The effect of antibiotic use on endodontic post-operative pain and flare-up rate: a systematic review with meta-analysis

Milani, Amin Salem; Froughreyhani, Mohammad; Taghiloo, Hamid; Nouroloyouni, Ahmad; Jafarabadi, Mohammad Asghari

doi:10.1038/s41432-021-0205-z

Cited by 6 publications

(5 citation statements)

References 65 publications

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“…Reducing postoperative pain is one the most important goals of a clinician. Reduced debris extrusion and preparation time can result in postoperative pain reduction [ 2 , 3 , 16 ]. The result of this study might help clinicians to achieve this goal.…”

Section: Discussionmentioning

confidence: 99%

“…Chemomechanical root canal instrumentation is often associated with the extrusion of necrotic debris, residual pulp tissue, microorganisms, and irrigants into the periapical tissue [ 1 ]. Apical extrusion of debris can elicit a severe inflammatory response and may be clinically associated with pain and edema [ 2 , 3 ]. Thus, minimizing the apical extrusion of debris should be prioritized by selecting the most suitable instrumentation technique.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating In Vitro Performance of a Novel Stainless Steel Rotary System (Gentlefile) Based on Debris Extrusion and Instrumentation Time

Nouroloyouni,

Safavi Hir,

Farhang

et al. 2023

BioMed Research International

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The new Gentlefile (GF) system, made of stainless steel and developed by MedicNRG in Kibbutz Afikim, Israel, claims to have advantages over traditional nickel-titanium files. However, research has shown that nickel-titanium files are mechanically superior due to their increased flexibility, cutting efficiency, and ability to maintain canal anatomy with less risk of procedural errors. This study compared the amount of debris extrusion and the time required for root canal instrumentation using GF versus the nickel-titanium ProTaper Universal (PTU) system and a manual step-back (MSB) stainless steel technique. This in vitro experimental study utilized 66 extracted human single-canal mandibular premolars with mature apices and root curvature of less than 10 degrees. The teeth were randomly divided into three groups ( n = 22 ) and standardized for working length before being placed in preweighed vials. Group 1 was instrumented with PTU, Group 2 with GF, and Group 3 with the MSB technique. Extruded debris was collected in the vials, dried in an incubator, and weighed using the same scale. The change in weight indicates the debris amount. Instrumentation time was recorded using a stopwatch. The normal distribution of data was assessed using the Kolmogorov-Smirnov test. The groups were then compared regarding the amount of extruded debris and instrumentation time using the Kruskal-Wallis test and one-way ANOVA, followed by the Games-Howell test, respectively ( alpha = 0.05 ). No significant difference in apical debris extrusion was found among the three groups ( P > 0.05 ). However, a significant difference in instrumentation time was detected between the groups ( P < 0.05 ). MSB instrumentation took significantly longer than both the PTU ( P = 0.001 ) and GF ( P = 0.001 ) systems. The GF system did not demonstrate reduced apical debris extrusion or faster instrumentation time compared to PTU. MSB had the longest instrumentation time compared to the other techniques.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluating In Vitro Performance of a Novel Stainless Steel Rotary System (Gentlefile) Based on Debris Extrusion and Instrumentation Time

Nouroloyouni,

Safavi Hir,

Farhang

et al. 2023

BioMed Research International

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“…Long term factors that mention the success of the endodontic therapy are: the retention of the tooth 63,65 , the absence of clinical symptoms, the absence of radiographic evidence of periapical pathology and healing of sinus tack or fistula. Short term factors that can be used to compare the two therapy methods are the frequency or magnitude or duration of postoperative pain, swelling or flare-up, the need of analgesic use 48,[79][80][81][82][83][84][85] . Controlled trials and Systematic reviews [43][44][45][46][48][49][50][51][52] have been made comparing endodontic therapy in one or more visits based on these factors.…”

Section: Discussionmentioning

confidence: 99%

Single versus multiple visits endodontic therapy on healing rate of periapical lesions: A systematic review and meta-analysis

Theodoridis,

Economides

2023

Balkan J Dent Med

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The choice of one or more sessions for the endodontic treatment of teeth with pulp necrosis and apical periodontitis is controversial. The purpose of this systematic review was to compare the radiographic healing of necrotic teeth with pre-existing periapical lesions after at least 1 year of follow-up period between two therapy groups: 1. single visit endodontic treatment, 2. multiple visits endodontic treatment with calcium hydroxide as intracanal medicament. It was made a literature search of only Randomized Controlled Trials (RCTs) on PubMed database. 5 RCTs met the inclusion and exclusion criteria and were included in this review, with a total sample size of 513 cases. Complete radiographic healing was observed in 226 (83.4%) of 271 cases treated in one visit and 198 (81.8%) of 242 cases treated in more than one visit. A meta-analysis was performed, showing no significant difference in the healing rate between the two therapy groups (fixed effect model, RR: 1.025; 95% Cl: 0.950 - 1.107). Based on the results of this study, endodontic treatment of teeth with pulp necrosis and radiographic evidence of apical periodontitis in one or more appointments showed similar radiographic healing rate.

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“…Antibiotikumbehandling må aldrig stå alene som behandling af odontogene smerter eller endodontisk infektion og må i saerdeleshed aldrig anvendes i forbindelse med irreversibel pulpitis (22). Systemiske antibiotika har kun ringe eller slet ingen effekt på smerte af endodontisk oprindelse (23)(24)(25). Supplerende systemisk antibiotikumbehandling er indiceret i kombination med endodontisk behandling, hvis en patient har en akut apikal absces med systemisk påvirkning (lokaliserede fluktuerende haevelser, forhøjet legemstemperatur > 38° C, utilpashed, lymfadenopati, trismus), eller hvis patienten er medicinsk kompromitteret.…”

Section: Antibiotikaunclassified

Nødbehandling

Bjørndal¹,

Poulsen²,

Ragnarsson³

et al. 2023

Tidende

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Klinisk relevans I forbindelse med nødbehandling er det vigtigt at lindre smerte, at få kontrol over infektionen og at lægge en plan for den videre behandling. En korrekt diagnose forudsætter en god anamnese, klinisk undersøgelse og røntgenoptagelser. Hvis pulpa ikke er inficeret, er konservativ behandling som fx gradvis ekskavering at foretrække. Hvis pulpa er inficeret og har irreversibel inflammation, er der behov for invasiv endodontisk behandling. Hvis der er begrænset tid til rådighed, kan man nøjes med en oplukning, også i tilfælde med nekrose, men kun hvis der ikke er hævelse eller pus. Antibiotikum skal kun ordineres, hvis der er systemisk påvirkning, og kun i kombination med endodontisk behandling.

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The effect of antibiotic use on endodontic post-operative pain and flare-up rate: a systematic review with meta-analysis

Cited by 6 publications

References 65 publications

Evaluating In Vitro Performance of a Novel Stainless Steel Rotary System (Gentlefile) Based on Debris Extrusion and Instrumentation Time

Evaluating In Vitro Performance of a Novel Stainless Steel Rotary System (Gentlefile) Based on Debris Extrusion and Instrumentation Time

Single versus multiple visits endodontic therapy on healing rate of periapical lesions: A systematic review and meta-analysis

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