Four years of clinical experience with the efficacy of Pulpotec® as a root canal dressing for the management and control of odontogenic pain: A prospective randomized clinical trial


Bestoon Mohammed Faraj

School of Dentistry, University of Sulaimani, Sulaimani  



Abstract
     Background: The choice of methods and materials for the relief of preoperative symptom and control of inter-appointment flare-up remains an important consideration in endodontic therapy. Aim: The objectives of this study was to discover clinically the influence of pulpotec (Produits Dentaires S.A., Switzerland) on the incidence of inter-appointment flare-up, with a view to advance the resolution of pain and/or swelling in patients presenting for emergency root canal treatment. Materials and Methods: Pulpotec paste was used as an intracanal medicament in multi-appointment root canal treatment in 860 teeth (510 symptomatic and 350 asymptomatic) belonging to 860 patients from February 2008 to March 2012. The follow-up visit was scheduled, and the incidence and severity of inter-appointment pain was recorded at different time periods (8, 24, and 48 h, 3 days, and 1 week after the treatment) on simple descriptive pain intensity scale. Results: The incidence of intense pain was 10 (1.16%) and 6 (0.69%) of the treatment cases at 24 and 48 h, respectively. Moderate pain was described only by 137 patients within the 24 h–3 days time interval after treatment. Conclusion: Pulpotec intracanal dressing is beneficial in rapid resolution of pain and/or swelling in emergency root canal treatment and in controlling postoperative pain in multi-appointment root canal treatment. 

References:
1-Wong M, Lytle WR. A comparison of anxiety levels associated with root canal therapy and oral surgery treatment. Journal of Endodontics.    1991; 17:461–465. 
2-Pak JG, White SN. Pain prevalence and severity before, during, and after root canal treatment: A systematic review. Journal of Endodontics  .2011; 37: 429-438. 
3-Hasler J F, Mitchell D F. Analysis of 1628 cases of odontalgia: A corroborative study. Journal of Indianapolis District Dental Society .1963;  17: 23-25. 
4-Drinnan D L. Differential diagnosis of orofacial pain. Dent Clin North Am 1987; 31: 627643. 
5-Oguntebi BR, De Schepper EJ, Taylor TS, White CL, Pink FE. Postoperative pain incidence related to the type of emergency treatment of  symptomatic pulpitis. Oral Surgery, Oral Medicine, Oral Pathology. 1992; 4: 479-483. 
6-Torabinejad M, Kettering JD, McGraw JC, Cummings RR, Dwyer TG, Tobias TS. Factors associated with endodontic interappointment  emergencies of teeth with necrotic pulps. Journal of Endodontics .1988; 14:261-266.  
7-Tsesis I, Faivishevsky V, Fuss Z, Zukerman O. Flare-ups after endodontic treatment: a meta-analysis of literature. Journal of Endodontics  .2008; 34:1177–1181. 
8-Walton R, Fouad A. Endodontic interappointment flare-ups: a prospective study of incidence and related factors. Journal of Endodontics.  1992; 18:172-177. 
9-Siqueira JF, Rocas IN, Favieri A, Machado AG, Gahyva SM, Oliveira JC, Abad EC. Incidence of postoperative pain after intracanal procedures  based on an antimicrobial strategy. Journal of Endodontics .2002; 28:457-460. 
10-Maddox DL, Walton RE, Davis CO. Incidence of posttreatment endodontic pain related to medicaments and other factors. Journal of  Endodontics .1977; 3:447-451. 
11-Torabinejad M, Handysides R, Khademi A, Bakland LK. Clinical implications of the smear layer in endodontics: A review. Oral Surgery Oral  Medicine Oral Pathology Oral Radiology Endodontics. 2002; 94:658-666. 
12-Al-Salman KA, Al–Rawi BA, Rahawy OS. The effectiveness of using Pulpotec® in treatment of pulpitis by pulpotomy of vital deciduous  molar and vital immature permanent molar. Al–Rafidain Dental Journal. 2012; 12: 185-190.  
13-Imura N, Zuolo ML. Factors associated with endodontic flareups: A prospective study. International Endodontic Journal. 1995; 28:261-265. 
14-Bender IB. Pulpal pain diagnosis: a review. Journal of Endodontics.2000; 26:175–179.  [15].Van Cura JE, Remeikis NA.A corticosteroid-  antibiotic combination in the treatment of acute secondary apical periodontitis. International Dental Journal .1970; 39:307-312. 
16-Simon M, Van Mullem PJ, Lamers AC.Antimicrobial effectiveness in endodontic therapy using formocresol and two new alcoformol agents.  Oral Surgery, Oral Medicine, Oral Pathology .1979; 47:471-474. 
17-Udoye C, Aguwa E. Flare-up incidence and related factors in adults. Journal of Dentistry and Oral Hygiene. 2010; 2:19-22. 
18-Segura-Egea JJ, Cisneros-Cabello R, Llamas-Carreras JM, Velasco-Ortega E. Pain associated with root canal treatment. International    Endodontic Journal .2009: 42:614–620. [19].Harrison JW, Baumgartner JC, Svec TA. Incidence of pain associated with clinical factors during or  after root canal therapy. Part I. Interappointment Pain. Journal of Endodontics .1983; 9:384-387.