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The aim of this study was to assess the differences, if any, between general dental practitioners (GDPs) and endodontists, in the diagnosis and treatment of endodontic emergencies during the worldwide outbreak of COVID-19. An online questionnaire was randomly sent by social media to clinicians in different countries from 24 April, 2020 to May 4, 2020. The survey consisted of a series of questions about demographic characteristics, endodontic emergency diagnoses, approaches to prevent aerosol formation, drug prescriptions in case of symptomatic irreversible pulpitis, and the ways in which dentists managed endodontic emergencies during the COVID-19 lockdown. A total of 1,058 dentists responded to the questionnaire; 344 (32.6%) of the participants were endodontists. Slightly less than half of the participants (n = 485, 45.8%) worked during the lockdown, but only 303 participants (28.6%) treated endodontic cases/emergencies. The responses showed agreement between endodontists and GDPs regarding the diagnosis of symptomatic irreversible pulpitis (SIP), symptomatic apical periodontitis (SAP), reversible pulpitis, and asymptomatic irreversible pulpitis (AIP). SIP and SAP were considered an emergency, whereas reversible pulpitis and AIP were not considered an emergency (p > 0.05). Non-aerosol-generating procedures and treatment approaches differed between the groups (p < 0.05). One-third of the participants did not use rubber dam (p > 0.05). Ibuprofen and amoxicillin-clavulanic acid were the most frequently prescribed drugs for pain associated with SIP. In conclusion, the most relevant findings in our survey were the differences between endodontists and GDPs in diagnosis, precheck triage, deep caries excavation procedures, and endodontic emergency pain relief strategies.

This study aimed at assessing the performance of Reciproc Blue (RB) and XP Endo Shaper (XPS), used for canal retreatment on extracted teeth, in terms of debris extrusion and obturating materials removal. Thirty mandibular premolars were prepared to ProTaper X2 file, obturated using warm vertical compaction, and then incubated for 28 days at 100% humidity at 37°C. Teeth were randomly assigned into two groups, according to the system used for retreatment (RB and XPS). During retreatment, debris extruded beyond the apex was collected in preweighed Eppendorf tubes, and the retreatment time was measured. Afterward, the teeth were longitudinally sectioned to assess the remaining obturating materials. Data were statistically analyzed using the Mann–Whitney test and chi-square test at a 95% confidence level. All the samples had extruded debris at varying weights ranging from 0.125 mg to 3.680 mg. XPS extruded less debris than RB, but no difference was detected (Mann–Whitney test; P > 0.05 ). RB and XPS required 54.9 ± 17.9 and 22.3 ± 9.3 seconds to perform retreatment procedures, respectively (Mann–Whitney test; P < 0.05 ). The sealer was found in all the samples. Compared to the RB group, fewer samples with remaining gutta-percha were found in the XPS group (Chi-square test; P < 0.05 ). None of the files fractured during the retreatment procedure. The tested files appear to extrude debris beyond the apex. Although XPS was able to remove the gutta-percha completely from the majority of the canals, it was unable to remove the sealer.

Purpose This prospective single-blind, parallel-group, randomized clinical trial was aimed to compare the effect of three different rotary instrumentation systems ProTaper Next (PTN), Self-Adjusting File (SAF) and XP-endo Shaper (XPS) on postoperative pain and analgesic intakes. Patients and Methods A total of 159 molars diagnosed with symptomatic irreversible pulpitis were randomly divided into three study groups according to the instrumentation techniques: PTN (n = 54), SAF (n = 52), and XPS (n = 53). The preoperative pain scores were taken before the onset of treatment in the groups. After a single appointment for root canal treatment, the patients were asked to rate the level of their pain according to the Visual Analog Scale (VAS) of 100 mm at 6, 24, 48, and 72-hour post-treatment intervals. Ibuprofen was prescribed to be taken while experiencing pain; patients were requested to note the number of pills consumed at intervals after treatment. Results The patients in SAF and XPS groups had lower mean VAS scores than the PTN group at 24-, 48-, and 72-hour intervals (p < 0.05). The most common analgesic intake was optimally seen in the PTN group at a 6-hour interval. All shaping procedures caused postoperative pain, whose intensity decreased with time. Conclusion The SAF and XPS groups had a lesser intensity of pain as well as minimum analgesic intakes as compared to the PTN group. All instrumentation systems moderately caused pain, and the PTN group experienced the highest pain among others.