Journal of endodontics
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This study evaluated in vitro the bond strength of Epiphany sealer prepared with resinous solvent of Epiphany system (Thinning resin) by using a push-out test. Forty maxillary canines were sectioned transversally below the cementoenamel junction to provide 4-mm-thick dentin disks that were centered in aluminum rings and embedded in acrylic resin. Root canals were prepared with tapered diamond bur. ⋯ The highest mean value (14.91 +/- 2.82 MPa) was obtained with Epiphany prepared with solvent followed by photoactivation (GIV), which was statistically different (P < .01) from the other groups. Groups I (8.15 +/- 2.47 MPa), II (9.46 +/- 2.38 MPa), and III (9.80 +/- 2.51 MPa) had inferior bond strength values and were statistically similar among themselves (P > .01). The resinous solvent of Epiphany system increased the bond strength of Epiphany sealer to dentin walls when followed by photoactivation.
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Journal of endodontics · Dec 2008
Randomized Controlled Trial Comparative StudyThe anesthetic efficacy of diphenhydramine and the combination diphenhydramine/lidocaine for the inferior alveolar nerve block.
The purpose of this prospective, randomized study was to compare the degree of pulpal anesthesia obtained in vital, asymptomatic teeth using 1.8 mL of 1% diphenhydramine with 1:100,000 epinephrine, 1.8 mL of 2% lidocaine with 1:100,000 epinephrine, and 3.6 mL of 2% lidocaine with 1:100,000 epinephrine combined with 1% diphenhydramine with 1:100,000 epinephrine in inferior alveolar nerve blocks. We also studied injection and postinjection pain. An electric pulp tester was used to test for anesthesia, in 4-minute cycles for 60 minutes, of the second molars through the central incisor. ⋯ The diphenhydramine solution was irritating on injection and postinjection and resulted in a very low level of anesthetic success. We concluded that a 1% diphenhydramine solution should be used cautiously for the inferior alveolar nerve block. The combination lidocaine/diphenhydramine solution was irritating postinjection and was not as effective as a lidocaine solution for pulpal anesthesia.
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Journal of endodontics · Dec 2008
Characteristics of accessory mental foramina observed on limited cone-beam computed tomography images.
In this retrospective study with limited cone-beam computed tomography (limited CBCT), we investigated the anatomic characteristics of the accessory mental foramina and accessory branches of the mandibular canal. The CBCT records of approximately 150 patients were evaluated, and 17 accessory mental foramina were found in 16 patients. The anatomic peculiarities of the mandibular canal that might be relevant to endodontic treatment were observed. ⋯ Verification of the existence of accessory mental foramina would prevent accessory nerve injury during periapical surgery. In root canal treatment, the possibility of accessory mental foramina-related nerve paresthesia seems low unless the mental foramen and mandibular canal are injured. Limited CBCT is effective for presurgical 3-dimensional assessment of the neurovascular structures in dentoalveolar treatment.
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Journal of endodontics · Nov 2008
Randomized Controlled TrialComparison of the anesthetic efficacy of the conventional inferior alveolar, Gow-Gates, and Vazirani-Akinosi techniques.
The purpose of this prospective, randomized study was to compare the degree of pulpal anesthesia obtained with the conventional inferior alveolar, the Gow-Gates, and the Vazirani-Akinosi techniques in vital, asymptomatic teeth. With a crossover design, 40 subjects received all 3 techniques in a random manner by using 3.6 mL of 2% lidocaine with 1:100,000 epinephrine at 3 separate appointments. An electric pulp tester was used to test for anesthesia in 3-minute cycles for 60 minutes of the first molars, first premolars, and lateral incisors. ⋯ There was no significant difference (P > .05) in success among the 3 techniques. However, the Gow-Gates and Vazirani-Akinosi techniques resulted in a statistically slower onset of pulpal anesthesia than the inferior alveolar nerve block. We concluded that in vital, asymptomatic teeth and for the subjects who achieved lip numbness, the conventional inferior alveolar nerve block is similar to the Gow-Gates and Vazirani-Akinosi techniques regarding anesthetic success but has a faster onset of pulpal anesthesia.
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Journal of endodontics · Aug 2008
Lipoteichoic acid partially contributes to the inflammatory responses to Enterococcus faecalis.
Enterococcus faecalis, a pathogenic gram-positive bacterium, is closely related to refractory apical periodontitis. Because lipoteichoic acid (LTA) is considered a major virulence factor of gram-positive bacteria, in the present study, highly pure LTA from E. faecalis was prepared, and its ability to stimulate murine macrophages was investigated in comparison with those of the killed whole cells. Upon exposure to E. faecalis LTA, RAW 264.7 (a murine macrophage cell line) produced a significantly (p < 0.05) high level of tumor necrosis factor-alpha (TNF-alpha) and nitric oxide (NO) in a concentration-dependent manner. ⋯ Concomitantly, LTA enhanced the DNA-binding activity of a transcription factor, nuclear factor-kappa B (NF-kappaB), which plays an important role in the transcriptional activation of genes encoding inflammatory mediators. In contrast, heat-killed E. faecalis stimulated both TLR2 and TLR4, whereas the killed E. faecalis whole cells induced significant (p < 0.05) levels of TNF-alpha and NO in RAW 264.7 cells as their LTA did. These results suggest that LTA partially contributes to E. faecalis-induced inflammatory responses.