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Introduction: The aim of the present study was to evaluate the influence of the calcium hydroxide with chlorhexidine combination and calcium hydroxide alone as an intra-canal medicament on postoperative pain and swelling (flare-up) in two visits endodontic retreatment cases. Methods: Twenty four patients, aged from 20-50 years old with no gender prediction, suffering from failed previous endodontic treatment were included in this study. After confirming the diagnosis clinically and radiographically, patients were randomly assigned into two equal groups of 12 patients each. After removal of the previous root canal filling, root canals were prepared and cleaned with 2.5% sodium hypochlorite, root canals were medicated with calcium hydroxide chlorhexidine combination in the intervention group, whereas the comparator group was medicated with calcium hydroxide as intracanal medicaments for 7 days. Endodontic treatment was completed in the second visits and lateral condensation technique with ADSEAL resin sealer used for obturation. Pain was assessed postoperatively after 6, 12, 24, 48, 72 hours and at 7 days before obturation. Patients were given an analgesic (Ibuprofen 200 mg) in case of severe pain. Categorical Scale for pain measuring and presence and absence of swelling was used as the primary outcome measure. Results: Results showed statistically significant difference between the two groups at the first 6 hours with calcium hydroxide Ca group recorded high incidence of postoperative flare up, and no statistically significant difference at 12, 24, 48, 72, and 7 days between the two groups in categorical scale or swelling records. There was no statistically significant difference in the intake of analgesics between the two groups. Conclusion: The study concluded that calcium hydroxide chlorhexidine combination resulted in better pain control. Also there was no difference in prevalence of swelling and in the intake of analgesics between the two groups.

Introduction:This study aimed to compare the shaping ability and cutting efficiency of Trunatomy, Protaper Next and 2Shape file systems in preparing severely curved canals. Methods: Forty-five mandibular mesiobuccal canals with 40-60 degrees of curvature were divided into three equal groups: Trunatomy, Protaper Next and 2Shape. Pre- and post-instrumentation images were taken using cone beam computed tomography to measure canal transportation, centering ability, dentin thickness and canal curvature radius and volume. Pre- and post-instrumentation weights were measured using ananalytical scale. Results: Trunatomy had significantly the lowest values of canal transportation, amount of removed dentin and percent change in canal curvature radius and volume. Protaper Next had significantly the highest buccolingual canal transportation. There was no significant difference among the three systems in canal centering. Trunatomy significantly recorded lesser percent change in root canal weightthan 2Shape. Conclusion:The three file systems were able to prepare severely curved root canals efficiently and safely Clinical relevance: Trunatomy system can prepare root canals with severe curvature and complex anatomy with minimal amount of removed dentin.

Objective: This study evaluated the effectiveness of Diode laser (980 nm) activated irrigation to passive ultrasonic irrigation and traditional irrigation needles for smear layer eradication. Methodology:To achieve a uniform length of 16 mm, 45 extracted permanent single-rooted mandibular premolars were disinfected and decoronated. After sealing the apices with flowable composite and impeding them in epoxy resin blocks, all teeth were mechanically prepared with ProTaper Next rotary files up to X4. NaOCl was utilized as an irrigant in between each file. According to the activation method, samples were randomly assigned to one of three groups (n=15): Group 1 (DL): a 980 nm Diode laser coupled with an optical fiber of 200 μm; Group 2 (PUI): passive ultrasonic irrigation; and Group 3 (CG): a conventional irrigation protocol without activation (Control group).Results: There was a significant difference between the three groups in coronal middle and apical thirds (p = 0.01, p <0.001 and p = 0.003 respectively). There were no significant differences between PUI and DL activation-irrigation efficacy regarding the smear layer removal. On the other hand, there was a significant difference between both groups and the control group at the middle third. While only the DL showed significant difference from the CG at the coronal and apical thirds. Conclusion:DL demonstrated excellent cleaning effectiveness at all root-canal sections that was comparable to PUI. However, no activation approach was able to completely remove the smear layer.