Aim:This prospective randomized clinical study (1) investigated the prevalence of post-obturation pain after single visit root canal treatment and (2) evaluated the influence of factors affecting the pain experience.Materials and Methods:One thousand three hundred and twenty eight (1328) patients were included in this study. Conventional single visit root canal treatment was carried out. The chemicomechanical preparation of root canals was done by a rotary protaper system with a combination of hand instruments. Post-operative pain was recorded by each patient by using visual analogue scale in well-defined categories at three time intervals, 12 h, 24 h, and 48 h. The data were analyzed using Fisher's exact test.Results:The prevalence of post-obturation pain (severe) within 48 h after treatment was 4% (n = 54) but less as compared to the pain experienced after 12 h (9%) and 24 h (8.6%). The factors that significantly influenced post-obturation pain experience were: Age (Fishers exact test = 46.387, P = 0.0), gender (Fishers exact test = 23.730, P = 0.0), arch (Fishers exact test = 11.710, P = 0.001), and presence of pre-operative pain (Fishers exact test = 67.456, P = 0.0).Conclusion:The presence of post-operative pain was low (4%). The important prognostic determinants of post-obturation pain were: Old age, female, mandibular teeth, and presence of pre-operative pain. The vital condition of the tooth does not affect the intensity and frequency of post-obturation pain.

A BSTRACT Background: The chances of extrusion of mineral trioxide aggregate (MTA) are quite high if apical barrier is not present in immature pulpless permanent teeth. Platelet-rich fibrin (PRF) enriched with platelets and growth factors serves to accelerate the wound healing of periapical lesion in immature pulpless permanent teeth and also serves as internal matrix to condense MTA. Aim: The aim of the present study was to comprehensively review the clinical success of MTA+PRF in healing of periapical lesions in immature pulpless permanent teeth. Materials and Methods: An electronic search for systematic review was conducted in Pubmed/Medline ( www.ncbi.nlm.nih.gov ), Cochrane ( www.cochrane.org ), Scopus ( www.scopus.com ) databases upto 15th January 2020 related to the healing of periapical lesions in permanent teeth with immature apices when combination of MTA+PRF was used. A sample of 10 relevant studies and case reports were identified in our search out of 65. The sampling method was simple random technique. The studies and case reports with Randomised Controlled Trials(RCTs), Invitro studies, Case reports and animal studies in healing of periapical lesion were included in our comprehensive systematic review. Results: The search showed that the combination of MTA+PRF showed faster and definite periapical lesion healing in immature permanent teeth. The follow-up period was also recorded in all the relevant studies and case reports. Conclusion: Acclerated bone filling was seen in healing of periapical leions when MTA+PRF was used.

A variety of instruments are available for the extirpation of the pulp and the instrumentation and preparation of the root canal. Recently, nickel-titanium (NiTi) alloy is utilised for the manufacturing of endodontic instruments. Compared to other metals, these alloys are highly flexible, which significantly enhances ease of canal shaping. This review article gives an account in the advances of NiTi endodontic instruments with an emphasis on metallurgical, mechanical properties, the design features of each generation with a special focus on the latest generations of NiTi instruments.

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There was no statistically significant difference between the three tested groups - ProTaper, K3 and Mtwo in cleaning different regions of the canal - coronal, middle and apical.

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