More studies are required with adequate quality, as well as a full-result report, including summary measurements of both response variables and effect size, to determine the most effective irrigant agents for use in pulpectomies.

Introduction Factors that contribute to swelling and trismus are complex, and they are originated by surgical trauma. The aim of the present study was to determine whether clinical and radiographic factors could predict the level of swelling and trismus after lower third molar surgery, through longitudinal approach. Methodology A prospective longitudinal trial was carried out. Forty-five patients of both genders with clinical and radiographic diagnosis of asymptomatic mandibular impacted third molar and with no intake of analgesic or anti-inflammatory drugs 12 h prior to surgery were recruited and evaluated in a 72 h follow-up period. A mixed repeated measures model and backward and restricted maximal likelihood methods were used to analyze the data. Results Male gender, body mass index (BMI), the relation to the lingual and buccal walls, and age were determinants for predicting postoperative swelling and for exerting a significant influence (P < 0.05). Conclusions This study suggests the association of male gender, the relation to lingual and buccal walls, BMI, and age with measurement of swelling.

Introduction The inferior alveolar nerve block (IANB) is the most common anesthetic technique used on mandibular teeth during root canal treatment. Its success in the presence of preoperative inflammation is still controversial. The aim of this study was to evaluate the sensitivity, specificity, predictive values, and accuracy of three diagnostic tests used to predict IANB failure in symptomatic irreversible pulpitis (SIP). Methodology A cross-sectional study was carried out on the mandibular molars of 53 patients with SIP. All patients received a single cartridge of mepivacaine 2% with 1 : 100000 epinephrine using the IANB technique. Three diagnostic clinical tests were performed to detect anesthetic failure. Anesthetic failure was defined as a positive painful response to any of the three tests. Sensitivity, specificity, predictive values, accuracy, and ROC curves were calculated and compared and significant differences were analyzed. Results IANB failure was determined in 71.7% of the patients. The sensitivity scores for the three tests (lip numbness, the cold stimuli test, and responsiveness during endodontic access) were 0.03, 0.35, and 0.55, respectively, and the specificity score was determined as 1 for all of the tests. Clinically, none of the evaluated tests demonstrated a high enough accuracy (0.30, 0.53, and 0.68 for lip numbness, the cold stimuli test, and responsiveness during endodontic access, resp.). A comparison of the areas under the curve in the ROC analyses showed statistically significant differences between the three tests (p < 0.05). Conclusion None of the analyzed tests demonstrated a high enough accuracy to be considered a reliable diagnostic tool for the prediction of anesthetic failure.

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Objective: To summarize the clinical/radiographic outcomes from the evidence of studies published since 1988 on different DPC agents applied on vital pulp-exposed primary teeth. Methods: The following electronic databases were searched: PubMed, Embase, Cochrane Library, Dentistry and Oral Science Source, and Google Scholar. Inclusion criteria were randomized controlled trials (RCTs) published between January 1988 and December 2019, with at least 6 months of follow-up, comparing the clinical and radiographic success rates of two or more DPC agents applied in primary teeth with cariously and non-cariously exposed pulp. Results: Initial searches identified 83 potentially relevant studies on DPC in primary teeth. Sixty-four of these studies were excluded, whereas 19 articles satisfied the inclusion criteria and were retrieved in full text for data extraction and a methodological quality assessment. Finally, 12 of these articles were included in the systematic review. Low and moderate risks of bias were observed. Overall, DPC clinical and radiographic success rates among the selected studies ranged between 53% and 100%. Conclusions: For DPC in primary teeth, this systematic review found that diverse new biologically and compatible agents with promising success rates are currently available for paediatric dentistry practitioners. There is no evidence that justifies discarding the judicious use of DPC procedures in primary teeth. K E Y W O R D S caries exposure, direct pulp capping, primary teeth, pulpotomy, systematic review How to cite this article: Garrocho-Rangel A, Esparza-Villalpando V, Pozos-Guillen A. Outcomes of direct pulp capping in vital primary teeth with cariously and non-cariously exposed pulp: A systematic review.

Post-Market Research Clinical evidence supports the use of dexketoprofen trometamol (DEX) to manage acute postoperative pain. However, controversies surround the impact of the use of this drug in preoperative analgesic protocols. The aim of the present meta-analysis was to evaluate the effectiveness of the preoperative administration of DEX under postoperative pain conditions. Electronic and manual searches were conducted through diverse electronic databases. A systematic review and meta-analysis to evaluate the analgesic efficacy of the preoperative administration of DEX was performed including Randomized Clinical Trials (RCTs) published between 2002 and 2017. Suitable individual studies were evaluated through a quality system, and the data were extracted and analyzed. Fourteen RTCs were included (12 parallel trials and 2 cross-over trials), published in the English and Turkish languages. Follow-up periods ranged from 4, 6, 8, 24, and 48 hr. All trials measured the outcome result as Acute Pain Level (APL) (VAS, NRS, VRS), time to requiring a second dose of DEX or analgesic emergency and consumption of opioids via patient-controlled analgesia. When the comparators were other drugs - paracetamol, Lornoxicam or placebo during the preoperative time, preoperative administration of DEX was superior. When the comparison comprised preoperative and postoperative DEX, both alternatives exhibited comparable analgesic effects. The analgesic efficacy of the preoperative administration of DEX when compared to placebo, lornoxicam, and paracetamol on postoperative pain was evident. Preoperative administration of DEX compared to its immediate postoperative administration showed a similar analgesic effect.

Chlorhexidine was introduced almost seven decades ago and has a myriad of applications in dentistry. Few studies have evaluated the antimicrobial and antifungal capacity of different concentrations of chlorhexidine mouthwashes. Therefore, the aim of this study, was to evaluate in vitro, the antibacterial and antifungal capacity of three commercially available mouthwashes in Costa Rica, with different concentrations of chlorhexidine, 0.12%, 0.06%, and 0.03%. The experimental method selected was the Kirby-Bauer method to evaluate the antibacterial and antifungal effect of each compound by measuring the inhibitory effect on Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, and Candida albicans strains, exposed to the antiseptic solutions. All samples showed some degree of antibacterial and antifungal effect. Even though we provide in vitro results, our findings are of relevance since all the species used in our experiment are microorganisms that may be present in dental plaque. Our results further support evidence that oral hygiene regimens may include mouthwashes with low doses of chlorhexidine and maintain reasonable antibacterial and antifungal efficacy.

The objective of this systematic review and meta-analysis was to compare the pain/anxiety levels associated with the anesthetic process by conventional and computer-controlled delivery systems (CCDS) in children. Four electronic databases (PubMed, EMBASE, Scopus, Google Scholar, and Dentistry & Oral Science Source/EBSCO) were comprehensively explored for eligible studies, in English or Spanish, published from January 1995 to December 2019. A systematic literature review and meta-analysis were conducted according to the PRISMA statement, including only randomized controlled clinical trials. An exhaustive search was performed in different electronic databases under a specific PICO-posed question. Relevant studies were selected based on titles and abstracts, and the full texts were retrieved. From these articles, important information was extracted. Wand demonstrated significantly lower pain than the conventional injection did. In the subgroup by pain scale analysis, the Facial Image Scale and Wong-Baker Faces Pain Scale showed a significant difference in favor of the CCDS. In general, the reviewed evidence shows that less perceived pain and anxiety occur when the local anesthetic technique is performed with a CCDS than with the traditional technique.