1
|
Sun X, Tan Y, Liu R, Li P. Numerical investigation and optimization of innovative root canal irrigation needles with composite flow control structures. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2024:e3852. [PMID: 39049450 DOI: 10.1002/cnm.3852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 07/03/2024] [Accepted: 07/08/2024] [Indexed: 07/27/2024]
Abstract
Needle syringe irrigation is frequently used in root canal therapy, and the flow pattern during irrigation can be efficiently manipulated by means of passive flow control technique, resulting in expected irrigation performance improvement. Therefore, novel needles with composite flow control structures are numerically investigated and optimized in this study. Based on the 30G needle, six single/double side-vented needles with dimple and protrusion are proposed. Two flow rates in line with clinical applications, 5.3 and 8.6 m/s, are used in the analysis. Three performance parameters are investigated. The safety of the irrigation system is evaluated by the root canal apical pressure, whereas the irrigant extension and the flushing efficiency are evaluated by the extending depth and the effective cleaning area, respectively. The results demonstrate that the shear stress of the double-side-vented needle is higher while the irrigant extension is enhanced with a dimple structure. The performance of the double-side-vented needle with a dimple is superior to that of other designs, with up to 33% improvement in extending depth and a 22% increase in effective cleaning area over the prototype. New needles do not raise risk of irrigant extrusion. Furthermore, the effect of dimple depth and outlet angle are investigated. The needle with a dimple of 0.04 mm depth shows the highest extending depth within the confines of the investigation. The effective cleaning area is significantly influenced by the needle outlets, and the effective cleaning area expands with an increase in needle outlet angle, while the extending depth gradually declines.
Collapse
Affiliation(s)
- Xiaoyu Sun
- MOE Key Laboratory of Thermo-Fluid Science and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Youwei Tan
- MOE Key Laboratory of Thermo-Fluid Science and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Ruirui Liu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Ping Li
- MOE Key Laboratory of Thermo-Fluid Science and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| |
Collapse
|
2
|
Czopik B, Woźniakiewicz A, Świętoniowska N, Zarzecka J, Woźniakiewicz M. Quantitative Insight into PCA Formation following Different Chlorhexidine Activation Methods in Endodontic Treatment. Molecules 2023; 28:6159. [PMID: 37630411 PMCID: PMC10457975 DOI: 10.3390/molecules28166159] [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: 06/14/2023] [Revised: 08/10/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
The aim of the study was a quantitative analysis of p-chloroaniline (PCA) formation during 2% CHX activation with US and MDI methods in a root canal-like environment with the HPLC-DAD method and, thus, a safety assessment of US and MDI agitation of CHX in endodontic treatment. Two percent CHX was activated with the US method using ISO 30 and 35 K-file, and the MDI method using ISO 30.06 and 35.06 GP cones for 15, 30, 60, and 90 s. PCA concentration was assessed with the HPLC-DAD method. PCA concentration was also assessed for 2% CHX after 0, 3, 18, and 21 days of storage in ambient conditions. PCA was detected in all samples in all methods of activation. The concentration of PCA was dependent on time of activation in US ISO 30 and ISO 35 group (p < 0.05). In the MDI ISO 30.06 and ISO 35.06 groups, a similar trend was observed but without statistical significance (p > 0.05). PCA was detected in shelf-stored 2% CHX and the concentration was related to the time of storage. PCA is released after CHX activation with US and MDI, but mean concentrations are not higher than those observed from self-degradation of shelf-stored 2% CHX.
Collapse
Affiliation(s)
- Barbara Czopik
- Department of Conservative Dentistry with Endodontics, Faculty of Medicine, Institute of Stomatology, Jagiellonian University Medical College, Montelupich 4 St., 31-155 Kraków, Poland;
| | - Aneta Woźniakiewicz
- Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, Gronostajowa 2, 30-387 Kraków, Poland; (A.W.); (M.W.)
| | - Natalia Świętoniowska
- Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, Gronostajowa 2, 30-387 Kraków, Poland; (A.W.); (M.W.)
| | - Joanna Zarzecka
- Department of Conservative Dentistry with Endodontics, Faculty of Medicine, Institute of Stomatology, Jagiellonian University Medical College, Montelupich 4 St., 31-155 Kraków, Poland;
| | - Michał Woźniakiewicz
- Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, Gronostajowa 2, 30-387 Kraków, Poland; (A.W.); (M.W.)
| |
Collapse
|
3
|
Seghayer I, Lee AHC, Cheung GSP, Zhang C. Effect of Passive Ultrasonic Irrigation, Er,Cr:YSGG Laser, and Photon-Induced Photoacoustic Streaming against Enterococcus faecalis Biofilms in the Apical Third of Root Canals. Bioengineering (Basel) 2023; 10:bioengineering10040490. [PMID: 37106677 PMCID: PMC10135464 DOI: 10.3390/bioengineering10040490] [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: 03/08/2023] [Revised: 04/08/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
PURPOSE This study aimed to compare the antibacterial effectiveness of passive ultrasonic irrigation (PUI), Er,Cr:YSGG laser (WTL), and photon-induced photoacoustic streaming (PIPS) using an Er:YAG laser against Enterococcus faecalis biofilms in the apical third of root canals. METHODS Root canals of 70 single-rooted human teeth were instrumented and infected with E. faecalis for 3 weeks to form biofilms. The samples were randomly divided into five groups as follows: (i) PUI + 3% NaOCl (n = 16); (ii) Er,Cr:YSGG laser (n = 16); (iii) PIPS + 3% NaOCl (n = 16); (iv) positive control group (n = 10); and (v) negative control group (n = 10). The bacterial content in the root canal was sampled using (a) the paper-point sampling method before (S1) and after (S2) treatment and (b) pulverising the apical 5 mm of the root. The number of bacteria recovered from each group was counted as colony-forming units (CFUs). The amount of reduction between the groups was compared with the Kruskal-Wallis test and post-test Dunn's multiple comparisons tests. The significance level was set at 5% (p < 0.05). RESULTS The samples from the paper-point sampling method showed that the amount of bacteria before (S1) and after treatment (S2) was significantly different between PIPS and WTL, as well as between the PUI and WTL groups. In contrast, no significant difference was found between the PIPS and PUI groups. From the pulverised samples, the results indicated no significant difference among all experimental groups in the amount of bacterial reduction in the apical 5 mm of the root. CONCLUSIONS PUI and PIPS showed a significantly greater reduction in bacterial content within the main root canal compared with the WTL. There was no difference among all experimental groups in the apical third of the root.
Collapse
Affiliation(s)
- Ibrahim Seghayer
- Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Angeline H C Lee
- Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Gary S P Cheung
- Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Chengfei Zhang
- Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| |
Collapse
|
4
|
Aydın RN, Gençoğlu N. Histological Investigation of the Cleaning Effectiveness of Different Biomechanic Processes of Isthmus in Lower Molars. Eur J Dent 2022. [DOI: 10.1055/s-0042-1753455] [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
Abstract
Objectives This study aimed to evaluate the efficacy of different instruments (Hyflex, ROTATE, and hand files) and irrigation methods (EndoUltra, EndoActivator, and side-perforated syringe) in the mesial root canal of a mandibular first molar with isthmuses.
Materials and Methods Sixty-three mandibular molar teeth with isthmus were selected using cone beam computed tomography (CBCT) images. The root canals were instrumented with Hyflex, ROTATE, or hand files (21 of each) and three of each as control group and the specimens were embedded in silicone blocks. Final irrigation was performed with the perforated syringe or ultrasonic (EndoUltra) or sonic irrigation (EndoActivator). All canals were irrigated using 5.25% NaOCl solution (15 mL). Then, the roots were stained with hematoxylin–eosin, and specimens were sliced for histologic evaluation. The isthmus regions (2.7, 3, 4.7, and 5 mm from the apex) were analyzed, and the percentage of debris was calculated.
Statistical Analysis All data were statistically analyzed using one-way analysis of variance and Tukey's tests.
Results Both Hyflex and ROTATE groups showed less debris compared with the hand instrument group (P < 0.05). When irrigation methods were compared, EndoUltra showed the least, followed by EndoActivator and perforated needle irrigation having the maximum debris (p < 0.05). When sections were compared, the maximum debris was found in the apical section and the least in the coronal section (p < 0.05).
Conclusion Although none of the methods cleaned the isthmus completely, nickel–titanium (NiTi) systems and ultrasonic and sonic systems removed more debris than the side-perforated needle syringe irrigation.
Collapse
Affiliation(s)
- Rabia N. Aydın
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, İstanbul, Turkey
| | - Nimet Gençoğlu
- Department of Endodontics, Faculty of Dentistry, Marmara University, İstanbul, Turkey
| |
Collapse
|
5
|
Elmallawany A, Hussein YF, Ali MM, Montasser K, Aly Y, Sharaf N. Effect of Ultrasonic and Diode Laser Irrigation Activation on Post-operative Pain and Microbial Reduction in Single Visit Endodontic Treatment of Necrotic Mandibular Molars. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: To clinically evaluate the effect of continuous ultrasonic and diode laser 810 wave length irrigation activation techniques on postoperative pain and bacterial reduction in single visit endodontic treatment of mandibular molars.
Material and methods: Forty patients requiring root canal treatment therapy for necrotic mandibular molars teeth were included in this study with age ranges between 20 and 45 years. In all cases, single visit endodontic treatment was carried out using Revo-S rotary file system in crown down sequence. NaOCl 2.5% irrigation solution was used during treatment. Patients were randomly and equally assigned into two groups according to irrigation technique. Group (1): conventional syringe irrigation and group (2): continuous ultrasonic irrigation. Each group was subdivided into two sub groups (n = 10); subgroup 1A (conventional syringe irrigation with no laser), subgroup 1B (conventional syringe irrigation with diode laser), subgroup 2A (continuous ultrasonic irrigation with no laser) and subgroup 2B (continuous ultrasonic irrigation with diode laser).
Postoperative pain evaluation was done using Visual Analogue Scale (VAS) at 6, 12, 24, 36, 48 hours and 7 days postoperatively. Microbiological detection of bacterial reduction was done by taking Samples (S1 and S2) for bacterial cultures. S1 after finishing access cavity and before mechanical preparation and S2 after finishing mechanical preparation and irrigation activation and before obturation. Samples were cultured on blood agar and determined as colony forming units (CFU/mL). Microbiological bacterial reduction was calculated accordingly. Statistical analyses were analyzed using the Mann-Whitney U test. The significance level was set at p < 0.05.
Results: In all sub groups, postoperative pain decreased by time in all time intervals but pain was significantly lower in subgroup (2B) (continuous ultrasonic irrigation with diode laser) than subgroup (1A) (conventional syringe irrigation with no laser) in all time interval. Microbiological results showed the highest bacterial reduction was in subgroup (2B) (continuous ultrasonic irrigation with diode laser) and least bacterial reduction was in subgroup (1A) (conventional syringe irrigation with no laser).
Conclusion: Using diode laser and continuous ultrasonic irrigation activation techniques as adjunctive methods showed improvement in postoperative pain records and enhanced bacterial reduction in root canal therapy.
Keywords: Continuous ultrasonic irrigation, diode laser 810, post-operative pain, bacterial reduction, single visit endodontic treatment.
Collapse
|
6
|
Boutsioukis C, Arias-Moliz MT. Present status and future directions - irrigants and irrigation methods. Int Endod J 2022; 55 Suppl 3:588-612. [PMID: 35338652 PMCID: PMC9321999 DOI: 10.1111/iej.13739] [Citation(s) in RCA: 85] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/21/2022] [Indexed: 11/30/2022]
Abstract
Irrigation is considered the primary means of cleaning and disinfection of the root canal system. The purpose of this review was to set the framework for the obstacles that irrigation needs to overcome, to critically appraise currently used irrigants and irrigation methods, to highlight knowledge gaps and methodological limitations in the available studies and to provide directions for future developments. Organization of bacteria in biofilms located in anatomic intricacies of the root canal system and the difficulty to eliminate them is the main challenge for irrigants. Sodium hypochlorite remains the primary irrigant of choice, but it needs to be supplemented by a chelator. Delivery of the irrigants using a syringe and needle and activation by an ultrasonic file are the most popular irrigation methods. There is no evidence that any adjunct irrigation method, including ultrasonic activation, can improve the long‐term outcome of root canal treatment beyond what can be achieved by instrumentation and syringe irrigation. It is necessary to redefine the research priorities in this field and investigate in greater depth the penetration of the irrigants, their effect on the biofilm and the long‐term treatment outcome. New studies must also focus on clinically relevant comparisons, avoid methodological flaws and have sufficiently large sample sizes to reach reliable conclusions. Future multidisciplinary efforts combining the knowledge from basic sciences such as Chemistry, Microbiology and Fluid Dynamics may lead to more effective antimicrobials and improved activation methods to bring them closer to the residual biofilm in the root canal system.
Collapse
Affiliation(s)
- C Boutsioukis
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M T Arias-Moliz
- Department of Microbiology, Faculty of Dentistry, University of Granada, Granada, Spain
| |
Collapse
|
7
|
Al-rujaib BA, Zaghloul MH, Reda A, Badr AE. Efficacy of Different Endodontic Irrigant Activation Systems on Smear Layer Removal and Canal Cleanliness: Comparative Scanning Electron Microscopic Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: This study assessed the effectiveness of 5 different irrigant activation systems on canal cleanliness and removal of smear layer from root canals.
METHODS: A total of 110 mandibular premolars with straight root canal were assigned to five groups (n = 20): conventional needle irrigation, passive ultrasonic activation, sonic activation with EndoActivator, negative apical pressure EndoVac (EV), or EDDY system, besides a control group (n = 10). All teeth were prepared to size 40, and irrigated with NaOCl (5.25%) according to the respective technique. Roots were split longitudinally and subjected to scanning electron microscopic analysis. The presence of smear layer and debris was evaluated using 5-grade scoring systems with ×1000 and ×400 magnification, respectively. Data were analyzed at 5%.
RESULTS: Regarding the smear layer, activation with EV and ED was significantly more effective than other activation groups (p < 0.05). Activation of the irrigant significantly improved removal of debris (p < 0.05).
CONCLUSION: No activation technique was able to eliminate smear layer and debris completely from root canals, nevertheless, EDDY is significantly better in removing debris and smear layer from the apical third of the canal.
Collapse
|
8
|
Castro-Núnez GM, Dos Santos JREV, Zaniboni JF, Escalante-Otárola WG, Porto TS, Kuga MC. Effect of mechanical cleaning protocols in the fiber post space on the adhesive interface between universal adhesive and root dentin. Microsc Res Tech 2022; 85:2131-2139. [PMID: 35141981 DOI: 10.1002/jemt.24071] [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: 10/13/2021] [Revised: 01/07/2022] [Accepted: 01/21/2022] [Indexed: 11/10/2022]
Abstract
The aim of this study was to evaluate the effects of cleaning protocols on the presence of residues, open dentinal tubules, and bond strength of a self-etch adhesive plus a dual-cure resin cement to dentin in the fiber-post space. The methods for cleaning utilized were conventional irrigation (CI), rotary brush with continuous rotary movement (RB), and continuous ultrasonic irrigation (CUI). Sixty bovine incisors were used for fiber-post space preparation. Thirty roots were divided into three groups (n = 10) according to the cleaning protocols and submitted to scanning electron microscope to evaluate presence of residues and relative quantity of open dentinal tubules on dentin surface. Similar protocols were performed in the other thirty roots (n = 10) using a self-etching adhesive system (Scotchbond Universal) and a dual-cure resin cement (Relyx Unicem 2). After 6 months cervical, middle, and apical thirds sections of fiber-post space were submitted to push-out testing. To data ANOVA and Tukey's test were employed (α = 5%). RB and CUI showed the lowest presence of residues on dentin surface (p = .015) and the highest bond strength values (p < .001), regardless of the dentin third. CUI presented the highest quantity of open dentinal tubules in middle and apical thirds (p < .001). CI presented the lowest bond strength value of resin cement, regardless of dentin third (p < .001). Mechanical cleaning protocols, such as RB and CUI, presented better surface cleaning capabilities and higher bond strength than CI with dual-cure resin cement employed. The use of a mechanical cleaning protocol seems to cause appropriate condition on the root dentin surface. Mechanical cleaning of root dentin provided greater bond strength of the self-etching system with dual resin cement. Conventional irrigation did not provide adequate root dentin cleaning.
Collapse
Affiliation(s)
| | | | - Joissi Ferrari Zaniboni
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | | | - Thiago Soares Porto
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Milton Carlos Kuga
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| |
Collapse
|
9
|
Tashkandi N, Alghamdi F. Effect of Chemical Debridement and Irrigant Activation on Endodontic Treatment Outcomes: An Updated Overview. Cureus 2022; 14:e21525. [PMID: 35223300 PMCID: PMC8863357 DOI: 10.7759/cureus.21525] [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] [Accepted: 01/09/2022] [Indexed: 12/20/2022] Open
Abstract
Chemical debridement is considered one of the most important steps during root canal treatment to target unreached areas and provide thorough disinfection of the canals. The efficiency of this step efficiency can be increased using different agitation and irrigation techniques/devices. This comprehensive review aimed to summarize the effect of various irrigant activation and agitation techniques/devices on endodontic treatment outcomes. Using mechanical active irrigation, which enables the activation or agitation of the irrigating solution, is beneficial in root canal treatment by increasing the efficiency of delivering the irrigant up to working length and ensuring isthmus cleanliness. However, considerable variation was noticed between the protocols used in each technique with a lack of well-designed randomized clinical trials to focus on the long-term outcome. Moreover, a low level of evidence was noticed regarding the effectiveness of certain activation techniques over others. Therefore, each study needs to be carefully weighed before using its results and embracing its conclusion. Future studies need to focus more on the antimicrobial effect of each technique and its effect on the healing of apical periodontitis. Also, recent advances, such as multisonic and laser activation, are promising tools that need more clinical investigations to show their efficiency.
Collapse
|
10
|
The C-shaped root canal systems in mandibular second molars in an Emirati population. Sci Rep 2021; 11:23863. [PMID: 34903785 PMCID: PMC8668958 DOI: 10.1038/s41598-021-03329-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 12/01/2021] [Indexed: 12/23/2022] Open
Abstract
Our study aimed to describe the root and canal morphology of mandibular second molars in Emirati population and to study the prevalence and types of morphological change in C-shaped canal configuration along the root length in an effort to describe C-shaped molars as a unit. Cone beam computed tomography (CBCT) scans of Emirati patients were analyzed in multiple plans and root and canal configuration of mandibular second molars were evaluated. Moreover, specific types of morphological change in C-shaped canal configuration along root length were studied and reconstructed using 3D reconstruction software. A total of 508 mandibular second molars were evaluated. Among the non-C-shaped mandibular second molars, two separate roots were the most prevalent root morphology (78.3%). The mesial root's most common root canal configuration was Vertucci Type II (46.5%), and in the distal root, Vertucci Type I (90.5%). The prevalence of C-shaped mandibular second molars was 17.9% and was significantly prevalent (P < 0.001) in females. Specific types of morphological change in C-shaped molars along the root length were observed and described for the first time, in which the most common types of morphological change were C1-C2-C3d (18%), C1-C3c-C3d (15.4%), C4-C3c-C3d (7.7%), and C3c-C3c-C3d (7.7%). This study showed wide variations in the root and canal morphology in mandibular second molars in Emirati population with a relatively high prevalence of C-shaped canal configuration (17.9%). Moreover, specific types of morphological change in C-shaped configuration were detected and described for the first time in this population.
Collapse
|
11
|
Pedrinha VF, Cardenas Cuellar MR, Velásquez-Espedilla EG, Duarte MAH, Andrade FBD, Rodrigues PDA. Impact of irrigation protocols with some chelators and mechanical agitation on intratubular decontamination. Braz Oral Res 2021; 35:e127. [PMID: 34878082 DOI: 10.1590/1807-3107bor-2021.vol35.0127] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 05/05/2021] [Indexed: 11/21/2022] Open
Abstract
This study evaluated main canal and intratubular decontamination using different irrigation solutions followed by adjunctive agitation steps for infected root canals. Sixty-eight lower incisors were contaminated with Enterococcus faecalis and allocated to groups according to canal treatment (n = 10): G1, NaOCl followed by ethylenediaminetetraacetic acid (EDTA); G2, a mixture of NaOCl with hydroxyethylidene bisphosphonate (HEBP); and G3, NaOCl followed by EDTA-T (EDTA with sodium lauryl ether sulfate). All three groups of teeth were agitated with passive ultrasonic irrigation (PUI) using saline solution, whereby G4, G5, and G6 were prepared as above, and agitation was performed using an XP-Endo Finisher instrument. Microbiological samples were collected from the root canals with paper points at three times: before and after chemomechanical preparation and after agitation. The colony-forming units (CFU)/mL count was determined, and bacterial intratubular viability was analyzed via confocal laser scanning microscopy using Live/Dead staining. Statistical analysis was performed using a Kruskal-Wallis test followed by Dunn tests. A Friedman test was applied for colony-counting data (α = 0.05). CFU/mL counting indicated equally effective decontamination in the experimental groups (p > 0.05). According to microscopy images, the use of irrigation solutions followed by agitation with the XP-Endo Finisher yielded better results. Moreover, NaOCl+EDTA-T followed by XP-Endo Finisher resulted in significantly lower viability than in the PUI-activated groups (p < 0.05). The cervical and medium thirds of the specimens presented similar results. Overall, NaOCl+EDTA-T exhibited the best intratubular antibacterial activity, mainly for canals that were subsequently agitated using XP-Endo Finisher.
Collapse
Affiliation(s)
- Victor Feliz Pedrinha
- Universidade Federal do Pará - UFPA, Graduate Program in Dentistry, Laboratory of Dental Materials, Belém, PA, Brazil
| | - Maricel Rosario Cardenas Cuellar
- Universidade de São Paulo - USP, Bauru Dental School, Department of Operative Dentistry, Dental Materials and Endodontics, Bauru, SP, Brazil
| | - Evelyn Giuliana Velásquez-Espedilla
- Universidade de São Paulo - USP, Bauru Dental School, Department of Operative Dentistry, Dental Materials and Endodontics, Bauru, SP, Brazil
| | - Marco Antonio Hungaro Duarte
- Universidade de São Paulo - USP, Bauru Dental School, Department of Operative Dentistry, Dental Materials and Endodontics, Bauru, SP, Brazil
| | - Flaviana Bombarda de Andrade
- Universidade de São Paulo - USP, Bauru Dental School, Department of Operative Dentistry, Dental Materials and Endodontics, Bauru, SP, Brazil
| | - Patrícia de Almeida Rodrigues
- Universidade Federal do Pará - UFPA, Graduate Program in Dentistry, Laboratory of Dental Materials, Belém, PA, Brazil
| |
Collapse
|
12
|
Villalta-Briones N, Baca P, Bravo M, Solana C, Aguado-Pérez B, Ruiz-Linares M, Arias-Moliz MT. A laboratory study of root canal and isthmus disinfection in extracted teeth using various activation methods with a mixture of sodium hypochlorite and etidronic acid. Int Endod J 2020; 54:268-278. [PMID: 32970865 DOI: 10.1111/iej.13417] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 09/10/2020] [Accepted: 09/17/2020] [Indexed: 12/29/2022]
Abstract
AIM To evaluate in a laboratory setting the antibiofilm activity of several irrigating protocols including conventional irrigation, ultrasonic activation and XP-endo Finisher, with a mixture of sodium hypochlorite and etidronic acid in infected isthmuses and root canals of extracted human mandibular molar teeth. METHODOLOGY Fifty-six mesial roots of mandibular molars, half of them with a continuous isthmus from the cervical to the apical third between the two root canals (type 1), and the other half with a continuous isthmus from the cervical to the middle third and one canal in the apical third (type 2), were included. The root canals were contaminated for 7 days with an Enterococcus faecalis suspension. There were three experimental groups plus a control group (n = 7 per type of root canal anatomy). All the root canals, except for the control group that was not treated, were chemomechanically prepared and then assigned to one of the experimental groups according to the final adjunctive procedure: conventional irrigation, ultrasonic activation or XP-endo Finisher activation. The irrigating solution used was a combination of 2.5% sodium hypochlorite and 9% etidronic acid, and the final protocols were applied for three cycles of 30 s with a 3 mL volume. The antibiofilm activity was evaluated at each location (root canal and isthmus) and third (cervical, middle and apical) using confocal laser scanning microscopy and the live/dead technique. Statistical analysis was performed using SPSS (descriptive statistics) and SUDAAN (P-value calculations). RESULTS Root canals had significantly lower biovolume values than the isthmuses (P < 0.05). The biovolume in the root canals was significantly reduced in all the experimental groups in all the thirds except for conventional irrigation in the apical third (P > 0.05). In the cervical and middle thirds, ultrasonic activation was associated with the lowest biovolumes (P < 0.05), followed by XP-endo Finisher. In the isthmus, disinfection was similar in all the thirds for all the protocols. Conventional irrigation was associated with intermediate values with no significant differences from the control group or from the activated protocols (P > 0.05), although the latter were significantly different from the control group (P < 0.05). No differences were found between ultrasonic activation and XP-endo Finisher in the middle and apical thirds (P > 0.05) in the isthmuses. CONCLUSIONS In this laboratory study on extracted teeth, the isthmus was more difficult to disinfect than root canals. In the root canals, ultrasonic activation and XP-endo Finisher had a greater effectiveness than conventional irrigation. In the isthmuses, no differences were observed between the two activation techniques and conventional irrigation.
Collapse
Affiliation(s)
- N Villalta-Briones
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - P Baca
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - M Bravo
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - C Solana
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - B Aguado-Pérez
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - M Ruiz-Linares
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - M T Arias-Moliz
- Department of Microbiology, School of Dentistry, University of Granada, Granada, Spain
| |
Collapse
|
13
|
Loroño G, Zaldivar JR, Arias A, Cisneros R, Dorado S, Jimenez‐Octavio JR. Positive and negative pressure irrigation in oval root canals with apical ramifications: a computational fluid dynamics evaluation in micro‐CT scanned real teeth. Int Endod J 2020; 53:671-679. [DOI: 10.1111/iej.13260] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 12/05/2019] [Indexed: 12/17/2022]
Affiliation(s)
- G. Loroño
- Postgraduate Program in Endodontics European University of Madrid MadridSpain
| | - J. R. Zaldivar
- Department of Conservative and Prosthetic Dentistry School of Dentistry Complutense University MadridSpain
| | - A. Arias
- Department of Conservative and Prosthetic Dentistry School of Dentistry Complutense University MadridSpain
| | - R. Cisneros
- Postgraduate Program in Endodontics European University of Madrid MadridSpain
| | - S. Dorado
- Instituto de Investigación Tecnológica Escuela Técnica Superior de Ingeniería ICAI Universidad Pontificia Comillas Madrid Spain
| | - J. R. Jimenez‐Octavio
- Instituto de Investigación Tecnológica Escuela Técnica Superior de Ingeniería ICAI Universidad Pontificia Comillas Madrid Spain
| |
Collapse
|
14
|
Liu YJ, Yang WD, Wang WM, Zhu YN, Lin ZT, Zhu M. Relationship between canal morphology and isthmus in mesio-buccal roots of maxillary first molars in 9- to 12-year-old children: An in-vivo cone-beam computed tomography analysis. Arch Oral Biol 2020; 112:104645. [PMID: 31991228 DOI: 10.1016/j.archoralbio.2019.104645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/23/2019] [Accepted: 12/23/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVES This study aims to analysis the distribution of root canal isthmuses (RCIs), and its relationship with canal morphology in the mesio-buccal roots of maxillary first molars in children aged 9-12 in a Chinese sub-population. METHODS 494 healthy, untreated maxillary first molars with fully developed mesio-buccal roots were examined. Cone-beam computed tomography (CBCT) scans were acquired as part of diagnosis and treatment plannings unrelated to the present study. The images were evaluated to identify the canal morphology of mesio-buccal roots according to Vertucci's classification. A map-reading strategy was used to identify RCIs. RESULTS In mesio-buccal roots, the most common canal morphology was type Ⅳ (38.5 %). The frequency of type I (1.6 %) was much lower than adults. RCIs were found in 92.5 % mesio-buccal roots. The RCIs which began in the cervical third and ended in the middle third (CT-MT) (31.0 %) had the highest frequency. In type III, the RCIs which began and ended in the middle third (MT-MT) (30.3 %) were most common. For type V, 30.8 % RCIs began in the cervical third and ended in the apical third (CT-AT). No significant differences were found between sexes and sides (P > 0.05). CONCLUSIONS For children aged 9-12, the frequency of type I canals was much lower in mesio-buccal roots of maxillary permanent first molars, while the frequency of RCIs was higher than adults, especially in the apical third. The distribution of RCIs had its own characteristics in each canal type, closely related to the structures.
Collapse
Affiliation(s)
- Ya-Jing Liu
- Department of Endodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210008, China
| | - Wei-Dong Yang
- Department of Endodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210008, China.
| | - Wen-Mei Wang
- Department of Oral Mucosa Diseases, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210008, China
| | - Ya-Nan Zhu
- Department of Endodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210008, China
| | - Zi-Tong Lin
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210008, China
| | - Min Zhu
- Department of Endodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210008, China
| |
Collapse
|
15
|
Yang Q, Liu MW, Zhu LX, Peng B. Micro‐CT study on the removal of accumulated hard‐tissue debris from the root canal system of mandibular molars when using a novel laser‐activated irrigation approach. Int Endod J 2019; 53:529-538. [DOI: 10.1111/iej.13250] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Q. Yang
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education School and Hospital of Stomatology Wuhan University Wuhan China
| | - M. W. Liu
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education School and Hospital of Stomatology Wuhan University Wuhan China
| | - L. X. Zhu
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education School and Hospital of Stomatology Wuhan University Wuhan China
| | - B. Peng
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education School and Hospital of Stomatology Wuhan University Wuhan China
| |
Collapse
|
16
|
Distribution of sodium hypochlorite throughout the mesial root canal system of mandibular molars after adjunctive irrigant activation procedures: a micro-computed tomographic study. Clin Oral Investig 2019; 24:907-914. [PMID: 31240405 DOI: 10.1007/s00784-019-02970-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/23/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To evaluate and compare irrigant distribution throughout the root canal system of mesial roots of mandibular molars after application of distinct adjunctive irrigant activation procedures. MATERIALS AND METHODS Fifteen extracted mandibular molars presenting Fan's type II, III, or IV isthmus configurations were selected. The canals were initially enlarged and cleaned. The same specimens were subjected to conventional positive pressure irrigation (PPI) followed by adjunctive irrigation approaches: passive ultrasonic irrigation (PUI), mechanical activation with the XP-endo Finisher instrument, and a control group in which the irrigant remained in the canal with no activation. Retention time for the irrigant was the same for all groups. Sodium hypochlorite mixed with a contrast medium (Omnipaque 300) was used as the irrigant. Before and immediately after the adjunctive irrigation, micro-computed tomographic (micro-CT) scans were taken to evaluate the volume of the entire root canal system that was filled by the irrigant. An exclusive analysis was also done for the isthmus area. RESULTS Analysis of the entire root canal system showed that the XP-endo Finisher instrument promoted better distribution of the irrigant than PUI and the control group (p < 0.01). PUI was not significantly different from the control group (p > 0.05). A separate analysis of the isthmus area showed no significant difference between the adjunctive irrigation methods and the control (p > 0.05). CONCLUSIONS The XP-endo Finisher instrument promoted better distribution of irrigant throughout the root canal system, especially in the apical canal segment, when compared to PUI. However, the tested approaches did not differ as to the ability to drive irrigants into the isthmus area. CLINICAL RELEVANCE This study highlighted that the XP-endo Finisher instrument presented a better performance to distribute irrigant throughout the root canal system, especially in the apical canal segment compared to positive pressure irrigation and PUI.
Collapse
|
17
|
Lee OYS, Khan K, Li KY, Shetty H, Abiad RS, Cheung GSP, Neelakantan P. Influence of apical preparation size and irrigation technique on root canal debridement: a histological analysis of round and oval root canals. Int Endod J 2019; 52:1366-1376. [DOI: 10.1111/iej.13127] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/10/2019] [Indexed: 12/22/2022]
Affiliation(s)
- O. Y. S. Lee
- Faculty of Dentistry The University of Hong Kong Hong Kong
| | - K. Khan
- Faculty of Dentistry The University of Hong Kong Hong Kong
| | - K. Y. Li
- Centralized Research Laboratories Faculty of Dentistry The University of Hong Kong Hong Kong
| | - H. Shetty
- Department of Conservative Dentistry and Endodontics Nair Hospital Dental College Mumbai India
| | - R. S. Abiad
- Endodontic Division Faculty of Dentistry Beirut Arab University Beirut Lebanon
| | | | - P. Neelakantan
- Faculty of Dentistry The University of Hong Kong Hong Kong
| |
Collapse
|
18
|
Ultrasonic Irrigant Activation during Root Canal Treatment: A Systematic Review. J Endod 2019; 45:31-44.e13. [PMID: 30558797 DOI: 10.1016/j.joen.2018.09.010] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/05/2018] [Accepted: 09/16/2018] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The aim of this study was to systematically review the evidence on the cleaning and disinfection of root canals and the healing of apical periodontitis when ultrasonic irrigant activation is applied during primary root canal treatment of mature permanent teeth compared with syringe irrigation. METHODS An electronic search was conducted of the Cochrane Library, Embase, LILACS, PubMed, SciELO, and Scopus databases using both free-text key words and controlled vocabulary. Additional studies were sought through hand searching of endodontic journals and textbooks. The retrieved studies were screened by 2 reviewers according to predefined criteria. The included studies were critically appraised, and the extracted data were arranged in tables. RESULTS The electronic and hand search retrieved 1966 titles. Three clinical studies and 45 in vitro studies were included in this review. Ultrasonic activation did not improve the healing rate of apical periodontitis compared with syringe irrigation after primary root canal treatment of teeth with a single root canal. Conflicting results were reported by the in vitro microbiological studies. Ultrasonic activation was more effective than syringe irrigation in the removal of pulp tissue remnants and hard tissue debris based on both clinical and in vitro studies. Ultrasonic activation groups were possibly favored in 13 studies, whereas syringe irrigation groups may have been favored in 3 studies. CONCLUSIONS The level of the available evidence was low, so no strong clinical recommendations could be formulated. Future studies should focus on the antimicrobial effect and healing of apical periodontitis in teeth with multiple root canals.
Collapse
|
19
|
Presence of isthmi in mandibular mesial roots and associated factors: an in vivo analysis. Surg Radiol Anat 2019; 41:815-822. [PMID: 30937566 PMCID: PMC6570693 DOI: 10.1007/s00276-019-02231-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 03/26/2019] [Indexed: 11/23/2022]
Abstract
Purpose To investigate the prevalence of isthmi and middle mesial (MM) canals in the mesial roots of mandibular first molars (MFM) in a Mongoloid subpopulation and to evaluate their association with demographic and anatomic characteristics. Methods Cone-beam computed tomography (CBCT) images of 496 patients with 823 MFMs were selected and analyzed. The following data were collected: patient age and gender, side, presence and distribution of MM canal and isthmus, distance between mesiobuccal (MB) and mesiolingual (ML) orifices, and MB–ML root canal system (RCS) morphology. Logistic regression was used to determine the association between demographic and anatomic characteristics and the presence of isthmi in the apical third. Results The overall prevalence of isthmus and an MM canal in MFM was 64.6% and 10.8%, respectively. The highest prevalence of isthmi and MM canals was found in patients of ≤ 20 and of 41–60 years, respectively (p < 0.05). The prevalence of isthmi declines with age. A total of 41.3% of the MFMs had isthmi in the apical third of the mesial roots. Younger age, shorter MB–ML orifice distance, and Weine type II RCS increased the probability of the presence of an isthmus in the apical third (p < 0.05). Conclusion The prevalence of isthmus in MFM is high in the subject population, but the prevalence of MM canals is not as high as previously reported. Demographic and anatomic characteristics could aid clinicians to better predict the presence of MM canal and an isthmus.
Collapse
|
20
|
Comparative Effectiveness of New Mechanical Irrigant Agitating Devices for Debris Removal from the Canal and Isthmus of Mesial Roots of Mandibular Molars. J Endod 2016; 43:326-331. [PMID: 27989584 DOI: 10.1016/j.joen.2016.10.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 08/19/2016] [Accepted: 10/10/2016] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The aim of this study was to compare the effectiveness of Easy Clean (Easy Dental Equipment, Belo Horizonte, MG, Brazil) in continuous and reciprocating motion, passive ultrasonic irrigation (PUI), Endoactivator systems (Dentsply Maillefer, Ballaigues, Switzerland), and conventional irrigation for debris removal from root canals and isthmus. METHODS Fifty mesial roots of mandibular molars were embedded in epoxy resin using a metal muffle; afterward, the blocks containing the roots were sectioned at 2, 4, and 6 mm from the apex. After instrumentation, the roots were divided into 5 groups (n = 10) for application of the final irrigation protocol using Easy Clean in continuous rotation, Easy Clean in reciprocating motion, PUI, Endoactivator, and conventional irrigation. Scanning electron microscopic images were taken after instrumentation and after the first, second, and third activation of irrigating solution to evaluate the area of remaining debris with image J software (National Institutes of Health, Bethesda, MD). RESULTS The protocol of 3 irrigating solution activations for 20 seconds provided better cleaning of the canal and isthmus. On conclusion of all procedures, analysis of the canals showed a statistical difference only at 2 mm; the Easy Clean in continuous rotation was more efficient than conventional irrigation (P < .05). On conclusion of all steps, the largest difference was observed in the isthmus in which the Easy Clean in continuous rotation was more effective than conventional irrigation at the 3 levels analyzed and the Endoactivator at 4 mm (P < .05). The PUI promoted greater cleaning than conventional irrigation at 6 mm (P < .05). There was no statistical difference between Easy Clean in continuous rotation, Easy Clean in reciprocating motion, and PUI (P > .05). CONCLUSIONS Irrigating solution activation methods provided better cleaning of the canal and isthmus, especially the Easy Clean used in continuous rotation. The protocol of 3 irrigating solution activations for 20 seconds favored better cleaning.
Collapse
|
21
|
Vivan RR, Duque JA, Alcalde MP, Só MVR, Bramante CM, Duarte MAH. Evaluation of Different Passive Ultrasonic Irrigation Protocols on the Removal of Dentinal Debris from Artificial Grooves. Braz Dent J 2016; 27:568-572. [DOI: 10.1590/0103-6440201600725] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 07/25/2016] [Indexed: 11/22/2022] Open
Abstract
Abstract The aim of this study was to evaluate the influence of different passive ultrasonic irrigation protocols on the removal of debris in artificially created grooves in the cervical, middle and apical root thirds. Forty extracted bovine incisor roots were instrumented to 1 mm of the root apex with a R50 Reciproc instrument and irrigated with 2.5% sodium hypochlorite. The roots were then inserted in a muffle and cleaved into two hemisections. Grooves (3-mm long) were done at 2, 7 and 12 mm from the root apex in one hemisection and filled with dentinal debris. The hemisections were regrouped into the muffle and divided into 4 groups (n=10) according to the final irrigation protocol: Control group: 3x20 s using a #30 gauge needle without agitation of the irrigating solution; Group PUI-s (static passive ultrasonic irrigation): 3x20 s of passive ultrasonic irrigation with the tip of the insert maintained static on the apical third; Group PUI-t (passive ultrasonic irrigation per third): 20 s of PUI in each third; Group PUI-d (passive dynamic ultrasonic irrigation): 3x20 s of PUI dynamically moving the insert in the whole extent of the root canal. In all groups, was used a total of 6 mL of 2.5% sodium hypochlorite as irrigant. After these procedures, the grooves were analyzed with a stereomicroscope and assigned scores as regards removal of the debris. The data were analyzed statistically (a=0.05). The results showed a better cleaning in all the groups where the irrigating solution was agitated with ultrasonic device than in the control group (p<0.05). In the apical third, the PUI-d and PUI-s showed similar performance (p>0.05) and a better cleanness than PUI-t (p<0.05). The dynamic and static methods of agitation of the irrigating solution provided more effective cleaning. PUI-d provided the most completely clean grooves suggesting that its use is the most adequate in cases of teeth with complex canal anatomy.
Collapse
|
22
|
Middha M, Sangwan P, Tewari S, Duhan J. Effect of continuous ultrasonic irrigation on postoperative pain in mandibular molars with nonvital pulps: a randomized clinical trial. Int Endod J 2016; 50:522-530. [DOI: 10.1111/iej.12666] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 05/26/2016] [Indexed: 01/23/2023]
Affiliation(s)
- M. Middha
- Department of Conservative Dentistry and Endodontics; Post Graduate Institute of Dental Sciences (PGIDS); Rohtak India
| | - P. Sangwan
- Department of Conservative Dentistry and Endodontics; Post Graduate Institute of Dental Sciences (PGIDS); Rohtak India
| | - S. Tewari
- Department of Conservative Dentistry and Endodontics; Post Graduate Institute of Dental Sciences (PGIDS); Rohtak India
| | - J. Duhan
- Department of Conservative Dentistry and Endodontics; Post Graduate Institute of Dental Sciences (PGIDS); Rohtak India
| |
Collapse
|
23
|
Leoni GB, Versiani MA, Silva-Sousa YT, Bruniera JFB, Pécora JD, Sousa-Neto MD. Ex vivoevaluation of four final irrigation protocols on the removal of hard-tissue debris from the mesial root canal system of mandibular first molars. Int Endod J 2016; 50:398-406. [DOI: 10.1111/iej.12630] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 03/15/2016] [Indexed: 11/29/2022]
Affiliation(s)
- G. B. Leoni
- Department of Restorative Dentistry; Dental School of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP Brazil
| | - M. A. Versiani
- Department of Restorative Dentistry; Dental School of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP Brazil
| | - Y. T. Silva-Sousa
- Department of Endodontics; Faculty of Dentistry; University of Ribeirão Preto; Ribeirão Preto SP Brazil
| | - J. F. B. Bruniera
- Department of Endodontics; Faculty of Dentistry; University of Ribeirão Preto; Ribeirão Preto SP Brazil
| | - J. D. Pécora
- Department of Restorative Dentistry; Dental School of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP Brazil
| | - M. D. Sousa-Neto
- Department of Restorative Dentistry; Dental School of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP Brazil
| |
Collapse
|
24
|
Liu Z, Liu J, Gu L, Liu W, Wei X, Ling J. The shaping and cleaning abilities of self-adjusting files in the preparation of canals with isthmuses after glidepath enlargement with ISO or ProTaper Universal NiTi files. J Dent Sci 2016; 11:83-89. [PMID: 30894951 PMCID: PMC6395177 DOI: 10.1016/j.jds.2015.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 08/31/2015] [Indexed: 11/19/2022] Open
Abstract
Background/purpose This study compared the shaping and cleaning ability of self-adjusting files (SAF) after glidepath enlargement with ISO NiTi files (Group I) or ProTaper Universal (PTU; Group II) for preparing maxillary premolar canals with isthmuses. Materials and methods Twenty-eight teeth containing isthmuses were scanned preoperationally after glidepath enlargement and preparation with SAF (n = 14). Changes in canal and isthmus volume, prepared surface, debris volume, and transportation were determined. Data were compared by t test between groups and paired t test within each group. Results No difference was observed regarding changes in canal volume or prepared surface between the two groups (P > 0.05). Paired t tests showed that the coronal and middle prepared areas of the canal after using SAF in Group I were statistically larger than those using ISO files, whereas the use of an adjuvant preparation with SAF after PTU resulted in a significant increase in the apical prepared area in Group II. ISO and SAF systems deviated less from the center than did PTU and SAF systems at most sections. After the use of SAF, isthmus volumes were significantly increased within each group (P < 0.05). Although less debris resulted from the use of SAF instruments as compared to glidepath instruments, there was no significant difference between both groups (P > 0.05). Conclusion SAF following glidepath enlargement with ISO files could improve preparation of the coronal and middle part of the canals, and adjuvant preparation with SAF after using large-taper instruments increased the apical prepared area.
Collapse
Affiliation(s)
| | | | | | | | - Xi Wei
- Corresponding authors. Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology and Institute of Stomatological Research, Sun Yat-sen University, 56 Ling Yuan Xi Road, Guangzhou 510055, China.
| | - Junqi Ling
- Corresponding authors. Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology and Institute of Stomatological Research, Sun Yat-sen University, 56 Ling Yuan Xi Road, Guangzhou 510055, China.
| |
Collapse
|
25
|
Rico-Romano C, Zubizarreta-Macho Á, Baquero-Artigao MR, Mena-Álvarez J. An analysis in vivo of intracanal bacterial load before and after chemo-mechanical preparation: A comparative analysis of two irrigants and two activation techniques. J Clin Exp Dent 2016; 8:e9-e13. [PMID: 26855714 PMCID: PMC4739376 DOI: 10.4317/jced.52585] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 09/14/2015] [Indexed: 11/28/2022] Open
Abstract
Background The goals of this randomized double-blind trial were to assess the antimicrobial activity in vivo of Sodium hypochlorite (NaOCl) vs. chlorhexidine gluconate (CHX) used in combination either with EndoActivator® or IRRI S® files in patients with apical periodontitis. Material and Methods A total of 120 patients with apical periodontitis (in single or multiple root canals) were randomly assigned to the four irrigation protocols outlined below: Group A: 5.25% sodium hypochlorite (NaOCl) + EndoActivator®; Group B: 5.25% NaOCl + IRRI S® files; Group C: 2% chlorhexidine gluconate (CHX) + EndoActivator®; Group D: 2% CHX + IRRI S® files. Paper points were used to collect microbiological samples before (1A samples) and after (1B samples) irrigation. Viable colony-forming units (CFU) were quantified twice: (1) without speciation, and (2) only for Enterococcus Faecalis(EF). Statistical analysis was performed using SPSS 22.0 for Windows. Results No significant differences were observed between NaOCl and CHX in the reduction of CFU; in fact, reduction was < 93% for the two irrigants. Conversely, statistically significant differences were found between the two activation techniques (sonic and ultrasonic) in the reduction of Enterococcus Faecalis(EF). Thus, the effectiveness of ultrasonic activation was significantly higher (< 93%; p=0.012) as compared to sonic activation. Following the combination of the two irrigants with the two activation techniques (groups A, B, C and D), significant differences were observed between group A and B (p=0.025) in the reduction of EF populations, reaching up to 94%. Conclusions NaClO and CHX are effective in reducing intracanal bacterial load. Ultrasonic activation is the most effective activation technique in reducing EF populations. Key words:Chlorhexidine gluconate, sodium hypochlorite, ultrasonic irrigation, sonic irrigation, apical periodontitis, Enterococcus faecalis.
Collapse
Affiliation(s)
- Cristina Rico-Romano
- Associate Professor. Master's Degree in Clinical Endodontics and Periapical Microsurgery. Faculty of Health Sciences. Alfonso X el Sabio University. Madrid, Spain
| | - Álvaro Zubizarreta-Macho
- Associate Professor. Master's Degree in Clinical Endodontics and Periapical Microsurgery. Faculty of Health Sciences. Alfonso X el Sabio University. Madrid, Spain
| | | | - Jesús Mena-Álvarez
- Head Academic Master Degree in Endodontics. Faculty of Health Sciences. Alfonso X el Sabio University. Madrid, Spain
| |
Collapse
|
26
|
Darcey J, Jawad S, Taylor C, Roudsari RV, Hunter M. Modern endodontic principles part 4: irrigation. ACTA ACUST UNITED AC 2016; 43:20-2, 25-6, 28-30 passim. [DOI: 10.12968/denu.2016.43.1.20] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- James Darcey
- Consultant and Honorary Lecturer in Restorative Dentistry, University Dental Hospital of Manchester
| | - Sarra Jawad
- Specialty Registrar/Honorary Clinical Lecturer in Restorative Dentistry, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester M15 6FH
| | - Carly Taylor
- Clinical Lecturer/Honorary Specialty Registrar in Restorative Dentistry, Dental School, University of Manchester
| | - Reza Vahid Roudsari
- Clinical Lecturer/Honorary Specialty Registrar in Restorative Dentistry, Dental School, University of Manchester
| | - Mark Hunter
- Registered Endodontic Specialist, simplyendo, Altrincham, Postgraduate Clinical Teaching Fellow, Dental School, University of Manchester, Oxford Road, Manchester M13 9PL, UK
| |
Collapse
|
27
|
Frequency of Root Canal Isthmi in Human Permanent Teeth Determined by Cone-beam Computed Tomography. J Endod 2015; 41:1535-9. [PMID: 26187423 DOI: 10.1016/j.joen.2015.05.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 05/04/2015] [Accepted: 05/17/2015] [Indexed: 11/22/2022]
Abstract
INTRODUCTION This study evaluated the frequency of root canal isthmi (RCIs) in human permanent teeth by using cone-beam computed tomography. METHODS A sample of 1400 teeth of 618 patients (394 women; mean age, 43.4 years) was selected. RCIs were detected longitudinally on 0.1-mm/0.1-mm axial slices of cone-beam computed tomography images of roots scanned from the pulp orifice to the apex, and findings were classified into 7 categories according to RCIs beginning and end: (1) both in the cervical third, (2) begin in the cervical third and end in the middle third, (3) begin in the cervical third and end in the apical third, (4) both in the middle third, (5) begin in the middle third and end in the apical third, (6) both in the apical third, or (7) no isthmus. A χ(2) test with Yates correction or the Fisher exact test was used to analyze categorical variables, described as frequencies (%). The Student t test was used to compare quantitative variables. RESULTS RCI is a common anatomic structure in human permanent teeth, except in maxillary anterior teeth. CONCLUSIONS The higher frequencies of RCIs (87.9%) were found in mandibular first molars. The frequencies of RCIs according to mean age and tooth group were not significantly different (P > .05), except in mandibular central incisors. RCIs were less frequent among older patients.
Collapse
|
28
|
Kim SY, Kim BS, Kim Y. Mandibular second molar root canal morphology and variants in a Korean subpopulation. Int Endod J 2015; 49:136-44. [DOI: 10.1111/iej.12437] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 01/30/2015] [Indexed: 01/20/2023]
Affiliation(s)
- S. Y. Kim
- Department of Conservative Dentistry; Seoul St. Mary's Dental Hospital; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - B. S. Kim
- Department of Radiology; Ewha Womans University School of Medicine; Seoul Korea
| | - Y. Kim
- Department of Conservative Dentistry; Dental Research Institute; Ewha Womans University School of Medicine; Seoul Korea
| |
Collapse
|
29
|
Sahar-Helft S, Sarp ASK, Stabholtz A, Gutkin V, Redenski I, Steinberg D. Comparison of positive-pressure, passive ultrasonic, and laser-activated irrigations on smear-layer removal from the root canal surface. Photomed Laser Surg 2015; 33:129-35. [PMID: 25719951 DOI: 10.1089/pho.2014.3788] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The purpose of this study was to compare the efficacy of three irrigation techniques for smear-layer removal with 17% EDTA. BACKGROUND DATA Cleaning and shaping the root canal system during endodontic treatment produces a smear layer and hard tissue debris. Three irrigation techniques were tested for solution infiltration of this layer: positive-pressure irrigation, passive ultrasonic irrigation, and laser-activated irrigation. MATERIALS AND METHODS Sixty extracted teeth were divided into six equal groups; 17% EDTA was used for 60 sec irrigation of five of the groups. The groups were as follows: Group 1, treated only with ProTaper™ F3 Ni-Ti files; Group 2, positive-pressure irrigation, with a syringe; Group 3, passive ultrasonic irrigation, inserted 1 mm short of the working length; Group 4, passive ultrasonic irrigation, inserted in the upper coronal third of the root; Group 5, Er:YAG laser-activated irrigation, inserted 1 mm short of the working length; and Group 6, Er:YAG laser-activated irrigation, inserted in the upper coronal third of the root. RESULTS Scanning electron microscopy showed that the smear layer is removed most efficiently using laser-activated irrigation at low energy with 17% EDTA, inserted either at the working length or only in the coronal upper third of the root. Amounts of Ca, P, and O were not significantly different on all treated dentin surfaces. CONCLUSIONS Smear-layer removal was most effective when the root canals were irrigated using Er:YAG laser at low energy with 17% EDTA solution. Interestingly, removal of the smear layer along the entire canal was similar when the laser was inserted in the upper coronal third and at 1 mm short of the working length of the root canal. This effect was not observed with the ultrasonic and positive-pressure techniques.
Collapse
Affiliation(s)
- Sharonit Sahar-Helft
- 1 Department of Endodontics, Faculty of Dental Medicine, Hebrew University-Hadassah , Jerusalem, Israel
| | | | | | | | | | | |
Collapse
|
30
|
Tissue response to root canal irrigation systems in dogs’ teeth with apical periodontitis. Clin Oral Investig 2014; 19:1147-56. [DOI: 10.1007/s00784-014-1340-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Accepted: 10/14/2014] [Indexed: 11/26/2022]
|
31
|
Thomas AR, Velmurugan N, Smita S, Jothilatha S. Comparative Evaluation of Canal Isthmus Debridement Efficacy of Modified EndoVac Technique with Different Irrigation Systems. J Endod 2014; 40:1676-80. [DOI: 10.1016/j.joen.2014.05.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 05/05/2014] [Accepted: 05/12/2014] [Indexed: 11/26/2022]
|
32
|
Metzger Z, Solomonov M, Kfir A. The role of mechanical instrumentation in the cleaning of root canals. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/etp.12048] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
33
|
De-Deus G, Marins J, Neves ADA, Reis C, Fidel S, Versiani MA, Alves H, Lopes RT, Paciornik S. Assessing accumulated hard-tissue debris using micro-computed tomography and free software for image processing and analysis. J Endod 2013; 40:271-6. [PMID: 24461417 DOI: 10.1016/j.joen.2013.07.025] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 07/23/2013] [Accepted: 07/29/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The accumulation of debris occurs after root canal preparation procedures specifically in fins, isthmus, irregularities, and ramifications. The aim of this study was to present a step-by-step description of a new method used to longitudinally identify, measure, and 3-dimensionally map the accumulation of hard-tissue debris inside the root canal after biomechanical preparation using free software for image processing and analysis. METHODS Three mandibular molars presenting the mesial root with a large isthmus width and a type II Vertucci's canal configuration were selected and scanned. The specimens were assigned to 1 of 3 experimental approaches: (1) 5.25% sodium hypochlorite + 17% EDTA, (2) bidistilled water, and (3) no irrigation. After root canal preparation, high-resolution scans of the teeth were accomplished, and free software packages were used to register and quantify the amount of accumulated hard-tissue debris in either canal space or isthmus areas. RESULTS Canal preparation without irrigation resulted in 34.6% of its volume filled with hard-tissue debris, whereas the use of bidistilled water or NaOCl followed by EDTA showed a reduction in the percentage volume of debris to 16% and 11.3%, respectively. The closer the distance to the isthmus area was the larger the amount of accumulated debris regardless of the irrigating protocol used. CONCLUSIONS Through the present method, it was possible to calculate the volume of hard-tissue debris in the isthmuses and in the root canal space. Free-software packages used for image reconstruction, registering, and analysis have shown to be promising for end-user application.
Collapse
Affiliation(s)
- Gustavo De-Deus
- Department of Endodontics, Grande Rio University, Rio de Janeiro State University, Rio de Janeiro, Brazil.
| | - Juliana Marins
- Department of Dental Clinics, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Aline de Almeida Neves
- Department of Endodontics, Grande Rio University, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Claudia Reis
- Department of Dental Clinics, University of Espirito Santo, Espirito Santo, Brazil
| | - Sandra Fidel
- Department of Dental Clinics, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Marco A Versiani
- Department of Restorative Dentistry, Dental School of Ribeirao Preto, University of São Paulo, São Paulo, Brazil
| | - Haimon Alves
- Nuclear Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ricardo Tadeu Lopes
- Nuclear Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | |
Collapse
|
34
|
|
35
|
Castagna F, Rizzon P, da Rosa RA, Santini MF, Barreto MS, Húngaro Duarte MA, Reis Só MV. Effect of passive ultrassonic instrumentation as a final irrigation protocol on debris and smear layer removal-a sem analysis. Microsc Res Tech 2013; 76:496-502. [DOI: 10.1002/jemt.22192] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 01/30/2013] [Accepted: 01/31/2013] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Ricardo Abreu da Rosa
- Conservative Dentistry Department; Federal University of Rio Grande do Sul; RS; Brazil
| | | | - Mirela Sangoi Barreto
- Conservative Dentistry Department; Federal University of Rio Grande do Sul; RS; Brazil
| | | | | |
Collapse
|
36
|
Canal and Isthmus Debridement Efficacy of the VPro EndoSafe Negative-pressure Irrigation Technique. J Endod 2012; 38:1631-4. [DOI: 10.1016/j.joen.2012.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Revised: 08/25/2012] [Accepted: 09/10/2012] [Indexed: 11/19/2022]
|
37
|
Canal and Isthmus Debridement Efficacy Using a Sonic Irrigation Technique in a Closed-canal System. J Endod 2012; 38:1265-8. [DOI: 10.1016/j.joen.2012.05.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 05/22/2012] [Accepted: 05/23/2012] [Indexed: 11/17/2022]
|
38
|
Comparison of a Continuous Ultrasonic Irrigation Device and Conventional Needle Irrigation in the Removal of Root Canal Debris. J Endod 2012; 38:1261-4. [DOI: 10.1016/j.joen.2012.05.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 05/12/2012] [Accepted: 05/17/2012] [Indexed: 11/21/2022]
|
39
|
Fan B, Ye W, Xie E, Wu H, Gutmann JL. Three-dimensional morphological analysis of C-shaped canals in mandibular first premolars in a Chinese population. Int Endod J 2012; 45:1035-41. [DOI: 10.1111/j.1365-2591.2012.02070.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
40
|
Seo DG, Gu Y, Yi YA, Lee SJ, Jeong JS, Lee Y, Chang SW, Lee JK, Park W, Kim KD, Kum KY. A biometric study of C-shaped root canal systems in mandibular second molars using cone-beam computed tomography. Int Endod J 2012; 45:807-14. [DOI: 10.1111/j.1365-2591.2012.02037.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
41
|
Dynamic Movement of Intracanal Gas Bubbles during Cleaning and Shaping Procedures: The Effect of Maintaining Apical Patency on Their Presence in the Middle and Cervical Thirds of Human Root Canals—An In Vivo Study. J Endod 2012; 38:200-3. [DOI: 10.1016/j.joen.2011.10.026] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 10/25/2011] [Accepted: 10/26/2011] [Indexed: 11/20/2022]
|
42
|
de Gregorio C, Paranjpe A, Garcia A, Navarrete N, Estevez R, Esplugues EO, Cohenca N. Efficacy of irrigation systems on penetration of sodium hypochlorite to working length and to simulated uninstrumented areas in oval shaped root canals. Int Endod J 2012; 45:475-81. [DOI: 10.1111/j.1365-2591.2011.01999.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
43
|
Munoz HR, Camacho-Cuadra K. In vivo efficacy of three different endodontic irrigation systems for irrigant delivery to working length of mesial canals of mandibular molars. J Endod 2012; 38:445-8. [PMID: 22414827 DOI: 10.1016/j.joen.2011.12.007] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 12/06/2011] [Accepted: 12/08/2011] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Many in vitro studies have debated over the ability of different irrigant delivery and/or agitation systems to reach the apical third of curved root canals; however, little is known about irrigant penetration in vivo. Therefore, the purpose of this study was to compare the efficacy of the conventional endodontic irrigation needle, passive ultrasonic irrigation (PUI), and a negative pressure system for irrigant delivery to working length (WL) of mesial canals of mandibular molars. METHODS Thirty mesial canals of 30 vital mandibular first or second molars were randomly assigned into 3 groups (n = 10): (1) Monoject syringe with 27-gauge needle; (2) PUI with IrriSafe tip; and (3) EndoVac system. All canals were treated following the same preparation protocol to size 35/0.04 by using 5.25% NaOCl as irrigant during preparation procedure. Before obturation, canals were irrigated with 1 mL of a radiopaque solution by using the assigned irrigation system, and a digital radiograph was taken by using a parallel technique. With the aid of image editing software the distance between WL and maximum irrigant penetration was measured. RESULTS Mean distances for Monoject, PUI, and EndoVac groups were 1.51 mm, 0.21 mm, and 0.42 mm, respectively. Analysis of variance test showed statistically significant differences between groups (P < .001). Tukey honestly significant difference test showed statistically significant differences between the Monoject group and the other 2 groups (P < .001) but no significant differences between PUI and EndoVac groups (P = .06). CONCLUSIONS PUI and EndoVac are more effective than the conventional endodontic needle in delivering irrigant to WL of root canals.
Collapse
Affiliation(s)
- Hugo Roberto Munoz
- Postgraduate Endodontic Department, School of Dentistry, Universidad de San Carlos de Guatemala, Guatemala City, Guatemala.
| | | |
Collapse
|
44
|
Villas-Bôas MH, Bernardineli N, Cavenago BC, Marciano M, del Carpio-Perochena A, de Moraes IG, Duarte MH, Bramante CM, Ordinola-Zapata R. Micro–Computed Tomography Study of the Internal Anatomy of Mesial Root Canals of Mandibular Molars. J Endod 2011; 37:1682-6. [DOI: 10.1016/j.joen.2011.08.001] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 08/02/2011] [Accepted: 08/02/2011] [Indexed: 11/27/2022]
|
45
|
Vera J, Arias A, Romero M. Effect of Maintaining Apical Patency on Irrigant Penetration into the Apical Third of Root Canals When Using Passive Ultrasonic Irrigation: An In Vivo Study. J Endod 2011; 37:1276-8. [DOI: 10.1016/j.joen.2011.05.042] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Revised: 05/26/2011] [Accepted: 05/31/2011] [Indexed: 10/18/2022]
|