Endodontics

  1. Diabetes patients and root canals
The purpose of this study was to compare the success of primary root canal treatment between type 2 diabetic patients and nondiabetic patients and to investigate the effect of periapical healing on blood sugar levels in type 2 diabetic patients with apical periodontitis. The study included 60 mandibular molars with necrotic pulps and apical radiolucency and based on their blood sugar (HbA1c levels), patients were divided into two groups: type 2 diabetic (HbA1c >=6.5%) and nondiabetic (HbA1c <6.5%). Forty-six teeth were evaluated 12-months later. Both groups showed a significant reduction in the periapical score after a year but significantly less healing was observed in the diabetic group (43%) compared with the nondiabetic group (80%). HbA1c levels in the diabetic group increased at each follow-up after endodontic treatment. Diabetes may have a negative impact on the outcome of endodontic treatment in terms of periapical healing. Nonsurgical endodontic treatment did not improve blood sugar levels in patients with type 2 diabetes.

Arya S et al. Healing of apical periodontitis after nonsurgical treatment in patients with type 2 diabetes. J Endodontics 2017 Aug 10.

Q Diabetes mellitus
A May have a positive impact on endodontic treatment in terms of periapical healing
B Subjects in the test group showed progressive reduction of HbA1c levels
C May have a negative impact on endodontic treatment in terms of periapical healing
D Has neither a positive or negative influence on endodontic treatment outcomes

  1. Pain reduction
This clinical trial assessed the effect of a preoperative, single, oral dose of prednisolone on postoperative pain and postoperative analgesic intake in patients with symptomatic, irreversible pulpitis in mandibular molars. Four hundred patients, randomly assigned to two equal groups, received either 40 mg prednisolone or placebo tablets 30 min before single-visit root canal treatment. Patients recorded their pain level 6, 12 and 24 h after treatment on a visual analogue scale. The relative risk reduction in pain incidence was 20.31% at 6 h, 23.39% at 12 h and 28.85% at 24 h. Prednisolone had significantly less post-obturation pain intensity compared to placebo at all time intervals. No adverse effects were recorded. Preoperative oral administration of a single dose of 40 mg prednisolone was beneficial to control short-term post-obturation pain after single-visit root canal treatment in patients with symptomatic irreversible pulpitis reducing pain incidence after 24 h by approximately 30% and postoperative analgesic intake by approximately 55%.

Elkhadem A. The effect of preoperative oral administration of prednisolone on postoperative pain in patients with symptomatic irreversible pulpitis: a single-centre randomized controlled trial. Int Endodontic J 2017 May 31.

Q Which of the following did a preoperative oral administration of a single dose of 40 mg prednisolone cause?
A A risk reduction of pain of 23.39% at 12 hours post-operatively
B An increase in pain 6 hours post-operatively
C Adverse effects in 20.31% of cases
D A reduced postoperative analgesic intake by approximately 5%.