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Kim KH, Lévesque C, Malkhassian G, Basrani B. Efficacy of the GentleWave System in the removal of biofilm from the mesial roots of mandibular molars before and after minimal instrumentation: An ex vivo study. Int Endod J 2024; 57:922-932. [PMID: 38374488 DOI: 10.1111/iej.14044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/29/2024] [Indexed: 02/21/2024]
Abstract
AIM To compare the efficacy of Enterococcus faecalis biofilm removal using the GentleWave System (GWS) (Sonendo Inc, CA) on non-instrumented versus minimally instrumented root canal systems. METHODOLOGY Thirty-four mandibular molars were autoclaved and allocated to four groups: Negative control (n = 5); positive control (n = 5); Group 1: non-instrumentation + GWS (NI + GWS) (n = 12); and Group 2: minimal instrumentation + GWS (MI + GWS) (n = 12). Of 34 samples, 24 samples with Vertucci type 2 configuration within the mesial root of each sample were allocated to Groups 1 and 2 and then matched based on the working length and root canal configuration. After inoculation of samples with E. faecalis for 3 weeks, the GWS was used on Group 1 without any instrumentation and Group 2 after instrumentation of mesial canals until size 20/06v. CFU and SEM analysis were used. RESULTS Log10 (CFU/mL) from the positive control, and Group 1 and 2 were 7.41 ± 0.53, 3.41 ± 1.54, and 3.21 ± 1.54, respectively. Both groups showed a statistically significant difference in the reduction of viable E. faecalis cells compared to the positive control (Group 1 [p = .0001] and Group 2 [p < .0001]), whilst showing no significant difference between the two tested groups (p < .05). CONCLUSION The use of GWS on the non-instrumented root canal system could be an effective disinfection protocol in removing the biofilm without dentin debris formation.
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Affiliation(s)
- Kwang Ho Kim
- Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Céline Lévesque
- Microbiology, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Gevik Malkhassian
- Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Bettina Basrani
- Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
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Berutti E, Pasqualini D, Scotti N, Mandras N, Roana J, Carpegna G, Palopoli P, Alovisi M. Confocal laser scanning evaluation of the influence of ledges on root canal disinfection. AUST ENDOD J 2024. [PMID: 38946230 DOI: 10.1111/aej.12871] [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: 11/12/2023] [Revised: 05/09/2024] [Accepted: 06/20/2024] [Indexed: 07/02/2024]
Abstract
The aim was to analyse the influence of an apical ledge on root canal disinfection. Forty-four single-rooted teeth were micro-CT scanned and inoculated with Enterococcus faecalis. In Group S shaping was performed with ProTaper Next (PTN) up to X3 at working length (WL). In Group L an apical ledge was created with K-Files #40 and shaping completed up to PTN X3. NaOCl 5% and EDTA 10% irrigant solutions were alternated. Confocal laser scanning microscope (CLSM) and viability staining were used to analyse the proportions of dead (red) and live (green) bacteria and penetration ability inside dentinal tubules. Data were analysed with the Mann-Whitney test with Bonferroni correction (p < 0.05). In Group L the amount of red fluorescence resulted significantly lower, and penetration ability was decreased in the apical and middle portion (p < 0.05). The presence of an apical ledge may negatively influence the disinfection both in the apical and middle third.
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Affiliation(s)
- Elio Berutti
- Department of Surgical Science, CIR-Dental School, University of Turin, Turin, Italy
| | - Damiano Pasqualini
- Department of Surgical Science, CIR-Dental School, University of Turin, Turin, Italy
| | - Nicola Scotti
- Department of Surgical Science, CIR-Dental School, University of Turin, Turin, Italy
| | - Narcisa Mandras
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Janira Roana
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Giorgia Carpegna
- Department of Surgical Science, CIR-Dental School, University of Turin, Turin, Italy
| | - Pietro Palopoli
- Department of Surgical Science, CIR-Dental School, University of Turin, Turin, Italy
| | - Mario Alovisi
- Department of Surgical Science, CIR-Dental School, University of Turin, Turin, Italy
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Xiqian L, Ying Z, Mian M. The effect of apical patency on postoperative pain following endodontic therapy: A systematic review and meta-analysis. Eur J Oral Sci 2024; 132:e12986. [PMID: 38632110 DOI: 10.1111/eos.12986] [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: 07/19/2023] [Accepted: 03/26/2024] [Indexed: 04/19/2024]
Abstract
This systematic review and meta-analysis aimed to determine whether apical patency increases postoperative pain after endodontic therapy. This study explored the degree and incidence of postoperative pain during root canal therapy, as well as the number of required analgesic doses. We searched PubMed, Scopus, Embase, Web of Science, Cochrane Library, and gray literature from the date of database inception until May 2023. RevMan 5.4 software was used for data analysis. Twelve studies were considered eligible for meta-analysis. The mean pain scores on days 1 (mean difference [MD] = -1.69) and 2 (MD = -0.85) differed significantly between the apical patency and non-patency groups. The odds for pain after 24 h were significantly lower (OR 0.59) in the apical patency group than in the non-patency group. Furthermore, the mean number of required analgesic doses was not significantly different between the two groups. In conclusion, apical patency significantly alleviated postoperative pain (low-quality evidence) and reduced the incidence of pain (moderate evidence). However, high-quality randomized controlled trials are required to validate these findings.
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Affiliation(s)
- Liu Xiqian
- Department of Stomatology, Changzhi Medical College Affiliated Heping Hospital, Changzhi City, Shanxi Province, China
| | - Zhai Ying
- Department of Stomatology, Yangquan Coal Industry Group General Hospital, Yangquan City, Shanxi Province, China
| | - Mao Mian
- Department of Pharmacy, Sichuan Cancer Hospital and Institute, Chengdu, China
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Zhang SH, Gao ZR, Zhou YH, Tan L, Feng Y, Ye Q, Zhao J, Zhao YQ, Hu J, Chen Y, Liu Q, Aimee DM, Guo Y, Feng YZ. Comparison of Easydo Activator, ultrasonic and needle irrigation techniques on sealer penetration and smear layer removal in vitro. BMC Oral Health 2024; 24:56. [PMID: 38195412 PMCID: PMC10775461 DOI: 10.1186/s12903-023-03833-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 12/26/2023] [Indexed: 01/11/2024] Open
Abstract
The effects of Easydo Activator (EA), a new sonic irrigation system, on sealer penetration at the root apex were compared to needle irrigation (NI) and passive ultrasonic irrigation (PUI) in this study. Forty-two single-rooted teeth were prepared and randomly divided into three groups (n = 14): group 1: NI; group 2: PUI; and group 3: EA. A solution of 3% sodium hypochlorite (NaOCl) was used for irrigation. Nine teeth in each group were filled with AH Plus sealer mixed with CY5 fluorescent dye and a single gutta-percha cone. The sealer penetration area, maximum penetration depth and percentage of sealer penetration at 5 mm and 1 mm from the apex were analyzed by confocal laser scanning microscopy (CLSM). The remaining 5 teeth in each group were subjected to test smear layer scores by scanning electron microscopy (SEM). The CLSM evaluation showed that increases in the area, depth and percentage of sealer penetration were detected at 1 and 5 mm from the root apex in the PUI group compared with the NI group, and greater increases were observed in the EA group (P < 0.05). The SEM experiment showed that the lowest scores for the smear layer and debris removal were achieved by the EA group when compared with the PUI and NI groups (P < 0.05). In conclusion, EA was superior to PUI and NI regarding sealer penetration at the root apex during endodontic treatment, and it could provide a new technical idea for clinical root canal therapy.
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Affiliation(s)
- Shao-Hui Zhang
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
- Department of Stomatology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, 441000, China
| | - Zheng-Rong Gao
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Ying-Hui Zhou
- Department of Ultrasound Diagnosis, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Li Tan
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Yao Feng
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Qin Ye
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Jie Zhao
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Ya-Qiong Zhao
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Jing Hu
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Yun Chen
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Qiong Liu
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Dusenge Marie Aimee
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Yue Guo
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
| | - Yun-Zhi Feng
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
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Uematsu T, Yahata Y, Ohnishi K, Suzuki S, Kanehira M, Tanaka T, Sudo S, Suresh VV, Saito M. Irrigation with reduced sodium hypochlorite solution concentration using laser-induced cavitation is effective and safe in rat intraradicular biofilm model. AUST ENDOD J 2023; 49:544-553. [PMID: 37489629 DOI: 10.1111/aej.12783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 07/08/2023] [Accepted: 07/08/2023] [Indexed: 07/26/2023]
Abstract
This study aimed to investigate the optimal sodium hypochlorite solution (NaOCl) concentration to effectively remove the root canal biofilm without stimulating periradicular inflammation using coronal laser-activated irrigation (CLAI). To compare the efficacy of different NaOCl concentrations combined with CLAI in removing the biofilm, an in vivo intraradicular biofilm rat model was used. Root canals were irrigated using an Er:YAG laser with either 5% or 0.5% NaOCl. Biofilm removal efficacy of CLAI was compared to that of conventional needle irrigation using scanning electron microscopy (SEM) and quantitative polymerase chain reaction (qPCR). Histological observation of CLAI-associated periradicular inflammation was also conducted. In both the 5% and 0.5% CLAI groups, SEM observation showed the opening of the dentin tubules and biofilm removal. qPCR analysis indicated that the residual bacteria counts after cleaning were significantly lower in the 5% and 0.5% CLAI groups than in the conventional needle irrigation and positive control groups (Tukey test, p < 0.05), and no significant difference was observed between the 5% and 0.5% CLAI groups (p > 0.05). Periapical inflammation in the 5% CLAI group revealed the most severe, including significant neutrophilic and lymphocytic infiltration with abscess formation, while only mild vasodilation was observed in the 0.5% CLAI group. CLAI can remove the biofilm independently of chemical action, which avoids the risks associated with high NaOCl concentrations. Therefore, this root canal irrigation technique ensures safety and effectiveness, promising to contribute to new treatment strategies intended to remove intraradicular biofilm.
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Affiliation(s)
- Takehiro Uematsu
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Yoshio Yahata
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Koyuki Ohnishi
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Shigeto Suzuki
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Masafumi Kanehira
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Toshinori Tanaka
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Susumu Sudo
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Venkata Venkataiah Suresh
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Masahiro Saito
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Park EH, Park R, Seo J, Kim W, Kim HY, Shon WJ. Efficacy of a novel remotely-generated ultrasonic root canal irrigation system for removing biofilm-mimicking hydrogel from a simulated isthmus model. Int Endod J 2023; 56:765-774. [PMID: 36825362 DOI: 10.1111/iej.13905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/25/2023]
Abstract
AIM To evaluate the efficacy of a novel ultrasonic irrigation device, remotely-generated irrigation with a non-invasive sound field enhancement (RINSE) system, in removing biofilm-mimicking hydrogel from a simulated isthmus model and compare it with sonically- and ultrasonically-activated irrigation systems. METHODOLOGY A polycarbonate root canal model containing two standardized root canals (apical diameter of 0.20 mm, 4% taper, 18 mm long with a coronal reservoir) connected by three isthmuses (0.40 mm deep, 2 mm high, 4 mm long) was used as the test model. The isthmuses were filled with a hydroxyapatite powder-containing hydrogel. The canals were filled with irrigant, and the models were randomly assigned to the following activation groups (n = 15): EndoActivator (EA), ultrasonically activated irrigation (UAI), and RINSE system (RS). Syringe irrigation (SI) with a 30G needle served as the control. Standardized images of the isthmuses were taken before and after irrigation, and the amount of hydrogel removed was determined using image analysis software and compared across groups using anova (p < .05). RESULTS Hydrogel removal was significantly higher with the RS (83.7%) than with UAI, EA, or SI (p ≤ .01). UAI (69.2%) removed significantly more hydrogel than SI and EA (p < .05), while there was no significant difference between SI (24.3%) and EA (25.7%) (p = .978). CONCLUSIONS RINSE system resulted in the most hydrogel removal, performing better than UAI or EA. The effect of RS was also not reliant on the insert or tip entering the pulp chamber or root canal, making it particularly useful in conservative endodontics.
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Affiliation(s)
- Eun Hyun Park
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Ryeol Park
- Department of Mechanical Engineering, Sogang University, Seoul, South Korea
| | - Jaedeok Seo
- Department of Mechanical Engineering, Sogang University, Seoul, South Korea
| | - Wonjung Kim
- Department of Mechanical Engineering, Sogang University, Seoul, South Korea
| | - Ho-Young Kim
- Department of Mechanical Engineering, Seoul National University, Seoul, South Korea
| | - Won-Jun Shon
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, South Korea
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Al-Jadaa A, Saidi Z, Mahmoud M, Al-Taweel R, Zehnder M. Assessment of Irrigant Agitation Devices in Simulated Closed and Open Root Canal Systems. J Endod 2023; 49:438-444.e6. [PMID: 36642215 DOI: 10.1016/j.joen.2023.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/06/2023] [Accepted: 01/06/2023] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The in vitro efficacy of irrigant activation devices has not been contrasted to their safety. This was attempted in this study using apically closed versus patent simulated root canal systems in epoxy resin models, with the latter featuring a simulated periapical lesion. METHODS All 72 models had 2 joining canals connected by an isthmus, which was filled with dentin debris. The simulated periapical lesion was filled with colored gelatin in the 36 respective models. Canals were irrigated with 1.3% sodium hypochlorite. Samples were divided into 4 subgroups per system (n = 9): conventional irrigation, sonic low (EndoActivator; Dentsply Sirona, Charlotte, NC) and high frequency (EDDY; VDW, Munich, Germany), and ultrasonic agitation of the irrigant (always applying 3 cycles of 20 seconds). The total cleared surface areas (mm2) in the simulated isthmus and periapical lesion were compared between systems and devices using parametric tests (P < .05). RESULTS The cleaning of the isthmus was more effective in the apically open compared with the closed systems and was also significantly influenced by the agitation method (P < .001). In the closed systems, EDDY and ultrasonic agitation achieved the significantly (P < .05) best cleaning of the isthmus. In the open systems, ultrasonic agitation showed the single best result (P < .05). EDDY caused by far the highest and ultrasonic agitation the lowest dissolution of the gelatin in the simulated periapical lesion. CONCLUSIONS Under the conditions of this study, ultrasonic agitation of a previously administered sodium hypochlorite irrigant was more laterally targeted and thus safer and more effective than sonic agitation methods.
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Affiliation(s)
- Anas Al-Jadaa
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Zehraa Saidi
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Maise Mahmoud
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Rahaf Al-Taweel
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Matthias Zehnder
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
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Boutsioukis C, Arias‐Moliz MT, Chávez de Paz LE. A critical analysis of research methods and experimental models to study irrigants and irrigation systems. Int Endod J 2022; 55 Suppl 2:295-329. [PMID: 35171506 PMCID: PMC9314845 DOI: 10.1111/iej.13710] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 11/28/2022]
Abstract
Irrigation plays an essential role in root canal treatment. The purpose of this narrative review was to critically appraise the experimental methods and models used to study irrigants and irrigation systems and to provide directions for future research. Studies on the antimicrobial effect of irrigants should use mature multispecies biofilms grown on dentine or inside root canals and should combine at least two complementary evaluation methods. Dissolution of pulp tissue remnants should be examined in the presence of dentine and, preferably, inside human root canals. Micro-computed tomography is currently the method of choice for the assessment of accumulated dentine debris and their removal. A combination of experiments in transparent root canals and numerical modeling is needed to address irrigant penetration. Finally, models to evaluate irrigant extrusion through the apical foramen should simulate the periapical tissues and provide quantitative data on the amount of extruded irrigant. Mimicking the in vivo conditions as close as possible and standardization of the specimens and experimental protocols are universal requirements irrespective of the surrogate endpoint studied. Obsolete and unrealistic models must be abandoned in favour of more appropriate and valid ones that have more direct application and translation to clinical Endodontics.
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Affiliation(s)
- Christos Boutsioukis
- Department of EndodontologyAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
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Sinha N, Asthana G, Parmar G, Langaliya A, Shah J, Kumbhar A, Singh B. Evaluation of Ozone Therapy in Endodontic Treatment of Teeth with Necrotic Pulp and Apical Periodontitis: A Randomized Clinical Trial. J Endod 2021; 47:1820-1828. [PMID: 34562501 DOI: 10.1016/j.joen.2021.09.006] [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: 08/02/2021] [Revised: 09/08/2021] [Accepted: 09/11/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The aim of this study was to compare the effect of different application techniques of ozone on the prevalence of postendodontic pain in patients undergoing single-visit root canal treatment. METHODS hundred eight patients with necrotic pulp in single-rooted teeth and apical periodontitis participated in the trial. A standard single-visit endodontics protocol was followed with 5.25% sodium hypochlorite and rotary nickel-titanium files. After shaping and cleaning, patients were randomly allocated into the following groups: group 1 (n = 21), ozone treatment with no activation (NA); group 2 (n = 22), ozone treatment with manual dynamic activation (MDA); group 3, (n = 21), ozone treatment with passive ultrasonic activation (PUA); group 4 (n = 23), ozone treatment with sonic activation (SA); and group 5 (n = 21), no ozone treatment (the control group). Patient levels of discomfort were recorded at 6 different time intervals using the visual analog scale (VAS). Comparison of the mean difference between the groups and time intervals was performed using 2-way analysis of variance followed by a post hoc Bonferroni test. The level of significance was set at 5%. RESULTS VAS scores were highest for the control > NA > MDA > SA > PUA groups. A statistically significant reduction in VAS scores was observed in the PUA and SA groups in comparison with the NA, control, and MDA groups. Timewise comparison showed a highly significant decline in VAS scores at all time intervals (P < .001). CONCLUSIONS Ultrasonic and sonic activation of ozone resulted in less pain in patients undergoing single-visit endodontics compared with no ozone treatment.
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Affiliation(s)
- Nidhi Sinha
- Department of Conservative Dentistry and Endodontics, Pacific Dental College and Hospital, Udaipur, Rajasthan, India.
| | - Geeta Asthana
- Department of Conservative Dentistry and Endodontics, Government Dental College, Ahmedabad, Gujarat, India
| | - Girish Parmar
- Department of Conservative Dentistry and Endodontics, Government Dental College, Ahmedabad, Gujarat, India
| | - Akshayraj Langaliya
- Department of Conservative Dentistry and Endodontics, Ahmedabad Municipal Dental College, Ahmedabad, Gujarat, India
| | - Jinali Shah
- Department of Conservative Dentistry and Endodontics, Ahmedabad Municipal Dental College, Ahmedabad, Gujarat, India
| | - Aravind Kumbhar
- Department of Conservative Dentistry and Endodontics, Ahmedabad Municipal Dental College, Ahmedabad, Gujarat, India
| | - Bijay Singh
- Department of Prosthodontics, Pacific Dental College and Hospital, Udaipur, Rajasthan, India
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Cheung AWT, Lee AHC, Cheung GSP. Clinical efficacy of activated irrigation in endodontics: a focused review. Restor Dent Endod 2021; 46:e10. [PMID: 33680899 PMCID: PMC7906851 DOI: 10.5395/rde.2021.46.e10] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 02/02/2023] Open
Abstract
Root canal debridement, which includes the removal of infected tissues and microbial biofilms, is considered the corner stone of root canal treatment. Chemical adjuncts play a multitude of functions in this regard, as tissue solvents, antimicrobial agents and for removing the smear layer. These adjuncts (irrigants) are usually delivered using a syringe and needle. With increasing knowledge of the complexity of root canal anatomy and tenacity of microbial biofilms, the need for strategies that potentiate the action of these irrigants within the root canal system cannot be overemphasized. Several such activated irrigation strategies exist. The aim of this review is to comprehensively discuss the different irrigant activation methods from the context of clinical studies.
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Affiliation(s)
- Amelia Wan Tin Cheung
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Angeline Hui Cheng Lee
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Gary Shun Pan Cheung
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
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Nangia D, Nawal RR, Talwar S. Evaluation of apical extrusion and cone-beam computed tomography assessment of irrigant penetration in oval-shaped canals, using XP Endo Finisher and EndoActivator. J Conserv Dent 2021; 23:185-189. [PMID: 33384493 PMCID: PMC7720767 DOI: 10.4103/jcd.jcd_390_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 07/13/2020] [Accepted: 08/10/2020] [Indexed: 12/05/2022] Open
Abstract
Background: Thorough cleaning of the pulp space is a challenging task. The mechanical instrumentation alone is usually not sufficient to completely debride the canals, and therefore, it requires the chemical action of irrigants also to disinfect the difficult to reach areas. Aim: The purpose of this study was to determine apical extrusion and assess irrigant penetration through cone-beam computed tomography (CBCT) for EndoActivator (EA) and XP Endo Finisher (XP). Materials and Methods: Sixty single-rooted mandibular premolars with oval-shaped canals were equally divided into three groups after instrumentation, based on the final irrigation: Group-1 syringe needle (30G Max-I-probe), Group-2 EA, and Group-3 XP. After the final irrigation, the weight of the extruded sodium hypochlorite was calculated. The prepared canals were then irrigated with a radiopaque contrast medium, which was activated according to the group of the sample (Group-1, 2, or 3). The volume of irrigant filled in the canal, especially in the apical third was determined through special tools in CBCT imaging. Statistics: One-way ANOVA test was used to compare the different groups. Results and Conclusion: Significantly more apical extrusion was seen in XP (P < 0.001). Both XP and EA have shown complete penetration of irrigant in the canal (100%).
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Affiliation(s)
- Divya Nangia
- Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Ruchika Roongta Nawal
- Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Sangeeta Talwar
- Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
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Li J, Bergeron BE, Chao J, Xu T, Tay FR, Fan B. Micro-computed tomography evaluation of root canal filling quality with apical negative pressure. J Dent 2020; 100:103431. [PMID: 32682921 DOI: 10.1016/j.jdent.2020.103431] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES The objective of the present study was to compare, using micro-computed tomography (micro-CT), the location and volume percentage of voids in root canals that were obturated with a premixed tricalcium silicate sealer and a single gutta-percha master cone, in the presence or absence of apical negative pressure. METHODS Twenty extracted human mandibular premolars were cleaned and shaped. The teeth were assigned to 2 groups (n = 10) according to the filling technique: apical negative pressure sealer application combined with the single-cone technique (NPS) or syringe-assisted sealer application combined with the single-cone technique (SS). Each specimen was scanned using micro-CT at 10 μm resolution. The percentages of voids were calculated from segmental regions of interest. Data were analysed using nonparametric statistical methods, with statistical significance pre-set at α = 0.05. RESULTS Significant difference was identified (p < 0.05) in the overall percentage of voids between the NPS group (0.33 %; interquartile range 0.25 %) and the SS group (6.29 %; interquartile range 5.57 %). In the NPS group, the percentages of voids in the coronal-third or middle-third of the canal space were statistically lower than that in apical-third (p < 0.0167, Bonferroni adjustment), with no significant difference between the former two groups. In the SS group, no significant difference in the percentages of voids was identified among the coronal-third, middle-third and apical-third of the canal space. CONCLUSIONS Apical negative pressure sealer application combined with the single-cone technique produces fewer voids in root canal fillings than the conventional single-cone technique. CLINICAL SIGNIFICANCE The apical negative pressure sealer application technique combined with single-cone filling constitutes a novel root canal obturation technique that improves the quality of root canal filling by minimising the volume of voids within the three-dimensional canal space.
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Affiliation(s)
- Jinxia Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Brian E Bergeron
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Jing Chao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Ting Xu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Franklin R Tay
- The Dental College of Georgia, Augusta University, Augusta, GA, USA.
| | - Bing Fan
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
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Delly, Widyastuti W, Aryadi, Hidayat A. Differences in apical vapor lock formation after sodium hypochlorite irrigation with and without surfactant using two needle types. SCIENTIFIC DENTAL JOURNAL 2020. [DOI: 10.4103/sdj.sdj_51_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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AlRahabi MK, AlKady AM. Current Trends in Practice of Residents in the Saudi Board of Endodontics Program. Eur J Dent 2020; 13:619-624. [PMID: 31891979 PMCID: PMC6938417 DOI: 10.1055/s-0039-3399456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives
The purpose of the current study was to collect information about some techniques and armamentarium currently used by the Saudi Board of Endodontics residents in relation to the technical steps of root canal therapy.
Materials and Methods
A web-based survey was sent to the Saudi Board of Endodontics residents, based in the western area of Saudi Arabia. The survey assessed controversial concepts, and collected information regarding new instruments and materials, used in the technical steps of nonsurgical root canal treatment. A one-sample chi-square test, with a 95% level of significance, was applied to determine whether there were significant differences between respondents’ answers.
Results
A total of 45 out of 50 residents (90%) responded to the questionnaire. The majority of Saudi Board residents of Endodontics, who participated in this survey, used the mean of working length (ML) measured by periapical X-Ray and apex locator in the presence of a radiographic lesion (63.3%), and maintained apical patency in all cases (80.0%). ProTaper Universal (40%) and ProTaper Next (41.2%) were the most common NiTi rotary systems used for root canal instrumentation. Thirty percent of respondents used adjunct device with irrigation, and 80% advocated smear layer removal. Zinc oxide–eugenol-based sealers were the most common used sealers (70%), and most residents (86.6%) did not advocate sealer extrusion.
Conclusions
This study revealed that residents of the Saudi Board of Endodontics program adopt new endodontic technologies. There is, however, a need for more investigations regarding this objective, including responses from all residents in Saudi Arabia.
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Affiliation(s)
- Mothanna K AlRahabi
- Department of Restorative Dental Science, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia
| | - Ayman M AlKady
- Department of Restorative Dental Science, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia
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Passive Ultrasonic Irrigation Efficacy in the Vapor Lock Removal: Systematic Review and Meta-Analysis. ScientificWorldJournal 2019; 2019:6765349. [PMID: 30992694 PMCID: PMC6434262 DOI: 10.1155/2019/6765349] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 02/24/2019] [Indexed: 12/16/2022] Open
Abstract
Passive Ultrasonic Irrigation (PUI) represents one of the most used systems to improve the endodontic irrigants activity. PUI acts increasing the reaction rate of NaOCl, with an increase of dentinal debris and smear layer removal. There is a stronger shear stress and a vapor lock reduction. Aim of this systematic review was to figure out the effects of the PUI on the vapor lock removal, during irrigation. Literature research has been carried out by two reviewers, consulting online databases such as PubMed, EBSCO, and Google Scholar, using keywords like Vapor Lock, Vapour Lock, and Vapor Lock Endodontic. The articles list has been screened based on titles and abstracts, applying eligibility and inclusion criteria. The three articles were eligible for quantitative and statistical analysis, by using RevManager Software Version 5.3. Results show statistical heterogeneity (P=0.08; I2 index=61%) in the vapor lock elimination between the use of PUI and PPI, with an overall Odds Ratio=0.08, CI=95% [0.03;0.25]. PUI resulted to be a useful technique to improve NaOCl activity for vapor lock removal, despite PPI alone using a needle.
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Amato M, Pantaleo G, Abtellatif D, Blasi A, Gagliani M, Iandolo A. An in vitro evaluation of the degree of pulp tissue dissolution through different root canal irrigation protocols. J Conserv Dent 2018; 21:175-179. [PMID: 29674820 PMCID: PMC5890408 DOI: 10.4103/jcd.jcd_49_18] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aim The aim of this study is to evaluate in vitro, using artificial lateral canals, the rate of dissolution of the pulp tissue through different protocols of canal irrigation. Materials and Methods One hundred artificial canals provided with lateral canals have been used. Each lateral canal was filled with pulp tissue and calibrated to 0.002 mg. All canals were irrigated using five different protocols. Five groups have been used for the experiment: Group A, distilled water (control); Group B, preheated NaOCl; Group C, NaOCl heated inside the canal; Group D, NaOCl ultrasonically activated; and Group E, NaOCl heated inside the canal with ultrasonic activation. All samples were weighed through professional microbalance in three different phases: before insertion of the pulp tissue into the lateral canal, after insertion of the pulp tissue and, finally, after different protocols of irrigation. A statistical analysis with Kruskal-Wallis test and Mann-Whitney test was performed. Results The partial dissolution of the pulp tissue inside the artificial lateral canal occurs only using the protocol with NaOCl heated inside the canal with ultrasonic activation. Other irrigation protocols are not able to dissolve the pulp tissue. Discussion and Conclusions The main objective of endodontic therapy is the removal of damaged tissues and bacteria. Modern literature highlights that it is impossible to remove all the pulp tissues and bacteria from the whole endodontic space. Hence, to achieve excellence and get positive results in the short and long term, it is necessary to use techniques and technologies that may increase the degree of root canal detersion.
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Affiliation(s)
- Massimo Amato
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Giuseppe Pantaleo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Dina Abtellatif
- Department of Endodontics, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt
| | - Andrea Blasi
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Massimo Gagliani
- Department of Biomedical, Surgical and Dental Sciences, "Giorgio Vogel" Dental Clinics, University of Milan, Milan, Italy
| | - Alfredo Iandolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
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Mohammadi Z, Jafarzadeh H, Shalavi S, Kinoshita JI. Establishing Apical Patency: To be or not to be? J Contemp Dent Pract 2017; 18:326-329. [PMID: 28349913 DOI: 10.5005/jp-journals-10024-2040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The apical portion of the root canal is very complex and challenging during endodontic treatment. Root canal preparation and obturation to the apical constriction may provide the best prognosis. Incomplete debridement, foramen transportation, and inadequate seal in the apical portion are considered to be responsible for treatment failure. The technique "apical patency" is considered as a way for maintaining the apical part the free of the debris by recapitulation, using a small K-file through the area of the apical foramen. This term was firstly proposed by Buchanan. In this technique, the smallest diameter file is set 1 mm longer than working length and recapitulated after each instrument to prevent packing of debris in the apical part. Apical patency has been found to be effective in achieving an apical seal with gutta-percha. Teeth prepared with a step back method and with maintained apical patency may show less leakage when obturated with cold lateral condensation technique. Data regarding the effect of apical patency on the healing of periapical tissue are very scarce, and it has been shown that the patency file has detrimental effect on the healing of periapical tissues in animal studies. However, using patency file in endodontic treatment is controversial and further studies are needed. The purpose of this article is to review the effect of using a patency file on the extrusion of root canal contents, the apical seal, postoperative pain, and healing of periapical tissues. Furthermore, the effect of establishing patency on reaching irrigation solutions to the apical portion of the canal and prognosis of root canal treatment are discussed. CLINICAL SIGNIFICANCE Keywords: Apical patency, Apical seal, Apical transportation, Postoperative pain, Prognosis.
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Affiliation(s)
- Zahed Mohammadi
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shaheed Beheshti University of Medical Sciences, Iranian National Elite Foundation, Tehran, Islamic Republic of Iran
| | - Hamid Jafarzadeh
- Department of Endodontics, Dental Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad Islamic Republic of Iran, Phone: +00985138829501, e-mail:
| | | | - Jun-Ichiro Kinoshita
- Department of Conservative Dentistry, Showa University Dental Hospital, Tokyo, Japan
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Plotino G, Cortese T, Grande NM, Leonardi DP, Di Giorgio G, Testarelli L, Gambarini G. New Technologies to Improve Root Canal Disinfection. Braz Dent J 2016; 27:3-8. [DOI: 10.1590/0103-6440201600726] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 02/22/2016] [Indexed: 11/21/2022] Open
Abstract
Abstract Effective irrigant delivery and agitation are prerequisites to promote root canal disinfection and debris removal and improve successful endodontic treatment. This paper presents an overview of the currently available technologies to improve the cleaning of the endodontic space and their debridement efficacy. A PubMed electronic search was conducted with appropriate key words to identify the relevant literature on this topic. After retrieving the full-text articles, all the articles were reviewed and the most appropriate were included in this review. Several different systems of mechanical activation of irrigants to improve endodontic disinfection were analysed: manual agitation with gutta-percha cones, endodontic instruments or special brushes, vibrating systems activated by low-speed hand-pieces or by sonic or subsonic energy, use of ultrasonic or laser energy to mechanically activate the irrigants and apical negative pressure irrigation systems. Furthermore, this review aims to describe systems designed to improve the intracanal bacterial decontamination by a specific chemical action, such as ozone, direct laser action or light-activated disinfection. The ultrasonic activation of root canal irrigants and of sodium hypochlorite in particular still remains the gold standard to which all other systems of mechanical agitation analyzed in this article were compared. From this overview, it is evident that the use of different irrigation systems can provide several advantages in the clinical endodontic outcome and that integration of new technologies, coupled with enhanced techniques and materials, may help everyday clinical practice.
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Vera J, Ochoa-Rivera J, Vazquez-Carcaño M, Romero M, Arias A, Sleiman P. Effect of Intracanal Cryotherapy on Reducing Root Surface Temperature. J Endod 2015; 41:1884-7. [PMID: 26433855 DOI: 10.1016/j.joen.2015.08.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 08/12/2015] [Accepted: 08/16/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The positive effect of cryotherapy has been widely described in medicine. The aim of the present study was to validate a new methodology to reduce and maintain external root surface temperature for at least 4 minutes. METHODS Twenty extracted single-rooted teeth were instrumented to size 35/.06 and subjected to 2 different irrigation interventions with a repeated-measures design using 5% sodium hypochlorite first (control) and 2.5°C cold saline solution later (experimental). In both, 20 mL of the irrigant solution was delivered for a total time of 5 minutes with a microcannula attached to the EndoVac system (Kerr Endo, Orange County, CA) inserted to the working length. The initial and lowest temperatures were recorded in the apical 4 mm with a digital thermometer for both irrigants. Data were analyzed with the repeated measure analysis of variance (Greenhouse-Geisser correction) and Bonferroni post hoc tests. Differences in maintaining a -10°C temperature reduction over 4 minutes were assessed with the Fisher exact test. RESULTS Although significant differences were found between the initial and lowest temperatures in both the control and experimental irrigation procedures (P < .001), the experimental intervention reduced it almost 10 times that of the control. When maintaining a -10°C temperature reduction over 4 minutes, the teeth in the experimental group also sustained significantly better results (P = 3.047 × 10(-10)). CONCLUSIONS Using cold saline solution as the final irrigant reduced the external root surface temperature more than 10°C and maintained it for 4 minutes, which may be enough to produce a local anti-inflammatory effect in the periradicular tissues.
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Affiliation(s)
- Jorge Vera
- Department of Postgraduate Endodontics, University of Tlaxcala, Tlaxcala, Mexico; Private Practice, Puebla, Mexico.
| | - Jorge Ochoa-Rivera
- Department of Postgraduate Endodontics, University of Tlaxcala, Tlaxcala, Mexico; Private Practice, Jalapa, Mexico
| | - Marino Vazquez-Carcaño
- Department of Postgraduate Endodontics, University of Tlaxcala, Tlaxcala, Mexico; Private Practice, Tlaxcala, Mexico
| | - Monica Romero
- Private Practice, Puebla, Mexico; Department of Endodontics, Benemerita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Ana Arias
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California
| | - Philippe Sleiman
- Department of Endodontics, University of North Carolina School of Dentistry, Chapel Hill, North Carolina; Lebanese University Dental School, Beirut, Lebanon
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20
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Plotino G, Grande N. Nuove tecnologie per il miglioramento della disinfezione canalare. DENTAL CADMOS 2015. [DOI: 10.1016/s0011-8524(15)30079-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Arora M, Sangwan P, Tewari S, Duhan J. Effect of maintaining apical patency on endodontic pain in posterior teeth with pulp necrosis and apical periodontitis: a randomized controlled trial. Int Endod J 2015; 49:317-24. [PMID: 25866134 DOI: 10.1111/iej.12457] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 04/08/2015] [Indexed: 01/09/2023]
Abstract
AIM To evaluate the association between apical patency and post-operative pain in posterior teeth with pulp necrosis and apical periodontitis. METHODOLOGY Sixty-eight patients requiring primary root canal treatment in mandibular first molars with necrotic pulps and apical periodontitis were included. The patients were randomly allocated to one of two groups: patency (n = 34) and nonpatency (n = 34). After administering local anaesthesia, root canal preparation was completed using ProTaper rotary instruments. A size 10 K-file was used as a patency file and carried 1 mm beyond the working length (WL) between each instrument change in the patency group, while it was carried up to WL in the nonpatency group. Patients were asked to record their pain experience on a pain chart daily for 7 days. Three patients (two in the patency group, one in the nonpatency group) did not return with completed pain charts on the subsequent visit, resulting in a total of 65 patients for the final analysis (patency, n = 32; nonpatency, n = 33). Data was analysed using Chi Square test, t-test, Mann-Whitney test and Wilcoxon Signed Ranks test. RESULTS Overall, 43% of the patients experienced post-operative pain. The patency group had less incidence of pain (34%) as compared to the nonpatency group (52%), but the difference was not significant (P = 0.163). CONCLUSION Maintenance of apical patency during chemomechanical preparation had no significant influence on post-operative pain in posterior teeth with necrotic pulps and apical periodontitis.
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Affiliation(s)
- M Arora
- 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
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Rossi-Fedele G, Guastalli AR. Effect of an alcohol-based caries detector on the surface tension of sodium hypochlorite preparations. Braz Dent J 2015; 26:66-8. [PMID: 25672387 DOI: 10.1590/0103-6440201300172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 12/11/2014] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to evaluate the effect of an alcohol-based caries detector (Kurakay) on the surface tension of a conventional sodium hypochlorite (NaOCl) preparation, and a product containing a surface-active agent (Chlor-XTRA). The surface tensions of the following solutions were tested: NaOCl, a mixture of NaOCl and Kurakay 9:1 w/w, Chlor-XTRA, a mixture of Chlor-XTRA and Kurakay 9:1 w/w. Ten measurements per test solution were made at 20°C, using an optical method called the "Pendant drop method", with a commercially available apparatus. The addition of Kurakay reduced the surface tension for NaOCl (p<0.05) whilst no significant difference was detected for Chlor-XTRA (p>0.05). Statistically significant differences between the NaOCl and Chlor-XTRA groups were found (p<0.05). The addition of an alcohol-based caries detector resulted in a reduction of the original surface tension values for NaOCl only. Taking into account the fact that mixtures of NaOCl and Kurakay have been used to assess the penetration of root canal irrigants in vitro, the related changes in surface tension are a possible source of bias.
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Affiliation(s)
| | - Andrea R Guastalli
- Chemical Engineering Department, University of Barcelona, Barcelona, Spain
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van der Sluis L, Boutsioukis C, Jiang LM, Macedo R, Verhaagen B, Versluis M. Root Canal Irrigation. SPRINGER SERIES ON BIOFILMS 2015. [DOI: 10.1007/978-3-662-47415-0_9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Sáinz-Pardo M, Estevez R, Pablo ÓVD, Rossi-Fedele G, Cisneros R. Root Canal Penetration of a Sodium Hypochlorite Mixture Using Sonic or Ultrasonic Activation. Braz Dent J 2014; 25:489-93. [PMID: 25590194 DOI: 10.1590/0103-6440201300209] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 10/20/2014] [Indexed: 12/16/2022] Open
Abstract
The purpose of this ex vivo study was to determine, in "open" and "closed" systems, whether the design has an influence on the penetration length of sodium hypochlorite mixed with a radiopaque contrast medium, measured in millimeters, when delivered using positive pressure (PP) and using sonic (SI) or passive ultrasonic (PUI) activation. Sixty single-rooted teeth were divided into two groups: open and closed systems (n=30). Root canal shaping was performed to a working length of 17 mm. The samples were divided into three sub-groups (n=10) according to irrigant delivery and activation: PP, and SI or PUI activation. By using radiographs, penetration length was measured, and vapor lock was assessed. For the closed group, the penetration distance means were: PP 15.715 (±0.898) mm, SI 16.299 (±0.738) mm and PUI 16.813 (±0.465) mm, with vapor lock occurring in 53.3% of the specimens. In the open group, penetration to 17 mm occurred in 97.6% of the samples, and no vapor lock occurred. Irrigant penetration and distribution evaluation using open and closed systems provide significantly different results. For closed systems, PUI is the most effective in delivering the irrigant to working length, followed by SI.
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Versiani MA, De-Deus G, Vera J, Souza E, Steier L, Pécora JD, Sousa-Neto MD. 3D mapping of the irrigated areas of the root canal space using micro-computed tomography. Clin Oral Investig 2014; 19:859-66. [DOI: 10.1007/s00784-014-1311-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 08/26/2014] [Indexed: 10/24/2022]
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Debris Remaining in the Apical Third of Root Canals after Chemomechanical Preparation by Using Sodium Hypochlorite and Glyde: An In Vivo Study. J Endod 2014; 40:1419-23. [DOI: 10.1016/j.joen.2014.05.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 04/01/2014] [Accepted: 05/29/2014] [Indexed: 11/21/2022]
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Efficacy of flowable gel-type EDTA at removing the smear layer and inorganic debris under manual dynamic activation. J Endod 2013; 39:910-4. [PMID: 23791262 DOI: 10.1016/j.joen.2013.04.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 03/12/2013] [Accepted: 04/03/2013] [Indexed: 11/21/2022]
Abstract
INTRODUCTION A flowable gel-type EDTA solution containing urea peroxide and polyacrylic acid was recently introduced into the endodontic market. However, its efficacy for removing the smear layer and inorganic debris remains unknown. This study was performed to investigate the relative efficacies of the flowable gel-type and liquid-type EDTA solutions for removal of the smear layer and inorganic debris. We also evaluated the effects of manual dynamic activation (MDA). METHODS Wettability was evaluated by measuring the contact angle. The incidence of accidental extrusion of irrigant was determined. The effervescent effect was evaluated by mixing the solutions with sodium hypochlorite. The efficacies of the EDTA solutions at removing the smear layer and inorganic debris were evaluated by scanning electron microscopic examination. RESULTS The contact angles of the 2 EDTA solutions did not differ significantly throughout the experiment (P > .05). Accidental extrusion occurred 4 times for the liquid-type EDTA but never for the gel-type EDTA. The gel-type but not the liquid-type EDTA showed an effervescent effect. The EDTA/MDA treatment combinations did not produce significantly different smear layer scores (P > .05). However, the debris scores for the coronal and middle parts were significantly lower for the gel-type EDTA with MDA than for the liquid-type EDTA without MDA (P < .05). CONCLUSIONS Our results suggest that the newly introduced gel-type EDTA might be an acceptable irrigant for removing the smear layer and inorganic debris present on the root canal wall.
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Boutsioukis C, Kastrinakis E, Lambrianidis T, Verhaagen B, Versluis M, van der Sluis LWM. Formation and removal of apical vapor lock during syringe irrigation: a combined experimental and Computational Fluid Dynamics approach. Int Endod J 2013; 47:191-201. [DOI: 10.1111/iej.12133] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Accepted: 04/19/2013] [Indexed: 11/30/2022]
Affiliation(s)
- C. Boutsioukis
- Physics of Fluids Group; Faculty of Science and Technology; University of Twente; Enschede The Netherlands
- MESA+ Institute for Nanotechnology; University of Twente; Enschede The Netherlands
| | - E. Kastrinakis
- Chemical Engineering Department; School of Engineering; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - T. Lambrianidis
- Department of Endodontology; Dental School; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - B. Verhaagen
- Physics of Fluids Group; Faculty of Science and Technology; University of Twente; Enschede The Netherlands
- MIRA Institute for Biomedical Technology and Technical Medicine; University of Twente; Enschede The Netherlands
| | - M. Versluis
- Physics of Fluids Group; Faculty of Science and Technology; University of Twente; Enschede The Netherlands
- MESA+ Institute for Nanotechnology; University of Twente; Enschede The Netherlands
- MIRA Institute for Biomedical Technology and Technical Medicine; University of Twente; Enschede The Netherlands
| | - L. W. M. van der Sluis
- Center of Dentistry and Oral Hygiene; University Medical Center Groningen; University of Groningen; the Netherlands
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Merino A, Estevez R, de Gregorio C, Cohenca N. The effect of different taper preparations on the ability of sonic and passive ultrasonic irrigation to reach the working length in curved canals. Int Endod J 2012; 46:427-33. [DOI: 10.1111/iej.12006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 09/05/2012] [Indexed: 11/28/2022]
Affiliation(s)
- A. Merino
- Universidad Europea de Madrid; Madrid; Spain
| | - R. Estevez
- Universidad Europea de Madrid; Madrid; Spain
| | | | - N. Cohenca
- Department of Endodontics and Pediatric Dentistry; School of Dentistry; University of Washington; Seattle; WA; USA
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Vera J, Hernández EM, Romero M, Arias A, van der Sluis LWM. Effect of maintaining apical patency on irrigant penetration into the apical two millimeters of large root canals: an in vivo study. J Endod 2012; 38:1340-3. [PMID: 22980174 DOI: 10.1016/j.joen.2012.06.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Revised: 05/29/2012] [Accepted: 06/04/2012] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Factors such as complex root canal anatomy and the vapor lock phenomenon have been shown to limit the penetration of irrigating solutions into the apical third in both in vivo and in vitro studies involving small and wide canals. Hence, the aim of this study was to determine whether the use of a patency file is related to the presence of a radiopaque irrigating solution in the apical 2 mm of large human root canals. METHODS Forty-three large human root canals were randomly divided into 2 groups. Apical patency was maintained in 1 group (P, n = 22) during shaping and cleaning procedures with a no. 10 K-file 1 mm beyond the working length (WL) but not in the other group (no patency [NP], n = 21). In both groups, the canals were shaped with the K3 system. Irrigation was performed with 1 mL of a solution prepared with a radiopaque contrast medium and 5.25% sodium hypochlorite. Digital images were taken, and 2 calibrated readers determined the presence or absence of the irrigating solution in the apical 2 mm of the root canals. RESULTS There were significantly more canals with irrigant in the apical 2 mm when apical patency was maintained with a no. 10- Kfile 1 mm beyond the WL than when apical patency was not maintained throughout the cleaning and shaping procedures (P = .04). CONCLUSIONS Maintaining apical patency improves the delivery of irrigants into the apical third of large human root canals.
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Affiliation(s)
- Jorge Vera
- University of Tlaxcala, Tlaxcala, Mexico.
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