Effect of occlusal reduction on postendodontic pain: A systematic review and meta‐analysis of randomised clinical trials

The purpose of this systematic review was to assess the effect of occlusal reduction on post‐operative pain following root canal treatment and was performed in accordance with the PRISMA statement being registered in the PROSPERO database (CRD42018089941). Two reviewers independently conducted a systematic literature search in the PubMed (MEDLINE), Dentistry & Oral Sciences Source and the Cochrane Library databases. Seven studies were included, of which three were used to perform meta‐analysis for 6 days post‐operative and the rest for qualitative synthesis. Three studies were assessed as low risk of bias, three as some concern, and one as high risk of bias. Occlusal reduction diminishes the post‐operative pain (SMD ?1.10 (95%CI ?2.06, ?0.15) I² = 96.9%) at 6 days for teeth diagnosed as irreversible pulpitis, and, overall, likely reduces post‐operative pain for patients presenting with irreversible pulpitis and/or symptomatic apical periodontitis. Future high‐quality clinical trials are needed to better understand the role of occlusal reduction.     

Effectiveness of technology‐enhanced learning in Endodontic education: a systematic review and meta‐analysis

The aim of the present systematic review was to evaluate the effectiveness of technology‐enhanced learning (TEL) in the field of Endodontics to improve educational outcomes compared to traditional learning methods. Randomized controlled studies published in English were identified from two electronic databases (PubMed and Scopus) up to May 2018. Two authors independently performed study selection, data extraction and assessed the risk of bias (ROB). Any teaching method using TEL was considered as the intervention, and this was compared to traditional methods. The outcome measuring the effectiveness of learning activities was evaluated by Kirkpatrick's four‐level training evaluation model. The four levels of training outcomes are as follows: Reaction, Learning, Behaviour and Results. A meta‐analysis was performed to estimate the standardized mean difference (SMD) by the random effects model. In total, 13 studies were included in the systematic review. Only three studies were assessed as ‘low’ ROB. A meta‐analysis could not be performed in the domains of Reaction and Behaviour. No significant difference was observed in knowledge gain (Learning domain) between TEL and traditional methods (SMD, 0.14 (95% CI ?0.10 to 0.39) I² = 62.7%). Similarly, no difference was observed in performance (Behaviour domain). A variable response was found in attitude (Reaction domain). From the available evidence, it can be concluded that TEL is equally as effective as traditional learning methods.     

Comparison of coconut water, propolis, HBSS, and milk on PDL cell survival

Coconut water is biologically pure and sterile, with a rich presence of amino acids, proteins, vitamins, and minerals. The purpose of this study was to use a collagenase-dispase assay to investigate the potential of a new storage medium, coconut water, in comparison with propolis, Hank's balanced salt solution (HBSS), and milk in maintaining viable periodontal ligament (PDL) cells on simulated avulsed teeth. Seventy freshly extracted human teeth were divided into 4 experimental groups and 2 control groups. The positive and negative controls corresponded to 0-minute and 8-hour dry times, respectively. The experimental teeth were stored dry for 30 minutes and then immersed in 1 of the 4 media (coconut water, propolis, HBSS, and milk). The teeth were then treated with dispase grade II and collagenase for 30 minutes. The number of viable PDL cells was counted with a hemocytometer and analyzed. Statistical analysis showed that coconut water kept significantly more PDL cells viable compared with propolis, HBSS, or milk. Coconut water can be used as a superior transport medium for avulsed teeth.     

Evaluation of the pulp chamber size of human maxillary first molars: an institution based in vitro study.

The aim of this in vitro study was to determine the morphological measurements of the pulp chamber and also to establish the relationship of the cemento-enamel junction (CEJ) to the roof of the pulp chamber of the maxillary first molars in an Indian population. One hundred extracted human maxillary first molars were used. Each molar tooth was radiographed by radio visiography (RVG). Measurements were made by using the grid option in RVG. The results (mean +/- SD; in mm) were as follows: distance from floor of the pulp chamber to the furcation = 2.7 +/- 0.63; distance from roof of the pulp chamber to the furcation = 5.34 +/- 0.9; distance from tip of the palatal cusp to the furcation = 11.58 +/- 1.01; distance from the tip of the palatal cusp to the floor of the pulp chamber = 8.86 +/- 0.68; distance from the tip of the palatal cusp to the roof of the pulp chamber = 6.2 +/- 0.66; height of the pulp chamber = 2.62 +/- 0.61. The results of these measurements revealed that the morphological measurements of the maxillary first molars in the Indian population were similar to that reported by previous studies; the roof of the pulp chamber was found at the CEJ in 96% of the specimens.     

Effect of root canal debridement on inflammatory cytokine levels

In endodontic infections, inflammatory mediators such as cytokines are released, recruited and retained until the infection is eradicated. Root canal therapy is performed to prevent the spread of infection. The aim of this study was to investigate the effects of root canal debridement (cleaning and shaping) on periapical inflammation by measuring the levels of inflammatory cytokines, Interleukin‐8 (IL‐8) and Interleukin‐10 (IL‐10). The study includes twenty patients with pulp necrosis and asymptomatic apical periodontitis. Periradicular sample was collected using paper points before and after root canal debridement. Cytokine levels were determined by Sandwich Enzyme‐Linked Immunosorbent Assay (ELISA). Data were analysed using paired t‐test (PASW Statistics 18) (P = 0.05). All samples showed the presence of IL‐8 and IL‐10 prior to root canal debridement. Significantly reduced levels (P < 0.05) of IL‐8 and IL‐10 were detected after root canal debridement. In conclusion, root canal debridement significantly decreased the levels of the tested pro‐ and anti‐inflammatory cytokine in the periradicular interstitial fluid.