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Post-Operative Endodontic Pain Management: An Overview of Systematic Reviews on Post-Operatively Administered Oral Medications and Integrated Evidence-Based Clinical Recommendations

Aim: The purpose of this study was to evaluate the efficacy of 3% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), and chitosan nanoparticles against Candida albicans using the agar disc-diffusion test. Materials and Methods: Strain of C. albicans was cultivated in Sabouraud Dextrose Agar. Chitosan nanoparticles were synthesized using an ionic gelation method. Four groups were made according to the irrigants used. Group 1: 3% NaOCl, Group 2: 2% CHX, Group 3: chitosan nanoparticles, and Group 4: saline as control. Discs were added with the different irrigants and placed in a dish containing C. albicans. The plates were incubated at 37°C for 24h. The zone of inhibition was measured in millimeter. Results: Statistical analysis was performed using the test of one-way variance (ANOVA) and post hoc Tukey. Group 1 showed significantly higher zone of inhibition compared to Groups 2 and 3 (P < 0.05). There were no significant differences between the zones of inhibition of Groups 2 and 3 (P < 0.05). Conclusion: Chitosan nanoparticles and 2% CHX have similar efficacy against C. albicans, whereas 3% NaOCl was significantly better than both chitosan nanoparticles and CHX.

Comparative evaluation of antifungal efficacy of conventional endodontic irrigants and chitosan nanoparticles

Can natural irrigants replace sodium hypochlorite? A systematic review

Aim: The aim of the study was to clinically evaluate the postoperative pain following use of cryotherapy in teeth with symptomatic irreversible pulpitis and symptomatic apical periodontitis after single-visit-endodontics. Methods: After institutional ethical approval (SVIEC/ON/Dent/SRP/18115) and informed consent, a total of 120 patients were included as per inclusion and exclusion criteria. Patients with single-rooted, mature teeth having symptomatic irreversible pulpitis with symptomatic apical periodontitis were included in the study. All the enrolled individuals were randomly divided by computer randomization into two groups: Group A – normal saline (n = 60) and Group B – cryotherapy (n = 60). Endodontic access cavity along with cleaning and shaping was performed under isolation. In Group A, irrigation was done with normal saline for 5 min. In Group B, 2.5°C cold saline was used for 5 min. In both the groups, obturation and postendodontic restoration were performed at the same visit. An evaluation was done by the blinded evaluator using a modified Verbal Rating Scale at 24 h and 48 h. In this study, both patients and evaluators were blinded. Paired t-test and independent t-test were used with SPSS 18.0 version. P < 0.05 was considered statistically significant. Results: Both at 24 and 48 h, cryotherapy showed a highly statistically significant difference (P < 0.000) than normal saline irrigation in the reduction of postoperative pain after single-visit endodontic treatment. Conclusion: Final irrigation with 2.5°C cold saline can result in a significant reduction in postoperative pain as compared to that of normal saline after single-visit endodontics in single-rooted teeth with symptomatic irreversible pulpitis with symptomatic apical periodontitis.

Evaluation of postoperative pain with cryotherapy in teeth with symptomatic irreversible pulpitis with symptomatic apical periodontitis after single-visit endodontics: A randomized clinical study

Introduction: In root canal therapy, the cleaning and shaping of canals are routinely applied by clinicians in order to remove microorganisms. Eradicating bacteria from the root canal system plays a crucial role in long-term success; however, it is not always easy to disinfect root canals properly because of their complicated anatomy and bacterial load. Achieving an optimally disinfected root canal environment requires adjunctive antibacterial therapeutic methods. High-power laser utilization as an adjunctive strategy to conventional treatment is a relatively new approach that helps clinicians. Methods: This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Online databases, namely Web of Science, PubMed/MEDLINE, Scopus, and Cochrane Library, were searched electronically regarding lasers and endodontic treatments. Appropriate studies were included according to the inclusion/exclusion criteria. Results: Among 504 obtained studies by search, 48 were considered for a detailed analysis. Ten articles performed in vivo evaluation, while nine assessed the effect of lasers on artificial models, and 29 conducted ex vivo experiments on extracted teeth. When the diode laser, the most frequently used laser, was utilized as an adjunct therapy after NaOCl irrigation, it killed more bacteria than conventional irrigation with NaOCl. Laser-activated irrigation (LAI) with the Er, Cr: YSGG laser and NaOCl disinfects the root canal effectively. Also, photon-induced photoacoustic streaming (PIPS) with Er: YAG and NaOCl exhibited a high bactericidal effect and deep tubular penetration. Conclusion: High-power laser utilization, considering proper case selection and method, can assist in root canal treatment of infected teeth.

The Effect of High-Power Lasers on Root Canal Disinfection: A Systematic Review.

This systematic review aimed to qualitatively and quantitatively evaluate the effectiveness of cryotherapy in the reduction of postendodontic pain The review question was, "What will be the success rate of cryotherapy technique among human patients with postendodontic pain?" The review protocol was framed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist Six studies were included in the review, and quantification of five studies was performed through a meta-analysis In the forest plot representation of the studies comparing the control and cryotherapy groups in terms of the success rate in the management of postendodontic pain, the combined risk ratio (RR) was 080 (95% CI: 056 to 113) with a P value of 020 Based on the quantitative analysis, it can be suggested that intracanal cryotherapy does not play a significant role in reducing postendodontic pain

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Effect of intracanal cryotherapy on postendodontic pain: A systematic review and meta-analysis of randomized controlled trials.

Aim: The present study aimed to individually evaluate and compare the aerobic and anaerob?ic antibacterial activity of Allium sativum extract, aqueous ozone, diode laser, and 3% sodium hypochlorite (NaOCl) as root canal irrigants. Materials and Methods: Forty-eight patients were selected and randomly allocated to one of the four groups (n = 12 each) according to the irrigant to be used in each group. For each included tooth, the preirrigation and postirrigation (after irrigation with the test solution) samples were collected through sterile paper points and microbial culturing was done by swabbing on blood agar plates followed by incubation for aerobic and anaerobic bacteria. Statistical Analysis: Manual colony-forming units counting were done, and statistical analysis was performed. Analysis of variance (one-way) followed by post hoc test was performed as a parametric test to compare the difference between the groups for both aerobic and anaerobic bacteria. Results: All the groups showed a statistically significant reduction in bacteria (P Conclusion: A. sativum extract, aqueous zone, diode laser, and 3% NaOCl showed significant antibacterial activity against aerobic and anaerobic bacteria.

Comparative evaluation of antibacterial efficacy of Allium sativum extract, aqueous ozone, diode laser, and 3% sodium hypochlorite in root canal disinfection: An in vivo study

Nishant Chauhan

Papers

Effect of intracanal cryotherapy on postendodontic pain: A systematic review and meta-analysis of randomized controlled trials.

Comparative evaluation of antibacterial efficacy of Allium sativum extract, aqueous ozone, diode laser, and 3% sodium hypochlorite in root canal disinfection: An in vivo study