AimTo establish the effects of submucosal single doses of two medicines on postoperative pain after root canal treatment in mandibular molar teeth with symptomatic irreversible pulpitis.MethodologyIn this randomized controlled, double‐blind clinical trial, 90 patients with the diagnosis of symptomatic irreversible pulpitis in their mandibular first or second molars were included and randomly divided into three groups (n = 30): a control group that received normal saline and two experimental groups that received a single dose of either tramadol (100 mg 2 mL−1) or dexamethasone (8 mg 2 mL−1). After local anaesthesia and before treatment, submucosal injections were administered into the mucobuccal fold adjacent to the mandibular molars, and a routine single‐visit root canal treatment procedure was performed in all groups. After the root canal treatments, the patients were asked to score their pain level using the Heft–Parker visual analogue scale (0–170 mm) at 6, 12, 24, 48 and 72 h. The experimental groups were compared using one‐way anova or Kruskal–Wallis H‐test. The groups that were significantly different were compared pairwise using Student's t‐test or the Mann–Whitney U‐test. The findings were expressed as the mean ± standard deviation or median (min‐max). The categorical variables were tested using the chi‐square test or Fisher's exact chi‐square test, and the results were expressed as counts and percentages.ResultsAt the 6‐h and 48‐h time intervals, the intensity of pain was significantly less in both the dexamethasone and tramadol groups than in the control group (P < 0.0167). At the end of 12 h, the pain level in the dexamethasone group was significantly less compared to the other groups (P < 0.0167).ConclusionsPretreatment submucosal dexamethasone and tramadol injections significantly diminished post‐treatment endodontic pain of patients with symptomatic irreversible pulpitis following single‐visit root canal treatment. However, dexamethasone was more effective than tramadol in pain reduction in the first 12 h.

Background:There is a growing interest about electronic apex locators for working length determination. There are several studies dealing with their performance in different conditions.Aims:The aim of this study is to evaluate the accuracy of Root ZX and Raypex 6 in teeth with different apical diameters.Materials and Methods:Actual working length (AWL) of 80 single rooted teeth were determined as 0.5 mm short of apical foramen. The teeth were divided into 4 groups (n = 20). First group (G 0) included teeth with mature apices. Root canals of the other groups (G 32, G 57 and G 72) were enlarged until apical sizes of 0.32, 0.57 and 0.72 mm were obtained. Samples were embedded in alginate and electronic measurements (EM) were performed.Statistical analysis:was achieved with Fisher exact test.Results:Both devices revealed a high rate of success in G 0 and G 32. Their accuracy decreased significantly in G 57 and G 72 groups (P < 0.05). Intra-group results of Root ZX and Raypex 6 were similar (P > 0.05).Conclusions:Root ZX and Raypex 6 are reliable in teeth with mature apices. At foramen diameters exceeding 0.57 mm, their accuracy is susceptible.

Aim: To establish the effects of submucosal tramadol, dexamethasone and articaine on the success of inferior alveolar nerve blocks (IANB) during root canal treatment of mandibular molars with symptomatic irreversible pulpitis (SIP). Methodology:In this randomized double-blind, controlled clinical trial, 120 patients with the diagnosis of SIP in their mandibular first or second molars were included and randomly divided into four groups (n = 30). The control group received normal saline and three experimental groups received a single dose of dexamethasone (8 mg/2 mL), or tramadol (100 mg/2 mL) or articaine (4% / 2 mL). The pre-operative pain levels of the patients were measured with the Heft-Parker visual analogue scale (HP VAS). All patients received standard IANB of 4% articaine with 1:200000 epinephrine. Following the observation of lip numbness, submucosal injections were administered into the mucobuccal fold adjacent to the mandibular molars. After 15 min, standard root canal treatment was initiated, and the pain intensity levels recorded from the access cavity preparation to pulp extirpation were measured with HP VAS. The duration of the anaesthesia was also evaluated. The experimental groups were compared using one-way ANOVA or Kruskal-Wallis H-test. The groups that were significantly different were compared pairwise using the Tukey Multiple Comparison test. The Chi-square test was used to compare the categorical variables. Results:The submucosal administration of articaine significantly increased the success rate to 63% in comparison with the control group that received submucosal saline (p < .05). The success rate of pulpal anaesthesia was 37% in the control group, 57% in the tramadol group and 47% in the dexamethasone group, with no significant difference in the success rate among these groups. In the dexamethasone group, the duration of the anaesthetic effect of IANB was significantly longer than those in the other groups (p < .001). Conclusions:In patients with SIP, pre-operative submucosal administration of articaine increased the success rate of IANB, while administration of dexamethasone | 1983 AKSOY ET AL.

The aim of this study is to evaluate the incidence of crack formation while using Reciproc, WaveOne and Twisted File Adaptive with and without ethylenediaminetetraacetic acid (EDTA) gel. Seventy extracted mandibular premolars were included. The teeth were decoronated until roots of 16 mm were obtained. Samples were distributed into seven groups: group 1, no canal preparation (control); other groups were instrumented so; group 2, Reciproc; group 3, Reciproc + EDTA; group 4, WaveOne; group 5, WaveOne + EDTA; group 6, Twisted File Adaptive; group 7, Twisted File Adaptive + EDTA. Roots were horizontally sectioned from 3, 6 and 9 mm from apex and observed under stereomicroscope. The number and the incidence of cracks were recorded and statistically analysed with chi-squared and Kruskal-Wallis tests. Control group did not reveal any cracks. Crack formation with three novel Ni-Ti instruments was similar. Using EDTA gel did not reduce crack occurrence.

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