sodium-hypochlorite and Toothache

Use of magnifying loupe may increase the efficiency of dental care. This clinical trial compared the time in performing non-surgical endodontic therapy with or without the use of a magnifying loupe.. Patients who required primary endodontic treatment in clinical trial centres at the University of Hong Kong (HKU) in Hong Kong and Peking University (PKU) in Beijing were invited to participate in this study. Two HKU dentists and 2 PKU dentists, forming 2 pairs of dentists with similar years of clinical experience, performed endodontic treatments according to the same procedures and used the same materials, either in single or multiple visits. They had no prior experience with the use of a magnifying loupe. One dentist from each pair was trained to use a magnifying loupe (x2.5). The treatment time was recorded.. Eighty-four PKU patients with a mean age of 42.8 years and 98 HKU patients with a mean age of 46.0 years were recruited in this study. Ninety-six teeth were treated with a magnifying loupe and 86 teeth were treated without a magnifying loupe. The results showed that treatment time was not associated with age, gender, tooth vitality, or the presence of apical radiolucency or sinus tract. The results of ANCOVA revealed the treatment time was associated with the clinic (HKU or PKU), root canal system (single or multiple), presence of preoperative pain, treatment visit (single or multiple), the use of a magnifying loupe, and the experience of the operator.. In this study, the use of a magnifying loupe could significantly reduce the endodontic treatment time.. Clinical Trials ChiCTR-IOR-15005988 registered 15 February 2015.

Topics: Adult; Calcium Hydroxide; Clinical Competence; Dental Alloys; Dental Fistula; Dental Pulp Cavity; Equipment Design; Female; Humans; Lenses; Male; Middle Aged; Nickel; Periapical Diseases; Root Canal Irrigants; Root Canal Obturation; Root Canal Preparation; Root Canal Therapy; Sodium Hypochlorite; Time Factors; Titanium; Toothache; Zinc Oxide-Eugenol Cement

The purpose of this study was to compare levels of postoperative discomfort after cleaning and shaping of root canals using two protocols for removal of smear layer. Seventy-three consecutive patients requiring root canal treatment were included. At random, canals were cleaned and shaped with one of the following protocols. In group 1, 5.25% sodium hypochlorite was used as the root canal irrigant. The smear layer was removed by placing 17% EDTA in the canal(s) for 1 min followed by a 5-ml rinse with 5.25% NaOCl. In group 2, canals were irrigated with 1.3% NaOCl; the smear layer was removed by placing MTAD in the canal(s) for 5 min. Access cavities were closed with a sterile cotton pellet and Cavit. The patients recorded degree of discomfort at various time intervals after cleaning and shaping on a visual analogue scale for 1 wk. No significant statistical difference was found in the degree of discomfort between the two groups (p = 0.58).

Topics: Adult; Analysis of Variance; Chelating Agents; Chi-Square Distribution; Edetic Acid; Humans; Pain, Postoperative; Polysorbates; Root Canal Irrigants; Root Canal Preparation; Smear Layer; Sodium Hypochlorite; Surface-Active Agents; Surveys and Questionnaires; Toothache

Endodontic therapy is one of the commonly used procedures for treating the teeth affected by various pathologies. One of the major problems for endodontists despite the advancements in the root canal procedures is the posttreatment endodontic flare-ups. Much debate exists regarding the completion of endodontic therapy in a single sitting or multiple sittings. Hence, we assessed the incidence of endodontic flare-ups in patients undergoing single-sitting root canal therapies.. The present study included 200 patients who underwent single-sitting endodontic therapy. Clinical details and conditions of each and every tooth of every patient were recorded before and after the completion of endodontic therapy. Irrigation during the root canal procedures was done by 2.5% NaOCl solution in most of the cases while others were irrigated with various combinations of ethylenediaminetetraacetic acid (EDTA) and cycloheximide (CHX) solutions. Follow-up records and readings of the patents were noted and were subjected to statistical analysis.. Four groups were formed which divided the patients equally on the basis of their age. Out of 50 patients in the age group of 21 to 30 years, only 4 showed posttreatment endodontic flare-ups, while no endodontic flare-up was recorded in patients with age group of 31 to 50 years. Only two male and four females showed flare-ups postoperatively. A nonsignificant correlation was obtained when flare-up cases were compared on the basis of type of irrigation solution used during canal preparation.. Single-sitting endodontic therapy appears to be a successful procedure with good prognosis and minimal posttreatment flare-up results, even in patients with periapical pathologies.. Single-sitting root canal procedures can be successfully carried in patients with vital or nonvital pulp tissues and also in patients with periapical lesions.

Topics: Adolescent; Adult; Anti-Infective Agents; Child; Cycloheximide; Edetic Acid; Female; Humans; Male; Middle Aged; Office Visits; Root Canal Preparation; Root Canal Therapy; Sodium Hypochlorite; Toothache; Young Adult

To investigate the probability of and factors influencing periapical status of teeth following primary (1°RCTx) or secondary (2°RCTx) root canal treatment.. This prospective study involved annual clinical and radiographic follow-up of 1°RCTx (1170 roots, 702 teeth and 534 patients) or 2°RCTx (1314 roots, 750 teeth and 559 patients) carried out by Endodontic postgraduate students for 2-4 (50%) years. Pre-, intra- and postoperative data were collected prospectively on customized forms. The proportion of roots with complete periapical healing was estimated, and prognostic factors were investigated using multiple logistic regression models. Clustering effects within patients were adjusted in all models using robust standard error.. proportion of roots with complete periapical healing after 1°RCTx (83%; 95% CI: 81%, 85%) or 2°RCTx (80%; 95% CI: 78%, 82%) were similar. Eleven prognostic factors were identified. The conditions that were found to improve periapical healing significantly were: the preoperative absence of a periapical lesion (P = 0.003); in presence of a periapical lesion, the smaller its size (P ≤ 0.001), the better the treatment prognosis; the absence of a preoperative sinus tract (P = 0.001); achievement of patency at the canal terminus (P = 0.001); extension of canal cleaning as close as possible to its apical terminus (P = 0.001); the use of ethylene-diamine-tetra-acetic acid (EDTA) solution as a penultimate wash followed by final rinse with NaOCl solution in 2°RCTx cases (P = 0.002); abstaining from using 2% chlorexidine as an adjunct irrigant to NaOCl solution (P = 0.01); absence of tooth/root perforation (P = 0.06); absence of interappointment flare-up (pain or swelling) (P =0.002); absence of root-filling extrusion (P ≤ 0.001); and presence of a satisfactory coronal restoration (P ≤ 0.001).. Success based on periapical health associated with roots following 1°RCTx (83%) or 2°RCTx (80%) was similar, with 10 factors having a common effect on both, whilst the 11th factor 'EDTA as an additional irrigant' had different effects on the two treatments.

Topics: Adult; Chelating Agents; Chlorhexidine; Cohort Studies; Contraindications; Dental Fistula; Dental Pulp Cavity; Edetic Acid; Female; Follow-Up Studies; Gutta-Percha; Humans; Male; Periapical Diseases; Periapical Tissue; Post and Core Technique; Prognosis; Prospective Studies; Radiography; Retreatment; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Preparation; Root Canal Therapy; Sodium Hypochlorite; Tooth Apex; Toothache; Treatment Outcome; Wound Healing; Zinc Oxide-Eugenol Cement

The aim of this study was to investigate levels of matrix metalloproteinase-8 (MMP-8) and substance P (SP) in gingival crevicular fluid (GCF) during root canal treatment (RCT) of nonvital teeth.. Patients scheduled for nonsurgical RCT were prospectively selected; all patients provided informed consent. GCF samples were collected from teeth scheduled for RCT and their contralateral teeth across 3 different time periods. MMP-8 and SP levels were measured using enzyme-linked immunosorbent assay (ELISA). Data were analyzed using a mixed model analysis and the Pearson correlation analysis.. Patients' subjective pain levels were significantly related to both MMP-8 and SP levels. MMP-8 and SP levels in GCF were decreased during RCT, and they showed a positive correlation with each other (P < .05).. This study demonstrated that periradicular inflammation of endodontic origin can elevate SP and MMP-8 levels in GCF.

Topics: Adult; Female; Follow-Up Studies; Gingival Crevicular Fluid; Humans; Inflammation Mediators; Male; Matrix Metalloproteinase 8; Neurotransmitter Agents; Pain Measurement; Periapical Periodontitis; Prospective Studies; Root Canal Irrigants; Root Canal Obturation; Root Canal Preparation; Root Canal Therapy; Sodium Hypochlorite; Substance P; Tooth, Nonvital; Toothache

The objective of this prospective clinical study was to evaluate the incidence of flare-ups (pain and/or swelling requiring endodontic interappointment and emergency treatment) and identify the risk factors associated with their occurrence in patients who received endodontic treatment from June 2006 to June 2007 at the endodontics clinic of the São Paulo Dental Association (APCD), Jardim Paulista branch, São Paulo, Brazil. The incidence of flare-ups was 1.71% out of 408 teeth that had received endodontic therapy. Statistical analysis using the chi-squared test (P < .05) indicated a direct correlation between the flare-up rate and the presence of a periradicular radiolucency.

Topics: Adult; Brazil; Edema; Edetic Acid; Emergency Treatment; Female; Humans; Incidence; Male; Middle Aged; Pain, Postoperative; Periapical Diseases; Postoperative Complications; Prospective Studies; Retreatment; Risk Factors; Root Canal Irrigants; Root Canal Preparation; Root Canal Therapy; Sodium Hypochlorite; Toothache; Young Adult

Topics: Camphor; Chlorophenols; Drug Combinations; Formocresols; Humans; Hydrogen Peroxide; Root Canal Therapy; Sodium Hypochlorite; Therapeutic Irrigation; Toothache; Water

Topics: Dental Materials; Humans; Hydrogen Peroxide; Root Canal Therapy; Sodium Hypochlorite; Therapeutic Irrigation; Toothache