***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This study compared preoperative administration of acetaminophen or a combination of acetaminophen and ibuprofen versus placebo for potential increased effectiveness of inferior alveolar nerve ( IAN ) block anesthesia . There were 40 patients with irreversible pulpitis r and omly assigned to a drug or placebo group . Thirty minutes after ingestion of medication , an IAN block was administered . A cold test was done 15 minutes after the block , and if the patients had no sensitivity , endodontic therapy was initiated . If the patient had no pain on access , the IAN was recorded as successful . If the patient had sensitivity to cold or to the access procedure , it was recorded as a failure . Overall success was 60 % for all three groups . Success was 71.4 % for the acetaminophen group , 75.9 % for the acetaminophen and ibuprofen group , and 46.2 % for the placebo group . There was no significant difference between the groups ; however , there was a trend toward higher success in the medication groups OBJECTIVES This prospect i ve study was conducted to determine whether there is any significant difference in the incidence of postobturation pain after single- and multiple-visit root canal treatment ( RCT ) . METHODS The frequency of postobturation pain was recorded and evaluated over an observation period of 30 days in 291 of 300 consecutive patients receiving RCT .  The patients were assigned r and omly and consecutively into either single- or multiple-visit groups . The canals of all teeth were prepared and filled by a single operator using the step-back and lateral condensation techniques . The data were analysed statistically to determine the relationship , if any , between the pain experienced and pulpal vitality , tooth type , pre-operative pain , and the sex and age of the patient . RESULTS Nine of the 300 patients were excluded from the analysis as they failed to attend for postoperative review s. A significantly higher incidence ( P < 0.01 ) of postobturation pain was found in the multiple-visit group ( 38 % ) than in the single-visit group ( 27 % ) within 24 h of obturation . The incidence of pain decreased thereafter , with all patients being sysmptom free at the end of the observation period . No significant correlation was found between postobturation pain and any other factor , with the exception that teeth which had nonvital pulp prior to treatment were associated with a significantly greater ( P < 0.005 ) incidence of postobutration pain . CONCLUSIONS Pain was significantly higher in the multiple-visit RCT group and significantly associated with the treatment of the nonvital pulp AIM This longitudinal , prospect i ve study ( 1 ) investigated the prevalence of post-obturation pain after root canal treatment  and ( 2 ) evaluated the influence of factors affecting the pain experience . METHODOLOGY Twenty practitioners , comprising general dental practitioners , MSc graduates and Endodontists , participated in this study . The patient sample ( n = 415 ) was derived from consecutive patients attending the practitioners ' surgeries for root canal treatment on a single tooth . Demographic , medical history , preoperative and intra-operative data as well as  pain experience on day 1 and day 2 after root canal obturation were recorded . Intensity of pain experienced was recorded on a visual analogue scale ( VAS ) of 0 - 5 . The data were analysed using logistic regression models . RESULTS The prevalence of post-obturation pain within 48 h after treatment was 40.2 % ( n = 167 ) but less than 12 % of patients experienced severe pain ( VAS 4 or 5 ) on either day 1 or day 2 . The factors that significantly influenced post-obturation pain experience were : gender ( OR = 0.434 , P < 0.001 ) , tooth type ( OR = 1.733 , P = 0.007 ) , size of periapical lesion ( OR = 0.493 , P = 0.004 ) , history of post-preparation pain ( OR = 4.110 , P = < 0.001 ) or generalized swelling ( OR = 3.435 , P = 0.005 ) and number of treatment visits ( OR = 2.604 , P < 0.001 ) . CONCLUSIONS The prevalence of post-obturation pain was high ( 40.2 % ) . The important prognostic determinants of post-obturation pain were female , molar tooth , size of periapical lesion smaller than 3 mm , history of post-preparation pain or generalized swelling and single-visit treatment The purpose of this prospect i ve clinical trial was to investigate the analgesic efficacy of three oral medication groups on postoperative endodontic pain in male and female dental patients , with an emphasis on analgesic differences between the sexes . Forty-three patients were administered ibuprofen 600 mg , placebo , or pentazocine 50 mg/0.5 mg naloxone in a r and omized , double-blinded manner . Beginning immediately after endodontic treatment , patients took the assigned medication every 6 hours for 24 hours and recorded their degree of discomfort on a 100-mm visual analog scale . Statistical analysis of the data showed that ibuprofen 600 mg provided statistically significantly greater analgesia than placebo at 6 and 12 hours ( P = 0.0014 and 0.0024 ) , and pentazocine/naloxone provided statistically significantly greater analgesia than placebo at 12 hours ( P = 0.0084 ) . Sex-dependent differences were noted within the pentazocine/naloxone group , which showed significantly greater analgesia in females compared with males ( P = 0.007 ) OBJECTIVE The purpose of this prospect i ve , r and omized , double-blind study was to compare the anesthetic efficacy of 4 % articaine and 2 % lidocaine ( both with 1:100,000 epinephrine ) for buccal infiltration in patients experiencing irreversible pulpitis in maxillary posterior teeth . STUDY DESIGN Forty patients with irreversible pulpitis in first premolar or first molar were divided into 4 study groups and received buccal infiltration of either 4 % articaine or 2 % lidocaine in a double-blind manner . Endodontic access was begun 5 minutes after solution deposition . Success was defined as no or mild discomfort ( VAS recordings ) during the endodontic procedure . RESULTS The success rate for maxillary buccal infiltration to produce pulpal anesthesia using articaine was 100 % in first premolar and first molar , and for the lidocaine solution , success rate was 80 % in first premolar and 30 % in first molar . There was high significant difference between the articaine and lidocaine solutions ( ANOVA ; P < .001 ) . CONCLUSION The efficacy of 4 % articaine was superior to 2 % lidocaine for maxillary buccal infiltration in posterior teeth Acute pain and swelling following endodontic treatment are a challenge for both the patient and the dentist . According to previous studies , the incidence of flare-ups increases after endodontic treatment of teeth with necrotic pulps . Calcium hydroxide is currently used as a multi- purpose drug in root canal therapy . The aim of this study was to evaluate the incidence and severity of flare-ups after treatment of pulpless teeth using calcium hydroxide as an intracanal dressing .  Sixty patients with single-root necrotic teeth participated in this study . These patients were r and omly divided into three groups of 20 . The patients were treated in Group A in a single-visit approach , in group B with a two-visit approach without any intracanal dressing and group C with a two-visit approach using calcium hydroxide as an intracanal dressing for one week . All of the patients were followed for 72 hours after each treatment session . The information about the incidence and severity of pain and swelling was recorded in tables , using a modified Visual Analogue Scale for pain severity measurement and a scale with four degrees for measuring the severity of swelling . The data were analyzed by chi-square test and GENMODE procedure & NA ; There is uncertainty over whether the patient group in which acute pain studies are conducted ( pain model ) has any influence on the estimate of analgesic efficacy . Data from four recently up date d systematic review s of aspirin 600/650 mg , paracetamol 600/650 mg , paracetamol 1000 mg and ibuprofen 400 mg were used to investigate the influence of pain model . Area under the pain relief versus time curve equivalent to at least 50 % maximum pain relief over 6 h was used as the outcome measure . Event rates with treatment and placebo , and relative benefit ( RB ) and number needed to treat ( NNT ) were used as outputs from the meta‐analyses . The event rate with  placebo was systematic ally statistically lower for dental than postsurgical pain for all four treatments . Event rates with analgesics , RB and NNT were infrequently different between the pain models . Systematic difference in the estimate of analgesic efficacy between dental and postsurgical pain models remains unproven , and , on balance , no major difference is likely One hundred six patients with pretreatment pain presenting for endodontic treatment participated in a controlled double-blind study of dexamethasone use . Endodontic therapy was performed and , after controlling for use of nonuse of dexamethasone , patient variables and treatment factors were evaluated for their effects on endodontic posttreatment pain .  Patients with no radiographic periapical lesions had significantly more pain than patients with periapical lesions at 8- , 24- , 48- , and 72-h posttreatment regardless of whether they received placebo or dexamethasone . No other patient or treatment factors correlated with posttreatment pain . Twenty-two patients in the subgroup receiving placebo reported an 81 % incidence of posttreatment pain , 73 % of them required posttreatment pain medications . By 72-h posttreatment , the incidence and severity of pain in the placebo group was minimal AIM To assess previous patient experience of endodontic treatment  and to quantify their satisfaction with the endodontic treatment provided in a dental school clinic . DESIGN Self-completed question naire . SETTING Hacettepe University , Faculty of Dentistry , Department of Endodontics , Ankara , Turkey . PARTICIPANTS 200 r and omly selected , scheduled non-emergency patients in good health and older than 11 years who were to be treated by undergraduate , graduate students and academics . MAIN OUTCOME MEASURES Patient satisfaction and attitudes to root canal therapy .  RESULTS 96 per cent of patients , regardless their level of education , age and sex , reported that they expected RCT would save their teeth . 15 per cent of the patients were in favour of extraction versus RCT  before the therapy , but this reduced to only 2.5 per cent post treatment . 82 per cent of patients reported that they were satisfied with their treatment and the clinic . CONCLUSIONS Increasing public knowledge of and interest in endodontic treatment indicates that the need for an increase in teaching of the subject and associated re sources will be required The purpose of this prospect i ve , r and omized , double-blind study was to compare the anesthetic efficacy of 4 % articaine with 1:100,000 epinephrine to 2 % lidocaine with 1:100,000 epinephrine for inferior alveolar nerve blocks in patients experiencing irreversible pulpitis in m and ibular posterior teeth . Seventy-two emergency patients diagnosed with irreversible pulpitis of a m and ibular posterior tooth r and omly received , in a double-blind manner , 2.2 ml of 4 % articaine with 1:100,000 epinephrine or 2.2 ml of 2 % lidocaine with 1:100,000 epinephrine using a conventional inferior alveolar nerve block . Endodontic access was begun 15 min after solution deposition , and all patients were required to have profound lip numbness . Success was defined as none or mild pain ( Visual Analogue Scale recordings ) on endodontic access or initial instrumentation . The success rate for the inferior alveolar nerve block using articaine was 24 % and for the lidocaine solution success was 23 % . There was no significant difference ( p = 0.89 ) between the articaine and lidocaine solutions . Neither solution result ed in an acceptable rate of anesthetic success in patients with irreversible pulpitis The purpose of this prospect i ve study was to determine the anesthetic efficacy of the supplemental buccal infiltration injection of a cartridge of 4 % articaine with 1:100,000 epinephrine in m and ibular posterior teeth diagnosed with irreversible pulpitis when the conventional inferior alveolar nerve ( IAN ) block failed . Fifty-five emergency patients , diagnosed with irreversible pulpitis of a m and ibular posterior tooth , received an IAN block and had moderate to severe pain on endodontic access . An infiltration of a cartridge of 4 % articaine with 1:100,000 epinephrine was administered buccal to the tooth requiring endodontic treatment . Success of the infiltration injection was defined as no pain or mild pain on endodontic access or instrumentation . The results showed that anesthetic success was obtained in 58 % of the m and ibular posterior teeth . We can conclude that when the IAN block fails to provide profound pulpal anesthesia , the supplemental buccal infiltration injection of a cartridge of 4 % articaine with 1:100,000 epinephrine would be successful 58 % of the time for m and ibular posterior teeth in patients present 
    Output:
    
Pretreatment root canal-associated pain prevalence was high but dropped moderately within 1 day and substantially to minimal levels in 7 days .
Pretreatment root canal-associated pain severity was moderate , dropped substantially within 1 day of treatment , and continued to drop to minimal levels in 7 days .