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Barros MC, Pedrinha VF, Graeff MSZ, Bramante CM, Duarte MAH, de Andrade FB. A new model of in vitro dentin intratubular contamination for Fusobacterium nucleatum: Validation by confocal laser scanning microscopy. Heliyon 2023; 9:e18042. [PMID: 37539102 PMCID: PMC10395344 DOI: 10.1016/j.heliyon.2023.e18042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/20/2023] [Accepted: 07/05/2023] [Indexed: 08/05/2023] Open
Abstract
Objectives To test and validate a new protocol for in vitro contamination of dentinal tubules using Fusobacterium nucleatum (F. nucleatum) by confocal laser scanning microscopy (CLSM), in addition to evaluating the effectiveness of conventional endodontic irrigants such as sodium hypochlorite (NaOCl) and chlorhexidine (CLX) on this biofilm. Material and methods Thirty lower premolars were contaminated with F. nucleatum (ATCC 51190) for 7 days under anaerobic conditions using the proposed new model. The specimens were divided into a control group and experimental groups, according to the irrigants: NaOCl 2.5% and CLX 2%. Then, the samples were submitted for analysis by CLSM and the LIVE/DEAD technique to quantify bacterial viability. Data normality was verified by the Shapiro-Wilk test. Intragroup and intergroup comparisons were performed using the Kruskal-Wallis test, followed by Dunn's post-test. Results The CLSM images obtained demonstrated the effectiveness of the proposed new contamination protocol, with a high percentage of viable bacteria in relation to the treated groups (p < 0.05). Lower viability values were observed for the 2.5% NaOCl group. Conclusion The new contamination protocol resulted in a high and homogeneous percentage of viable bacteria in the dentinal tubules in all specimens evaluated. Both irrigating solutions proved to be effective in reducing the intratubular microbiota, especially 2.5% NaOCl.
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Affiliation(s)
- Mirela Cesar Barros
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Victor Feliz Pedrinha
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | | | - Clovis Monteiro Bramante
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Flaviana Bombarda de Andrade
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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Sharma A, Sharma R, Sharma M, Jain S, Rai A, Gupta S. Endodontic Flare-Ups: An Update. Cureus 2023; 15:e41438. [PMID: 37546112 PMCID: PMC10403811 DOI: 10.7759/cureus.41438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 08/08/2023] Open
Abstract
Root canal treatment deals with mechanical and chemical cleaning followed by obturation that promotes healing and repair of periradicular tissues. Flare-ups can occur in between or some days after endodontic therapy leading to unscheduled visit by the patient. This complication is characterized by severe pain and/ or swelling. There is a correlation between number of appointments, intracanal medicament used and flare-ups. However, there is no sure procedure that can avoid this complication. Therefore, this review article has discussed about causes and some procedures to prevent and treat flare-ups.
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Affiliation(s)
- Anjali Sharma
- Conservative Dentistry and Endodontics, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, IND
| | - Rohit Sharma
- Conservative Dentistry and Endodontics, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, IND
| | - Madhurima Sharma
- Prosthodontics and Crown and Bridge, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, IND
| | - Saloni Jain
- Conservative Dentistry and Endodontics, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, IND
| | - Aparna Rai
- Conservative Dentistry and Endodontics, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, IND
| | - Sheersh Gupta
- Conservative Dentistry and Endodontics, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, IND
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Marković L, Ivanišević A, Matijević J, Chan RSM, Tsoi JKH, Šnjarić D, Gjorgievska E. Micro-CT analysis and leakage of bioceramic retrofillings after ultrasonic and Er:YAG laser cavity preparations: an in vitro study. Lasers Med Sci 2023; 38:145. [PMID: 37347307 DOI: 10.1007/s10103-023-03809-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 06/11/2023] [Indexed: 06/23/2023]
Abstract
The purpose of the study was to determine the influence of preparation techniques on marginal adaptation and sealing of Biodentine™ and TotalFill® RRM bioceramic retrograde fillings. Fifty-two single-root teeth extracted for periodontal reasons were used. Root canals were instrumented using Reciproc Blue #25 and obturated using a single cone technique with an AH Plus® root canal sealer. Retrograde cavities were prepared with Piezomed device (Piezo), Er:YAG laser in short-pulse(SP) and quantum square pulse(QSP) modes and filled with Biodentine™ (BD) or TotalFill® RRM (TF). There were 6 groups (n=8): (1) Piezo BD, (2) Piezo TF, (3) SP BD, (4) SP TF, (5) QSP BD, and (6) QSP TF, and positive and negative controls (n=2). Micro-CT analysis was performed on two samples from each group. Percentage volumes of internal and external voids in apical 1.5 mm were determined. Rhodamine B dye leakage was done on six samples. The samples were cut longitudinally and examined under a stereomicroscope. Digital recordings were analyzed in ImageJ software. The deepest penetration of color in mm was recorded. The data were statistically analyzed using ANOVA and Duncan's test at the level of significance α=0.05. TotalFill® RRM performed significantly better than Biodentine™ in terms of sealing (p<0.05) and marginal adaptation, as evaluated by micro-CT. Sealing was significantly better in SP compared to QSP mode preparations (p<0.05). Differences between Piezomed and laser modes were not significantly different (p>0.05). Sealing was statistically significantly better with TotalFill® RRM compared to Biodentine™ and in Er:YAG SP preparations compared to Er:YAG QSP.
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Affiliation(s)
| | - Ana Ivanišević
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
| | - Jurica Matijević
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Rosalind Sin Man Chan
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, SAR, Hong Kong, People's Republic of China
| | - James Kit Hon Tsoi
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, SAR, Hong Kong, People's Republic of China
| | - Damir Šnjarić
- Department for Endodontics and Restorative Dentistry, School of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Elizabeta Gjorgievska
- Department of Paediatric and Preventive Dentistry, Faculty of Dental Medicine, University "Ss Cyril and Methodius" Skopje, Skopje, Republic of Macedonia
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Nassar R, Nassar M, Senok A, Williams D. Phytic Acid Demonstrates Rapid Antibiofilm Activity and Inhibits Biofilm Formation When Used as a Surface Conditioning Agent. Microbiol Spectr 2023; 11:e0026723. [PMID: 37191582 PMCID: PMC10269681 DOI: 10.1128/spectrum.00267-23] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/24/2023] [Indexed: 05/17/2023] Open
Abstract
Root canal infections are associated with biofilms and are treated with chemical irrigants with a high success rate. However, treatment failure does arise, which is attributed primarily to resistance exhibited by biofilms. Currently used irrigants in root canal treatment have disadvantages, and there is therefore a need for more biocompatible alternatives with antibiofilm properties to reduce root canal treatment failure and complications. The aim of this study was to evaluate the in vitro antibiofilm properties of phytic acid (IP6), which is a potential alternative treatment agent. Single- and dual-species biofilms of Enterococcus faecalis and Candida albicans were developed on the well surfaces of 12-well plates and on hydroxyapatite (HA) coupons, and then exposed to IP6. In addition, selected HA coupons were preconditioned with IP6 before biofilm development. IP6 demonstrated bactericidal effects and altered the metabolic activity of biofilm cells. Confocal laser-scanning microscopy showed that IP6 caused significant and rapid reduction in live biofilm cells. At sublethal concentrations, IP6 did not alter the expression of tested virulence genes except for C. albicans hwp1, the expression of which was upregulated but not reflected by a change in hyphal transformation. IP6-preconditioned HA coupons led to extensive inhibition of dual-species biofilm formation. The results of this study highlight for the first time the antibiofilm inhibitory properties of IP6 and the potential for its exploitation in several clinical applications. IMPORTANCE Root canal infections are biofilm associated, and despite mechanical and chemical treatment procedures, infection recurrence occurs, and this is likely due to the high tolerance of associated biofilms to antimicrobials. The currently used treatment agents have several disadvantages, which necessitates the search for new improved agents. In this study, the natural chemical phytic acid was found to exhibit antibiofilm activity against established mono and dual mature biofilms over a short contact time. Most importantly, phytic acid was found to cause significant inhibition of dual-species biofilm formation when used as a surface preconditioning agent. The findings of this study identified a novel use of phytic acid as a potential antibiofilm agent that can be used in several clinical applications.
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Affiliation(s)
- Rania Nassar
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Mohannad Nassar
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Abiola Senok
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - David Williams
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
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Patil R, Singh SV, Mandlik JS, Jadhav A, Handa A, Jadhav A. Evaluating the Efficacy of Certain Intermediate Irrigants in Preventing Precipitate Formed Due to Sodium Hypochlorite and Chlorhexidine Within the Root Canal System: An In Vitro Study. Cureus 2023; 15:e39871. [PMID: 37404418 PMCID: PMC10315102 DOI: 10.7759/cureus.39871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 05/08/2023] [Indexed: 07/06/2023] Open
Abstract
AIM Root canal irrigation using a mixture of sodium hypochlorite (NaOCL) and chlorhexidine gluconate (CHX) might cause a precipitate to develop. This study aims to check the efficacy of sodium thiosulfate and normal saline as irrigating solutions. MATERIALS AND METHODS Roots of 45 teeth were biomechanically prepared, and the teeth were then tested. A size 15k file was introduced to the point where the apical foramen could be visible in order to provide an accurate reading of the working length. As a precaution against irrigating solutions leaking out, the specimens' tips were sealed with modeling wax before being instrumented. Each group's root canals were instrumented with #F4 hand Protaper (Dentsply Sirona, USA) as recommended by the manufacturer. Between instrumentation, The canals were lubricated with ethylenediamine tetraacetic acid (EDTA) and irrigated with 2.5% sodium hypochlorite (RC Help, Prime Dental, Mumbai, India). Fifteen samples were randomly assigned to one of three experimental categories based on the middle watering arrangement used: Group 1 (control), Group 2 (saline irrigant), and Group 3 (3.86% sodium thiosulfate). The jewel plate was submerged in water to cool it down, while two longitudinal scores were made on the root's buccal and lingual surfaces. We used a stereomicroscope to examine the exposed surfaces of the root trench in the coronal, middle, and apical thirds for the orange-earthy colored material (Stereozoom Nikon magnifying lens under 20X amplification), and we used the Mann-Whitney U test and the Kruskal Wallis test during our thorough analysis. RESULTS The precipitation generated in the coronal, middle, and apical thirds had significantly different thicknesses. While precipitation did occur in all three regions, it was at a much lower rate in the apical third compared to the coronal and middle regions. In Group 1, the control group, the precipitate was thicker than in Groups 2 (saline irrigant) and 3 (3.86% sodium thiosulfate). CONCLUSION Sodium thiosulfate, which is a biocompatible solution, can be used as an intermediate irrigant as it shows less precipitate as compared to saline.
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Affiliation(s)
- Rucha Patil
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Pune, IND
| | - Sarita V Singh
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Pune, IND
| | - Jyoti S Mandlik
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Pune, IND
| | - Aniket Jadhav
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Pune, IND
| | - Aishwarya Handa
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Pune, IND
| | - Abhijeet Jadhav
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College and Hospital, Pune, IND
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Stănuși AȘ, Popa DL, Ionescu M, Cumpătă CN, Petrescu GS, Ţuculină MJ, Dăguci C, Diaconu OA, Gheorghiță LM, Stănuşi A. Analysis of Temperatures Generated during Conventional Laser Irradiation of Root Canals-A Finite Element Study. Diagnostics (Basel) 2023; 13:diagnostics13101757. [PMID: 37238240 DOI: 10.3390/diagnostics13101757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/03/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
The success of endodontic treatment is dependent on the removal of bacteria. A modern strategy to reduce bacterial load is laser irradiation. During this procedure, there is a local increase in temperature with possible side effects. The aim of this study was to determine the thermal behavior of a maxillary first molar when performing the conventional irradiation technique using a diode laser. For this study, a 3D virtual model of a maxillary first molar was created. The preparation of the access cavity, the rotary instrumentation of the palatal root canal and the laser irradiation protocol were simulated. The model was exported in a finite element analysis program where the temperature and heat flux were studied. Temperature and heat flux maps were obtained, and the temperature increase on the internal wall of the root canal was analyzed. The maximum temperature value exceeded 400 °C and was maintained for less than 0.5 s. The obtained temperature maps support the bactericidal effect of diode laser and the limitation of damage to surrounding tissues. On internal root walls, the temperature reached several hundred degrees Celsius, but for very short durations. Conventional laser irradiation is an adjuvant method of decontamination of the endodontic system.
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Affiliation(s)
- Adrian Ștefan Stănuși
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | | | - Mihaela Ionescu
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Cristian Niky Cumpătă
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University Titu Maiorescu of Bucharest, 67A Gheorghe Petrascu Str., 031593 Bucharest, Romania
| | - Gabriel Sebastian Petrescu
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mihaela Jana Ţuculină
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Constantin Dăguci
- Department of Oro-Dental Prevention, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Oana Andreea Diaconu
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Lelia Mihaela Gheorghiță
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Andreea Stănuşi
- Department of Prosthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Pauletto G, Carlotto IB, Rosa LSD, Pereira GKR, Bier CAS. Effect of sodium/calcium hypochlorite on adhesion and adaptation of fiber posts luted with a dual resin cement. Braz Dent J 2023; 34:111-118. [PMID: 37466518 PMCID: PMC10355260 DOI: 10.1590/0103-6440202305396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/16/2023] [Indexed: 07/20/2023] Open
Abstract
This study aimed to evaluate the effect of different concentrations of sodium hypochlorite (NaOCl) and calcium hypochlorite [Ca(OCl)2] on the bond strength and adaptation of glass fiber posts luted with a dual-curing resin cement. Fifty decoronated premolars were sectioned 14 mm from the apex and endodontically treated. The root canal filling was partially removed. The specimens were divided into 5 groups (n=10) according to the irrigant for post space irrigation: 0.9% sodium chloride (NaCl), (control); 2.5% NaOCl; 5.25% NaOCl; 2.5% Ca(OCl)2; and 5.25% Ca(OCl)2. For each group, irrigation was performed with 5 ml of solution. Afterward, the posts were luted with a dual-curing resin cement. One slice from each third was obtained and submitted to the push-out test and failure modes analysis. An additional slice from the middle third was submitted to confocal images for analysis of adaptation failures (gaps). Two-way ANOVA, Tukey's post-hoc, Kruskal-Wallis with Bonferroni adjusted, and chi-square tests, analyzed data. The group treated with 5.25% NaOCl showed lower bond strength values and generated more cohesive failures compared to the control (p < 0.05). Bond strength decreased from coronal to apical in the post space (p < 0.001). The groups treated with NaOCl had the highest percentages of gaps compared to the control (p < 0.05). Regardless of concentration, Ca(OCl)2 did not influence the bond strength and the occurrence of gaps (P > 0.05). Ca(OCl)2 is a good option for irrigating the post space before luting a fiber post with a dual-curing resin cement.
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Affiliation(s)
- Guilherme Pauletto
- Post-Graduate Program in Oral Science, Faculty of Dentistry,
Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State,
Brazil
| | - Israel Bangel Carlotto
- Post-Graduate Program in Oral Science, Faculty of Dentistry,
Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State,
Brazil
| | - Lucas Saldanha Da Rosa
- Post-Graduate Program in Oral Science, Faculty of Dentistry,
Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State,
Brazil
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Science, Faculty of Dentistry,
Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State,
Brazil
| | - Carlos Alexandre Souza Bier
- Post-Graduate Program in Oral Science, Faculty of Dentistry,
Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State,
Brazil
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Matoso FB, Montagner F, Jardine AP, Quintana RM, Grecca FS, Kopper PMP. Effect of different disinfection protocols in bacterial viability of an intraradicular biofilm formed in situ. Braz Dent J 2023; 34:42-49. [PMID: 37466524 PMCID: PMC10355264 DOI: 10.1590/0103-6440202305244] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/18/2023] [Indexed: 07/20/2023] Open
Abstract
The present study aimed to evaluate bacterial viability after the use of different disinfection protocols in root canals infected with a multispecies biofilm (MB) formed in situ. Palatal roots with a single canal were obtained from extracted maxillary molars and sterilized before being inserted into the mouth. The roots were contaminated with a MB in an intraoral appliance worn by ten volunteers. All volunteers wore six roots simultaneously in two intraoral devices for 21 days. One root from each volunteer was assigned to each group (n=10): PUI - passive ultrasonic irrigation; EC - Easy Clean; XPF - XP-endo Finisher; aPDT - antimicrobial photodynamic therapy; CI - conventional irrigation; and NC - negative control. The samples were evaluated under confocal laser scanning microscopy. The percentage of viable cells (VC) was calculated over the total percentage of MB biovolume. Data were statistically analyzed (α=5%). The cell viability in the entire root canal or for each third was compared between groups (Kruskal-Wallis test, Dunn post-hoc test) and for the same group (Friedman test, Dunn post-hoc test). Disinfection protocols were not significantly different from each other (P>.05). Samples in EC, PUI, and aPDT had lower cell viability than in NC (P<.05). In the coronal third of samples in the EC, XPF, PUI and aPDT, the percentage of VC biovolume was lower than in the NC (P<.05). The percentage of VC in EC samples was lower in the coronal and middle thirds than in the apical third (P<.05). EC, PUI and aPDT had significant effects on cell viability in intraradicular multispecies biofilm formed in situ when compared with untreated samples.
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Affiliation(s)
- Felipe Barros Matoso
- Graduate Program in Dentistry, Federal University of Rio Grande
do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Francisco Montagner
- Graduate Program in Dentistry, Federal University of Rio Grande
do Sul (UFRGS), Porto Alegre, RS, Brazil
| | | | - Ramiro Martins Quintana
- Graduate Program in Dentistry, Federal University of Rio Grande
do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Fabiana Soares Grecca
- Graduate Program in Dentistry, Federal University of Rio Grande
do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Patricia Maria Poli Kopper
- Graduate Program in Dentistry, Federal University of Rio Grande
do Sul (UFRGS), Porto Alegre, RS, Brazil
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Jain S, Patni P, Jain P, Raghuwanshi S, Pandey SH, Tripathi S, Soni A. Comparison of dentinal tubular penetration of Intra-canal heated and Pre-heated sodium hypochlorite through different agitation techniques. J Endod 2023:S0099-2399(23)00235-2. [PMID: 37105500 DOI: 10.1016/j.joen.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023]
Abstract
INTRODUCTION The efficacy of sodium hypochlorite (NaOCl) as an intracanal irrigant is widely debated in endodontic therapy. This study aimed to analyze and compare the penetration abilities of different modes of NaOCl application and assess the impact of various agitation strategies on promoting root canal cleanliness. MATERIALS AND METHODS This study included 168 single-rooted mandibular premolars that were randomly divided into eight groups. The two modes of application of 5% NaOCl evaluated were intracanal heating and preheating, and the agitation strategies included ultrasonic, sonic, and manual dynamic agitations (MDAs). The samples were sectioned and observed at a magnification of 1000× under a scanning electron microscope. RESULTS The analysis of variance test showed a statistically significant difference among the various groups of agitation (P < 0.05). The post hoc Tukey test confirmed that preheated NaOCl with ultrasonic agitation, intracanal-heated NaOCl with sonic agitation, and MDA had significantly higher debris scores of 1, 4, and 5, respectively, in the apical third of the canal. CONCLUSION The results indicated that the combination of intracanal-heated NaOCl and ultrasonic agitation is an effective method for reducing debris in the root canal system. These findings highlight the importance of considering both the mode of application and the agitation strategies when optimizing the use of NaOCl as an intracanal irrigant in endodontic therapy.
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Affiliation(s)
- Swati Jain
- Sri Aurobindo College of Dentistry, Sri Aurobindo University, Indore, MP, India
| | - Pallav Patni
- Sri Aurobindo College of Dentistry, Sri Aurobindo University, Indore, MP, India.
| | - Pradeep Jain
- Sri Aurobindo College of Dentistry, Sri Aurobindo University, Indore, MP, India
| | - Swadhin Raghuwanshi
- Sri Aurobindo College of Dentistry, Sri Aurobindo University, Indore, MP, India
| | - Sanket Hans Pandey
- Sri Aurobindo College of Dentistry, Sri Aurobindo University, Indore, MP, India
| | - Shubham Tripathi
- Sri Aurobindo College of Dentistry, Sri Aurobindo University, Indore, MP, India
| | - Ankita Soni
- Sri Aurobindo College of Dentistry, Sri Aurobindo University, Indore, MP, India
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Arias Z, Nizami MZI, Chen X, Chai X, Xu B, Kuang C, Omori K, Takashiba S. Recent Advances in Apical Periodontitis Treatment: A Narrative Review. Bioengineering (Basel) 2023; 10:bioengineering10040488. [PMID: 37106675 PMCID: PMC10136087 DOI: 10.3390/bioengineering10040488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/07/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Apical periodontitis is an inflammatory response caused by pulp infection. It induces bone resorption in the apical and periapical regions of the tooth. The most conservative approach to treat this condition is nonsurgical endodontic treatment. However, clinical failure has been reported with this approach; thus, alternative procedures are required. This review highlights recent literature regarding advanced approaches for the treatment of apical periodontitis. Various therapies, including biological medications, antioxidants, specialized pro-resolving lipid mediators, and stem cell therapy, have been tested to increase the success rate of treatment for apical periodontitis. Some of these approaches remain in the in vivo phase of research, while others have just entered the translational research phase to validate clinical application. However, a detailed understanding of the molecular mechanisms that occur during development of the immunoinflammatory reaction in apical periodontitis remains unclear. The aim of this review was to summarize advanced approaches for the treatment of apical periodontitis. Further research can confirm the potential of these alternative nonsurgical endodontic treatment approaches.
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Affiliation(s)
- Zulema Arias
- Department of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Mohammed Zahedul Islam Nizami
- Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR 999077, China
| | - Xiaoting Chen
- Department of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Xinyi Chai
- Department of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Bin Xu
- Department of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Canyan Kuang
- Department of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Kazuhiro Omori
- Department of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Shogo Takashiba
- Department of Pathophysiology-Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
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Miranda TC, Andrade JFM, Gelfuso GM, Cunha-Filho M, Oliveira LA, Gratieri T. Novel technologies to improve the treatment of endodontic microbial infections: Inputs from a drug delivery perspective. Int J Pharm 2023; 635:122794. [PMID: 36870400 DOI: 10.1016/j.ijpharm.2023.122794] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
Endodontic microbial infections are still a challenge for an effective treatment for being biofilm-mediated and very refractory to conventional therapies. Biomechanical preparation and chemical irrigants cannot fully eradicate biofilms due to the anatomic structure of the root canal system. Instruments employed in biomechanical preparation and irrigants solution cannot reach the narrow and deepest portion of root canals, especially the apical thirds. In addition, aside from the dentin surface, biofilms can also infiltrate dentine tubules and periapical tissues, compromising treatment success. Therefore, different technologies have been investigated to achieve a more effective outcome in the control of endodontic infections. However, these technologies continue to face great difficulties in reaching the apical region and eradicating biofilms to avoid the recurrence of infection. Here, we present an overview of the fundamentals of endodontics infections and review technologies currently available for root canal treatment. We discuss them from a drug delivery perspective, highlighting each technology's strength to envision the best use of these technologies.
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Affiliation(s)
- Thamires C Miranda
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Jayanaraian F M Andrade
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Guilherme M Gelfuso
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Marcilio Cunha-Filho
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Laudimar A Oliveira
- Department of Dentistry, Faculty of Health Sciences, University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Tais Gratieri
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil.
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Chu X, Feng S, Zhou W, Xu S, Zeng X. Cleaning efficacy of EDDY versus ultrasonically-activated irrigation in root canals: a systematic review and meta-analysis. BMC Oral Health 2023; 23:155. [PMID: 36932445 PMCID: PMC10024384 DOI: 10.1186/s12903-023-02875-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 03/13/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Ultrasonically-activated irrigation (UAI) is effective in root canal irrigation but may damage canal walls. EDDY is a sonic activation system with flexible working tips that cause no harm to dentinal walls. This review explores the intracanal cleaning efficacy of EDDY compared with UAI in vitro. METHODS The systematic review was registered in the PROSPERO database (CRD42021235826). A literature search was conducted in six electronic databases. In vitro studies that compared the removal of smear layer, debris, soft tissue or microbes in root canals between EDDY and UAI were included. Data extraction and quality assessment were performed. Meta-analyses were conducted on smear layer removal and debris elimination with the standardized mean difference (SMD). Heterogeneity was measured using the I2 test and the Chi2 test. The random-effect model was used when I2 > 50%, or p < 0.1, otherwise the fixed-effect model was applied. The level of significance was set at p < 0.05. RESULTS 19 articles were included in this systematic review and 7 articles were included in meta-analyses. Meta-analyses on smear layer removal showed unimportant differences between EDDY and UAI at any canal third (coronal [SMD = 0.08, 95% confidence interval (95%CI): -0.29 to 0.45; p = 0.44, I2 = 0%]; middle [SMD = 0.02, 95% CI: -0.44 to 0.47; p = 0.94, I2 = 0%]; apical [SMD = 0.01, 95%CI: -0.35 to 0.38; p = 0.70, I2 = 0%]). Meta-analyses on debris removal evaluated by scanning electron microscope (coronal [SMD = 0.03, 95% CI: -0.41 to 0.46; p = 0.27, I2 = 23%]; middle [SMD = -0.24, 95% CI: -0.83 to 0.35; p = 0.80, I2 = 0%]; apical [SMD = 0.24, 95%CI: -0.20 to 0.67; p = 0.36, I2 = 2%]) and micro-CT (SMD = 0.36, 95% CI: -0.67 to 1.40; p = 0.03, I2 = 70%) both found insignificant differences. No meta-analysis was undertaken on soft-tissue removal and disinfection due to the various study designs, but the qualitative analyses implied that EDDY achieved similar performance to UAI in both aspects. CONCLUSIONS Limited evidence indicated that EDDY was comparable to UAI in removing smear layer, debris, soft tissue and microbes ex vivo. Considering UAI may damage canal walls, EDDY might be a substitute for UAI in irrigation activation. But more randomized clinical trials are required to explore the clinical extrapolation of the results in this review.
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Affiliation(s)
- Xiaojun Chu
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No 366 Jiangnan Avenue South, Guangzhou, 510280, Guangdong, China
| | - Shuting Feng
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No 366 Jiangnan Avenue South, Guangzhou, 510280, Guangdong, China
| | - Weiqing Zhou
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No 366 Jiangnan Avenue South, Guangzhou, 510280, Guangdong, China
| | - Shuaimei Xu
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No 366 Jiangnan Avenue South, Guangzhou, 510280, Guangdong, China
| | - Xiongqun Zeng
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No 366 Jiangnan Avenue South, Guangzhou, 510280, Guangdong, China.
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Sfeir G, Bukiet F, Hage W, El Hachem R, Zogheib C. Impact of Final Irrigation Protocol on the Push-Out Bond Strength of Two Types of Endodontic Sealers. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1761. [PMID: 36902876 PMCID: PMC10004703 DOI: 10.3390/ma16051761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
Aim: The aim of this study was to assess the impact of the final irrigation protocol on the push-out bond strength of calcium silicate-based sealers when compared to an epoxy resin-based sealer. Materials and Methods: Eighty-four single-rooted mandibular human premolars were shaped using the R25® instrument (Reciproc, VDW, Munich, Germany) and then divided into three subgroups of 28 roots each depending on the final irrigation protocol: EDTA (ethylene diamine tetra acetic acid) and NaOCl activation, Dual Rinse® HEDP (1-hydroxyethane 1,1-diphosphonate) activation or sodium hypochlorite (NaOCl) activation. Then, each subgroup was divided into two groups (14 each) according to the sealer used (AH Plus Jet® or Total Fill BC Sealer®) for single-cone obturation. Dislodgement resistance using a universal testing machine, samples' push-out bond strength and failure mode under magnification were determined. Results: EDTA/Total Fill BC Sealer® showed significantly greater values of push-out bond strength compared with HEDP/Total Fill BC Sealer® and NaOCl/AH Plus Jet®, with no statistical difference with EDTA/AH Plus Jet®, HEDP/AH Plus Jet® and NaOCl/Total Fill BC Sealer®, whereas HEDP/Total Fill BC Sealer® showed significantly lower values of push-out bond strength. The apical third demonstrated higher means of push-out bond strength compared with middle and apical thirds. The most common failure mode was cohesive but showed no statistical difference compared to other types. Conclusions: Irrigation solution and final irrigation protocol affect the adhesion of calcium silicate-based sealers.
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Affiliation(s)
- Germain Sfeir
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon
| | - Frédéric Bukiet
- Assistance Publique des Hôpitaux de Marseille, 13005 France; Aix Marseille Univ, CNRS, ISM, Inst. Movement Sci, 13288 Marseille, France
| | - Wajih Hage
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon
| | - Roula El Hachem
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon
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Pushout Bond Strength of Root Fillings after Irrigation of Root Canals Utilizing Sodium Hypochlorite, Chlorhexidine, and Homeopathic Mother Tincture ( Arnica Montana). Clin Pract 2023; 13:305-314. [PMID: 36826170 PMCID: PMC9954886 DOI: 10.3390/clinpract13010028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/03/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
The pushout bond strength of root fillings at radicular dentin was investigated employing NaOCl, CHX, and homoeopathic mother tincture (Arnica montana) as an irrigant. Sixty human permanent single-rooted extracted teeth were decoronated. The root canals were instrumented using Pro taper universal rotary system (Dentsply Tulsa Dental; Tulsa, Oklahoma) and were prepared up to F3 apical size. The roots were then randomly divided into three groups according to irrigation solution (n = 20) according to the final irrigation regimen: Group I: 3 mL 5.25% NaOCl followed by 3 mL Saline (control); Group II: 3 mL Arnica montana (10%, w/v) followed by 3 mL Saline; Group III: 3 mL CHX followed by 3 mL Saline. The canals were dried using paper points. The canals were coated with AH Plus sealer (Dentsply DeTey, Konstaz, Germany) with the aid of a Lentulo spiral (Dentsply DeTey, Konstaz, Germany) and obturated with #F3 gutta-percha. Each root was then horizontally sliced into three slices, labelled coronal, middle, and apical, each measuring 2 mm thick. Furthermore, at a crosshead speed of 2 mm/min, the test was carried out using the universal testing apparatus. The 5.25% NaOCl significantly decreased the bond strength of AH Plus to dentin. Both CHX and Arnica montana were capable of reversing the compromised pushout of AH Plus to NaOCl-treated dentin. After using NaOCl as an irrigant, the danger of diminished binding capacity of AH Plus to root canal walls arises. Final irrigation with Arnica montana and CHX reduces this risk.
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Advances in the Role of Sodium Hypochlorite Irrigant in Chemical Preparation of Root Canal Treatment. BIOMED RESEARCH INTERNATIONAL 2023; 2023:8858283. [PMID: 36685672 PMCID: PMC9859704 DOI: 10.1155/2023/8858283] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 01/15/2023]
Abstract
Irrigation of root canal system is of great significance to the success of endodontic treatment, where sodium hypochlorite (NaOCl) is the most widely used irrigant in chemical preparation. NaOCl functions by eliminating bacterial biofilms and dissolving organic tissue, which may vary according to several factors such as the microbiology of root canal infection and the concentration of the irrigant. It has been proposed that the effectiveness of NaOCl could be enhanced via several methods, including heating the irrigant, applying in conjunction with certain reagents, or activating by agitation techniques. Despite its antibacterial and tissue-dissolving capacities, NaOCl should be used with caution to avoid detrimental effect due to its cytotoxicity and negative effect on dentin properties. In this narrative review, we discussed the factors that affect the properties of NaOCl, the methods to improve its efficacy, and the side effects that might occur in clinical practice.
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Almeida GM, Carvalho VHM, Silva ÉBP, Cançado MAF, Barroso LS, Queiroz EL, An TL, Ribeiro APD, Carvalho-Junior JR, Leite AF. Periradicular repair after single- and two-visit root canal treatments using ultrasonic irrigant activation and calcium hydroxide dressing of teeth with apical periodontitis: study protocol for randomized controlled trials. Trials 2023; 24:23. [PMID: 36635764 PMCID: PMC9838070 DOI: 10.1186/s13063-022-07030-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 12/16/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND In certain clinical situations, root canal treatment in teeth with apical periodontitis is performed in multiple visits, with the use of intracanal dressing between visits, aiming to reduce microorganisms and their by-products of the root canal system prior to filling. However, in recent years, discussions have been growing about the real need for the use of intracanal dressing in these cases. The use of ultrasonic activation of the auxiliary chemical substance has increased the potential for decontamination promoted during the chemomechanical preparation of the root canal. Thus, this study is designed to explore whether the use of intracanal dressing between visits during endodontic treatment favors periradicular repair in teeth with apical periodontitis. METHODS This is a randomized, prospective, double-blinded, controlled clinical trial designed to evaluate 3 distinct clinical approaches used during endodontic therapy: group 1-root canal treatment in a single visit (RCT-SV); group 2-root canal treatment in two visits with intracanal dressing (RCT-TVWD); and group 3-root canal treatment in two visits without intracanal dressing (RCT-TVWOD). A total of 150 adult patients aged 18 to 60, with at least one tooth diagnosed with asymptomatic apical periodontitis and periradicular lesion (confirmed with a cone beam computed tomography (CBCT)), will be randomized and will undergo one of the types of clinical approaches during endodontic therapy. Patients' postoperative pain levels will also be recorded in periods of 24, 48, and 72 h and 7 days. Subsequently, clinical findings and long-term follow-up evaluations, with periradicular repair, will be performed at 6 and 12 months by intraoral periapical radiograph (IOPAR) and CBCT at the 24-month follow-up. DISCUSSION This study will evaluate the periradicular repair of mandibular molar teeth with apical periodontitis, providing information about the efficacy, benefits, and safety of performing the endodontic treatment in a single and two visits, with and without the use of calcium hydroxide dressing. All endodontic therapy procedures will be performed under a dental operating microscope and using ultrasonic activation of auxiliary chemical substances. These results may contribute to changes in the clinical approaches adopted during endodontic therapy of teeth with apical periodontitis and reveal the potential of complementary approaches that aim to enhance the decontamination of the root canal system during the preparation stage. TRIAL REGISTRATION ClinicalTrials.gov NCT05256667. Registered on 24 February 2022.
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Affiliation(s)
- Gustavo M. Almeida
- grid.7632.00000 0001 2238 5157Postgraduate Program in Health Sciences, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Vitor Hugo M. Carvalho
- grid.7632.00000 0001 2238 5157Postgraduate Program in Health Sciences, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Érika B. P. Silva
- grid.7632.00000 0001 2238 5157Dental Trauma Project of Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Marco Antonio F. Cançado
- grid.7632.00000 0001 2238 5157Dental Trauma Project of Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Leonardo S. Barroso
- grid.412286.b0000 0001 1395 7782Postgraduate Program in Endodontics, University of Taubaté, Taubaté, Brazil
| | - Erica L. Queiroz
- grid.137628.90000 0004 1936 8753Department of Cariology and Comprehensive Care, New York University College of Dentistry, New York, USA
| | - Tien Li An
- grid.7632.00000 0001 2238 5157Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Ana Paula D. Ribeiro
- grid.15276.370000 0004 1936 8091Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, University of Florida, Gainesville, USA
| | - Jacy R. Carvalho-Junior
- grid.7632.00000 0001 2238 5157Dental Trauma Project of Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil ,grid.7632.00000 0001 2238 5157Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - André F. Leite
- grid.7632.00000 0001 2238 5157Postgraduate Program in Health Sciences, College of Health Sciences, University of Brasilia, Brasilia, Brazil ,grid.7632.00000 0001 2238 5157Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil
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Kumar P, Soundharrajan P, Prakash R, Kombade SP, Yadav P, Chugh A, Patnana AK. An in-vitro analysis to evaluate the disinfection effectiveness of Cold Atmospheric Pressure (CAP) plasma jet in Enterococcus faecalis infected root canals. Biomater Investig Dent 2023; 10:2193214. [PMID: 37101697 PMCID: PMC10124976 DOI: 10.1080/26415275.2023.2193214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
Cold Atmospheric Pressure (CAP) plasma has shown successful antibacterial efficacy in different medical applications which have prompted researchers to explore its possible use in endodontics. The aim of the present study was to comparatively evaluate the disinfection effectiveness of CAP Plasma jet with 5.25% sodium hypochlorite (NaOCl) and Qmix in Enterococcus Faecalis infected root canals at different time intervals (2, 5, and 10 min). 210 single-rooted mandibular premolars were chemomechanically prepared and infected with E. faecalis. The test samples were exposed to CAP Plasma jet, 5.25% NaOCl, and Qmix for 2, 5, and 10 min. The residual bacteria from the root canals if any were collected and evaluated for colony-forming units (CFUs) growth. ANOVA and Tukey's tests were used to evaluate the significant difference between treatment groups. 5.25% NaOCl showed significantly more antibacterial effectiveness (<0.001) when compared with all other test groups except Qmix at 2 and 10 min of exposure time. A minimum contact time of 5 min with 5.25% NaOCl is recommended to get zero bacterial growth in E. faecalis infected root canals. QMix requires a minimum contact time of 10 min to achieve optimal CFUs reduction and CAP plasma jet requires a minimum contact time of 5 min to achieve substantial CFUs reduction.
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Affiliation(s)
- Pravin Kumar
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, India
- CONTACT Pravin Kumar Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, 342005, Rajasthan, India
| | - P. Soundharrajan
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Ram Prakash
- Department of Physics, Indian Institute of Technology, Jodhpur, India
| | | | - Pankaj Yadav
- Department of Bioscience and Bioengineering, Indian Institute of Technology, Jodhpur, India
| | - Ankita Chugh
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Arun Kumar Patnana
- Department of Dentistry, All India Insitute of Medical Sciences, Rajkot, India
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Sobrino M, Foschi F, Estévez R, Loroño G, Conde Villar A, Pérez-Alfayate R. Effects of continuous chelation on the instrumentation of curved canals with a martensitic NiTi file system: an ex vivo micro-CT evaluation. Odontology 2023; 111:123-131. [PMID: 35798914 DOI: 10.1007/s10266-022-00727-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/23/2022] [Indexed: 01/06/2023]
Abstract
This study aimed to evaluate the influence of continuous chelation on apical transportation and centrality in shaped curved canals prepared with a martensitic file system and evaluated by micro-CT. Twenty-four lower molar canals with a curvature of 25º-40º were scanned pre-operatively with micro-CT and divided into 2 groups according to two different irrigation regimens (n = 12). Group 1 was irrigated with NaOCl, group 2 with Dual Rinse. All canals were prepared with VDW.ROTATE system. The samples were scanned post-operatively and evaluated at 1, 3 and 5 mm from the apex to determine apical transportation and canal centrality using VG Studio software. Statistical analysis was performed with SPSS software using the non-parametric Mann-Whitney test. No statistically significant differences were found between the two groups for both apical transportation and canal centrality at any of the levels studied (p < 05). The use of continuous chelation during the instrumentation of the canals with martensitic alloy files does not produce greater transportation and does not generate changes in centralization compared to NaOCl-only irrigation. Combined chelation and disinfection while shaping with martensitic NiTi can simplify the irrigation regimen without inducing iatrogenic aberrations.
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Affiliation(s)
- M Sobrino
- Department of Dentistry, Postgraduate Program in Endodontics, Universidad Europea de Madrid, Madrid, Spain
| | - F Foschi
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Hospital, Tower Wing, Floor 22, London, SE1 9RT, UK. .,Peninsula Dental School, University of Plymouth, The John Bull Building, Plymouth Science Park, Plymouth, PL6 8BU, Devon, UK.
| | - R Estévez
- Department of Dentistry, Postgraduate Program in Endodontics, Universidad Europea de Madrid, Madrid, Spain
| | - G Loroño
- Department of Dentistry, Postgraduate Program in Endodontics, Universidad Europea de Madrid, Madrid, Spain
| | - A Conde Villar
- Department of Dentistry, Postgraduate Program in Endodontics, Universidad Europea de Madrid, Madrid, Spain
| | - R Pérez-Alfayate
- Department of Dentistry, Postgraduate Program in Endodontics, Universidad Europea de Madrid, Madrid, Spain
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Shekhar S, Mallya PL, Ballal V, Shenoy R. To evaluate and compare the effect of 17% EDTA, 10% citric acid, 7% maleic acid on the dentinal tubule penetration depth of bio ceramic root canal sealer using confocal laser scanning microscopy: an in vitro study. F1000Res 2022; 11:1561. [PMID: 36875990 PMCID: PMC9978241 DOI: 10.12688/f1000research.127091.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 03/05/2023] Open
Abstract
Background: The main factors that affect the success of an endodontic infection are effective cleaning and shaping of the root canal system including complete disinfection by using chemical irrigating solutions and obturation with an endodontic sealer to provide a fluid-tight seal. Using rotary and hand instruments for shaping and cleaning the root canal along with irrigants produces a smear layer on the surface of the root dentin affecting the penetration of the endodontic sealer into the dentinal tubules. This smear is difficult to remove with the use of only endodontic irrigants, hence, chelating agents were introduced in adjunct with irrigating solutions for irrigation protocol for effective removal of smear layer which affect the penetration of endodontic sealers into the dentinal tubules. Methods: 32 mandibular premolar teeth were used. The biomechanical preparation was done till Protaper F3 size. Irrigation was done with 2.5 mL sodium hypochlorite (NaOCl) solution after each instrumentation change for 1 min. Samples were then divided into 4 groups according to the irrigating solution used as the final rinse used with passive ultrasonic agitation. The groups were: Group I: 5 ml of saline, Group II: 5ml of 17% ethylenediaminetetraacetic acid, Group III: 5 ml of 10% citric acid, Group IV: 5 ml of 7% maleic acid each for one minute. All the canals were obturated with BioRoot tmRCS with gutta-percha using the ultrasonic condensation technique. For staining the samples for Confocal LASER microscopy, BioRoot tmRCS was mixed with Rhodamine B dye. Results: The maximum penetration of bio-ceramic sealer was observed in the coronal region. At the apical third, the maximum sealer penetration was seen with 7% maleic acid. Conclusions: Maximum sealer penetration was seen in the coronal section followed by the middle and apical section. Maximum sealer penetration was seen with 7 % maleic acid at the apical third.
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Affiliation(s)
- Shivangi Shekhar
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - P. Laxmish Mallya
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Vasudev Ballal
- Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Ramya Shenoy
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
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Shekhar S, Mallya PL, Ballal V, Shenoy R. To evaluate and compare the effect of 17% EDTA, 10% citric acid, 7% maleic acid on the dentinal tubule penetration depth of bio ceramic root canal sealer using confocal laser scanning microscopy: an in vitro study. F1000Res 2022; 11:1561. [PMID: 36875990 PMCID: PMC9978241 DOI: 10.12688/f1000research.127091.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 01/05/2024] Open
Abstract
Background: The main factors that affect the success of an endodontic infection are effective cleaning and shaping of the root canal system including complete disinfection by using chemical irrigating solutions and obturation with an endodontic sealer to provide a fluid-tight seal. Using rotary and hand instruments for shaping and cleaning the root canal along with irrigants produces a smear layer on the surface of root dentin affecting the penetration of the endodontic sealer into the dentinal tubules. This smear is difficult to remove with the use of only endodontic irrigants, hence, chelating agents were introduced in adjunct with irrigating solutions for irrigation protocol for effective removal of smear layer which effect the penetration of endodontic sealers into the dentinal tubules. Methods: 32 mandibular premolar teeth were used. The biomechanical preparation was done till Protaper F3 size. Irrigation was done with 2.5 mL sodium hypochlorite (NaOCl) solution after each instrumentation change for 1 min. Samples were then divided into 4 groups according to the irrigating solution used as the final rinse used with passive ultrasonic agitation. The groups were: Group I: 5 ml of saline, Group II: 5ml of 17% ethylenediaminetetraacetic acid, Group III: 5 ml of 10% citric acid, Group IV: 5 ml of 7% maleic acid each for one minute. All the canals were obturated with BioRoot tmRCS with gutta-percha using the ultrasonic condensation technique. For staining the samples for Confocal LASER microscopy, BioRoot tmRCS was mixed with Rhodamine B dye. Results: The maximum penetration of bio-ceramic sealer was observed in the coronal region. At the apical third, the maximum sealer penetration was seen with 7% maleic acid. Conclusions: Maximum sealer penetration was seen in the coronal section followed by the middle and apical section. Maximum sealer penetration was seen with 7 % maleic acid at the apical third.
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Affiliation(s)
- Shivangi Shekhar
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - P. Laxmish Mallya
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Vasudev Ballal
- Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Ramya Shenoy
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
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Muacevic A, Adler JR, Almansour LA, Ashi HM, Abulhamael AM, Alghamdi FT, Albahiti MT. Current Trends in Irrigation Solution and Adjunct Use During Endodontic Therapy Among Dental Professionals in Jeddah, Saudi Arabia: A Cross-Sectional Study. Cureus 2022; 14:e32168. [PMID: 36605063 PMCID: PMC9807316 DOI: 10.7759/cureus.32168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Chemical irrigation is a crucial component of endodontic therapy, and irrigation adjuncts increase the efficiency of non-surgical root canal system disinfection, reduce microbial loads, and enhance the penetration of irrigants throughout the root canal system. This study aimed to determine the current trends in chemical irrigation and its adjunct use during root canal therapy by general dental practitioners (GDPs) and endodontic specialists in both government and private sectors in the city of Jeddah, Saudi Arabia. Methods This cross-sectional study used a self-administered survey sent to GDPs and endodontic specialists in both government and private sectors in the city of Jeddah, Saudi Arabia. Responses were accepted from November 2019 till May 2020. The survey was randomly distributed to consenting participants. The results are presented using descriptive statistics. Results A total of 302 participants responded to the survey, with a 44% response rate. The majority of responses were from GDPs (54%), while 46% were from endodontic specialists. Regarding the workplace, 59% of respondents were public sector professionals, 25% were private sector professionals, and 16% were both public and private sector professionals. Around 30% of the respondents used sodium hypochlorite (NaOCI) as their primary irrigation solution during root canal treatment, with 52% using it at its full-strength concentration and 18% and 17% preferring to use it in combination with Ethylenediaminetetraacetic acid (EDTA) only or EDTA and saline, respectively. When asked to rank the reasons for choosing their irrigant of choice during therapy; antibacterial capability and tissue dissolution were the most crucial factors to 80% and 57% of participants, respectively. Half of the respondents irrigated the canal to 2 mm from the apex and 21% irrigated to 1 mm from the apex. Three-quarters of participants aimed to remove the smear layer during root canal treatment. Only 47% of respondents used adjuncts to irrigation, and 71% reported that their choice of irrigation solution would differ depending on whether the apex is open or closed. Conclusion Most respondents used full-strength NaOCI concentration as the main irrigation solution and routinely removed the smear layer during root canal treatment. Only 47% of respondents used irrigation adjuncts such as ultrasonics.
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The Potential of Phenothiazines against Endodontic Pathogens: A Focus on Enterococcus-Candida Dual-Species Biofilm. Antibiotics (Basel) 2022; 11:antibiotics11111562. [PMID: 36358217 PMCID: PMC9686549 DOI: 10.3390/antibiotics11111562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
Persistent apical periodontitis occurs when the endodontic treatment fails to eradicate the intraradicular infection, and is mainly caused by Gram-positive bacteria and yeasts, such as Enterococcus faecalis and Candida albicans, respectively. Phenothiazines have been described as potential antimicrobials against bacteria and fungi. This study aimed to investigate the antimicrobial potential of promethazine (PMZ) and chlorpromazine (CPZ) against E. faecalis and C. albicans dual-species biofilms. The susceptibility of planktonic cells to phenothiazines, chlorhexidine (CHX) and sodium hypochlorite (NaOCl) was initially analyzed by broth microdilution. Interaction between phenothiazines and CHX was examined by chequerboard assay. The effect of NaOCl, PMZ, CPZ, CHX, PMZ + CHX, and CPZ + CHX on biofilms was investigated by susceptibility assays, biochemical and morphological analyses. Results were evaluated through one-way ANOVA and Tukey’s multiple comparison post-test. PMZ, alone or in combination with irrigants, was the most efficient phenothiazine, capable of reducing cell counts, biomass, biovolume, carbohydrate and protein contents of dual-species biofilms. Neither PMZ nor CPZ increased the antimicrobial activity of CHX. Further investigations of the properties of phenothiazines should be performed to encourage their use in endodontic clinical practice.
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Oncu A, Celikten B, Aydın B, Amasya G, Açık L, Sevimay FS. Comparative evaluation of the antifungal efficacy of sodium hypochlorite, chlorhexidine, and silver nanoparticles against Candida albicans. Microsc Res Tech 2022; 85:3755-3760. [PMID: 36259632 DOI: 10.1002/jemt.24249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/22/2022] [Accepted: 10/08/2022] [Indexed: 11/07/2022]
Abstract
Candida albicans is a microorganism that causes root canal infections. However, it cannot be eliminated with conventional irrigation solutions. Recently, silver nanoparticles (AgNPs) have become popular for their superior antimicrobial effects. The purpose of this study was to evaluate the antifungal effect of AgNPs to C. albicans comparing with 5.25% sodium hypochlorite (NaOCl) and 2% chlorhexidine (CHX). Silver nanoparticles were synthesized by chemical reduction method. Minimum inhibitory concentration and minimum fungicidal concentration of AgNPs against C. albicans strain were determined according to microdilution method reported by Clinical Laboratory Standards Institute. C. albicans biofilm layer was formed on the dentin blocks for 10 days. The biofilm structure was observed by scanning electron microscopy. Statistical analysis was performed with one way analysis of variance analysis and group comparisons were performed with Tukey test. AgNPs showed the highest antifungal effect among the groups. 5.25% NaOCl showed the lowest antifungal effect among the groups. While the 2% CHX solution had a statistically lower antifungal effect than AgNPs, it was found to have a higher effect than NaOCl (p < .016). Nanoparticles present a wide research field as an alternative irrigation solution in root canal treatment. The antifungal effect of AgNPs against C. albicans was confirmed in this study. Further in vivo studies should evaluate the conditions of use and long-term prognosis of AgNPs.
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Affiliation(s)
- Aysenur Oncu
- Department of Endodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Berkan Celikten
- Department of Endodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Betül Aydın
- Department of Biology, Faculty of Sciences, Gazi University, Ankara, Turkey
| | - Gulin Amasya
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
| | - Leyla Açık
- Department of Biology, Faculty of Sciences, Gazi University, Ankara, Turkey
| | - Fatma Semra Sevimay
- Department of Endodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey
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Cîmpean SI, Pop-Ciutrila IS, Matei SR, Colosi IA, Costache C, Nicula GZ, Badea IC, Colceriu Burtea L. Effectiveness of Different Final Irrigation Procedures on Enterococcus faecalis Infected Root Canals: An In Vitro Evaluation. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15196688. [PMID: 36234029 PMCID: PMC9571448 DOI: 10.3390/ma15196688] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 06/01/2023]
Abstract
This study aimed to evaluate the antibacterial effect of three final irrigation protocols and to compare their ability to remove the smear layer and debris from the root canal. Methods: Sixty-three single-rooted human teeth were inoculated with Enterococcus faecalis for 14 days. The teeth were divided into a positive control group (N = 3) and three treatment groups (N = 20) as follows: final irrigation with saline solution (control group), irrigation with 5.25% NaOCl ultrasonically activated with EndoUltra (EU), standard needle irrigation with Qmix 2in1 (Qx) and irrigation with 5.25% NaOCl activated using SiroLaser Blue (SB). The bacterial load was evaluated by analyzing the colony-forming units (CFU/mL). Selected specimens were split longitudinally and examined using scanning electron microscopy in order to determine the presence of a smear layer and debris. Statistical analyses were performed using one-way ANOVA and the Kruskal−Wallis rank-sum test. Results: Activation of NaOCl with EndoUltra or SiroLaser Blue was superior at reducing intracanal bacteria relative to standard needle irrigation with Qmix 2in1 solution (p < 0.05). Even though SiroLaser Blue showed the best results for removing the smear layer and debris, no significant differences were detected between the groups (p > 0.05). Conclusions: Final irrigation with 5.25% NaOCl ultrasonically activated using EndoUltra or SiroLaser Blue demonstrated a higher efficacy in bacterial reduction than standard needle irrigation with Qmix 2in1.
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Affiliation(s)
- Sanda Ileana Cîmpean
- Department of Conservative Dentistry and Endodontics, Iuliu Hatieganu University of Medicine and Pharmacy, 33 Motilor Street, 400001 Cluj-Napoca, Romania
| | - Ioana-Sofia Pop-Ciutrila
- Department of Conservative Dentistry and Endodontics, Iuliu Hatieganu University of Medicine and Pharmacy, 33 Motilor Street, 400001 Cluj-Napoca, Romania
| | - Sebastian-Roberto Matei
- Department of Conservative Dentistry and Endodontics, Iuliu Hatieganu University of Medicine and Pharmacy, 33 Motilor Street, 400001 Cluj-Napoca, Romania
| | - Ioana Alina Colosi
- Department of Molecular Sciences, Discipline of Microbiology, Iuliu Hatieganu University of Medicine and Pharmacy, 6 Louis Pasteur Street, 400349 Cluj-Napoca, Romania
| | - Carmen Costache
- Department of Molecular Sciences, Discipline of Microbiology, Iuliu Hatieganu University of Medicine and Pharmacy, 6 Louis Pasteur Street, 400349 Cluj-Napoca, Romania
| | - Gheorghe Zsolt Nicula
- Department of Molecular Sciences, Discipline of Cell and Molecular Biology, Iuliu Hatieganu University of Medicine and Pharmacy, 6 Louis Pasteur Street, 400349 Cluj-Napoca, Romania
| | - Iulia Clara Badea
- Department of Prevention in Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 31 Avram Iancu Street, 400083 Cluj-Napoca, Romania
| | - Loredana Colceriu Burtea
- Department of Conservative Dentistry and Endodontics, Iuliu Hatieganu University of Medicine and Pharmacy, 33 Motilor Street, 400001 Cluj-Napoca, Romania
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75
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Ashkar I, Sanz JL, Forner L. Cyclic Fatigue Resistance of Glide Path Rotary Files: A Systematic Review of in Vitro Studies. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6662. [PMID: 36234003 PMCID: PMC9571085 DOI: 10.3390/ma15196662] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/18/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
The aim of the present systematic review was to perform a qualitative synthesis of in vitro studies that assess the cyclic fatigue resistance of rotary glide path (GP) files of endodontic applications. Systematic electronic searches were performed in the Medline, Embase, Scopus, SciELO, and Web of Science databases on 15 February 2022, and were last updated on 1 April In vitro studies that evaluated and compared the cyclic fatigue resistance of at least one rotary GP file system with another rotary GP file system were included. A total of 25 studies were included in the qualitative synthesis. All studies assessing the difference in the cyclic fatigue resistance between continuous and reciprocating rotation in rotary glide path files found that the latter resulted in a significantly higher cyclic fatigue resistance, as evidenced by a higher number of cycles until fracture and/or time until fracture. Within the limitations of this review and the in vitro nature of the included studies, the results indicate that the cyclic fatigue resistance of rotary GP files may be influenced by several intrinsic factors of the files, such as their taper, cross-sectional design, alloy properties, kinematics, and external factors, such as the curvature and radius at which the file is activated, the irrigation or lubricant used, and the temperature.
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SERÇE FİKİRLİ B, ALTUNKAYNAK B, KAYAOĞLU G. Kök kanal geometrisinin ve iğne tipinin apikalden irrigan taşmasına etkisi: ex vivo çalışma. ACTA ODONTOLOGICA TURCICA 2022. [DOI: 10.17214/gaziaot.945129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objective: The aim was to evaluate the effect of root canal geometry on the amount of apical extrusion of irrigant, by testing different tapers and needle types.
Materials and Method: Forty-three extracted single-rooted human mandibular premolar teeth were accessed. Experimental groups were instrumented to produce increasing amounts of taper in each successive group: Group 1 (#25/.02), Group 2 (#25/.04), Group 3 (#25/.06), and Group 4 (#25/.08) (n=43, each). Irrigation was done sequentially by using a 30-G open-ended flat needle, 30-G close-ended side-vented needle, and 27-G open-ended beveled needle. Flat and side-vented needles were each placed 3 mm short of the apex, while the beveled needle was placed as far as possible in the canal without binding. Extruded irrigant was collected in preweighed foam cubes. Statistical significance was set at p<0.05.
Results: An increase in canal taper led to a decrease in the amount of extruded irrigant for the flat needle (p<0.05; Groups 1 and 2 versus 3 and 4) and side-vented needle (p<0.05; Groups 1 and 2 versus 4), but no significant effect was found for the beveled needle. The amount of extruded irrigant was greater with the flat than with the side-vented needle at all tapers and with the beveled needle at most tapers (p<0.05). The side-vented needle was generally associated with the least amount of extrusion.
Conclusion: Given a constant needle insertion depth, the amount of apically extruded irrigant decreased as canal taper increased. The greatest and least amounts of extrusion were generally observed with the flat and side-vented needle, respectively.
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Affiliation(s)
| | | | - Güven KAYAOĞLU
- Department of Endodontics, Faculty of Dentistry, Gazi University
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77
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Rajamanickam K, Teja KV, Ramesh S, AbuMelha AS, Alkahtany MF, Almadi KH, Bahammam SA, Janani K, Choudhari S, Jose J, Srivastava KC, Shrivastava D, Patil S. Comparative Study Assessing the Canal Cleanliness Using Automated Device and Conventional Syringe Needle for Root Canal Irrigation-An Ex-Vivo Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6184. [PMID: 36143496 PMCID: PMC9504894 DOI: 10.3390/ma15186184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 06/16/2023]
Abstract
The success of endodontic treatment relies on both apical and coronal sealing. To achieve a good three-dimensional seal, the removal of the smear layer becomes mandatory. This study aims to assess the difference in debris accumulation and smear layer formation while using automated root canal irrigation and conventional syringe needle irrigation. Single-rooted human mandibular premolar teeth (n = 30) which were indicated for orthodontic extractions were selected. An endodontic access cavity was prepared, and a glide path was created. Based on the irrigation protocol decided upon for the study, the teeth were randomly allocated into three study groups, namely Group 1, where the manual syringe needle irrigation method was adopted; Group 2, in which automated root canal irrigation was undertaken; and Group 3, in which teeth remained un-instrumented as it was considered the Control group. The teeth were decoronated at the cement-enamel junction (CEJ) and were subjected for scanning electron microscopy (SEM) examination. Debris and smear layers were viewed in 1000× magnification and scored. A statistically significant (p < 0.05) lower mean debris and smear layer score (p < 0.05) was observed in both study groups when compared with the control group. However, no significant difference (p > 0.05) in the debris and smear layer was observed between the manual syringe needle irrigation and automated irrigation, although automated irrigation devices can be a potential alternative. The present study concluded that the efficacy of smear layer removal remained the same with both automated irrigation and manual syringe irrigation.
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Affiliation(s)
- Keerthika Rajamanickam
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
| | - Kavalipurapu Venkata Teja
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
| | - Sindhu Ramesh
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
| | - Abdulaziz S. AbuMelha
- Restorative Dental Science Department, College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia
| | - Mazen F. Alkahtany
- Department of RDS, Division of Endodontics, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Khalid H. Almadi
- Department of RDS, Division of Endodontics, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Sarah Ahmed Bahammam
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, Taibah University, P.O. Box 344, Medina 42353, Saudi Arabia
| | - Krishnamachari Janani
- Department of Conservative Dentistry and Endodontics, SRM Dental College, SRM Institute of Science & Technology, Chennai 600089, Tamil Nadu, India
| | - Sahil Choudhari
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
| | - Jerry Jose
- Private Practice, Aluva, Ernakulam District, Kochi 683106, Kerala, India
| | - Kumar Chandan Srivastava
- Department of Oral & Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
| | - Deepti Shrivastava
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
- Centre of Molecular Medicine and Diagnostics (COMManD), Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India
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Comparison of EASYDO ACTIVATOR, passive ultrasonic, and needle irrigation techniques on the treatment of apical periodontitis: a study in rats. Clin Oral Investig 2022; 26:7157-7165. [PMID: 36053353 DOI: 10.1007/s00784-022-04677-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/10/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To evaluate the long-term therapeutic effect of EASYDO ACTIVATOR, passive ultrasonic irrigation, and needle irrigation in experimental apical periodontitis in rats. MATERIALS AND METHODS Sprague-Dawley male rats were used to produce periapical lesions. The pulp chambers of the bilaterally first mandibular molars were exposed and left open for 21 days. The rats were divided into four groups according to different irrigation protocols. Seven days after irrigation, the mandibles were removed for micro-CT, histological, and immunohistochemical analysis. Serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were assessed by enzyme-linked immunosorbent assays (ELISA). Statistical data were analyzed by one-way analysis of variance (ANOVA) with LSD tests. RESULTS The passive ultrasonic irrigation and EASYDO ACTIVATOR groups had the smallest apical lesions compared to the other groups (P < 0.05), while the needle irrigation group had smaller lesions than the control group (P < 0.05). The EASYDO ACTIVATOR group had less inflammation infiltration compared to the control and needle irrigation groups (P < 0.05). The control and needle irrigation groups had more TNF-α expression compared to the passive ultrasonic irrigation and EASYDO ACTIVATOR groups (P < 0.05). The lowest IL-6 expression was observed in the EASYDO ACTIVATOR group. The EASYDO ACTIVATOR group had the lowest serum level of TNF-α than other groups (P < 0.05). IL-6 expression was significantly lower in the EASYDO ACTIVATOR group in comparison with the control and needle irrigation groups (P < 0.05). CONCLUSIONS EASYDO ACTIVATOR can significantly reduce the apical lesions and decrease the inflammatory response around the periapical area. CLINICAL RELEVANCE EASYDO ACTIVATOR is recommended for clinical application.
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Swimberghe RCD, Tzourmanas R, De Moor RJG, Braeckmans K, Coenye T, Meire MA. Explaining the working mechanism of laser‐activated irrigation and its action on microbial biofilms: a high‐speed imaging study. Int Endod J 2022; 55:1372-1384. [DOI: 10.1111/iej.13824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/11/2022] [Accepted: 08/24/2022] [Indexed: 11/29/2022]
Affiliation(s)
- R. C. D. Swimberghe
- Department of Oral Health Sciences, Section of Endodontology Ghent University Ghent Belgium
| | - R. Tzourmanas
- Department of Oral Health Sciences, Section of Endodontology Ghent University Ghent Belgium
| | - R. J. G. De Moor
- Department of Oral Health Sciences, Section of Endodontology Ghent University Ghent Belgium
| | - K. Braeckmans
- Department of Pharmaceutics, Bio‐Photonics Research Group, Laboratory of General Biochemistry & Physical Pharmacy Ghent University Ghent Belgium
| | - T. Coenye
- Department of Pharmaceutics, Laboratory of Pharmaceutical Microbiology Ghent University Ghent Belgium
| | - M. A. Meire
- Department of Oral Health Sciences, Section of Endodontology Ghent University Ghent Belgium
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Can the Concentration of Citric Acid Affect Its Cytotoxicity and Antimicrobial Activity? Dent J (Basel) 2022; 10:dj10080148. [PMID: 36005246 PMCID: PMC9406502 DOI: 10.3390/dj10080148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
Background: There has been no unanimity concerning the ideal concentration of citric acid for safe use in clinical practice. This study evaluated the cytotoxicity and the antibacterial activity in infected dentinal tubules of 10% and 1% citric acid (CA) solutions. Methods: The cytotoxicity of CA solutions in DMEM (diluted 1/10, 1/100) was assessed in L-929 fibroblasts. A broth macrodilution method (MIC and MBC) was used to assess CA antibacterial concentration. The antimicrobial activity of CA solutions was also evaluated after their final rinse inside root canals in previously Enterococcus faecalis-contaminated dentinal tubules. Ten infected dentine samples were rinsed for 5 min with 5% NaOCl and subsequently with 1% citric acid for 3 min. Another 10 were rinsed with 5% NaOCl and 10% citric acid for 3 min; the remaining four specimens were utilized as positive controls. Two uncontaminated specimens were used as negative controls. After LIVE/DEAD BacLight staining, the samples were assessed using CLSM to analyze the percentage of residual live and dead cells. Results: Both undiluted and diluted CA solutions showed severe toxicity; no changes from normal morphology were displayed when diluted 1/100. The MIC and MBC of CA were 6.25 mg/mL and 12.50 mg/mL, respectively. CA solutions demonstrated significantly low levels of bacterial counts than the positive control group, reporting a value of 9.3% for the 10% solution versus the 1% solution (35.2%). Conclusions: Despite its valuable antimicrobial properties, the cytotoxic effects of citric acid should be considered during endodontic treatment.
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81
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Fazelian N, Rahimi Dashtaki A, Eftekharian M, Amiri B. Influence of chlorhexidine 2% and sodium hypochlorite 5.25% on micro-tensile bond strength of universal adhesive system (G-Premio Bond). BRAZILIAN JOURNAL OF ORAL SCIENCES 2022. [DOI: 10.20396/bjos.v21i00.8667932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim: One of the reasons for the failure of adhesion in composite restorations and secondary caries may be the chemical irrigants used during the endodontic treatment. NaOCl is widely used for the biomechanical preparation of root canals due to its antimicrobial properties and capacity to dissolve organic material. In addition, another very effective decontamination solution is chlorhexidine 2%. There are few studies about the effect of root canal irrigation solutions on bond strength of universal adhesives therefore, in this study we have investigated the influence of CHX 2% and NaOCl 5.25% on micro-tensile bond strength of G-Premio Bond. Methods: Twenty-four human teeth were randomly allocated to the following groups: G1, immersion in saline solution 0.9% for 30 minutes (control); G2, immersion in CHX 2% for 30 minutes; G3, immersion in NaOCl 5.25% for 30 minutes. After restoration, the dentin/resin interface was tested by micro-tensile bond strength. The surfaces morphology was analyzed by Scanning Electron Microscopy. Data were analyzed by ANOVA followed by Tukey test in SPSS software Version 24. Results: There was a statistically significant difference between G3 and G1 (P < 0.05). There were no statistically significant differences among G1 and G2, G2 and G3. Conclusion: Root canal irrigation with NaOCl 5.25% significantly reduced the micro-tensile bond strength in the G-Premio Bond at self-etch mode, but the use of CHX did not make a significant difference.
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Roig-Soriano X, Souto EB, Elmsmari F, Garcia ML, Espina M, Duran-Sindreu F, Sánchez-López E, González Sánchez JA. Nanoparticles in Endodontics Disinfection: State of the Art. Pharmaceutics 2022; 14:1519. [PMID: 35890414 PMCID: PMC9316632 DOI: 10.3390/pharmaceutics14071519] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/13/2022] [Accepted: 07/19/2022] [Indexed: 01/27/2023] Open
Abstract
Endodontic-related diseases constitute the fourth most expensive pathologies in industrialized countries. Specifically, endodontics is the part of dentistry focused on treating disorders of the dental pulp and its consequences. In order to treat these problems, especially endodontic infections, dental barriers and complex root canal anatomy should be overcome. This constitutes an unmet medical need since the rate of successful disinfection with the currently marketed drugs is around 85%. Therefore, nanoparticles constitute a suitable alternative in order to deliver active compounds effectively to the target site, increasing their therapeutic efficacy. Therefore, in the present review, an overview of dental anatomy and the barriers that should be overcome for effective disinfection will be summarized. In addition, the versatility of nanoparticles for drug delivery and their specific uses in dentistry are comprehensively discussed. Finally, the latest findings, potential applications and state of the art nanoparticles with special emphasis on biodegradable nanoparticles used for endodontic disinfection are also reviewed.
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Affiliation(s)
- Xavier Roig-Soriano
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
| | - Eliana B Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
- REQUIMTE/UCIBIO, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - Firas Elmsmari
- Department of Clinical Sciences, College of Dentistry, Ajman University, University Street Al Jerf 1, Ajman 346, United Arab Emirates
- Center of Medical and Bio-Allied Health Sciences Research, Ajman University, University Street Al Jerf 1, Ajman 346, United Arab Emirates
| | - Maria Luisa Garcia
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, 08028 Barcelona, Spain
| | - Marta Espina
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, 08028 Barcelona, Spain
| | - Fernando Duran-Sindreu
- Department of Endodontics, Faculty of Dentistry, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
| | - Elena Sánchez-López
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
- Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, 08028 Barcelona, Spain
- Unit of Synthesis and Biomedical Applications of Peptides, IQAC-CSIC, 08034 Barcelona, Spain
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83
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Does the use of natural products for endodontic therapy in primary teeth have sufficient evidence for clinical practice? A scoping review. Clin Oral Investig 2022; 26:6043-6060. [DOI: 10.1007/s00784-022-04633-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/12/2022] [Indexed: 11/27/2022]
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84
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Jiao M, Zhang Y, Gao Z, Song W, Yu X, Xu H, Pan K. Bactericidal Efficacy of Photon-Induced Photoacoustic Streaming-Erbium:Yttrium-Aluminum-Garnet Laser Combined with Irrigation Solution on Enterococcus faecalis in Curved Root Canals: An In Vitro Study. Photobiomodul Photomed Laser Surg 2022; 40:499-506. [PMID: 35867120 DOI: 10.1089/photob.2022.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: This experiment aimed to study the bactericidal effect of photon-induced photoacoustic streaming (PIPS)-erbium:yttrium-aluminum-garnet (Er:YAG) laser on Enterococcus faecalis in curved root canals. Materials and methods: Sixty-two molars with moderately curved roots (10°-20°) and 62 molars with severely curved roots (25°-40°; one root was selected in each tooth) were assigned to group A and group B, respectively. A curved root canal model with E. faecalis infection was established. Four samples were used for sterility test, and 20 samples were used for testing if the modeling was valid. The remaining 100 samples were randomly divided into 5 subgroups (A1/A2/A3/A4/A5 and B1/B2/B3/B4/B5, n = 10) and treated as follows: A1/B1: PIPS-Er:YAG laser +5.25% sodium hypochlorite (NaOCl); A2/B2: passive ultrasonic irrigation +5.25% NaOCl; A3/B3: PIPS-Er:YAG laser+normal saline (NS); A4/B4: two-hole root canal irrigator +5.25% NaOCl; A5/B5: two-hole root canal irrigator+NS. After treatment, bacterial culture counts and scanning electron microscopic (SEM) observations were carried out for each subgroup, and the bacterial clearance rate of each subgroup was calculated. SPSS 23 software package was used for statistical analysis of the data, and a single-factor analysis of variance was used to compare the subgroups. Results: The bacterial clearance rate in group A was higher than that in group B; however, in each group, A or B, there were significant differences between the subgroups (p < 0.001) except for subgroups 1 and 2 (p > 0.05). SEM revealed that the antibacterial and smear layer removal effect of root canal in subgroups 1 and 2 was better than that in subgroups 3, 4, and 5. Conclusions: PIPS-Er:YAG can significantly enhance the bactericidal effect of NaOCl on E. faecalis in moderately and severely curved root canals.
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Affiliation(s)
- Mengyu Jiao
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.,School of Stomatology of Qingdao University, Qingdao, Shandong, China
| | - Yan Zhang
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.,School of Stomatology of Qingdao University, Qingdao, Shandong, China.,Department of Stomatology, Linyi People's Hospital, Linyi, Shandong, China
| | - Zhenliang Gao
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Wenbin Song
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.,School of Stomatology of Qingdao University, Qingdao, Shandong, China
| | - Xinbo Yu
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.,School of Stomatology of Qingdao University, Qingdao, Shandong, China
| | - Haiping Xu
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.,School of Stomatology of Qingdao University, Qingdao, Shandong, China
| | - Keqing Pan
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.,School of Stomatology of Qingdao University, Qingdao, Shandong, China
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85
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Özdemir O, Hazar E, Koçak S, Sağlam BC, Koçak MM. The frequency of sodium hypochlorite extrusion during root canal treatment: an observational clinical study. Aust Dent J 2022; 67 Suppl 1:S57-S64. [PMID: 35707880 DOI: 10.1111/adj.12924] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND To determine the frequency of sodium hypochlorite (NaOCl) extrusion and evaluate the outcome of the injury. METHODS A total of 1123 teeth indicated root canal treatment were included. Open-ended needle was used during/after the instrumentation. Acute burning pain during irrigation was considered as NaOCl extrusion. Negative aspiration was applied for patients with extrusion, and appropriate treatment was planned due to the symptoms. The number of patients who experienced extrusion and symptoms were recorded. Analysis of variance (ANOVA), at p<0.05, was used to compare the data groups. RESULTS NaOCl extrusion rate was found at 0.89%, and the injury with swelling that differential diagnosis of NaOCl accident caused by extrusion rate was 0.18%. The most common findings besides acute pain, as a sign of extrusion (n=10), were accompanying apical bleeding (n=6), and swelling (n=2). According to the number of visits, a significant correlation was found between the symptoms (p = 0.010). No serious injury such as a neurological sign, tissue necrosis, or trismus occurred in any patient. CONCLUSIONS Demographic characteristics of the patients and preoperative condition of teeth were not related to NaOCl extrusion. The increasing number of visits may affect the probability of an accident. Negative aspiration immediately may be crucial in preventing severe injuries. © 2022 Australian Dental Association.
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Affiliation(s)
- Olcay Özdemir
- Karabük University, Faculty of Dentistry, Department of Endodontics, 78050, Karabük, Turkey
| | - Ecehan Hazar
- Zonguldak Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, 67600, Zonguldak, Turkey
| | - Sibel Koçak
- Zonguldak Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, 67600, Zonguldak, Turkey
| | - Baran Can Sağlam
- Zonguldak Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, 67600, Zonguldak, Turkey
| | - Mustafa Murat Koçak
- Zonguldak Bülent Ecevit University, Faculty of Dentistry, Department of Endodontics, 67600, Zonguldak, Turkey
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86
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Moon W, Chung SH, Chang J. Sonic irrigation for removal of calcium hydroxide in the apical root canal: A micro-CT and light-coupled tracking analysis. PLoS One 2022; 17:e0268791. [PMID: 35653310 PMCID: PMC9162323 DOI: 10.1371/journal.pone.0268791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 05/08/2022] [Indexed: 11/19/2022] Open
Abstract
Objective This study aimed to evaluate the efficacy of three sonic irrigation systems for removal of calcium hydroxide dressing from the apical root canal. Materials and methods A total of 96 single-rooted teeth in three categories of root canal curvatures (straight: 0–5°, moderate: 6–20°, and severe: > 20°) were allocated to four groups: conventional needle irrigation, EndoActivator, EQ-S, and Vibringe. The root canals were instrumented using Protaper NEXT and filled with calcium hydroxide. After removal of calcium hydroxide, the remaining volume of calcium hydroxide was measured by micro-CT analysis. Data were compared among root canal curvatures and irrigation systems using the Kruskal-Wallis test and Mann-Whitney test (p < .05). The oscillating range of each irrigation system was measured using light-coupled motion tracking. Results The volumes of calcium hydroxide remaining in the canals with severe curvature were significantly higher than in those of straight curvature (p < .05). In the canals of moderate or severe curvature, EQ-S showed the highest removal percentage, followed by EndoActivator, Vibringe, and needle irrigation (p < .05). Light-coupled tracking showed the largest oscillating range in EQ-S (p < .05). Conclusions Sonically activated irrigation systems with a flexible tip can be beneficial for calcium hydroxide intracanal dressing removal in the curved apical canals.
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Affiliation(s)
- Wonjoon Moon
- Department of Dental Biomaterials Science, School of Dentistry and Dental Research Institute, Seoul National University, Jongno-gu, Seoul, Republic of Korea
| | - Shin Hye Chung
- Department of Dental Biomaterials Science, School of Dentistry and Dental Research Institute, Seoul National University, Jongno-gu, Seoul, Republic of Korea
| | - Juhea Chang
- National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital, Jongno-gu, Seoul, Republic of Korea
- * E-mail:
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87
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Nunes IAM, Novais TMG, Garcia PP, Silva WS, Tavarez RRDJ, Rizzi CDC, Carvalho CN, Filho EMM. Antimicrobial action of ozonated water and photodynamic therapy with sonic activation in root canals infected with Enterococcus faecalis. J Clin Exp Dent 2022; 14:e486-e491. [PMID: 35765359 PMCID: PMC9233916 DOI: 10.4317/jced.57909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 04/20/2022] [Indexed: 11/05/2022] Open
Abstract
Background New protocols are constantly being tested in the search for complete disinfection of root canals without the undesirable effects of sodium hypochlorite. This study evaluated the antimicrobial effect of ozonated water and photodynamic therapy (PDT) with sonic activation in root canals infected with Enterococcus faecalis. Material and Methods Seventy single-rooted canals of human teeth were prepared and contaminated with E. faecalis for 21 days. The teeth were divided into six experimental groups (n=10): ozonized water without (O + S-) and with sonic activation (O + S +); PDT without (PDT + S-) and with sonic activation (PDT + S +); PDT + ozonized water without (PDT + O + S-) and with sonic activation (PDT + O + S +); and two control groups, one positive (n = 5) and one negative (n = 5). Microbial collections were performed before and shortly after treatment, counted in the log of colony-forming units and tested for significant difference between these counts, if any (Student's t-test). The ANOVA two-way test was applied to evaluate whether the Treatment factor (Ozone, PDT and Ozone + PDT) and the Sonic factor (With and without sonic activation) had any effect on microbial reduction. Results In all protocols, there was a significant microbial reduction (p=0.025), whereas in the groups in which sonic activation was used, the microbial reduction was significantly greater (p=0.001). Conclusions The treatments significantly reduced the number of microorganisms in the root canals. Sonic activation helped to increase the microbial reduction in infected root canals. Key words:Endodontics, ozone, photodynamic therapy, enterococcus faecalis.
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88
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İnce Yusufoğlu S, Olcay K. Effect of Qmix 2in1, chlorhexidine gluconate, and ethylenediaminetetraacetic acid on postoperative pain after root canal treatment: A double-blind randomized clinical trial. J Dent Res Dent Clin Dent Prospects 2022; 16:70-75. [PMID: 35936934 PMCID: PMC9339748 DOI: 10.34172/joddd.2022.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/15/2021] [Indexed: 11/27/2022] Open
Abstract
Background. This study aimed to investigate the effects of different final irrigation solutions on postoperative pain following root canal treatment. Methods. Eighty-nine nonvital premolar and molar teeth with periapical lesions (PAI: 3‒4) without any clinical symptoms were included. The patients were randomly assigned to three groups according to the final irrigation solutions used: G1: 2 mL of Qmix (n=29), G2: 2 mL of 17% ethylenediaminetetraacetic acid (EDTA) (n=30), and G3: 2 mL of 2% chlorhexidine gluconate (CHX) (n=30). All the patients were prescribed 100 mg of flurbiprofen to use as needed for pain. The patients were asked to rate their pain status according to the verbal rating scale at 12, 24, 48, and 72 hours, and one week. The data were analyzed using Pearson's chi-squared test, Fisher's exact test, and chi-squared analysis with Monte Carlo simulation. The significance level was set at P≤0.05. Results. No significant differences were observed in postoperative pain rates at 12, 48, and 72 hours and one week (P>0.05). However, in the Qmix group, a significantly lower pain level was observed at 24 hours with EDTA and CHX (P=0.019). The rate of mild pain in the EDTA group at 72 hours (18.8%) was significantly higher in premolar teeth than in molar teeth (P=0.012). The moderate pain level in the EDTA group at 12 hours was significantly higher in those>60 years of age (P=0.008). Conclusion. The use of Qmix as an irrigation solution resulted in lower postoperative pain levels at 24 hours compared to other solutions. Therefore, Qmix can be considered a proper final irrigation solution in endodontic treatment regarding postoperative pain.
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Affiliation(s)
- Selen İnce Yusufoğlu
- Department of Endodontics, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Keziban Olcay
- Department of Endodontics, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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89
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Alfawaz H, Alqedairi A, Alhamdan M, Alkhzim N, Alfarraj S, Jamleh A. Effect of NaOCl and EDTA irrigating solutions on the cyclic fatigue resistance of EdgeTaper Platinum instruments. BMC Oral Health 2022; 22:195. [PMID: 35599316 PMCID: PMC9125847 DOI: 10.1186/s12903-022-02215-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 05/06/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND To compare the solution on the cyclic fatigue resistance of EdgeTaper Platinum (ETP) instruments with that of ProTaper Gold (PTG) in the presence of ethylenediaminetetraacetic acid (EDTA) or sodium hypochlorite (NaOCl) irrigating solutions. METHODS Sixty PTG and 60 ETP instruments with the same size (#25) and taper (8%) were tested under 17% EDTA, 5.25% NaOCl, or distilled water (n = 20 each). Cyclic fatigue was tested using artificial canals that were milled in stainless steel blocks using a laser micromachining technique. The canals had a curvature angle of 60 and a curvature radius of 5 mm. The center of maximum curvature was set at 5 mm from the instrument tip. The block of artificial canals was stabilized inside a container that was filled with one of the tested solutions. The temperature was fixed at 37 °C with a tolerance limit of 1 °C. The number of cycles to fracture (NCF) was calculated and the fractured surfaces were examined using a scanning electron microscope. All statistical analyses were performed using SPSS software Version 20 (IBM-SPSS Inc., Chicago, IL) at a confidence level of 95%. RESULTS ETP showed higher NCF than PTG in any of the tested solutions (P < 0.05). Within each group, NaOCl drastically decreased the NCF compared to water and EDTA (P < 0.05) and changing the solution from distilled water to EDTA did not affect the fatigue resistance (P > 0.05). CONCLUSIONS ETP showed improved cyclic fatigue performance compared to PTG in all tested irrigating solutions. EDTA can be used in combination with NiTi instruments during canal instrumentation without compromising the cyclic fatigue resistance of PTG and ETP instruments. However, NaOCl drastically decreased the NCF.
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Affiliation(s)
- Hussam Alfawaz
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh, 11545, Saudi Arabia.
| | - Abdullah Alqedairi
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh, 11545, Saudi Arabia
| | - Maha Alhamdan
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh, 11545, Saudi Arabia
| | - Najla Alkhzim
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh, 11545, Saudi Arabia
| | - Shatha Alfarraj
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh, 11545, Saudi Arabia
| | - Ahmed Jamleh
- Department of Restorative and Prosthetic Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
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90
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Orhan EO, Irmak Ö, Hür D. What does not form after accidental sodium hypochlorite contact with chlorhexidine? Int Endod J 2022; 55:685-688. [PMID: 35511028 DOI: 10.1111/iej.13729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/23/2022] [Accepted: 03/18/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Ekim Onur Orhan
- Translational Medicine Research and Clinical Center, Eskisehir Osmangazi University, Eskisehir, Turkey.,Department of Endodontics, Faculty of Dentistry, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Özgür Irmak
- Department of Restorative Dentistry, Faculty of Dentistry, Near East University, Nicosia, Cyprus
| | - Deniz Hür
- Department of Chemistry, Faculty of Science, Eskişehir Technical University, Eskisehir, Turkey
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91
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Effect of chlorhexidine digluconate on antimicrobial activity, cell viability and physicochemical properties of three endodontic sealers. Dent Mater 2022; 38:1044-1059. [PMID: 35491276 DOI: 10.1016/j.dental.2022.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Assess the biological and physicochemical properties of AH Plus, BioRoot RCS and Pulp Canal Sealer (PCS) leachates with and without chlorhexidine (CHX). METHODS The sealers were studied in no contact and 1-minute contact with CHX. For biological properties (antibacterial activity and cytotoxicity), leachates were formed in saline of freshly mixed, 1-, 7- and 28 days set sealers. The antibacterial properties of sealer leachates were investigated for planktonic and biofilm growth of E. faecalis, S. mutans, S.epidermidis and S.aureus. The 3-(4,5 dimethylthiazolyl-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay was used to evaluate murine fibroblast cell viability after exposure to the leachates. The physical properties (water uptake, sorption, solubility, porosity, surface characteristics) of sealers and the pH of the immersion liquid (saline or distilled water) were also assessed over a 28-days period. RESULTS CHX improved the antibacterial properties of the sealer leachates and reduced cell viability for all sealer leachates, except for freshly mixed PCS. BioRoot RCS leachates presented the highest antibacterial properties and cell viability with and without CHX contact. PCS was the material most affected by CHX in terms of physical properties, whereas for AH Plus, solubility was increased. CHX did not affect the physical properties of BioRoot RCS, except for solubility that was decreased. CHX contact did not change sealers' alkalinity in distilled water whereas it increased it for AH Plus and BioRoot RCS in saline. SIGNIFICANCE CHX improved the antibacterial efficacy of sealer leachates and either compromised or did not affect cell viability. CHX affected to various extent sealers' physicochemical properties.
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92
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Preclinical Testing of Boron-Doped Diamond Electrodes for Root Canal Disinfection—A Series of Preliminary Studies. Microorganisms 2022; 10:microorganisms10040782. [PMID: 35456832 PMCID: PMC9024724 DOI: 10.3390/microorganisms10040782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/29/2022] [Accepted: 04/04/2022] [Indexed: 11/23/2022] Open
Abstract
While numerous approaches have meanwhile been described, sufficient disinfection of root canals is still challenging, mostly due to limited access and the porous structure of dentin. Instead of using different rinsing solutions and activated irrigation, the electrolysis of saline using boron-doped diamond (BDD) electrodes thereby producing reactive oxygen species may be an alternative approach. In a first step, experiments using extracted human teeth incubated with multispecies bacterial biofilm were conducted. The charge quantities required for electrochemical disinfection of root canals were determined, which were subsequently applied in an animal trial using an intraoral canine model. It could be shown that also under realistic clinical conditions, predictable disinfection of root canals could be achieved using BDD electrodes. The parameters required are in the range of 5.5 to 7.0 V and 9 to 38 mA, applied for 2.5 to 6.0 min with approximately 5 to 8 mL of saline. The direct generation of disinfective agents inside the root canal seems to be advantageous especially in situations with compromised access and limited canal sizes. The biologic effect with respect to the host reaction on BDD-mediated disinfection is yet to be examined.
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93
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Gund MP, Wrbas KT, Hannig M, Rupf S. Apical periodontitis after intense bruxism. BMC Oral Health 2022; 22:91. [PMID: 35331220 PMCID: PMC8951715 DOI: 10.1186/s12903-022-02123-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/16/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Bruxism is known to cause masticatory muscle pain, temporomandibular joint pain, headaches, mechanical tooth wear, prosthodontic complications and cracked teeth. Less known to the practitioner, and described only experimentally in literature, is that bruxism can also damage the pulp. To our knowledge, this is the first known clinical case of a patient developing apical periodontitis due to bruxism. CASE PRESENTATION This article presents the case and successful treatment of a 28-year-old healthy male patient with apical periodontitis on teeth 36 and 46 requiring root canal treatment after an intense phase of bruxism. Due to an unclear diagnosis, treatment had been delayed. CONCLUSIONS Incomprehensible tooth pain can be the result of bruxism. Practitioners need to be informed that intense bruxism can possibly lead to apical periodontitis. It is important, therefore, that a thorough anamnesis is collected and taken into account during diagnostics.
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Affiliation(s)
- Madline P Gund
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University Hospital, Saarland University, Kirrberger Str. 100, Building 73, 66421, Homburg, Saar, Germany.
| | - Karl-Thomas Wrbas
- Department of Operative Dentistry and Periodontology, Centre for Dental Medicine, Oral and Maxillofacial Surgery, Medical Centre, University of Freiburg, Freiburg i.Br., Germany.,Division of Endodontics, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, 3500, Krems, Austria
| | - Matthias Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University Hospital, Saarland University, Kirrberger Str. 100, Building 73, 66421, Homburg, Saar, Germany
| | - Stefan Rupf
- Chair of Synoptic Dentistry, Saarland University, Kirrbergerstr. 100, Building 73, 66421, Homburg, Germany
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94
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Cai C, Wen C, Guan L, Huang Y, Jiang Q. Influence of sodium hypochlorite concentration on cavitation effect and fluid dynamics induced by photon-induced photoacoustic streaming (PIPS): A visualization study. Lasers Med Sci 2022; 37:2537-2544. [PMID: 35233704 DOI: 10.1007/s10103-022-03535-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/21/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of the present study was to visualize and compare the cavitation effect and fluid dynamics induced by photon-induced photoacoustic streaming (PIPS) using sodium hypochlorite (NaOCl) with different concentrations as irrigant. METHODS Forty artificial root canals were prepared using MTWO Niti file up to size #25/.06. The canals were randomly divided into four groups (n = 10/group). High-speed camera was used to visualize and compare the cavitation effect induced by PIPS in the artificial root canals containing saline or NaOCl. Fluid velocity and Reynolds number of saline, 1%-, 2.5%- and 5.25% NaOCl irrigants induced by PIPS in the apical region were calculated using TEMA 2D software while the fluid motions were recorded. RESULTS Visualization profile revealed that NaOCl presented a stronger cavitation effect and fluid dynamics than saline during PIPS activation. In the apical region, 1% NaOCl group presented the highest average velocity of 3.868 m/s, followed by 2.5% NaOCl group (3.685 m/s), 5.25% NaOCl group (2.353 m/s) and saline group (1.268 m/s), corresponding to Reynolds number of 1653.173, 1572.196, 995.503 and 477.692. Statistically higher fluid velocity was calculated in 1% and 2.5% NaOCl groups compared to saline group, respectively (p < 0.05). CONCLUSIONS The application of NaOCl and its concentration significantly influence the cavitation effect and fluid dynamics during PIPS activation. 1% and 2.5% NaOCl groups presented a more violent fluid motion in the apical region when activated by PIPS.
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Affiliation(s)
- Chen Cai
- Department of Endodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medical, Guangzhou, 510182, Guangdong, China
| | - Cheng Wen
- Department of Stomatology, The Third Affiliated Hospital of Shenzhen University, Shenzhen Luohu Hospital Group Luohu People's Hospital, Shenzhen, 518001, Guangdong, China
| | - Lanxi Guan
- Department of Endodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medical, Guangzhou, 510182, Guangdong, China
| | - Yuting Huang
- Department of Endodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medical, Guangzhou, 510182, Guangdong, China.
| | - Qianzhou Jiang
- Department of Endodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medical, Guangzhou, 510182, Guangdong, China.
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95
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Çiftçioğlu E, Yücel Ö, Işık V, Keleş A, Kayahan MB. Irrigant flow characteristics in the root canal with internal root resorption: a computational fluid dynamics evaluation. Odontology 2022; 110:769-776. [PMID: 35218447 DOI: 10.1007/s10266-022-00698-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/11/2022] [Indexed: 11/30/2022]
Abstract
Irrigation dynamics of syringe irrigation with different needle designs (side-vented, double side-vented, notched) and ultrasonic irrigation in the root canal with internal root resorption were evaluated using a computational fluid dynamics model. A micro-CT scanned mandibular premolar was used for modeling internal root resorption. The needles and the ultrasonic tip were positioned at 2, 4, and 5 mm from the working length. The insertion depth and the irrigation model were found influential on the shear stress and the irrigant extension. The extension of the irrigant increased toward 2-5 mm from the working length. Ultrasonic irrigation revealed the highest shear stress values regardless of the insertion depth. The shear stress distribution on the resorption cavity walls gradually increased when the needles were positioned coronally. The residence time of the irrigant in the canal was affected by the needle position relative to the internal root resorption cavity and the needle type.
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Affiliation(s)
- Elif Çiftçioğlu
- Department of Endodontics, İstanbul Okan University Faculty of Dentistry, İstanbul, Turkey.
| | - Özgün Yücel
- Department of Chemical Engineering, Gebze Technical University Faculty of Engineering, Kocaeli, Turkey
| | - Vasfiye Işık
- Department of Endodontics, İstanbul Health and Technology University Faculty of Dentistry, İstanbul, Turkey
| | - Ali Keleş
- Department of Endodontics, Ondokuz Mayıs University Faculty of Dentistry, Samsun, Turkey
| | - Mehmet Baybora Kayahan
- Department of Endodontics, İstanbul Health and Technology University Faculty of Dentistry, İstanbul, Turkey
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96
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Torres-Betancourt JA, Hernandez-Delgadillo R, Flores-Treviño JJ, Solís-Soto JM, Pineda-Aguilar N, Nakagoshi-Cepeda MAA, Isela Sánchez-Nájera R, Chellam S, Cabral-Romero C. Antimicrobial potential of AH Plus supplemented with bismuth lipophilic nanoparticles on E. faecalis isolated from clinical isolates. J Appl Biomater Funct Mater 2022; 20:22808000211069221. [PMID: 35114826 DOI: 10.1177/22808000211069221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The objective of this study was to determine the antimicrobial potential of AH plus supplemented with bismuth lipophilic nanoparticles (BisBAL NPs) on the growth of Enterococcus faecalis isolated from patients with endodontic infections. BisBAL NPs, synthesized with the colloidal method, were characterized, in its pure form or AH Plus-absorbed, by energy-dispersive X-ray spectroscopy and scanning electron microscopy (EDS-SEM). Antimicrobial activity was evaluated with disc diffusion assays, and antibiofilm activity with fluorescence microscopy. BisBAL NP-supplemented AH Plus had a 4.9 times higher antimicrobial activity than AH Plus alone (p = 0.0001). In contrast to AH Plus alone, AH Plus supplemented with BisBAL NP inhibited E. faecalis biofilm formation. The sealing properties of AH plus were not modified by the incorporation of BisBAL NPs, which was demonstrated by a 12-day split-chamber leakage assay with daily inoculation, which was used to evaluate the possible filtration of E. faecalis. Finally, BisBAL NP-supplemented AH plus-BisBAL NPs was not cytotoxic for cultured human gingival fibroblasts. Their viability was 83.7% to 89.9% after a 24-h exposure to AH Plus containing 50 and 10 µM BisBAL NP, respectively. In conclusion, BisBAL NP-supplemented AH Plus constitutes an innovative nanomaterial to prevent re-infection in endodontic patients without cytotoxic effects.
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Affiliation(s)
| | - Rene Hernandez-Delgadillo
- Universidad Autónoma de Nuevo león, UANL, Facultad de Odontología, Laboratorio de Biología Molecular, Monterrey, Nuevo León, México
| | - Jorge Jaime Flores-Treviño
- Universidad Autónoma de Nuevo león, UANL, Facultad de Odontología, Laboratorio de Biología Molecular, Monterrey, Nuevo León, México
| | - Juan Manuel Solís-Soto
- Universidad Autónoma de Nuevo león, UANL, Facultad de Odontología, Laboratorio de Biología Molecular, Monterrey, Nuevo León, México
| | - Nayely Pineda-Aguilar
- Centro de Investigaciones en Materiales Avanzados, CIMAV Unidad Monterrey, Nuevo León, México
| | | | - Rosa Isela Sánchez-Nájera
- Universidad Autónoma de Nuevo león, UANL, Facultad de Odontología, Laboratorio de Biología Molecular, Monterrey, Nuevo León, México
| | | | - Claudio Cabral-Romero
- Universidad Autónoma de Nuevo león, UANL, Facultad de Odontología, Laboratorio de Biología Molecular, Monterrey, Nuevo León, México
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97
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Teja KV, Ramesh S, Battineni G, Vasundhara KA, Jose J, Janani K. The effect of various in-vitro and ex-vivo parameters on irrigant flow and apical pressure using manual syringe needle irrigation: Systematic review. Saudi Dent J 2022; 34:87-99. [PMID: 35241897 PMCID: PMC8864379 DOI: 10.1016/j.sdentj.2021.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/14/2021] [Accepted: 12/01/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Fluid dynamics is a majorly neglected aspect to be studied in root canal irrigation. The fundamental rule to understand mechanics is to observe patterns of flow during the process. Thus, this work is conducted to do a systemic assessment of the in-vitro and ex-vivo based studies to evaluate the effect of various parameters on the irrigant flow and apical pressure on using a manual syringe needle for root canal irrigation. METHODS The literature search was conducted through libraries such as PubMed (Medline), CINAHL, Embase, Scopus and other hand literature from Google Scholar, the British medical library etc. The systematic review was reported following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. As they include studies that were in-vitro and ex-vivo based, the risk of bias of the selected articles was assessed using a customized tool based on the previous literature and parameters evaluated in the studies included. RESULTS The literature search resulted in 101 items of which 19 records were included in this review. Results reported that multiple factors and parameters were assessed to evaluate the flow and apical pressures on using manual syringe needle irrigation. CONCLUSIONS Present systematic review gives insights in-depth about the irrigation dynamics of manual syringe needle irrigation. Besides, it is inconclusive to compile a single factor or a single parameter contributing to the enhanced irrigant flow and least apical pressures.
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Affiliation(s)
- Kavalipurapu Venkata Teja
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, TamilNadu, India
| | - Sindhu Ramesh
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, TamilNadu, India
| | - Gopi Battineni
- Telemedicine and Telepharmacy Centre, School of Medicinal and Health Product Sciences, University of Camerino, Camerino, Italy
| | | | - Jerry Jose
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, TamilNadu, India
| | - Krishnamachari Janani
- Department of Conservative Dentistry and Endodontics, MDS, Private Consultant, Chennai, Tamil Nadu, India
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98
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Kapralos V, Valen H, Koutroulis A, Camilleri J, Ørstavik D, Sunde PT. The dentine-sealer interface: modulation of antimicrobial effects by irrigation. Int Endod J 2022; 55:544-560. [PMID: 35080277 DOI: 10.1111/iej.13692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 11/29/2022]
Abstract
AIM Assess whether sodium hypochlorite (NaOCl) or chlorhexidine (CHX) and two irrigation protocols may alter the antibacterial properties of dentine and three endodontic sealers using a novel ex vivo tooth model. METHODOLOGY Prior to antibacterial testing, the tooth model was validated by means of scanning electron microscopy (SEM) to evaluate the separation between dentine and sealer surfaces. Root blocks prepared from extracted human roots were pretreated with 17% EDTA + 0.9% saline and subsequently treated with 1% NaOCl (G1), 2% CHX (G2) or no irrigant (G3). Two irrigation protocols were further investigated, "1% NaOCl + 17% EDTA" (P1) and "1% NaOCl + 17% EDTA + 2% CHX" (P2). Following irrigation, the root blocks were either filled with AH Plus, BioRoot RCS and Pulp Canal Sealer (PCS), or left empty. All groups were incubated for 1, 7 and 28 days. Direct contact tests for planktonic E. faecalis and 48 hours E. faecalis biofilms were performed at the level of dentine and sealer surfaces. Statistical analysis was performed on the bacterial survival between irrigants (G1, G2 and G3) and between irrigation protocols (P1 and P2) (p<0.05). RESULTS The model was considered reproducible as SEM examination of dentine samples indicated consistent separation between dentine and sealer surfaces. Irrigation with CHX (G2) and irrigation protocol (P2) enhanced the antibacterial properties of dentine without sealer application as well as dentine in contact with all three sealers tested, especially against planktonic E. faecalis. G2 and P2 also improved the antibacterial effect of AH Plus surfaces for all three incubation times. No irrigation groups (G1, G2) or irrigation protocols (P1, P2) altered the antibacterial properties of BioRoot RCS surfaces against planktonic bacteria or biofilms. Only BioRoot RCS surfaces eliminated the planktonic E. faecalis in all irrigation groups (G1, G2, G3) and protocols (P1, P2) investigated while PCS surfaces eliminated E. faecalis in biofilms in all groups up to 7 days. CONCLUSIONS The tooth model was reproducible. CHX improved the antibacterial activity upon both sealer and dentine surfaces. Among sealers, BioRoot RCS was less affected by NaOCl and CHX, and exhibited high antibacterial properties regardless the irrigation applied.
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Affiliation(s)
- V Kapralos
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
| | - H Valen
- Nordic Institute of Dental Materials (NIOM), Sognsveien 70 A, 0855, Oslo, Norway
| | - A Koutroulis
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
| | - J Camilleri
- School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | - D Ørstavik
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
| | - P T Sunde
- Section of Endodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Box 1109 Blindern, 0317, Oslo, Norway
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99
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Morozova Y, Voborná I, Žižka R, Bogdanová K, Večeřová R, Rejman D, Kolář M, Do Pham DD, Holík P, Moštěk R, Rosa M, Pospíšilová L. Ex Vivo Effect of Novel Lipophosphonoxins on Root Canal Biofilm Produced by Enterococcus faecalis: Pilot Study. Life (Basel) 2022; 12:life12010129. [PMID: 35054522 PMCID: PMC8781533 DOI: 10.3390/life12010129] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/09/2022] [Accepted: 01/12/2022] [Indexed: 11/24/2022] Open
Abstract
(1) Background: The root canal system has complex anatomical and histological features that make it impossible to completely remove all bacteria by mechanical means only; they must be supplemented with disinfectant irrigation. Current disinfectants are unable to eliminate certain microorganisms that persist in the root canal, resulting in treatment failure. At the Institute of Organic Chemistry and Biochemistry, Prague, novel substances with the bactericidal effect, termed lipophosphonoxins (LPPOs), have been discovered. The aim of this pilot study was to investigate the ex vivo effects of second- and third-generation LPPOs on Enterococcus faecalis and compare them with 5% sodium hypochlorite (NaOCl), 0.12% chlorhexidine digluconate, and 17% ethylenediaminetetraacetic acid (EDTA). (2) Methods: The root canal’s dentin was used as a carrier for biofilm formation in the extracted human mature mandibular premolars. The samples were filled with cultivation broth and 0.25% glucose with tested solutions. In control samples, only fresh cultivation broth (negative control) and cultivation broth with bacterial suspension (growth control) were used. Each sample was inoculated with E. faecalis CCM4224 except for the negative control, and cultivation was performed. To determine the number of planktonic cells, the sample content was inoculated on blood agar. To evaluate biofilm formation inhibition, samples were placed in tubes with BHI. (3) Results: LPPOs exhibited a reduction in biofilm growth and bacteria comparable to NaOCl, and they were superior to other tested disinfectants. (4) Conclusions: The study results suggest the effect of lipophosphonoxins on E. faecalis CCM 4224 reduces planktonic bacterial cells and inhibits formation of biofilm in root canal samples.
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Affiliation(s)
- Yuliya Morozova
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Palackého 12, 772 00 Olomouc, Czech Republic; (R.Ž.); (P.H.); (R.M.); (M.R.); (L.P.)
- Correspondence: (Y.M.); (I.V.)
| | - Iva Voborná
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Palackého 12, 772 00 Olomouc, Czech Republic; (R.Ž.); (P.H.); (R.M.); (M.R.); (L.P.)
- Correspondence: (Y.M.); (I.V.)
| | - Radovan Žižka
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Palackého 12, 772 00 Olomouc, Czech Republic; (R.Ž.); (P.H.); (R.M.); (M.R.); (L.P.)
| | - Kateřina Bogdanová
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (K.B.); (R.V.); (M.K.)
| | - Renata Večeřová
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (K.B.); (R.V.); (M.K.)
| | - Dominik Rejman
- Institute of Organic Chemistry and Biochemistry, Czech Academy of Sciences, Fleming Square 542/2, 160 00 Prague, Czech Republic; (D.R.); (D.D.D.P.)
| | - Milan Kolář
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15 Olomouc, Czech Republic; (K.B.); (R.V.); (M.K.)
| | - Duy Dinh Do Pham
- Institute of Organic Chemistry and Biochemistry, Czech Academy of Sciences, Fleming Square 542/2, 160 00 Prague, Czech Republic; (D.R.); (D.D.D.P.)
| | - Pavel Holík
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Palackého 12, 772 00 Olomouc, Czech Republic; (R.Ž.); (P.H.); (R.M.); (M.R.); (L.P.)
| | - Roman Moštěk
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Palackého 12, 772 00 Olomouc, Czech Republic; (R.Ž.); (P.H.); (R.M.); (M.R.); (L.P.)
| | - Matej Rosa
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Palackého 12, 772 00 Olomouc, Czech Republic; (R.Ž.); (P.H.); (R.M.); (M.R.); (L.P.)
| | - Lenka Pospíšilová
- Institute of Dentistry and Oral Sciences, Faculty of Medicine and Dentistry, Palacký University, Palackého 12, 772 00 Olomouc, Czech Republic; (R.Ž.); (P.H.); (R.M.); (M.R.); (L.P.)
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100
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The Efficacy of Selected Sodium Hypochlorite Heating Methods for Increasing and Maintaining Its Intracanal Temperature—An Ex Vivo Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12020891] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: Enhancement of the temperature of sodium hypochlorite (NaOCl) solution would increase its cleaning potential and decontamination of the root canal system. Therefore, the aim of the present in vitro investigation was to compare the efficacy of different methods of NaOCl heating by evaluating the temperature profiles developed at different levels of the root canal system. Methods: Five thermocouples were applied at different levels of the root canal system of extracted human premolars. NaOCl solution was heated according to two methods: extraoral heating (50 °C, 60 °C, and 70 °C) using a magnetic hotplate heater and intracanal heating by F-06, XF-30/04, and ML-12 pluggers at 100 °C, 150 °C, and 180 °C. Results: The extraoral heating method was ineffective to produce a significant temperature increase at the root apex. Comparable results were obtained using the intracanal heating method through the ML-12 plugger that showed slightly better results only when set at 180 °C. On the other hand, negligible differences were observed in terms of temperature maintenance at several levels of the root between the F-06 and XF-30/04 pluggers, even though the time intervals were higher in case of XF-30/04. Conclusions: The intracanal heating method provided a better temperature persistence in the middle third of the root canal system. Conversely, extraoral heating was ineffective to produce a significant temperature increase at the apex of the root. Comparable results were obtained even using the ML-12 plugger.
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