IntroductionAchieving appropriate anesthesia in mandibular molar teeth with irreversible pulpitis is one of the most challenging aspects of root canal treatment.1 It is more complicated in teeth with symptomatic irreversible pulpitis.2 Inferior alveolar nerve block is not profoundly successful in mandibular teeth with symptomatic irreversible pulpitis and sometimes supplemental techniques are necessary.
3Nowadays photobiomodulation (PBM) is considered as an adjunct in anesthesia, the addition of galliumaluminum-arsenide laser irradiation to intravenous regional anesthesia is safe, and reduces pain during and after the operation. The most local anesthetics in dentistry block sodium channels. Tetrodotoxin resistance sodium channels are resistant to local anesthetics and sensitized by prostaglandins.
5PBM has been used in dentistry for its anti-inflammatory, 6 regeneration 7 and analgesic 4 properties. It can prevent nerve impulse conduction. Studies have shown that laser irradiation prevents axonal transmission of signals in nerve fibers A-delta and C, since nociceptive signals are transmitted by the fibers of to the spinal cord, it is likely that laser radiation reduces the transmission and subsequently reduces the feeling of pain.8 PBM effectiveness was shown in reducing pain after root canal therapy, 9 but it hasn't been used as an adjunct in anesthesia in dentistry. Some PBM applications in dentistry include the following: To control pain, swelling and inflammation after surgery thus reducing the need for medication.
10To reduce pain after tooth fillings or dentin cutting with an inhibitory effect on the pulp nervous system.
11The anti-inflammatory mechanism of PBM and its Abstract Introduction: Achieving appropriate anesthesia in patients with symptomatic irreversible pulpitis in mandibular molars during endodontic treatment is always one of the most challenging aspects. Photobiomodulation (PBM) has been used in dentistry due to its anti-inflammatory properties and regenerative effects. This study evaluates the effects of PBM in the depth of anesthesia in inferior alveolar nerve block.
Methods:In this randomized clinical trial, 44 patients requiring endodontic treatment in lower molar, left or right were selected, half of them were randomly treated with PBM therapy. Laser irradiation by 980 nm diode laser with a single dose (15 J/cm 2 , for 20 seconds) before anesthesia was performed at the buccal aspect. Inferior alveolar nerve block was performed once. Success was defined as no or mild pain (no need for any supplemental injection), based on the visual analogue scale during access cavity preparation. Results were evaluated using SPSS software.
Results:The results of this study showed that the necessity for supplemental injection was lower in the group receiving laser than in the group without laser (P = 0.033). The mean pain intensity during dentin cutting was lower in the group receiving laser than in the group without laser (P = 0.031). Also, the mean pain intensity during pulp dropping was lower in the gr...
The formation of Ca(OH) which influences the biological properties of calcium silicate cements was impaired by blood and acid exposures in ProRoot MTA, CEM Cement, and Retro MTA; however, in the case of Biodentine, only exposure to acid had this detrimental effect.
Background: Due to the complications of root canal treatment, conservative modalities to preserve pulp vitality are favorable. Direct pulp capping (DPC) refers to the coverage of the pulp tissue exposed by a biocompatible agent that can improve the prognosis of the tooth by 44% to 95%. Some recent studies have reported more predictable results (a success rate of about 90%) for DPC with laser and regenerative materials such as mineral trioxide aggregate (MTA). This study aimed to clinically compare DPC with ProRoot MTA alone and in combination with Er:YAG (erbium-doped yttrium aluminium garnet) laser irradiation (2940 nm). Methods: This clinical trial was conducted on 26 patients with a mean age of 29 years (in the range of 17 to 46 years) who required DPC following pulp exposure during deep caries removal. The teeth were divided into two groups. In the control group, the teeth underwent DPC with ProRoot MTA while in the test group, the teeth were first irradiated with a 2940 nm Er:YAG laser and then underwent DPC with ProRoot MTA. The patients were recalled at one, 3 and 6 months for the follow-up (clinical and radiographic examinations). The data were analyzed using Fisher exact test. Results: The success rate was 75% in the laser group and 93% in the control group. The groups were not significantly different (P>0.05).
Conclusion:No significant difference was found in terms of the success rate of DPC with ProRoot MTA alone and in combination with Er:YAG laser irradiation.
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