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    Acupuncture reduces the postoperative pain in teeth with symptomatic apical periodontitis: a preliminary randomized placebo-controlled prospective clinical trial
    (Quintessence Publishing Co Inc, 2019) Arslan, Hakan; Ahmed, Hany Mohamed Aly; Yildiz, Ezgi Doganay; Gundogdu, Eyup Candas; Seckin, Fatih; Arslan, Sumeyye
    Objective: Endodontic treatment generally results in a wide range of postoperative pain intensity. The aim of this study was to investigate the effect of preoperative acupuncture on postoperative pain in molar teeth with symptomatic apical periodontitis. Method and Materials: Thirty patients having symptomatic apical periodontitis with a preoperative and percussion pain of visual analog scale (VAS) more than 60 were included in this study. The patients were randomly distributed into two groups; G1, real acupuncture; and G2, placebo (mock acupuncture). After 15 minutes of application, root canal treatment was performed. A logistic regression analysis was used to determine the variable(s) (group, age, gender, tooth number, preoperative pain, preoperative percussion pain, and radiographic status) that controls the postoperative pain significantly. Chisquare, Mann Whitney U, and independent t tests were per-formed to analyze the data, and the level of significance was set at .05 (P = .05). Results: A regression analysis demonstrated that the group variable had the most significant effect on postoperative pain at day 1 (P = .003). Results showed that acupuncture reduced the preoperative and percussion pain levels significantly more than placebo group at all day intervals (P < .05). For postoperative pain at the 7-day follow-up, the pain ranged from "mild" to "no pain" in G1, compared with "moderate" to "minimal" in G2. Only one patient required postoperative analgesics in the acupuncture group compared to eight patients for placebo. Conclusions: Preoperative acupuncture can be beneficial in reducing postoperative pain in teeth with symptomatic apical periodontitis.
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    Duration of ultrasonic activation causing secondary fractures during the removal of the separated instruments with different tapers
    (SPRINGER HEIDELBERG, 2020) Arslan, Hakan; Yildiz, Ezgi Doganay; Tas, Gizem; Akbiyik, Nuray; Topcuoglu, Huseyin Sinan
    Objectives The aim of the present study was to determine the effect of taper (.08, .06, and .04) of separated K3XF instruments on duration taken for the secondary fracture formation during ultrasonic activation. Materials and methods Ten 25/.08 K3XF (SybronEndo, Orange, CA, USA), ten 25/.06 K3XF, and ten 25/.04 K3XF instruments were used for the study. The apical 5 mm of the instruments was cut to simulate the fragments in root canals. Fragments of the instruments were sandwiched between two straight dentin blocks. An ultrasonic tip was used to cause a secondary fracture of the fragment. The time needed for the secondary fracture was recorded for each instrument. The data were statistically analyzed using the Kruskal-Wallis H test (alpha = 0.05). Results Secondary fractures occurred in all instruments. In the .08 taper group, secondary fractures took longer than in the case of the .06 and the .04 taper groups (P < 0.05). There were no significant differences between the .06 and the .04 taper groups in terms of the time required for the occurrence of a secondary fracture (P > 0.05). Conclusions In the .08 taper group, secondary fracture took longer time than in the case of the .06 and the .04 taper groups due to its larger cross-sectional area involved.
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    Effect of Low-level Laser Therapy on Postoperative Pain in Molars with Symptomatic Apical Periodontitis: A Randomized Placebo-controlled Clinical Trial
    (Elsevier Science Inc, 2018) Yildiz, Ezgi Doganay; Arslan, Hakan
    Introduction: In this clinical trial, we evaluated the effect of low-level laser therapy (LLLT) on postoperative pain in mandibular molar teeth with symptomatic apical periodontitis. Methods: Forty-two patients were included in the study according to the inclusion and exclusion criteria. Root canal treatment was conducted using reciprocating instruments. The patients were randomly distributed into 3 groups using a Web program as follows: control (no laser was applied), placebo (mock laser therapy), and LLLT. Postoperative pain levels on the 1st, 3rd, 5th, 7th, and 30th day and postoperative percussion pain levels on the visual analog scale were recorded. The chi-square, 1-way analysis of variance, and least significant difference post hoc tests were performed to analyze the data (P = .05). Results: LLLT resulted in lower pain levels than those noted in the control and placebo groups on days 1 and 3 (P < .05). There were no significant differences among the placebo, LLLT, and control groups in terms of postoperative percussion pain levels (P < .05). Conclusions: LLLT can be beneficial in reducing postoperative pain in endodontics.
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    The effect of photobiomodulation on total amount of substance P in gingival crevicular fluid: placebo-controlled randomized clinical trial
    (Springer London Ltd, 2019) Yildiz, Ezgi Doganay; Arslan, Hakan; Koseoglu, Serhat; Arabaci, Taner; Yildiz, Dursun Anil; Savran, Levent
    To investigate the effect of photobiomodulation (PBM) and placebo on total amount of substance P in gingival crevicular fluid (GCF) pre- and postoperatively. Twenty-six patients having tooth with symptomatic apical periodontitis were enrolled in this study. GCF was collected preoperatively. The patients were assigned into two groups (n=13), as follows: placebo and PBM. Sampling was repeated 7days after root canal treatment. Two independent samples T test was used for analyzing of the differences between preoperative and postoperative substance P levels in GCF (p=.05). The Pearson correlation analysis was used for determination of correlation among substance P levels and other variables. For placebo group, there is no significant difference between preoperative and postoperative total amounts of substance P level (p=0.553). For PBM group, postoperative total amount of substance P level was significantly higher than those of preoperative level (p=0.005). Within the limitation of the present study, PBM has immunomodulation effect linked to the modulation of the total amount of substance P in the gingival crevicular fluid. Thai Clinical Trials Registry: TCTR20161228002
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    The effect of taper and apical preparation size on fracture resistance of roots
    (WILEY, 2020) Yildiz, Ezgi Doganay; Fidan, Mehmet Eren; Sakarya, Rustu Ersoy; Dincer, Buket
    This study investigated the effect of taper and apical preparation size on the fracture resistance of roots. 84 mandibular incisor teeth were selected. Groups (n = 12): uninstrumented (control group), 25/0.04, 25/0.06, 25/0.08, 30/0.04, 30/0.06 and 30/0.08. K3XF files (Kerr Endodontics, Orange, CA) were used for canal preparation. Fracture resistance was tested using a Universal test machine. For statistical analysis, the level of significance was P <= 0.05, and one-way anova and post hoc LSD tests were used. The control group showed the highest fracture resistance (P < 0.05). No significant difference was found between 25/0.04 and 25/0.06; 25/0.06 and 25/0.08; 30/0.04 and 30/0.06; 30/0.06 and 30/0.08; 25/0.04 and 30/0.04; 25/0.06 and 30/0.06; and 25/0.08 and 30/0.08 (P > 0.05). Significant differences were found between 25/0.04 and 25/0.08; 30/0.04 and 30/0.08; and 25/0.08 and 30/0.04 (P < 0.05). In conclusion, the clinical selection of larger tapers can cause a higher risk of fracture.
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    Regenerative Endodontic Procedures in Necrotic Mature Teeth with Periapical Radiolucencies: A Preliminary Randomized Clinical Study
    (Elsevier Science Inc, 2019) Arslan, Hakan; Ahmed, Hany Mohamed Aly; Sahin, Yavuz; Yildiz, Ezgi Doganay; Gundogdu, Eyup Candas; Guven, Yahya; Khalilov, Ruslan
    Introduction: This preliminary study compared clinical and radiographic outcomes of regenerative endodontic procedures (REPs) with that of conventional root canal treatment (CRCT) in necrotic mature teeth with periapical radiolucencies. Methods: Fifty-six mature necrotic teeth with large periapical radiolucencies were distributed into 2 groups: group 1, REPs and group 2, CRCT (n = 28/group). Clinical and radiographic follow-up assessments were undertaken up to 12 months. Statistical analysis was performed using the independent samples t test and the chi-square test, and the level of significance was set at P = .05. Results: With a follow-up rate of about 73.4% of the total patients for 12 months, favorable clinical and radiographic outcomes were found in 92.3% and 80% in REPs and CRCT groups, respectively, and the difference was not statistically significant (P > .05). Half of the teeth treated with REPs responded to the electric pulp test. Conclusions: Regenerative endodontic procedures have the potential to be used as a treatment option for mature teeth with large periapical radiolucencies.
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    Success of maintaining apical patency in teeth with periapical lesion: a randomized clinical study
    (Quintessence Publishing Co Inc, 2019) Arslan, Hakan; Yildiz, Ezgi Doganay; Topcuoglu, Huseyin Sinan; Tepecik, Ebru; Ayaz, Nilay
    Objective: The aim of this study was to evaluate the effect of maintaining apical patency on periapical healing and postoperative pain levels in teeth with necrotic pulp and apical periodontitis. Method and materials: Fifty mature teeth with periapical lesions were randomly distributed into two treatment groups: patency, and nonpatency (n = 25). Patients were followed up over a 12-month period using clinical and radiographic assessments.The data were statistically analyzed using independent-samples t test and chi-square tests at a 95% confidence level (P = .05). Results: Seventeen teeth in the patency group (85.0%) and 19 teeth in the nonpatency group (86.4%) were classified as being successfully treated (P = .900). Conclusions: Within the limitations of the present study, maintaining apical patency did not affect endodontic treatment outcomes.