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Objective: To compare the performance of observers with different knowledge when detecting periapical lesions. Methods: We obtained nine dry human hemimandibles. Periapical lesions were created with a bur and radiographic sets were taken for each hemimandible in four stages (initial, no cancellous bone, removal of 0.5 and 1 mm of cortical bone). Each radiographic set comprised five digital radiographs taken at different angulations (ortho, mesio, disto, lingual and vestibuloradial). Thirty six radiographs sets were obtained with a total of 180 images. The images were evaluated by experienced examiners and students. Mann Whitney test and Spearman's correlation were applied for data comparison. Results: In all study stages, no statistically significant differences were found (P ≤ 0.05) between observers, with a positive association established by Spearman's correlation in two stages (removal of 0.05 and 1 mm of cortical bone; 0.866 and 0.500, respectively). Conclusions: There were no statistically significant differences in diagnostic accuracy between experienced examiners and students when detecting simulated periapical lesions in dry human mandibles. [ABSTRACT FROM AUTHOR]

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This study sought to determine the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine in patients with symptomatic and asymptomatic irreversible pulpitis in mandibular posterior teeth and if individual patient factors, pulpal disease characteristics, and previous medication are correlated to local anesthetic success. A second objective was to determine the specificity and sensibility of a cold test for prediction of anesthetic success prior to endodontic treatment. Seventy patients diagnosed with irreversible pulpitis in mandibular posterior teeth received 1.6 mL of 4% articaine with 1:100,000 epinephrine for an inferior alveolar nerve block (IANB) using a metal guide. The anesthetic solution was injected with a computer-preprogrammed delivery system for local anesthesia. Endodontic access was begun 15 minutes after solution deposition; later, patients rated their discomfort using the visual analog scale (VAS). The success rate for the IA NB using articaine was 64.2% in patients with symptomatic irreversible pulpitis and 86.9% in patients with asymptomatic irreversible pulpitis. Cold test prior to root canal treatment had a specificity and sensibility of 12.5% and 87.1%, respectively. The anesthetic efficacy of articaine in irreversible pulpitis is moderately acceptable, and anesthetic success increases when the patient has been premedicated with NSAIDs. The cold test appears to be a favorable indicator for predicting anesthetic success.