a-standardized-vitro-protocol-for-evaluating-human-dental-pulp-stem

A Standardized <em>In Vitro</em> Protocol for Evaluating Human Dental Pulp Stem Cell Differentiation and Proliferation on Nanomaterial Scaffolds

Reliable assessment of osteogenic and odontogenic differentiation, as well as stem cell proliferation, is fundamental to evaluating the biological ...

Ain Shams University

Gulf Medical University

Perforations are managed by surgical or nonsurgical approach depending on the relationship of the perforation site to the crestal bone level and attachment apparatus. Relocating the canal orifice or root canal close to the perforation site is quite challenging even with the aid of a dental operating microscope. In these two case reports, guided endodontics was applied in root canal localization and preparation in cases of furcation perforations. This is the report of two patients (42 and 15-year-old, respectively) who were referred for root canal treatment of the mandibular right first molar. The first case complained of pain on biting, foul odor, and bad taste. The referring dentist noted a furcation perforation and an inability to locate the mesial canals. Radiographic examination showed furcation radiolucency. Definitive diagnosis was symptomatic apical periodontitis. The second case complained of severe throbbing pain along with pain on biting. Mesial canals could not be detected due to a furcation perforation as noted by the referring dentist. Radiographic examination revealed a large furcation perforation and related bone resorption. Definitive diagnosis was acute apical abscess. In each case, a silicone impression of the mandibular arch was obtained and scanned along with cone-beam computed tomography scan to plan for localization and preparation of the mesiobuccal canals using implant planning software. Multiple guides were fabricated through rapid prototyping and allowed for the correct orientation and insertion of endodontic files through the canal. Canals were prepared and then obturated using warm vertical compaction technique and the perforation were repaired by mineral trioxide aggregate (MTA). Six-month and one-year follow-ups revealed no symptoms and evidence of radiographic healing. Thus, multiple endodontic three-dimensional guides can be successful in root canal localization and preparation in cases of furcation perforations.

Multiple Endodontic Guides for Root Canal Localization and Preparation in Furcation Perforations: A Report of Two Cases.

To evaluate the impact of cooling the anesthetic solution prior to administering intra-pulpal anesthesia on the severity of intraoperative pain during root canal treatment in mandibular molars with symptomatic irreversible pulpitis and symptomatic apical periodontitis. Forty patients with mandibular molars diagnosed with symptomatic irreversible pulpitis and symptomatic apical periodontitis received root canal treatment by a single operator following a standardized technique. Patients received an intra-pulpal injection of 2% lidocaine with 1:100,000 epinephrine and were randomly and equally assigned to two groups based on the temperature of the cartridge. The room-temperature group received a cartridge that was kept at 25-26 °C while for the cryoanesthesia group, the cartridge was cooled to a temperature of 4-5 °C. The HP-VAS scale was used to evaluate the patients' preoperative, intraoperative pre-injection, and intraoperative post-injection pain scores. The success rate was calculated by the lack of additional anesthesia following the intra-pulpal injection. Pain scores were statistically analyzed at a significance level of 0.05. Both the cryoanesthesia and the room-temperature groups were effective in significantly reducing the severity of intraoperative pain, where p < 0.001 for both groups. The cryoanesthesia group showed a 100% success rate compared to 80% for the room-temperature group without a statistically significant difference (p = 0.106). The difference in pain score reduction in both groups, however, was statistically significant (p < 0.001). Cryoanesthesia yielded more profound pulpal anesthesia compared to the room temperature intra-pulpal injection.

Effect of intrapulpal cryoanesthesia on intraoperative pain during root canal treatment in mandibular molars: a double blinded randomized control trial.

Article	Year
Multiple Endodontic Guides for Root Canal Localization and Preparation in Furcation Perforations: A Report of Two Cases. Iranian endodontic journal\| PubMed ID: 36751413	2023
Effect of intrapulpal cryoanesthesia on intraoperative pain during root canal treatment in mandibular molars: a double blinded randomized control trial. Scientific reports\| PubMed ID: 41136539	2025

Tarek M. Elsewify

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