Smear layer removal improved pulpectomy outcome in primary teeth

Photograph of carious teeth

Pulpectomy is, indicated for primary teeth with irreversibly inflamed or necrotic radicular pulps because of caries or trauma. The main aim of this trial was to evaluate the outcome of pulpectomy with smear layer removal versus no smear layer removal. Patients were randomised to receive pulpectomy under rubber dam with either smear layer removal (G1) [read the full story…]

Calcium hydroxide effective for partial pulpectomy in primary molars

anatomy of teeth

Pulpotomy  is one of a number of approaches (indirect pulp capping, direct pulp capping, pulpotomy, pulpectomy) for managing carious lesions approaching the pulp of primary teeth with the aim of retaining  the tooth in a symptom free state until it is lost naturally thus avoiding an extraction.  Formocresol has been used for a number of [read the full story…]

Persistent post endodontic pain many not be tooth related

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Another critical summary of a systematic review prepared under the auspices of the American Dental Association Center for Evidence-Based Dentistry.   Originally published in 2010 , the review  aimed to assess the frequency of non-odontogenic dentoalveolar pain six months or more after endodontic therapy. The summariser notes the that both English and non-English language articles were [read the full story…]

Preoperative ibuprofen and acetaminophen did not improve inferior alveolar nerve anaesthesia success in patients with pulpitis.

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The inferior alveolar nerve block (IANB)  does not always result in successful pulpal anaesthesia with studies noting failure rates between  44% and 81%.  Previous studies have suggested that preoperative medication might increase the success rate of the IANB.  The aim of this study was to determine the effect of the administration of the combination of [read the full story…]

Phentolamine use results in a faster return-to-normal soft-tissue function and sensation after local anaesthesia

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Soft-tissue numbness after local anaesthesia is considerably longer than pulpal anaesthesia and the duration of the typical dental appointment. This often impacts on patients normal daily activities.  The aim of this randomized, single-blind study was to evaluate the reversal of soft-tissue anaesthesia using phentolamine in asymptomatic endodontic patients. Adults patients requiring endodontic therapy in a [read the full story…]

Are single dose oral medications for post root treatment pain relief effective?

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The pain associated with root canal treatment is a major source of fear for patients. Pre treatment, treatment, and post treatment pain is anticipated, experienced, remembered, and shared by patients. The aim of this trail was to compare the effects of single doses of three oral medications on postoperative pain following instrumentation of root canals [read the full story…]

5 to 7% of patients have persistent pain after root canal treatment

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This  systematic review was first published in 2010 The American Dental Association Centre for Evidence-based Dentistry has now published a critical summary of this review. They found the review to be comprehensive using STROBE criteria to assess study quality.Eighteen of the 26 studies were prospective. However they noted that the reviewers did not report the [read the full story…]

Calcium hydroxide or MTA for apex formation in immature permanent teeth

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Pulp necrosis  in immature teeth arrests root development so apical closure cannot be achieved. Root canal treatment of these teeth is a challenge. Procedures to encourage apexification have long been the treatment of choice success in preserving damaged immature teeth.  A range of  materials have been recommended to induce apexification in teeth with immature apices. [read the full story…]

Preoperative NSAIDs improve local anaesthetic success for root canal treatment of mandibular teeth

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Inferior alveolar nerve block (IANB) is the most frequently used injection technique for achieving local anaesthesia for root canal treatment of mandibular teeth. However it is not always successful in endodontics with studies failure rates occurring between 44% and 81% of the time.  The aim of this randomised trial was to determine the effect of [read the full story…]

How much pain is experienced before, during, and after root canal treatment?

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Root canal procedures are commonly believed to be the most painful dental treatment yet only 17% have described it as their most painful dental experience. The aim of this review was to determine the influence of root canal treatment on pain prevalence and severity and estimate the prevalence and severity of pre-treatment, treatment, and post-treatment [read the full story…]