Most popular Dental Elf Blogs Jan – Mar 2023

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Topics covered in our most popular blogs in the first quarter of the 2023. included , selective caries removal, root canal dressings and pain management following dental extractions

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Antimicrobial photodynamic therapy and bacterial load in endodontics

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This review of the efficacy of adjunctive photodynamic therapy (aPDT) on reducing bacterial load in the primary endodontic treatment of teeth with chronic apical periodontitis included 8 studies. While the findings suggest a benefit from aPDT the limited number and quality of the availabel studies mean the findings should be interpreted cautiously.

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Stress of root canal treatment in patients and dentists

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This review to determine whether root canal treatment causes greater stress than other dental treatments, especially extractions, in patients and providers of dental treatment included 23 studies. The findings suggest that root canal treatment was more psychologically stressful for patients than routine restorative or cleaning procedures however a majority of the included studies (52%) were at high risk of bias.

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Coronal microleakage prevention after root canal treatment

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This review of the efficiency of orifice barriers in preventing coronal microleakage after root canal treatment included 18 in-vitro studies. The findings suggest the placement of an orifice barrier helped prevent coronal leakage. However the relevance of this to the clinical environment remains to be examined.

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Root canal treatment outcomes and pulpal status

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This review comparing the effectiveness of root canal treatment outcomes in teeth with a vital pulp versus a necrotic pulp included 28 studies. No differences between vital and necrotic pulps were seen for tooth survival. No studies reported on tooth function, adverse effects or oral health related quality of life (OHRQoL).

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Orthodontically induced external apical root resorption

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This review comparing orthodontically induced external apical root resorption (EARR) in root-filled teeth and vital pulp teeth included 11 mainly retrospective studies . The findings suggest less EARR in root-filled teeth but the evidence is of very low certainty.

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Pulpotomy v root canal treatment in permanent teeth

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This review of pulpotomy ( partial or full) v root canal treatment (RoCT) in permanent teeth with pulpitis included 2 RCTs involving 957 teeth. The findings suggests no difference in pain at 7 days or in success rates at 1 and 5 years but the evidence is limited.

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What irrigation and canal dressings are most effective in the treatment of Apical Periodontitis?

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In this blog Thibault Collloc looks at a review of is the effectiveness of instrumentation and irrigation with NaOCl and EDTA compared to any other root canal irrigant. The review was one of a number undertaken to inform guidelines for the European Society of Endodontics.

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Apical surgery versus non-surgical root canal treatment or retreatment

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This review of apical surgery compared with non-surgical root canal treatment or retreatment for teeth with apical periodontitis included 5 studies.None of the included studies were at low risk of bias so the findings should be viewed very cautiously.

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Inferior alveolar nerve block 2% mepivacaine versus 4% articaine – trial

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This well conducted randomised controlled trial assessed inferior alveolar nerve block (IANB) success of 2% mepivacaine and 4% articaine in patients with symptomatic irreversible pulpitis (SIP) in mandibular molars during access cavity preparation and instrumentation.

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