Joseph D. Maggio

Effectiveness of Various Medications on Postoperative Pain following Complete Instrumentation

The root canals of 588 consecutive nonsurgical patients with varying levels of pain were completely instrumented in 10 endodontic practices and 4 endodontic graduate programs. The participants were sequentially assigned to one of nine medications and a placebo. The severity of pain was assessed by the visual analog scale for 72 h following instrumentation. Among all of the parameters studied, three factors (preoperative pain, apprehension, and types of medication) were found to be significant in determining postinstrumentation pain. An association was found between the intensity of pre-and postoperative pain. As the intensity of preoperative pain increased, the chances for more severe postoperative pain increased (p < 0.0001). In addition, an association between the presence of apprehension before any treatment and postoperative pain was also noted (between 0.012 < p < 0.047). Examination of the time-effect curves for various medications in patients with no mild pain showed no statistical significant difference between the effectiveness of different medications and placebo. However, a multiple comparison of the effectiveness of various medications and placebo on patients in moderate and severe preoperative pain showed that ibuprofen, ketoprofen, erythromycin base, penicillin, and methylprednisolone plus penicillin were more effective than placebo within the first 48 h following complete instrumentation.

Scanning electron microscopic examination of root canal filling materials

The root canals of 130 freshly extracted, anterior teeth were prepared and filled with various root canal fillings by various techniques. The adhesion and adaptation of the filling materials to the walls of the root canals were then examined with the scanning electron microscope. In general, zinc oxide-eugenol cements adhered well, whereas greater variability occurred with zinc polycarboxylate cements. Silver and gutta-percha cones had no adhesion and required a sealer to fill the interface between cones and dentin. None of the techniques for inserting gutta-percha into the root canal was effective in obliterating the root canal space.

Titanium endodontic implants: a scanning electron microscope, electron microprobe, and histologic investigation

Ti tan ium cones w e r e e x a m i n e d before a n d after imp lan ta t i on in the root c a n a l s a n d b o n e s of two monqre l doqs. A thin, a d h e r e n t film w a s de tec ted on the implan t s after t h e y w e r e r emoved . Severe , i n f l a m m a t o r y lesions d e v e l o p e d a r o u n d the implan t s in both doqs after six months . A h y p o t h e s i s for this occu r r ence is offered.

Tissue reactions to polycarboxylate cements

Root canals of the teeth of two dogs were filled with polycarboxylate cements, with and without additives. After 120 to 225 days, histologic examination showed the presence of severe, persistent inflammatory lesions around the materials. The results indicated that there would be no advantages to using polycarboxylates as root canal filling materials.