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.
Aim and Background: 35% carbamide peroxide can cause adverse effects on the structure and composition of teeth. However, the addition of calcium and fluoride in bleaching agents may reduce enamel demineralization. The aim of the study is to evaluate the chemical changes in a tooth submitted to 35% of carbamide peroxide containing chitosan and carbopol as a carrier system using scanning electron microscopy/energy dispersive x-ray analysis (SEM-EDX). Materials and Methods: 30 freshly extracted anterior teeth were given root canal treatment. The teeth were randomly divided into 3 groups. Group 1 was Opalescence PF (35% carbamide peroxide), group 2 was chitosan with 35% carbamide peroxide, and group 3 was a control group (no treatment). All canals were filled with 0.06 tapered gutta-percha and AH-plus sealer. Then, intracoronal bleaching was applied. SEM-EDX analysis was performed to determine whether bleaching procedures changed the mineral content of the tooth. While SEM-EDX analysis, the tooth was analyzed based on elemental content and elemental distribution from standardized points under 300× magnification. Statistical analysis was performed with one way analysis of variance. Results: There was no significant difference in C, O, Na, P, Mg, K, and S values and the Ca/P ratio obtained by SEM-EDX analysis among groups ( P > .05), whereas the Ca level was significantly lower in Opalescence PF group than the control group ( P < .05). Conclusions: The results of this study show that chitosan does not cause mineral loss and dissolution in the inorganic content of a tooth. Thus, chitosan can be used as an alternative carrier system in the bleaching agent.
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