RESUMEN
BACKGROUND: Posttreatment endodontic pain has been reported in 25%-40% of all endodontic patients. Effective management of endodontic pain represents a continuing challenge. AIM: To evaluate and compare the efficacy of preoperative single dose of nonsteroidal anti-inflammatory drug, piroxicam (20 mg), with two types of corticosteroid drugs - dexamethasone (4 mg) or deflazacort (30 mg) - for the prevention and control of postendodontic pain. MATERIALS AND METHODS: A total of 132 volunteers selected for nonsurgical root canal therapy were randomly divided into the following four groups (n = 30 each) according to preoperative medication given: Group 1, piroxicam (20 mg); Group 2, dexamethasone (4 mg); Group 3, deflazacort (30 mg); and Group 4, placebo. The preoperative medications were administrated 1 h before the start of standard endodontic treatment. Patients were instructed to complete a pain diary using Visual Analog Scale preoperatively and at 6-, 12-, 24-, 48-, and 72-h intervals after root canal instrumentation. STATISTICAL ANALYSIS: The correlation between preoperative endodontic pain to postoperative pain and pair-wise comparison of four groups was evaluated by Kruskal-Wallis analysis of variance test followed by Mann-Whitney U-test. RESULTS: Compared to the placebo group, piroxicam, dexamethasone, and deflazacort resulted in a statistically significant reduction in postendodontic pain at 6, 12, and 24 h (P < 0.05). CONCLUSION: Preoperative single oral dose of piroxicam or dexamethasone or deflazacort is equally effective in controlling postendodontic pain.
RESUMEN
BACKGROUND: Endodontic obturating materials should form monoblocks, reinforcing the treated teeth against fracture. AIM: To evaluate and compare the effect of two resin sealers and a MTA sealer on the fracture resistance of endodontically treated teeth. MATERIALS AND METHODS: Fifty single-rooted mandibular premolars, decoronated at cemento-enamel junction, were divided into 5 groups (n = 10 each). Group 1 and group 2 served as negative and positive controls. Cleaning and shaping of root canals was done using ProTaper rotary files and 3% sodium hypochlorite irrigation. Obturation was done using AH plus (Dentsply, Germany) (group 3), MetaSEAL (Parkell, USA) (group 4), MTA Fillapex (Angeles, Brazil) (group 5) sealers and gutta-percha. Teeth were subjected to vertical loading using a universal testing machine and the point at which fracture of the roots occurred was recorded. The data was subjected to statistical analysis using one way analysis of variance (ANOVA) followed by pair-wise comparison using Tukey's Post-hoc test. RESULTS: AH Plus showed better fracture resistance among the sealer groups. Statistically, no significant difference was found between MetaSEAL and Fillapex groups. CONCLUSION: MTA Fillapex as a root canal sealer was not able to reinforce the tooth against fracture.