To compare oral health related quality of life (OHRQoL) and patients´ satisfaction with root canal treatment (RCT) and dental implant (DI) therapy performed by experienced practitioners. Patients with both an RCT and a DI performed respectively by an endodontist and an oral surgeon with more than 15 years of experience two years prior to the study were included. The survival and satisfactory outcome of both treatments were verified with clinical and radiographic data. Participants completed two constructed questionnaire (one for each treatment). OHRQoL assessment included 24 items (OHIP-14 plus other relevant 10 items from the original OHIP-49 questionnaire). Satisfaction regarding duration, cost and pain (both during and after treatment) of treatment was assessed with a 0-10 scale and perceptions with true/false questions. Weighted sums for each dimension, total OHIP scores, prevalence of impact and general satisfaction of patients were then calculated for DI and RCT and compared using the Wilcoxon test for related samples. Patients´ perceptions were compared with Chi-square test. Total OHIP scores were low for both treatments (8.82 and 7.87, respectively for RCT and DI). No significant differences were detected in OHIP total score or any dimension, except for physical pain (significantly higher for RCT than DI (p=0.044)). All patients were satisfied with both treatments; however, patients recalled that pain during treatment was significantly worse for RCT than DI (p=0.003). High long-term OHRQoL and satisfaction is expected with either DI or RCT performed by experienced practitioners; however, physical pain dimension is higher for RCT. This study demonstrated a high satisfaction and long-term quality of life of patients undergoing both DI and RCT if treatments provide a functional balance and are performed by experienced practitioners. Very importantly, all participants had received both treatment modalities and being their own control eliminates individual variability.

Background: Biofilm removal from the root canal during endodontic treatment is necessary to prevent further complications. Irrigation is essential to success. Several irrigants have been proposed without a proper comparison. The aim of the study is to compare the antibacterial capacity of different activated irrigants using passive ultrasonic activation (PUI) or XP-Endo finisher (XPF). Methods: A total of 100 instrumented teeth were incubated in an Eppendorf tube containing 0.5 McFarland of Enterococcus faecalis and incubated for 2 weeks at 37 °C. Roots were divided into 5 groups (n = 20) according to the irrigant type: ethylenediaminetetraacetic acid (EDTA) (17%), ethydronic acid (HEDP) (9%) mixed with 5.25% sodium hypochlorite (NaOCl), EDTA (17%) mixed with 5.25% NaOCl, PBS, and a control group. Each group was divided into two subgroups (n = 10): PUI and XPF. Results: As compared to the untreated control group, the irrigators included in the study had a significant effect in bacteria reduction. The obtained results show HEDP to be the most effective irrigant, since no bacteria were recovered after treatment of this group, followed by EDTA mixed with NaOCl and, finally, the EDTA-irrigated group. Conclusions: HEDP is the best irrigating agent in combination with XPF or PUI file activation to eliminate bacteria in our experimental model.

The objectives of the present study were to assess the antibacterial effectiveness of two sodium hypochlorite (NaOCl) concentrations (2.5% and 5.25%) activated by means of two techniques, passive ultrasonic irrigation (PUI) and XP-endo^® Finisher (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) (XPF) against bacteria growth in intracanal mature biofilm. Our aim was to determine if the effect of heating up NaOCl at body temperature (BT) contributed to an improvement of the efficacy of XPF. Sixty-two single-canal human roots previously instrumented were infected with E. faecalis inoculum at 0.5 McFarland and incubated at 37 °C for two weeks. Twelve specimens were randomly selected as positive control, and the remaining fifty were divided into five experimental groups (n = 10). The first two were irrigated with 2.5 vs. 5.25% NaOCl at room temperature (RT), activated with PUI, and the other three were irrigated with XPF. Of these three, two were irrigated using 2.5 vs. 5.25% NaOCl at RT and one was irrigated with 5.25% NaOCl at BT. Our results showed that NaOCl was effective in biofilm removal for all experimental groups (p > 0.05), especially in the groups irrigated with 5.25% NaOCl at room temperature (RT) activated with PUI and the group treated with 5.25% NaOCl at BT with XPF. These groups were the most successful ones (p < 0.001). NaOCl, activated with XPF, was as effective as PUI in biofilm removal from the apical third of the canal when it was used at higher concentration and heated up. This study indicates that XPF only reached the efficacy of PUI when NaOCl was heated up.