Evid Based Dent (2024). https://doi.org/10.1038/s41432-024-00996-7Effectiveness of mineral trioxide aggregate on postoperative pain in non-surgical endodontic treatment: a systematic review of randomized controlled trialsMaryam Altuhafy, Vikranth Ravipati, Ravleen Nagi, Luay Jabr, Zegar Zegar & Junad Khan
Introduction
Postoperative endodontic pain can negatively influence the quality of life of the patients. Mineral Trioxide Aggregate (MTA) has gained attention as a potential medicament in various endodontic procedures. MTA has been shown to have desirable properties such as biocompatibility, marginal adaptation, and sealing ability compared to other materials. Limited evidence is available about the effectiveness of MTA on the reduction of postoperative pain following endodontic treatment. This article aimed to compare the non-surgical post-endodontic pain-relieving effect of MTA compared with other materials.
Methods
Indexed databases (PubMed/Medline, EMBASE, OVID, Scopus, and Cochrane) were independently searched for relevant manuscripts published up to and until June 2023. Randomized controlled trials (RCTs) with a focus on teeth with pulp pathologies, with or without radiolucency, requiring primary endodontic treatment were included. Risk of bias across individual studies was performed using the Cochrane risk of bias tool for interventions.
Results
Out of the initial 169 articles searched, 9 RCTs met the selection criteria. The protocols were like all the studies, but the pain rating scales, filling material, and restoration materials varied. Out of the 9 included studies, in 4 studies MTA significantly reduced postoperative pain levels, 5 studies showed no difference between MTA and other materials, whereas 1 study reported an adverse effect of grey discoloration after MTA.
Conclusion
The findings of the present review indicate that MTA may reduce postoperative pain following non-surgical endodontic treatment. However, future standardized studies should be conducted to validate the results.
(03/2024)
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International Journal of Dental Materials 2024;6(1)
Self-perceived pain levels following irrigation with various concentrations of sodium hypochlorite solution and gels: A systematic review of randomized clinical studies
Junad Khan1,*, Maryam Altuhafy2, Ghida Askar3, Luay Jabr4, Zegar Zegar5
Background: Sodium hypochlorite, a prevalent root canal irrigation solution, valued for its antibacterial properties and tissue-dissolving abilities, varies in concentration (0.5% to 8.25%). However, its efficacy across formulations awaits systematic evaluation.
Aim: To evaluate self-perceived post-operative pain levels in a 5.25% concentration of NaOCl in gel or solution form.
Materials and Methods: An unrestricted search of indexed databases (PubMed, Embase, Scopus, Web of Science, and Cochrane) and a manual search were performed up to April 2023. Three randomized controlled trials (RCTs) compared a solution form of 5.25% NaOCl to other solution concentrations, whereas 2 RCTs compared a gel form of 5.25% NaOCl concentration to 5.25 % NaOCl solution form. The risk of Bias (RoB) assessment was conducted using the Cochrane tool.
Results: A total of 5 RCTs met the inclusion criteria and were included in the review. Four RCTs used the visual analog scale (VAS), whereas 1 RCT used the numeric rating scale (NRS) to assess post-operative pain. Three RCTs had a moderate Risk of Bias (RoB), whereas 1 had a low and 1 had a high RoB.
Conclusion: Based on the current evidence the concentration of NaOCl used during irrigation did not have any effect on the post-operative pain developed regardless of the use of a gel or solution forms. Future randomized studies with standardized protocols are needed to further investigate the efficacy of NaOCl concentration on postoperative pain in endodontic treatment.
Keywords: Root canal, irrigation, Sodium hypochlorite, postoperative pain, endodontic.
(03/2024)