Journal of endodontics最新文献

Introduction: The present study aimed to clinically compare the incidence of postoperative pain after endodontic treatment of posterior teeth using XP-endo Shaper (XPES; FKG Dentaire, La Chaux-de-Fons, Switzerland) and TruNatomy (TNY; Dentsply Sirona, Ballaigues, Switzerland) systems.

Methods: In a single-blind randomized clinical trial, 104 vital teeth with an indication for conventional endodontic treatment for prosthetic purposes were treated by a single specialist following a pre-established protocol. All participants were unaware of the treatment they received. The teeth were randomly divided into 2 groups (n = 52) according to the instrumentation system used (TNY group and XPES group). The treatments were performed in a single visit. The participants were asked to rate the intensity of postoperative pain on a numeric rating scale and a visual analogue scale (no pain, mild pain, moderate pain, and severe pain) after 24, 48, 72 hours and after 7 days.

Results: The incidence of postoperative pain was zero in both groups at 48 h, 72 h, and 7 days. At 24 h, most patients in the XPES and TNY groups had no pain, while the remaining participants in either group experienced mild pain (1 to 3), with no significant difference between groups (p > .05, Mann-Whitney test).

Conclusions: The instruments used in this study are associated with minimal postoperative pain, which only occurred in the first 24 h. Based on the parameters analyzed, we conclude that the systems tested cause mild postoperative pain over a short period of time.

Introduction: As a recently developed treatment modality, regeneration of the pulp-dentin-like complex via tissue engineering (TE) approaches is the focus of considerable attention. The persistence of bacteria within the root canal spaces is well known as the major challenge of dental pulp regeneration. Antimicrobial peptides (AMPs) are short peptides with inhibitory activities against a broad spectrum of microorganisms.

Methods: In the present study, antimicrobial hydrogels based on two photo-reactive biopolymers, i.e. collagen methacrylate (ColMA) and chitosan methacrylate (ChitMA), and containing two different AMPs, i.e. LLKKK18 and Tet213, were used to develop a potential scaffold with antimicrobial and regenerative features.

Results: The incorporation of AMPs had no significant effect on the physical, mechanical, rheological, and morphological properties of the new systems. The optimized concentration of LLKKK18 and Tet213 had appropriate antimicrobial activity against Gram-positive Enterococcus fæcalis (E. fæcalis) and did not exhibit any cytotoxicity to stem cells from the apical papilla (SCAP) encapsulated within the hydrogels compared to the control group without AMPs. The presence of AMPs also significantly promoted migration and differentiation of SCAP. In the AMP-loaded groups, greater levels of calcified nodules deposition, ALP, COL I, DSPP, DMP1, and VEGF mRNA gene expression, and COL I and DSPP protein expression were observed.

Conclusions: The results indicated the potential of engineered antimicrobial ColMA/ChitMA hydrogels for application in TE-based strategies to regenerate the pulp-dentin complex.

Objectives: the aim of this study was to perform a qualitative and quantitative synthesis of the available studies evaluating the possible relationship between apical periodontitis and autoimmune diseases.

Methods: The literature search was conducted across six electronic databases (PubMed/MEDLINE, Embase, SciELO, Web of Science, Cochrane Library, and Scopus). The search covered articles published up to September 2023. There was no disagreement between the 2 reviewers. The RevMan software (V5.3) was used for the meta-analysis. A dichotomized analysis was performed using the Mantel-Haenszel statistical method with a fixed-effect model and the risk ratio as the effect measure. A 95% confidence interval was adopted, and the significance level was set at p < 0.05. The presence of apical periodontitis was pre-defined as the event, with the experimental group consisting of patients with autoimmune disease and the control group consisting of patients without autoimmune disease (healthy individuals). The data used included the number of individuals presenting the event versus the total number of study participants.

Results: 9 studies were included and considered eligible. The methodological quality of the studies was classified as moderate in 5 of the 9 included studies, while 2 were rated as low, and 2 were rated as high-quality. The relative risk was 1.24 with a 95% confidence interval (1.08 to 1.62), in which the prevalence of apical periodontitis in comparing patients with autoimmune diseases and healthy patients yielded statistically significant results (p < 0.0001). Thus, patients with autoimmune diseases had a 24% higher relative risk of developing apical periodontitis compared to the healthy/control group.

Conclusions: The analysis of the studies included in this review suggests a potential association between apical periodontitis and autoimmune diseases. However, it is important to consider that the selected studies have limitations, primarily because they are observational studies.

Introduction: The purpose of this study was to evaluate the effect of cryotherapy application on postoperative pain in permanent molars with symptomatic irreversible pulpitis after full pulpotomy procedures.

Methods: Sixty-two patients with permanent maxillary and mandibular molars diagnosed with symptomatic irreversible pulpitis were included in the study. The teeth were randomly divided into two groups: the control group (n = 32) and the cryotherapy group (n = 30). In both groups, cotton pellets moistened with 2.5% NaOCl were used to achieve hemostasis. In the cryotherapy group, after hemostasis was achieved, the pulpotomy area was irrigated with saline solution at 2.5°C for 5 minutes. Then, in both groups, the pulp chamber was covered with Bio MTA+ (Cerkamed Company, Poland) and the composite restoration of the teeth (Clearfil Majesty Posterior, Kuraray Medical Inc., Tokyo, Japan) was completed. The participants were asked to rate the intensity of their postoperative pain via a Visual Analog Scale (VAS) at 6h, 12h, 24h, 48h, and 72 hours. The data were analyzed using the Shapiro-Wilk, Levene's, Student t, Repeated Measures ANOVA and the Chi-square test.

Results: The basic demographic data and analgesic intake of the two study groups were similar. Compared with those in the control group, the postoperative pain scores at 6h and 12 hours were significantly lower in the cryotherapy group (p < .05). The postoperative pain scores at 24h, 48h, and 72 hours were similar in both study groups.

Conclusions: During vital pulp treatment, the cryotherapy application after hemostasis reduced postoperative pain in permanent molars with symptomatic irreversible pulpitis in the early period.