Articaine: Is it the best local anaesthetic for teeth with irreversible pulpitis undergoing root canal treatment?

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5 systematic reviews were included in this umbrella review of whether articaine or lidocaine is the most appropriate local anaesthetic solution for teeth with irreversible pulpitis undergoing root canal treatment.

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Guideline: Antibiotics for Dental Pain and Swelling

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This new guideline from the American Dental Association is about the the appropriate use of systemic antibiotics for the urgent management of symptomatic irreversible pulpitis with or without symptomatic apical pulpitis, pulp necrosis and symptomatic apical periodontitis and pulp necrosis and localized acute apical abscess.

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Subcutaneous emphysema during root canal treatment

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This review of the factors affecting the development ofsubcutaneous emphysema during root canal therapy included
51 studies describing 65 cases. A majority (48%) were linked to drying tooth canals with pressurised air in three-way syringe

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Root canal obturation: Does apical extent of obturation affect outcome?

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Mark-Steven Howe looks at this review of the association between obturation extent and final treatment outcome of root canal treatment. Twenty two studies were included with 11 contributing to the meta-analysis suggestign that obturation extent may have an effect.

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Pulpotomy for permanent teeth with irreversible pulpitis?

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This review of success rates of coronal pulpotomy in carious teeth with signs and symptoms indicative of irreversible pulpitis included 8 studies only one of which was a RCT. The data suggest this this procedure may be an alternative to root canal treatment.

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Nonsurgical root canal therapy: What is the most effective oral premedication to reduce post treatment pain?

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This review of the most effective oral premedication in reducing pain in adults after nonsurgical root canal therapy including 16 studies. While a premedication of choice is suggested most outcomes are only supported by very low quality evidence.

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Irreversible pulpitis: What is the most effective local anaesthetic for inferior alveolar nerve block?

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This review of the most effective anaesthetic solutions for inferior alveolar nerve blocks for mandibular teeth with irreversible pulpitis included 11 RCTs. The findings suggest that mepivacaine with epinephrine performed better than lidocaine with epinephrine but the number of trials is limited and the quality of evidence was very low to moderate.

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Post endodontic pain: Is it affected by type of instrumentation?

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17 studies, none of which were at low risk of bias, were included in this review of the effect of type of instrumentation on post endodontic pain. The findings suggest lower incidence and intensity of postoperative pain with rotary instruments compared to hand files.

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Dexamethasone for post endodontic pain

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This review of dexamethasone for controlling pain following endodontic treatment included 5 relatively small RCTs . The findings suggest statistically significant reduction of pain in patients receiving dexamethasone at 8,12, and 24 hours.

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Root canal treatment – irrigant activation techniques to remove smear layer and debris?

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Kenny Strain looks at this new review of in-vitro studies examining irrigant activation techniques during root canal treatment. The findings suggest improvemed removal of smear layer and debris. However the impact on clinical outcomes needs further investigation.

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