BackgroundPeriapical lesions are inflammatory diseases that result in periapical bone destruction because of host defensive–microbial disturbances.ObjectiveTo evaluate the role of prophylactic ibuprofen and N-acetylcysteine (NAC) on the levels of tumor necrosis factor alpha (TNF- α), interleukin- 6(IL-6) and IL-17 and post-treatment pain level in chronic periapical lesions.Materials and methodsEighty patients with chronic apical lesions less than 1 cm were randomly assigned to receive NAC tablets (400 mg), ibuprofen tablets (400 mg), NAC (400 mg)/ibuprofen (200 mg) combination and placebo 90 minutes prior to sampling. Periapical exudates were collected from root canals. TNF- α, IL-6 and IL-17 levels were determined by ELISA and post-treatment pain was assessed using a visual analog scale (VAS).ResultsThere was a significant difference in IL-6 level between ibuprofen group and placebo (p = 0.019). Significant difference in IL-17 level was observed between NAC/ibuprofen combination group and placebo (p = 0.043). Four hours after treatment, a significant difference was observed in VAS pain score between ibuprofen group and placebo (p = 0.017). Eight hours post-treatment, VAS pain score for NAC group was statistically lower than placebo group (p = 0.033). After 12 hours VAS pain score showed a significant decrease in NAC group compared to placebo (p = 0.049).ConclusionThe prophylactic ibuprofen and NAC failed to clearly reflect their effect on cytokines levels in exudates of chronic periapical lesions. On the other hand it seems that NAC can be a substitute for ibuprofen in the management of post endodontic pain.

The aim of this report is to present two cases of canalis basilaris medianus as identified on cone-beam computed tomography (CBCT) in the base of the skull. The CBCT data sets were sent for radiographic consultation. In both cases, multi-planar views revealed an osseous defect in the base of the skull in the clivus region, the sagittal view showed a unilateral, well-defined, non-corticated, track-like low-attenuation osseous defect in the clivus. The appearance of the defect was highly reminiscent of a fracture of the clivus. The borders of osseous defect were smooth, and no other radiographic signs suggestive of osteolytic destructive processes were noted. Based on the overall radiographic examination, a radiographic impression of canalis basilaris medianus was made. Canalis basilaris medianus is a rare anatomical variant and is generally observed on the clivus. Due to its potential association with meningitis, it should be recognized and reported to avoid potential complications.

Aim: Scaling and root planning (SRP) is a major component of periodontal therapy which is often accompanied by painful experiences for the patient. The objective of the present study is to evaluate the pain control of two available types of ibuprofen, soft gelatin capsules and tablets, following SRP in patients with chronic periodontitis. Methodology: 75 patients with chronic periodontitis, undergoing routine periodontal SRP were selected. Following probing the amount of pain perceived was recorded as the baseline pain using visual analog scale (VAS). Further, they received either 800 mg ibuprofen tablet, 800 mg ibuprofen capsule or placebo and the pain level was measured thirty minutes thereafter. Participants underwent SRP procedure and the pain levels were recorded immediately and then at 30 and 60 minutes after SRP. Results: The mean VAS pain scores assessed immediately, thirty minutes and an hour after SRP for both ibuprofen and ibuprofen capsule groups were lower than placebo. Significant difference in the pain parameter only immediately after SRP between three groups were observed (p=0.012).The mean VAS pain score difference after thirty minutes and an hour upon SRP with baseline was insignificant in all study groups (p≤0.0001). However, the mean VAS pain score measured an hour after SRP showed significant difference between both NSAID groups and placebo group (p=0.012) Conclusions: Soft gelatin ibuprofen capsules are well suitable for pain management during SRP procedure in patients with chronic periodontitis due to reported rapid onset of action and less gasterointestinal intolerance.

Milk curd has a significant local impact, and the saliva increase depends on the dose. It seems that this effect is not only related to its acidic taste. As a result, factors other than pH are involved in the effect.

Dental anomalies are rare findings that may affect development of occlusion and early intervention may be required. Here, a case of multiple anomalies in primary and permanent dentitions is reported. The patient referred to the dental center with the chief complaint of multiple tooth decay. In the oral examination, the rare case of triplication between the right geminated mandibular A and right mandibular B was observed. A talon cusp on the maxillary deciduous lateral incisor was also noticed. In the panoramic radiograph view, two permanent supernumerary teeth were found at the region of primary tooth anomalies in both jaws. The article describes the management of the dentition during the dental transitory years of 5 to 7. Precise examination may reveal anomalies that require intervention. In some cases, presence of one anomaly in primary dentition, can suggest the possibility of further anomalies in both primary and permanent dentition. In this case, careful initial examination and dental panoramic radiographs led to early diagnosis and appropriate treatment plans in mixed dentition years.