined as an increase of 20 or more points on the visual analogue scale for a given tooth, within the periods of 4 h and 24 h after the initial treatment appointment. The data from a previous study were used to determine the incidence of flare-ups after using three modalities (Ledermix, calcium hydroxide and no medication) to manage patients presenting for relief of pain of endodontic origin. A statistical analysis showed that there were no significant differences in flare-up rates at both the 4-h and 24-h periods between the three modalities. Further research is required using the above definition of a flare-up and standardising treatment protocols.

Topics: Analysis of Variance; Calcium Hydroxide; Demeclocycline; Drug Combinations; Humans; Pain Measurement; Recurrence; Root Canal Irrigants; Toothache; Triamcinolone Acetonide

To investigate the relationship of postoperative pain to three different medicaments placed in the root canal after a complete biomechanical debridement of the root canal system in patients presenting for emergency relief of pain.. Two hundred and twenty-three teeth belonging to 221 patients presenting as emergencies to the Royal Dental Hospital of Melbourne were included in the study. Inclusion was limited to patients with a diagnosis of pulp necrosis and acute apical periodontitis. All teeth underwent conventional root canal treatment, which involved the instrumentation to the apices of each canal at the first visit. Canals were instrumented using a stepback technique and hand-files along with irrigants using Milton's (1% sodium hypochlorite) solution followed by 15% EDTAC. The canals were dried and one of the following three medicaments was inserted into the canal in random sequence: Group 1: Ledermix paste (Lederle Pharmaceuticals, Division of Cyanamid, Wolfratshausen, Germany); Group 2: calcium hydroxide paste (Calcipulpe, Septodont, France); and Group 3: no dressing. Before dismissal, the preoperative pain experienced on the previous night was recorded using a visual analogue pain scale. Patients were then instructed to record the degree of pain experienced 4 h after treatment and daily for a further 4 days.. The mean score pain for all three groups was between 42 and 48 prior to treatment being commenced. After 4 days, the pain score for Group 2 was 10, for Group 3 was 7 and for Group 1 was 4. Mean preoperative pain level was 44.4 (of a maximum 100) for all groups, and declined by 50% (to 22.1) after 24 h. Patients in Group 1 (Ledermix) experienced significantly less (P = 0.04) postoperative pain than those in the other two groups. There was no significant difference between Group 2 (calcium hydroxide) and Group 3 (no dressing).. Under the conditions of this study, painful teeth with acute apical periodontitis that had been dressed with Ledermix paste gave rise to less pain than that experienced by patients who had a dressing of calcium hydroxide or no dressing at all. Ledermix is an effective intracanal medicament for the control of postoperative pain associated with acute apical periodontitis, with a rapid onset of pain reduction.

Topics: Anti-Bacterial Agents; Calcium Hydroxide; Calcium Sulfate; Demeclocycline; Dental Cements; Dental Pulp Necrosis; Drug Combinations; Emergency Treatment; Glucocorticoids; Humans; Methylmethacrylates; Pain Measurement; Pain, Postoperative; Periapical Periodontitis; Polyvinyls; Prospective Studies; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Obturation; Single-Blind Method; Toothache; Triamcinolone Acetonide; Zinc Oxide; Zinc Oxide-Eugenol Cement

The aims of this study were to assess symptoms and signs caused by cracks in teeth and to assess a conservative management protocol.. The symptoms and signs of 100 consecutive teeth that had reversible pulpitis associated with cracks were compared to findings from other reports. Teeth were managed with a conservative protocol which involved removal of cracks, caries and restorations, followed by placement of a sedative lining and interim restoration unless there were pulp exposures or insufficient tooth structure remaining. Teeth were monitored for pulp healing after three months and for up to five years.. Eighty teeth did not require endodontic treatment. One tooth had an uncertain pulp status at review appointments. Fifteen teeth required endodontic treatment at the initial appointment because of carious pulp exposures (4 teeth), cracks extending into the pulp (2), and posts required (9). Four other teeth required endodontic treatment later following conservative pulp treatment due to continued pulpitis under the temporary restoration (1), pulpitis after core restoration (2), and pulp necrosis diagnosed at the review (1).. Provided there is an accurate diagnosis of the pulp status and its cause, teeth with reversible pulpitis due to cracks can be treated conservatively without endodontic treatment in about 80 per cent of cases.

Topics: Adolescent; Adult; Aged; Clinical Protocols; Cracked Tooth Syndrome; Demeclocycline; Dental Restoration, Permanent; Drug Combinations; Female; Humans; Male; Middle Aged; Prospective Studies; Pulpitis; Root Canal Therapy; Toothache; Triamcinolone Acetonide; Young Adult; Zinc Oxide-Eugenol Cement

Topics: Demeclocycline; Dental High-Speed Technique; Drug Combinations; Humans; Pain, Postoperative; Pulpotomy; Root Canal Irrigants; Root Canal Therapy; Toothache; Triamcinolone Acetonide

The purpose of the study was to compare the effect of three intracanal medicaments on the incidence of post-instrumentation flare-ups. All teeth were instrumented to a predetermined minimum size using a 0.5% solution of sodium hypochlorite as the irrigant. Formocresol, Ledermix, and calcium hydroxide were placed in strict sequence irrespective of the presence or absence of symptoms or radiographic signs of apical periodontitis. The patients were given written post-operative instructions and a prescription for 600 mg ibuprofen to be taken if mild to moderate pain developed. If severe pain and/or swelling developed the patient was instructed to call the office immediately and was considered to have had a flare-up. Twelve flare-ups occurred in teeth with radiographic signs of apical periodontitis; none in teeth without periapical radiolucencies. Six of the twelve flare-ups occurred in retreatment cases and the other six occurred in teeth without previous endodontic treatment. No significant difference was found in the flare-up rate among the three intracanal medicaments.

Topics: Acute Disease; Calcium Hydroxide; Chi-Square Distribution; Demeclocycline; Drug Combinations; Formocresols; Humans; Periapical Periodontitis; Recurrence; Reoperation; Root Canal Irrigants; Root Canal Therapy; Toothache; Triamcinolone Acetonide