Mineral trioxide aggregate as a root canal filling reduces postoperative pain

A recent study found that mineral trioxide aggregate (MTA) as a root canal filling reduces postoperative pain in teeth with asymptomatic apical periodontitis. This study was published in the journal, BMC Oral Health.

This two-arm, parallel-group, single-blind, randomized superiority trial included 119 patients, aged 18-65 years who had single-canal premolars diagnosed with asymptomatic apical periodontitis. Using the permuted block randomization method, the participants were divided into two groups: GP group (n=46) and the MTA group (n=48). In the first group, the cleaned and shaped root canals were filled with gutta-percha and AH Plus sealer. The second group participants had cleaned and shaped root canals which were filled with an MTA apical filling and a coronal gutta-percha and sealer. Patient pain was measured at 6, 12, 24, 48, and 72 h postoperatively with the help of a 10-point visual analog scale (VAS). The data were analyzed using the chi-square, independent t, Friedman, and Mann-Whitney U tests.

At the end of the study, it was observed that the mean of VAS scores decreased significantly over time in both groups and it was significantly lower in the MTA filling group when compared to the other group. In both the groups, female patients reported higher VAS scores at 6- and 12-hour periods. Thus, it can be concluded that MTA as a root canal filling material may be a valuable option for clinicians due to its low postoperative pain.

Use of ultrasonic bone knife combined with a dental electric motor in the extraction of mandibular middle and low impacted teeth

A recent study suggests that an ultrasonic bone knife (UBK) combined with a dental electric motor (DEM) has good results and prognosis, high safety, shorter operation time, low postoperative pain and swelling, mouth opening restriction and complication rate, and better psychological status of patients undergoing extraction of mandibular middle and low impacted teeth. This study was published in the journal, BMC Oral Health.

In this study, 200 patients having wisdom teeth were randomly divided into three groups: experimental group A which received UBK combined with DEM, experimental group B which received UBK combined with high-speed turbine mobile phone (HSTMP), and the control group which received bone chisel split crown (BCSC). The operation time, pain, swelling, psychological state during operation, limitation of mouth opening and other complications were recorded on the first, second and third days after operation.

It was found that operation time was shorter in experimental group A (EAG)when compared to experimental group B (EBG) and control group (CG). Likewise, psychological state of the EAG was significantly lower than the other two groups. Similarly, swelling, postoperative pain, and limitation of mouth opening and complications were significantly lower in EAG than those in the EBG and CG.

From the above results, it can be concluded that UBK combined with DEM may have good results and prognosis, high safety, shorter operation time, low postoperative pain and swelling, mouth opening restriction and complication rate, and better psychological status of patients who underwent extraction of mandibular middle and low obstructed teeth. Thus, UBK is the current preferred method of teeth extraction.

AFP gel application with a tooth brush effective in preserving dental health

According to a recent study, Acidulated Phosphate Fluoride (APF) gel as an alternative method has successfully contributed to the maintenance of dental health over 24 months. The study’s findings were published in the journal, Medicina (Kaunas).

A double-blind randomized controlled trial was conducted, involving a total of 180 children aged between 4 and 11 years. The participants were divided into three groups: NaF varnish (NaFV), APF in tray (APFt), and APF in toothbrush (APFtbru). Clinical examinations were carried out using standardized criteria, the ICDAS Index was assessed, and the Caries Treatment Needs Index (CTNI) was calculated. Dental examinations were performed at baseline , as well as at 12 months and 24 months.

At baseline, there were 16,719 dental surfaces included, out of which 15,434 surfaces were sound. After a period of 24 months, the Kaplan-Meier analysis demonstrated significant differences between the APFtbru group and the other two groups.

This study demonstrated that over a span of 24 months, the utilization of a toothbrush for applying APF gel as an alternative technique has proven to effectively preserve dental health. This method can be cost-effective and may offer advantages when compared to the conventional application of fluoride varnish.

Arrest of early childhood caries with a combination of silver diamine fluoride and sodium fluoride varnish

A recent study suggests that a combination of Sodium fluoride (NaF) varnish and Silver Diamine Fluoride (SDF) had a higher arrest rate of early childhood caries (ECC) than SDF alone. This study’s results were published in the journal, BMC Oral Health.

This 6-month follow-up of a randomized field trial included 1606 lesions in 220 children, aged ≤ 4 years. Only those children were included who had at least one active carious lesion with ICDAS codes ≥ 3. The participants were randomized to receive either 38% SDF alone or 38% SDF with 5% NaF varnish. These agents were applied on the caries lesions at baseline, followed by after 6 months. In both groups, NaF was additionally applied on all teeth in the oral cavity and reapplied after 3 months. The primary outcome of the study was lesion arrest status after six months. The secondary outcome was parents’ satisfaction with their children’s appearance. For bivariate comparison, Pearson Chi-Square test was used while the effect of the intervention on caries arrest was assessed using multi-level multiple logistic regression.

At the end of 6 months of application of SDF + NaF and SDF only, it was observed that the percentages of arrested lesions were 77.7% and 73.2%, respectively. According to the multivariable analysis, SDF + NaF had a significantly greater caries arrest effect than SDF alone. Most parents were satisfied with the appearance of their children.

Based on the above results, it can be concluded that SDF + NaF may have a higher arrest rate than SDF alone and this difference was significant in moderate lesions and may have implications for the non-invasive management of ECC.