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Hepsenoglu YE, Ersahan S, Erkan E, Gundogar M, Ozcelik F. Is SWEEPS better than PUI in reducing intracanal bacteria and inflammation in cases of apical periodontitis? Lasers Med Sci 2024; 39:182. [PMID: 39012553 PMCID: PMC11252177 DOI: 10.1007/s10103-024-04117-9] [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: 10/26/2023] [Accepted: 06/24/2024] [Indexed: 07/17/2024]
Abstract
To evaluate the efficacy of SWEEPS mode of the Er: YAG laser(SL) and passive ultrasonic irrigation(PUI) in the eradication of microorganisms and in the inflammation detection by IL-1β. Thirty patients with chronic apical periodontitis(AP) were allocated into two groups: Group SL-SWEEPS laser activated irrigation(n = 15) and Group PUI-passive ultrasonic irrigation(n = 15). Bacteriological samples were taken before(S1) and after chemomechanical preparation(S2), and then after final irrigation activation(S3). The levels of total bacteria and Streptococci were measured by means of PCR. Blood samples were collected before and 3rd day after treatment. Enzyme-linked immunosorbent assay was used to measure the levels of IL-1β. The bacterial reduction showed no differences between groups after chemo-mechanical treatment and after irrigant activation(p = 0.590). Post-treatment IL-1β levels were lower than pretreatment levels in both groups(p < 0.001). SL or PUI application in addition to chemomechanical preparation has similar effects on total bacterial level and inflammation detected by IL-1β in patients with AP.
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Affiliation(s)
- Yelda Erdem Hepsenoglu
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey
| | - Seyda Ersahan
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey.
| | - Erhan Erkan
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey
| | - Mustafa Gundogar
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey
| | - Fatih Ozcelik
- Department of Medical Biochemistry Department, Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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2
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Usta SN, Solana C, Ruiz-Linares M, Baca P, Ferrer-Luque CM, Cabeo M, Arias-Moliz MT. Effectiveness of conservative instrumentation in root canal disinfection. Clin Oral Investig 2023; 27:3181-3188. [PMID: 36867258 PMCID: PMC10264279 DOI: 10.1007/s00784-023-04929-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/22/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVES The impact of conservative instrumentation on the disinfection of root canals with different curvatures has not yet been determined. This ex vivo study aimed to evaluate and compare the effect of conservative instrumentation with TruNatomy (TN) and Rotate and a conventional rotary system, ProTaper Gold (PTG), on root canal disinfection during chemomechanical preparation of straight and curved canals. MATERIALS AND METHODS Ninety mandibular molars with straight (n = 45) and curved (n = 45) mesiobuccal root canals were contaminated with polymicrobial clinical samples. Teeth were divided into three subgroups (n = 14) according to the file systems and the curvature. Canals were instrumented with TN, Rotate, and PTG, respectively. Sodium hypochlorite and EDTA were used as irrigants. Intracanal samples were taken before (S1) and after (S2) instrumentation. Six uninfected teeth were used as negative controls. The bacterial reduction between S1 and S2 was measured by ATP assay, flow cytometry, and culture methods. Kruskal-Wallis and ANOVA tests were followed by the Duncan post hoc test (p < 0.05). RESULTS Bacterial reduction percentages were similar for the three file systems in straight canals (p > 0.05). However, PTG showed a lower reduction percentage of intact membrane cells in flow cytometry than TN and Rotate (p = 0.036). For the curved canals, no significant differences were obtained (p > 0.05). CONCLUSION Conservative instrumentation of straight and curved canals using TN and Rotate files resulted in similar bacterial reduction compared to PTG. CLINICAL RELEVANCE The disinfection efficacy of conservative instrumentation is similar to conventional instrumentation in straight and curved root canals.
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Affiliation(s)
- Sıla Nur Usta
- Department of Endodontics, Gulhane Faculty of Dentistry, University of Health Sciences, Etlik, Keçiören, 06018 Ankara Turkey
| | - Carmen Solana
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Matilde Ruiz-Linares
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Pilar Baca
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Carmen María Ferrer-Luque
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Monica Cabeo
- Department of Microbiology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
| | - Maria Teresa Arias-Moliz
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- Department of Microbiology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
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Alquria TA, Alfirdous RA, Gupta S, Santamaria MP, Santamaria IF, Gomes APM, Tiradentes N, Silva EG, Martinho FC. Comparison of conventional and contemporary root canal disinfection protocols against bacteria, lipoteichoic acid (LTA), and lipopolysaccharide (LPS). Sci Rep 2023; 13:1206. [PMID: 36681702 PMCID: PMC9867776 DOI: 10.1038/s41598-022-26855-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/21/2022] [Indexed: 01/22/2023] Open
Abstract
This study devised a dual-species biofilm model to investigate bacteria, lipoteichoic acid (LTA), and lipopolysaccharide (LPS) simultaneously, and compared the efficacy of conventional and contemporary disinfection protocols. Seventy single-rooted mandibular premolars were included. Fourteen teeth were negative control, and 56 teeth were infected with 3-week-old E. faecalis and E. coli GFP biofilm. Fourteen/56 teeth were positive control, with seven teeth processed for CLSM analysis and seven teeth sampled with paper points (PPs) and cryogenically ground for bacterial, LTA, and LPS analyses. Forty-two teeth were randomly divided into three groups: GWS (GentleWave system) + MIT (minimally invasive technique), PUI (passive ultrasonic irrigation) + CIT (conventional instrumentation technique), and XP-EF (XP-endo Finisher) + CIT (All, n = 14). Samples were collected before (s1) and after disinfection (s2) with PPs and after cryogenically ground (s3). CFUs were counted, and LTA and LPS were quantified with LTA-ELISA and LAL assay, respectively. XP-EF was as effective as PUI (p > 0.05). GWS + MIT was the most effective disinfection protocol against bacteria, LTA, and LPS (p < 0.05). In conclusion, PUI, XP-EF, and GWS were highly effective against bacteria, LTA, and LPS, with GWS being the most effective.
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Affiliation(s)
- Theeb A Alquria
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA
- Department of Restorative Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Rayyan A Alfirdous
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA
- Prince Abdulrahman Advanced Dental Institute, Riyadh, Kingdom of Saudi Arabia
| | - Swati Gupta
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA
| | | | - Ingrid F Santamaria
- Department of General Dentistry, School of Dentistry, University of Maryland, Baltimore, MD, USA
| | - Ana P M Gomes
- Endodontic Division, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Naiara Tiradentes
- Endodontic Division, Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Eduardo G Silva
- Department of Social and Pediatric Dentistry, Institute of Science and Technology, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, Brazil
| | - Frederico C Martinho
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD, USA.
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4
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Almeida GM, Carvalho VHM, Silva ÉBP, Cançado MAF, Barroso LS, Queiroz EL, An TL, Ribeiro APD, Carvalho-Junior JR, Leite AF. Periradicular repair after single- and two-visit root canal treatments using ultrasonic irrigant activation and calcium hydroxide dressing of teeth with apical periodontitis: study protocol for randomized controlled trials. Trials 2023; 24:23. [PMID: 36635764 PMCID: PMC9838070 DOI: 10.1186/s13063-022-07030-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 12/16/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND In certain clinical situations, root canal treatment in teeth with apical periodontitis is performed in multiple visits, with the use of intracanal dressing between visits, aiming to reduce microorganisms and their by-products of the root canal system prior to filling. However, in recent years, discussions have been growing about the real need for the use of intracanal dressing in these cases. The use of ultrasonic activation of the auxiliary chemical substance has increased the potential for decontamination promoted during the chemomechanical preparation of the root canal. Thus, this study is designed to explore whether the use of intracanal dressing between visits during endodontic treatment favors periradicular repair in teeth with apical periodontitis. METHODS This is a randomized, prospective, double-blinded, controlled clinical trial designed to evaluate 3 distinct clinical approaches used during endodontic therapy: group 1-root canal treatment in a single visit (RCT-SV); group 2-root canal treatment in two visits with intracanal dressing (RCT-TVWD); and group 3-root canal treatment in two visits without intracanal dressing (RCT-TVWOD). A total of 150 adult patients aged 18 to 60, with at least one tooth diagnosed with asymptomatic apical periodontitis and periradicular lesion (confirmed with a cone beam computed tomography (CBCT)), will be randomized and will undergo one of the types of clinical approaches during endodontic therapy. Patients' postoperative pain levels will also be recorded in periods of 24, 48, and 72 h and 7 days. Subsequently, clinical findings and long-term follow-up evaluations, with periradicular repair, will be performed at 6 and 12 months by intraoral periapical radiograph (IOPAR) and CBCT at the 24-month follow-up. DISCUSSION This study will evaluate the periradicular repair of mandibular molar teeth with apical periodontitis, providing information about the efficacy, benefits, and safety of performing the endodontic treatment in a single and two visits, with and without the use of calcium hydroxide dressing. All endodontic therapy procedures will be performed under a dental operating microscope and using ultrasonic activation of auxiliary chemical substances. These results may contribute to changes in the clinical approaches adopted during endodontic therapy of teeth with apical periodontitis and reveal the potential of complementary approaches that aim to enhance the decontamination of the root canal system during the preparation stage. TRIAL REGISTRATION ClinicalTrials.gov NCT05256667. Registered on 24 February 2022.
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Affiliation(s)
- Gustavo M. Almeida
- grid.7632.00000 0001 2238 5157Postgraduate Program in Health Sciences, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Vitor Hugo M. Carvalho
- grid.7632.00000 0001 2238 5157Postgraduate Program in Health Sciences, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Érika B. P. Silva
- grid.7632.00000 0001 2238 5157Dental Trauma Project of Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Marco Antonio F. Cançado
- grid.7632.00000 0001 2238 5157Dental Trauma Project of Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Leonardo S. Barroso
- grid.412286.b0000 0001 1395 7782Postgraduate Program in Endodontics, University of Taubaté, Taubaté, Brazil
| | - Erica L. Queiroz
- grid.137628.90000 0004 1936 8753Department of Cariology and Comprehensive Care, New York University College of Dentistry, New York, USA
| | - Tien Li An
- grid.7632.00000 0001 2238 5157Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Ana Paula D. Ribeiro
- grid.15276.370000 0004 1936 8091Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, University of Florida, Gainesville, USA
| | - Jacy R. Carvalho-Junior
- grid.7632.00000 0001 2238 5157Dental Trauma Project of Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil ,grid.7632.00000 0001 2238 5157Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - André F. Leite
- grid.7632.00000 0001 2238 5157Postgraduate Program in Health Sciences, College of Health Sciences, University of Brasilia, Brasilia, Brazil ,grid.7632.00000 0001 2238 5157Department of Dentistry, College of Health Sciences, University of Brasilia, Brasilia, Brazil
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5
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Alfirdous RA, Alquiria TA, Jacinto RC, Martinho FC. A modified dentin infection model with Fluorescent Lipopolysaccharide and
LPS
sampling technique to compare
XP‐Endo
finisher and passive ultrasonic irrigation. Int Endod J 2022; 55:1081-1090. [DOI: 10.1111/iej.13804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022]
Affiliation(s)
- R. A. Alfirdous
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
- Prince Abdulrahman Advanced Dental Institute Riyadh Kingdom of Saudi Arabia
| | - T. A. Alquiria
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
- Prince Abdulrahman Advanced Dental Institute Riyadh Kingdom of Saudi Arabia
| | - R. C. Jacinto
- Division of Endodontics, Department of preventive and restorative dentistry School of Dentistry, Aracatuba São Paulo SP Brazil
| | - F. C. Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
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6
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Velardi JP, Alquria TA, Alfirdous RA, Corazza BJM, Gomes APM, Silva EG, Griffin IL, Tordik PA, Martinho FC. Comparison of GentleWave system and passive ultrasonic irrigation with minimally invasive and conventional instrumentation against LPS in infected root canals. Sci Rep 2022; 12:4894. [PMID: 35318365 PMCID: PMC8940914 DOI: 10.1038/s41598-022-08835-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 02/14/2022] [Indexed: 01/22/2023] Open
Abstract
This study compared the effectiveness of GentleWave system (GWS) and passive ultrasonic irrigation (PUI) in removing lipopolysaccharides (LPS) from infected root canals after minimally invasive (MIT) and conventional instrumentation (CIT) techniques. Sixty first premolars with two roots were inoculated with fluorescent LPS conjugate (Alexa Fluor 594). Of those, twelve were dentin pretreated, inoculated with fluorescent LPS conjugate, and submitted to confocal laser scanning microscopy (CLSM) to validate the LPS-infection model. Forty-eight teeth were randomly divided into treatment groups: GWS + MIT, GWS + CIT, PUI + MIT, and PUI + CIT (all, n = 12). Teeth were instrumented with Vortex Blue rotary file size 15/0.04 for MIT and 35/0.04 for CIT. Samples were collected before (s1) and after a root canal procedure (s2) and after cryogenically ground the teeth (s3) for intraradicular LPS analysis. LPS were quantified with LAL assay (KQCL test). GWS + MIT and GWS + CIT were the most effective protocols against LPS, with no difference between them (p > 0.05). PUI + CIT was more effective than PUI + MIT (p < 0.05) but less effective than GWS + MIT and GWS + CIT. GWS was the most effective protocol against LPS in infected root canals using MIT and CIT techniques.
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Affiliation(s)
- Johnathan P Velardi
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, MD, USA
| | - Theeb A Alquria
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, MD, USA
| | - Rayyan A Alfirdous
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, MD, USA
| | - Bruna J M Corazza
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Ana P M Gomes
- Department of Restorative Dentistry, Endodontic Division, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Eduardo G Silva
- Department of Social and Pediatric Dentistry, Institute of Science and Technology, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Ina L Griffin
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, MD, USA
| | - Patricia A Tordik
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, MD, USA
| | - Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, MD, USA.
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7
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Saber SM, Alfadag AMA, Nawar NN, Plotino G, Hassanien EES. Instrumentation Kinematics Does Not Affect Bacterial Reduction, Post-Operative Pain and flare-ups: A Randomized Clinical Trial. Int Endod J 2022; 55:405-415. [PMID: 35100456 DOI: 10.1111/iej.13695] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 11/25/2022]
Abstract
AIM This randomized clinical trial aimed to assess the effect of instrumentation kinematics (reciprocation or continuous rotation) on bacterial reduction, post-operative pain and incidence of flare-ups after root canal treatment of single-rooted mandibular premolars with asymptomatic apical periodontitis. METHODOLOGY Sixty-six patients were included in this prospective, parallel, randomized clinical trial. Patients were randomly allocated into two groups (N=33) according to the kinematics of the shaping instrument: WaveOne Gold (WO) used in reciprocation or One Shape (OS) used in continuous rotation. Under complete asepsis, bacterial samples were taken before (S1) and after (S2) a standard cleaning and shaping protocol. Evaluation of bacterial reduction was done by both culture technique and quantitative real-time polymerase chain reaction (qPCR) analysis. Post-operative pain was evaluated using the visual analog scale (VAS) after 24, 48- and 72-hours following treatment, while flare-ups were recorded as a binary outcome (Yes/No). Independent and paired t-tests were used for inter and intragroup comparisons for bacterial count data respectively. For post-operative pain score, intergroup comparisons were analyzed using Mann-Whitney U test while intragroup comparisons were analyzed using Friedman test followed by pairwise comparisons utilizing Wilcoxon signed rank test with Bonferroni correction. The significance level was set at p≤0.05 within all tests. RESULTS All the allocated participants received the intervention and were analyzed. The comparison between culture and qPCR methods showed that qPCR analysis demonstrated significantly higher pre-instrumentation baseline bacterial count (p<0.05). The percentage of bacterial reduction, detected by either method, significantly decreased after instrumentation using either rotation or reciprocation kinematics (p<0.05). However, the difference between the WOG or OS files was statistically non-significant (p>0.05). The intra-group comparisons showed a significant reduction in post-operative pain with time (p<0.05) for both groups. However, the inter-group comparison demonstrated that the difference in post-operative pain after the use of either WOG or OS was statistically non-significant (p>0.05). The incidence of flare-ups between both groups was also not-significant (p=1). CONCLUSIONS Shaping kinematics, either rotation or reciprocation motions, had no impact on bacterial reduction and the incidence of post-operative pain and flare-ups after root canal preparation of single-rooted premolars with asymptomatic apical periodontitis.
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Affiliation(s)
- Shehabeldin Mohamed Saber
- Department of Endodontics, Ain Shams University, Cairo, Egypt.,Department of Endodontics, The British University, El-Shorouk city, Egypt
| | | | - Nawar Naguib Nawar
- Department of Endodontics, The British University, El-Shorouk city, Egypt
| | | | - Ehab El-Sayed Hassanien
- Department of Endodontics, Ain Shams University, Cairo, Egypt.,El-Galala University, El-Galala city, Egypt
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9
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Emara RS, Gawdat SI, El-Far HMM. Effect of XP-endo Shaper versus conventional rotary files on postoperative pain and bacterial reduction in oval canals with necrotic pulps: a randomized clinical study. Int Endod J 2021; 54:1026-1036. [PMID: 33560531 DOI: 10.1111/iej.13494] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 12/26/2022]
Abstract
AIM To assess postoperative pain and bacterial reduction following the use of XP-endo Shaper versus conventional rotary files in preparation of oval canals with necrotic pulps. METHODOLOGY This superiority, parallel, randomized, double blinded clinical trial was conducted in the clinic of the Endodontic Department, Faculty of Dentistry, Cairo University, Egypt. Sixty single-canalled mandibular premolars with necrotic pulps were randomly assigned into two equal groups. Canals were instrumented using XP-endo Shaper files in the intervention group and iRaCe rotary files in the control group. Bacterial samples were taken before and after canal instrumentation. Incidence and severity of postoperative pain was assessed using a modified VAS after 6, 12, 24 h and daily for 5 days. A culture method was used to assess the number of bacterial colony forming units. Incidence of analgesic intake as well as flare-ups was recorded. Data were analysed using chi-square, Fisher Exact, Mann-Whitney, Independent t-test, and Spearman's correlation for pain and bacterial counts. RESULTS The XP-endo Shaper compared with the iRaCe group was associated with a significantly lower incidence of postoperative pain at 6, 12, and 24 h (P = 0.039, 0.047, and 0.026, respectively), and severity of postoperative pain at 6 h (mean difference: 1.33, 95% CI: 0.307-2.352, P = 0.02), 12 h (mean difference: 1.1, 95% CI: 0.26-1.936, P = 0.007), 24 h (mean difference: 0.94, 95% CI: 0.178-1.701, P = 0.008) and 48 h (mean difference: 0.97, 95% CI: 0.192-1.747, P = 0.038). There was a significant decrease in bacterial count following canal instrumentation in both groups (P < 0.001) with no significant difference between them (mean difference: 0.83 × 105 , 95% CI: 0.336 × 105 -1.996 × 105 , P = 0.56). A weak correlation existed between postoperative pain severity and bacterial counts (P = 0.54). There was no significant difference in analgesic intake between the two groups (P = 0.085). Flare-ups occurred in 3.3% of teeth in the iRaCe group, while no flare-ups occurred in the XP-endo Shaper group. CONCLUSIONS XP-endo Shaper was associated with a significantly lower frequency of postoperative pain for up to 24 h, and lower severity of postoperative pain for up to 48 h compared with iRaCe files. Both systems were equally effective in bacterial reduction from oval root canals with necrotic pulps.
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Affiliation(s)
- R S Emara
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - S I Gawdat
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - H M M El-Far
- Department of Endodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
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10
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Ghoddusi J, Arian E, Golmohammadi M, Gharechahi M, Moushekhian S. Intratubular Enterococcus faecalis viability assessment following root canal instrumentation with rotary and reciprocating systems via fluorescence microscopy. J Dent Res Dent Clin Dent Prospects 2021; 14:214-217. [PMID: 33575009 PMCID: PMC7867686 DOI: 10.34172/joddd.2020.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/17/2020] [Indexed: 11/30/2022] Open
Abstract
Background. The present in vitro study aimed to compare the effectiveness of the WaveOne and ProTaper Gold systems in removing the Enterococcus faecalis biofilm.
Methods. Thirty-eight mandibular premolars were selected. The root canals were assigned to standard control (canals serially enlarged with ProTaper Gold S1-S2-F1-F2, n=15) and experimental (canals enlarged with Primary WaveOne file, n=15) groups. Following the instrumentation procedure, the root canals underwent a sampling procedure, and the colonyforming unit (CFU) counts were determined. The samples were also evaluated under a fluorescent microscope to evaluate viable bacteria. The data were analyzed using independent samples t test and paired samples t test.
Results. The results showed that, compared with the ProTaper group, the WaveOne group exhibited the least viable bacteria (P =0.004).
Conclusion. It was concluded that comparison with the ProTaper Gold rotary system, the WaveOne reciprocating file is more successful in reducing intratubular viable bacteria counts.
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Affiliation(s)
- Jamileh Ghoddusi
- Dental Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran
| | - Ehsan Arian
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Golmohammadi
- Department of Endodontics, Khorasan Shomali University of Medical Sciences, Bojnord, Iran
| | - Maryam Gharechahi
- Dental Materials Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran
| | - Siavash Moushekhian
- Dental Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran
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11
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Nasrabadi N, Jamali S, Vojoodi MG, Jamali M. The impact of Distinctive Root Canal Instrumentation Systems on Endotoxin Lessening from the Root Canal: A Systematic Review and Meta-Analysis. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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12
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de Camargo EJ, Duarte MAH, Alcalde MP, Só MVDR, Vasconcelos BCD, Silva EJNL, Plotino G, Vivan RR. Safety of large preparation with different instruments in the buccal canals of maxillary molars. AUST ENDOD J 2020; 47:81-89. [PMID: 33368843 DOI: 10.1111/aej.12481] [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: 09/03/2020] [Revised: 12/02/2020] [Accepted: 12/08/2020] [Indexed: 11/26/2022]
Abstract
This study aimed to evaluate the influence of large apical preparations with Reciproc (REC), Hyflex CM (HCM) and Twisted File Adaptive (TFA) systems using micro-computed tomography (MCT). Ninety mesiobuccal (MB) and distobuccal (DB) root canals of maxillary molars (n = 45) were scanned using MCT before and after the shaping procedures. The root canals (n = 15) were prepared until REC 40.06, HCM 40.04 and TFA 35.04. The root canal transportation (RCT), centring ability (CA), change in volume of the root canal and at different levels (VC), remaining dentine thickness (RDT), removal of dentine wall (RDW) and working time (WT) were evaluated. Data were analysed using the Kruskal-Wallis and Dunn tests, and the one-way ANOVA and Tukey tests with a level of significance set at 5%. No significant difference among the instruments was found regarding the RCT, CA, RDT, RDW and WT (P > 0.05), in larger apical preparations in curved MB and straight DB canals of maxillary molars.
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Affiliation(s)
- Ericson Janolio de Camargo
- Division of Endodontics, College of Dentistry, University Center of Várzea Grande (UNIVAG), Várzea Grande, Brazil.,Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Murilo Priori Alcalde
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | | | | | | - Gianluca Plotino
- Department of Endodontics, Sapienza Università di Roma, Rome, Italy
| | - Rodrigo Ricci Vivan
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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13
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Neves MAS, Provenzano JC, Fonseca SCL, Rodrigues RCV, Gonçalves LS, Siqueira JF, Rôças IN. Disinfection and outcome of root canal treatment using single-file or multifile systems and Ca(OH)2 medication. Braz Dent J 2020; 31:493-498. [PMID: 33146332 DOI: 10.1590/0103-6440202003245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 09/25/2020] [Indexed: 11/22/2022] Open
Abstract
This clinical study reports on the antibacterial effects and outcome of endodontic treatment using either a single-file or a multifile system, associated with calcium hydroxide interappointment medication. The root canals of single-rooted teeth with apical periodontitis were treated by using either Reciproc or BioRaCe instrument systems, 2.5% NaOCl irrigation, and calcium hydroxide medication. Bacteriological samples taken before preparation and immediately before obturation were evaluated for total bacterial counts by quantitative real-time polymerase chain reaction (qPCR). Patients were followed up and the treatment outcome was assessed by clinical and radiographic criteria. Decreasing lesions were classified as success in a lenient criterion or failure in a rigid one. Bacteria were detected in all initial samples (47 cases) and were significantly reduced after treatment in both groups (p<0.001). In the Reciproc and BioRaCe groups, 7/25 (28%) and 11/22 (50%) root canals yielded negative qPCR results before obturation, respectively (p>0.05). Quantitative bacterial reduction was similar between groups (p>0.05). The success rate in the BioRaCe group was 95.5% and 77% in the loose and rigid criterion, respectively. In the Reciproc group, corresponding figures were 88% and 76%. Differences in outcome were not significant (p>0.05). No diseased case showed negative qPCR results for bacteria. A difference of >1 Log10 counts was observed between healed and diseased cases. Root canal treatments of teeth with apical periodontitis using a single-file or a multifile system for preparation, associated with NaOCl irrigation and calcium hydroxide interappointment medication, showed similar antibacterial effectiveness and success rate.
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Affiliation(s)
- Mônica A S Neves
- Department of Endodontics, School of Dentistry, Universidade Estácio de Sá, Rio de Janeiro, RJ, Brazil
| | - José C Provenzano
- Department of Endodontics, School of Dentistry, Universidade Estácio de Sá, Rio de Janeiro, RJ, Brazil.,Department of Endodontics, School of Dentistry, UNIG - Universidade Iguaçu, Nova Iguaçu, RJ, Brazil
| | - Simone C L Fonseca
- Department of Endodontics, School of Dentistry, UNIG - Universidade Iguaçu, Nova Iguaçu, RJ, Brazil
| | - Renata C V Rodrigues
- Department of Endodontics, School of Dentistry, UVA - Universidade Veiga de Almeida University, Rio de Janeiro, RJ, Brazil
| | - Lucio S Gonçalves
- Department of Endodontics, School of Dentistry, Universidade Estácio de Sá, Rio de Janeiro, RJ, Brazil
| | - José F Siqueira
- Department of Endodontics, School of Dentistry, UNIG - Universidade Iguaçu, Nova Iguaçu, RJ, Brazil
| | - Isabela N Rôças
- Department of Endodontics, School of Dentistry, UNIG - Universidade Iguaçu, Nova Iguaçu, RJ, Brazil
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14
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Electrochemical Disinfection of Experimentally Infected Teeth by Boron-Doped Diamond Electrode Treatment. J Clin Med 2019; 8:jcm8122037. [PMID: 31766433 PMCID: PMC6947473 DOI: 10.3390/jcm8122037] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 11/15/2019] [Accepted: 11/19/2019] [Indexed: 02/05/2023] Open
Abstract
Disinfection and prevention of re-infection are the decisive treatment steps in endodontic therapy. In this study, boron-doped diamond (BDD) electrodes have been fabricated and used for disinfecting the root canals of extracted human teeth, which had been covered with bacterial biofilms formed by Bacillus subtilis and Staphylococcus epidermidis. The growth of B. subtilis could be successfully impaired, achieving a complete disinfection after 8.5 min treatment time with the success of disinfection depending on the insertion depth of the electrode in the root canal. S. epidermidis could completely be removed after 3.5 min treatment time. A clinically applicable electrode array led to complete disinfection after treatment times of 10 min for S. epidermidis and 25 min for B. subtilis. BDD electrode application allowed for the improved disinfection of root canals and dentin tubules based on a continuous production of reactive oxygen species and their enhanced penetration of dentin tubules most likely due the formation of a continuous stream of small gas bubbles. The treatment times that are required here will be shortened in clinical application, as mechanical shaping of the canal system would precede the disinfection process.
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15
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Martinho FC, de Rabello DGD, Ferreira LL, Nascimento GG. Participation of endotoxin in root canal infections: A systematic review and meta-analysis. Eur J Dent 2019; 11:398-406. [PMID: 28932155 PMCID: PMC5594974 DOI: 10.4103/ejd.ejd_84_17] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
This systematic review and meta-analysis aimed to evaluate the relationship between endotoxin levels and presence of clinical signs/symptoms and radiographic features in patients with endodontic infection. Electronic searches were performed on Medline/PubMed, Embase, Cochrane Library, Scielo, Science Direct, Web of Knowledge and Scopus databases for identification of relevant studies published up to December 2016. Grey literature was searched in Google Scholar. The selected literature was reviewed independently by two authors. Clinical studies evaluating the levels of endotoxin and the presence of clinical and radiographic features were included in this review. In order to determine the relationship between endotoxin levels and presence of clinical signs/symptoms and radiographic features meta-analyses were performed. Among the 385 articles identified in the initial search, 30 were included for full-text appraisal and only eight studies met the inclusion criteria for this systematic review. Meta-analysis revealed that individuals having teeth with tenderness to percussion (TTP) (P = 0.04; I2 57%) and previous episode of pain (PEP) (P = 0.001; I2 81%) had higher levels of endotoxin than their counterparts. Size of radiographic lesion >2 mm (P = 0.02; I2 68%) and presence of root canal exudation (EX) (P = 0.0007; I2 0%) were associated with higher levels of endotoxin. This systematic review and meta-analyses provided a strong evidence that endotoxin are related with the presence of clinical signs/symptoms and radiographic features in patients with endodontic infection.
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Affiliation(s)
- Frederico Canato Martinho
- Department of Restorative Dentistry, São José dos Campos Dental School, State University of São Paulo, São Paulo
| | | | - Luciana Louzada Ferreira
- Department of Restorative Dentistry, São José dos Campos Dental School, State University of São Paulo, São Paulo
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16
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Root Canal Disinfection by Single- and Multiple-instrument Systems: Effects of Sodium Hypochlorite Volume, Concentration, and Retention Time. J Endod 2019; 45:736-741. [DOI: 10.1016/j.joen.2019.02.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/04/2019] [Accepted: 02/08/2019] [Indexed: 11/18/2022]
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17
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Martins CM, De Souza Batista VE, Andolfatto Souza AC, Andrada AC, Mori GG, Gomes Filho JE. Reciprocating kinematics leads to lower incidences of postoperative pain than rotary kinematics after endodontic treatment: A systematic review and meta-analysis of randomized controlled trial. J Conserv Dent 2019; 22:320-331. [PMID: 31802813 PMCID: PMC6873607 DOI: 10.4103/jcd.jcd_439_18] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: Extrusion of infected debris into the periapical tissue has been cited as the major cause of postoperative pain, regardless of instrumentation technique. Aim: Comprehensively review two different kinematics of instrumentation (reciprocating and rotary) and association to the postoperative pain after endodontic treatment. Methods: Two investigators performed a systematic review with meta-analysis. MEDLINE/PubMed, Cochrane Library, and Scopus supplied relevant data from studies published until February 2018 to answer the PICO question. Primary outcome was overall postoperative pain, and the secondary outcomes were nature of the pain (mild, moderate, and severe) at 12, 24, and 48 h. Results: Ten randomized clinical trials fulfilled eligibility criteria, and five of them were submitted in the meta-analysis. Primary outcome indicated that reciprocating system results in less postoperative pain compared to rotary system (P < 0.05). As a secondary outcome, there was no statistical difference for mild, moderate, and severe pain after 12 and 24 h using reciprocating or rotary systems (P > 0.05). However, the reciprocation system showed less severe pain after 48 h (P < 0.05). Conclusion: Rotary motion had a negative impact on postoperative pain after endodontic treatment. Furthermore, after 48 h, more patients presented severe pain under rotary motion. More randomized clinical studies would be helpful.
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Affiliation(s)
- Christine Men Martins
- Department of Dentistry, Dental School of Presidente Prudente, University of Western São Paulo, Presidente Prudente, Sao Paulo, Brazil
| | - Victor Eduardo De Souza Batista
- Department of Dentistry, Dental School of Presidente Prudente, University of Western São Paulo, Presidente Prudente, Sao Paulo, Brazil
| | | | - Ana Cristina Andrada
- Department of Endodontics, University of Detroit Mercy School of Dentistry, Detroit, Michigan, USA
| | - Graziela Garrido Mori
- Department of Dentistry, Dental School of Presidente Prudente, University of Western São Paulo, Presidente Prudente, Sao Paulo, Brazil
| | - João Eduardo Gomes Filho
- Department of Dentistry, Dental School of Presidente Prudente, University of Western São Paulo, Presidente Prudente, Sao Paulo, Brazil
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18
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Machado CAD, Souza ACA, Loureiro C, Martinho FC, Cintra LTÂ, Dezan Junior E, Jacinto RDC. Comparison of two rotary systems in bacteria/lps removal from endodontic infections: randomized clinical trial. Braz Oral Res 2019; 33:e039. [DOI: 10.1590/1807-3107bor-2019.vol33.0039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 04/16/2019] [Indexed: 11/21/2022] Open
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Siddique R, Nivedhitha MS. Effectiveness of rotary and reciprocating systems on microbial reduction: A systematic review. J Conserv Dent 2019; 22:114-122. [PMID: 31142978 PMCID: PMC6519186 DOI: 10.4103/jcd.jcd_523_18] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: The role of microorganism and their products in the initiation, propagation, and persistence of periradicular periodontitis has been established. One of the major goals of the treatment of infected root canals of teeth with apical periodontitis is to promote maximal reduction in the intracanal bacterial populations. Engine-driven nickel-titanium instruments possess the latest generation of root canal instruments. The possible benefit of rotary instrumentation over other instrumentation techniques regarding cleaning and disinfecting effects would be irrigant warming and/or turbulence caused by the mechanical rotation of instruments. Furthermore, reciprocating instrument has been introduced for root canal preparation. It has been shown that instruments subjected to reciprocation have increased resistance to fatigue and longer usual life when combined with instruments used in continuous rotation motion. The reciprocating system uses single-file instrumentation technique which can shape and clean the canal in a shorter period and together with the lesser amount of antimicrobial agent. Objective: The objective of this study is to compare and evaluate the microbial reduction of rotary and reciprocating systems on microbial reduction. Search Strategy: A search was performed in Electronic databases (i.e., PubMed, Cochrane library, Science direct, Lilac, Sigle) using following search terms alone and in combination by means of PubMed search builder from January 1985 to December 2017. Selection Criteria: Studies were selected if they met the following criteria: In vivo studies comparing rotary and reciprocating system in asymptomatic apical periodontitis patients. Main Results: The results showed that the reciprocating system exerted an almost similar antibacterial effect when compared with the rotary system. Conclusion: The present systematic review does not provide concrete evidence to show increased antibacterial efficacy of reciprocating system as compared to the rotary system. Furthermore, clinical trials are required to evaluate the efficacy of various instrumentation systems in reducing bacteria from the root canal system.
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Affiliation(s)
- Riluwan Siddique
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Malli Sureshbabu Nivedhitha
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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20
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Neelakantan P, Ahmed HMA, Chang JWW, Nabhan MS, Wei X, Cheung GSP, Gomes BPFA. Effect of instrumentation systems on endotoxin reduction from root canal systems: A systematic review of clinical studies and meta‐analysis. AUST ENDOD J 2018; 45:407-413. [DOI: 10.1111/aej.12333] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Prasanna Neelakantan
- Discipline of Endodontology Faculty of Dentistry The University of Hong Kong Hong Kong Hong Kong
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry Faculty of Dentistry University of Malaya Kuala Lumpur Malaysia
| | - Jeffrey Wen Wei Chang
- Discipline of Endodontology Faculty of Dentistry The University of Hong Kong Hong Kong Hong Kong
| | - Mohamed Shady Nabhan
- Department of Prosthetic Dentistry Faculty of Dentistry Ain Shams University Cairo Egypt
| | - Xi Wei
- Department of Operative Dentistry and Endodontics Guanghua School of Stomatology, Affiliated Stomatological Hospital Guangdong Provincial Key Laboratory of Stomatology Sun Yat‐sen University Guangzhou China
| | - Gary Shun Pan Cheung
- Discipline of Endodontology Faculty of Dentistry The University of Hong Kong Hong Kong Hong Kong
| | - Brenda P. F. A. Gomes
- Department of Restorative Dentistry Endodontics Division Piracicaba Dental School State University of Campinas ‐ UNICAMP Piracicaba São Paulo Brazil
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21
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Gambarini G, Piasecki L, Miccoli G, Gaimari G, Di Giorgio R, Di Nardo D, Azim AA, Testarelli L. Classification and cyclic fatigue evaluation of new kinematics for endodontic instruments. AUST ENDOD J 2018; 45:154-162. [DOI: 10.1111/aej.12294] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Gianluca Gambarini
- Department of Oral and Maxillo Facial Sciences Sapienza University Rome Italy
| | - Lucila Piasecki
- Division of Endodontics University at Buffalo Buffalo NY USA
| | - Gabriele Miccoli
- Department of Oral and Maxillo Facial Sciences Sapienza University Rome Italy
| | - Gianfranco Gaimari
- Department of Oral and Maxillo Facial Sciences Sapienza University Rome Italy
| | - Roberto Di Giorgio
- Department of Oral and Maxillo Facial Sciences Sapienza University Rome Italy
| | - Dario Di Nardo
- Department of Oral and Maxillo Facial Sciences Sapienza University Rome Italy
| | - Adham A Azim
- Division of Endodontics University at Buffalo Buffalo NY USA
| | - Luca Testarelli
- Department of Oral and Maxillo Facial Sciences Sapienza University Rome Italy
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22
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Alves FR, Paiva PL, Marceliano-Alves MF, Cabreira LJ, Lima KC, Siqueira JF, Rôças IN, Provenzano JC. Bacteria and Hard Tissue Debris Extrusion and Intracanal Bacterial Reduction Promoted by XP-endo Shaper and Reciproc Instruments. J Endod 2018; 44:1173-1178. [DOI: 10.1016/j.joen.2018.04.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 03/29/2018] [Accepted: 04/04/2018] [Indexed: 01/29/2023]
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D'aviz FS, Farina AP, Souza MA, Cecchin D. Does adding an instrument after root preparation with Reciproc ® R25 increase bacterial reduction? J Conserv Dent 2018; 21:269-273. [PMID: 29899628 PMCID: PMC5977774 DOI: 10.4103/jcd.jcd_395_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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 was to compare the bacterial reduction achieved with reciprocating instruments such as Reciproc® R25 (VDW GMBH, Munich, Germany) and Reciproc® R25 combined with rotary file Mtwo 40.04 (VDW GMBH) during root canal preparation. Materials and Methods Fifty mesiobuccal root canals of maxillary molars were contaminated with Enterococcus faecalis broth culture and then an initial bacterial sample was collected from the root canal with paper cones and plated on brain-heart infusion agar. The root canals were divided into four groups as follows: Reciproc® R25 (n = 20) and Reciproc® R25 combined with Mtwo 40.04 instrument (n = 20). The negative controls consisted of five uncontaminated root canals and the positive control consisted of five contaminated roots that were not subjected to any decontamination procedure. Irrigation was performed using sodium chloride. After instrumentation, samples were collected with paper cones and the rate of bacterial reduction was calculated. Microbiological testing (colony-forming units [CFUs]) was performed to quantify the decontamination obtained by the proposed protocols. Statistical analysis was performed by paired t-test and analysis of variance test. Results Both techniques significantly reduced the number of bacteria in the root canal (P < 0.05), with no significant difference among them (P > 0.05). Conclusion The addition of the instrument Mtwo 40.04 after the root preparation with the instrument R25 does not improve its decontamination capability.
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Affiliation(s)
- Fernando Soveral D'aviz
- Department of Restorative Dentistry, Dental School of University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Ana Paula Farina
- Department of Restorative Dentistry, Dental School of University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Matheus Albino Souza
- Department of Restorative Dentistry, Dental School of University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Doglas Cecchin
- Department of Restorative Dentistry, Dental School of University of Passo Fundo, Passo Fundo, RS, Brazil
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24
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Rabello DG, Corazza BJ, Ferreira LL, Santamaria MP, Gomes AP, Martinho FC. Does supplemental photodynamic therapy optimize the disinfection of bacteria and endotoxins in one-visit and two-visit root canal therapy? A randomized clinical trial. Photodiagnosis Photodyn Ther 2017; 19:205-211. [DOI: 10.1016/j.pdpdt.2017.06.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/24/2017] [Accepted: 06/11/2017] [Indexed: 11/27/2022]
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25
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AlRahabi MK, Abuong ZA. Antibiotic abuse during endodontic treatment in private dental centers. Saudi Med J 2017; 38:852-856. [PMID: 28762439 PMCID: PMC5556303 DOI: 10.15537/smj.2017.8.19373] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 05/11/2017] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES We evaluated antibiotic prescription practices during root canal treatments among general dentists in private dental clinics in Al-Madinah Al Munawarah, Saudi Arabia. Methods: A self-administered, questionnaire about antibiotic used during root canal treatment was distributed to 75 randomly selected general dental practitioners working in private dental clinics in Al-Madinah Al-Munawarah, Saudi Arabia, between March and April 2016. The questionnaires were collected one week later. To compare results of the collected data, Chi-square test was used. Results: The results revealed that 60% of the dentists prescribed amoxicillin with clavulanic acid as the first choice treatment for endodontic pathosis. Clindamycin (51.6%) was the first choice for patients who were allergic to penicillin. Forty-five percent of the general practitioners prescribed antibiotics for 5 days. Approximately 83.3% of general practitioners prescribed antibiotics for acute apical abscesses. Prophylactic antibiotics were prescribed for cases with a history of infective endocarditis (65.5%), non-controlled diabetes (60.3%), placement of a prosthetic joint in the previous 2 years (46.6%), congenital heart disease (36.2%), and kidney dialysis shunts (34.5%). Conclusion: This study reveals antibiotic abuse in endodontic treatment practice in private dental clinics in Al-Madinah Al Munawarah, Saudi Arabia. General dental practitioners are lacking knowledge regarding the prescription of antibiotics in endodontic treatment and situations requiring prophylactic antibiotics.
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Affiliation(s)
- Mothanna K AlRahabi
- Department of Restorative Dental Science, College of Dentistry, Taibah University, Al Madinah AlMunawwarah, Kingdom of Saudi Arabia. E-mail.
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26
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Jorgensen B, Williamson A, Chu R, Qian F. The Efficacy of the WaveOne Reciprocating File System versus the ProTaper Retreatment System in Endodontic Retreatment of Two Different Obturating Techniques. J Endod 2017; 43:1011-1013. [DOI: 10.1016/j.joen.2017.01.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 12/28/2016] [Accepted: 01/15/2017] [Indexed: 10/19/2022]
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27
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Hou XM, Su Z, Hou BX. Post endodontic pain following single-visit root canal preparation with rotary vs reciprocating instruments: a meta-analysis of randomized clinical trials. BMC Oral Health 2017; 17:86. [PMID: 28545437 PMCID: PMC5445416 DOI: 10.1186/s12903-017-0355-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 02/23/2017] [Indexed: 11/28/2022] Open
Abstract
Background In endodontic therapy, continuous rotary instrumentation reduced debris compared to reciprocal instrumentation, which might affect the incidence of post-endodontic pain (PP). The aim of our study was to assess whether PP incidence and levels were influenced by the choice of rotary or reciprocal instruments. Methods In this meta-analysis the Pubmed and EM databases were searched for prospective clinical randomized trials published before April 20, 2016, using combinations of the keywords: root canal preparation/instrumentation/treatment/therapy; post-operative/endodontic pain; reciprocal and rotary instruments. Results Three studies were included, involving a total of 1,317 patients, 659 treated with reciprocating instruments and 658 treated with rotary instruments. PP was reported in 139 patients in the reciprocating group and 172 in the rotary group. The PP incidence odds ratio was 1.27 with 95% confidence interval (CI) (0.25, 6.52) favoring rotary instruments. The mild, moderate and severe PP levels odds ratios were 0.31 (0.11, 0.84), 2.24 (0.66, 7.59) and 11.71 (0.63, 218.15), respectively. No evidence of publication bias was found. Conclusions Rotary instrument choice in endodontic therapy is associated with a lower incidence of PP than reciprocating instruments, while reciprocating instruments are associated with less mild PP incidence.
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Affiliation(s)
- Xiao-Mei Hou
- The Second Dental Center, Peking University School and Hospital of Stomatology, Beijing, China
| | - Zheng Su
- Department of Endodontics, Capital Medical University School of Stomatology, No. 4 Tian Tan Xi Li, Dong Cheng, Beijing, 100050, China
| | - Ben-Xiang Hou
- Department of Endodontics, Capital Medical University School of Stomatology, No. 4 Tian Tan Xi Li, Dong Cheng, Beijing, 100050, China.
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28
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Nakamura VC, Pinheiro ET, Prado LC, Silveira AC, Carvalho APL, Mayer MPA, Gavini G. Effect of ultrasonic activation on the reduction of bacteria and endotoxins in root canals: a randomized clinical trial. Int Endod J 2017; 51 Suppl 1:e12-e22. [PMID: 28439928 DOI: 10.1111/iej.12783] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 04/20/2017] [Indexed: 02/01/2023]
Abstract
AIM This randomized clinical trial aimed to compare the effectiveness of ultrasonic activation with that of nonactivated irrigation on the removal of bacteria and endotoxin from root canals. METHODOLOGY Fifty patients with necrotic pulps and asymptomatic apical periodontitis were randomly allocated into two groups according to the final irrigation protocol after root canal preparation: Group UI - ultrasonic irrigation (n = 25) and Group NI - needle irrigation (n = 25). The root canals were medicated with calcium hydroxide for 14 days. Microbiological sampling was performed before (S1) and after the root canal preparation (S2), after the irrigation protocols (S3) and after the removal of the intracanal medication (S4). Total bacteria counts were determined by qPCR and the endotoxin levels by the limulus amebocyte lysate assay. Intragroup analyses were performed using the Wilcoxon test for related samples, whereas intergroup analyses were performed using the Mann-Whitney U-test (P < 0.05). RESULTS All S1 samples were positive for bacteria, with median numbers of 1.49 × 106 and 8.55 × 105 bacterial cells for the UI and NI groups, respectively. This number significantly decreased in S2 samples (UI: 1.41 × 104 ; NI: 3.53 × 104 ; both with P < 0.001). After final irrigation protocols, there was a significant decrease in bacterial load from S2 to S3 samples in both groups (UI: 4.29 × 103 ; NI: 1.08 × 104 ; P < 0.01). Intergroup analysis revealed a significant difference between irrigation methods regarding bacterial counts in S3 samples (P < 0.05). In contrast, no significant differences were observed between groups for endotoxin levels (P > 0.05). CONCLUSIONS Ultrasonic activation was more effective than nonactivated irrigation for reducing the number of bacteria but not the endotoxin levels in root canals of teeth with apical periodontitis.
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Affiliation(s)
- V C Nakamura
- Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - E T Pinheiro
- Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - L C Prado
- Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - A C Silveira
- Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - A P L Carvalho
- Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - M P A Mayer
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil
| | - G Gavini
- Discipline of Endodontic, Department of Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
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DE Oliveira BP, Aguiar CM, Câmara AC, DE Albuquerque MM, Correia ACRDEB, Soares MFDELAR. Evaluation of Microbial Reduction in Root Canals Instrumented with Reciprocating and Rotary Systems. Acta Stomatol Croat 2016; 49:294-303. [PMID: 27688413 DOI: 10.15644/asc49/4/4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE This in vitro study aimed to evaluate the efficacy of the disinfection of root canal systems carried out with Reciproc(TM) and ProTaper Universal(TM) systems using 1% sodium hypochlorite (NaOCl). METHODS Forty human single-rooted mandibular premolars were infected with Enterococcus faecalis, Pseudomonas aeruginosa, Staphylococcus aureus and Candida albicans, and twenty were not infected. The specimens were randomly divided into 6 groups (n = 10): Group 1: ProTaper Universal(TM) + 1% NaOCl; Group 2 (positive control): ProTaper Universal(TM) + saline; Group 3 (negative control without microorganisms): ProTaper Universal(TM) + saline; Group 4: Reciproc(TM) + 1% NaOCl; Group 5 (positive control): Reciproc(TM) + saline; Group 6 (negative control without microorganisms): Reciproc(TM) + saline. Samples were collected before and after the completion of specific treatments, and plated in specific media cultures. The Fisher exact test was used for the statistical analysis of differences in terms of presence or absence of microbial growth among groups. For all tested pathogens, significant differences (p < 0.001) were verified between the instrumentation systems used. RESULTS ProTaper Universal(TM) associated with 1% NaOCl completely eliminated all microorganisms. Microbial growth, however, was observed when Reciproc(TM) was used associated with 1% NaOCl. CONCLUSION According to the protocol executed for this study, the Reciproc(TM) system associated with 1% NaOCl was not able to completely eliminate E. faecalis, P. aeruginosa, S. aureus and C. albicans from the root canal systems.
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Affiliation(s)
- Bruna Paloma DE Oliveira
- - Department of Prosthetics and Oral and Facial Surgery, Faculty of Dentistry, Federal University of Pernambuco, Recife, Brazil
| | - Carlos Menezes Aguiar
- - Department of Prosthetics and Oral and Facial Surgery, Faculty of Dentistry, Federal University of Pernambuco, Recife, Brazil
| | - Andréa Cruz Câmara
- - Department of Prosthetics and Oral and Facial Surgery, Faculty of Dentistry, Federal University of Pernambuco, Recife, Brazil
| | - Miracy Muniz DE Albuquerque
- - Department of Pharmaceutical Sciences, School of Pharmaceutical Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | - Monica Felts DE LA Roca Soares
- - Department of Pharmaceutical Sciences, School of Pharmaceutical Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil
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Vossoghi M, Vossoghi M, Shahriari S, Faramarzi F, Yousefi Mashouf R, Farhadian M. Efficacy of a Novel Rotary System in Reduction of Intracanal Bacteria: An in Vitro Study. IRANIAN ENDODONTIC JOURNAL 2016; 11:219-22. [PMID: 27471535 PMCID: PMC4947848 DOI: 10.7508/iej.2016.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 05/15/2016] [Accepted: 05/27/2016] [Indexed: 12/16/2022]
Abstract
Introduction: This in vitro study aimed to assess the effectiveness of a single-file rotary system (OneShape) in reduction of intracanal bacteria. Methods and Materials: Eighty one single-rooted mandibular first premolars with single canals were used. Six samples were selected as aseptic control group. Seventy five remaining specimens were infected by Enterococcus faecalis and incubated for 72 h at 37°C. Then they were randomly divided into three groups (n=25). In each group, cleaning and shaping procedures were done using either two conventional rotary systems (ProTaper and iRace), or the single-file system (OneShape). Microbial samples from the intracanal environment were taken by paper points in two steps, before and after instrumentation. Then, they were diluted and plated in blood agar. In order to compare bacterial reduction and turbidity, the Kruskal-Wallis test was used followed by the Chi-Square and Mann-Whitney tests for pairwise comparison. The level of significance was set at 0.05. Results: The control group didn’t show any bacterial growth. The pre- and post-instrumentation samples were significantly different between three groups (P=0.02). Hence, there was no significant differences between turbidity of samples (P>0.05). Conclusion: OneShape system is efficient in bacterial reduction. In this regard ProTaper is the most effective system in intracanal bacterial reduction followed by iRaCe and OneShape, respectively.
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Affiliation(s)
- Maryam Vossoghi
- Prosthodontics Department, Kerman University of Medical Sciences, Kerman, Iran
| | - Mitra Vossoghi
- Endodontic Department, Faculty of Dentistry, Ilam University of Medical Sciences, Ilam, Iran
| | - Shahriar Shahriari
- Endodontic Department, Faculty of Dentistry, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Farhad Faramarzi
- Endodontic Department, Faculty of Dentistry, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Rasoul Yousefi Mashouf
- Department of Medical Microbiology, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Maryam Farhadian
- Department of Epidemiology and Biostatistics, School of Public Health, Hamadan University of Medical Science, Hamadan, Iran
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Quantification of Lipoteichoic Acid Contents and Cultivable Bacteria at the Different Phases of the Endodontic Retreatment. J Endod 2016; 42:552-6. [DOI: 10.1016/j.joen.2016.01.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/15/2015] [Accepted: 01/10/2016] [Indexed: 12/20/2022]
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32
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Melo TAFD, Gründling GSL, Montagner F, Scur AL, Steier L, Scarparo RK, Figueiredo JAPD, Vier-Pelisser FV. LPS levels in root canals after the use of ozone gas and high frequency electrical pulses. Braz Oral Res 2016; 30:S1806-83242016000100231. [PMID: 26981752 DOI: 10.1590/1807-3107bor-2016.vol30.0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Accepted: 11/09/2015] [Indexed: 11/22/2022] Open
Abstract
The present study aims to verify the effect of ozone gas (OZY® System) and high frequency electric pulse (Endox® System) systems on human root canals previously contaminated with Escherichia colilipopolysaccharide (LPS). Fifty single-rooted teeth had their dental crowns removed and root lengths standardized to 16 mm. The root canals were prepared up to #60 hand K-files and sterilized using gamma radiation with cobalt 60. The specimens were divided into the following five groups (n = 10) based on the disinfection protocol used: OZY® System, one 120-second-pulse (OZY 1p); OZY® System, four 24-second-pulses (OZY 4p); and Endox® System (ENDOX). Contaminated and non-contaminated canals were exposed only to apyrogenic water and used as positive (C+) and negative (C-) controls, respectively. LPS (O55:B55) was administered in all root canals except those belonging to group C-. After performing disinfection, LPS samples were collected from the canals using apyrogenic paper tips. Limulus Amoebocyte Lysate (LAL) was used to quantify the LPS levels, and the data obtained was analyzed using one-way ANOVA. The disinfection protocols used were unable to reduce the LPS levels significantly (p = 0.019). The use of ozone gas and high frequency electric pulses was not effective in eliminating LPS from the root canals.
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Affiliation(s)
- Tiago André Fontoura de Melo
- Clinical Department, School of Dentistry, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Francisco Montagner
- School of Dentistry, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Liviu Steier
- Institute of Clinical Education, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Roberta Kochenborger Scarparo
- Clinical Department, School of Dentistry, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Fabiana Vieira Vier-Pelisser
- Clinical Department, School of Dentistry, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Clinical Antibacterial Effectiveness of Root Canal Preparation with Reciprocating Single-instrument or Continuously Rotating Multi-instrument Systems. J Endod 2016; 42:25-9. [DOI: 10.1016/j.joen.2015.09.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 09/15/2015] [Accepted: 09/29/2015] [Indexed: 11/19/2022]
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Plotino G, Ahmed HMA, Grande NM, Cohen S, Bukiet F. Current Assessment of Reciprocation in Endodontic Preparation: A Comprehensive Review—Part II: Properties and Effectiveness. J Endod 2015; 41:1939-50. [DOI: 10.1016/j.joen.2015.08.018] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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35
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Pain after single-visit root canal treatment with two single-file systems based on different kinematics—a prospective randomized multicenter clinical study. Clin Oral Investig 2015; 19:2211-7. [DOI: 10.1007/s00784-015-1448-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 03/03/2015] [Indexed: 11/26/2022]
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36
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Çapar ID, Arslan H. A review of instrumentation kinematics of engine-driven nickel-titanium instruments. Int Endod J 2015; 49:119-35. [PMID: 25630977 DOI: 10.1111/iej.12432] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 01/24/2015] [Indexed: 10/24/2022]
Abstract
Over the years, NiTi alloys have become indispensable materials in endodontic treatment. With technological advancements in metallurgy, manufacturers have attempted to produce instruments with enhanced features. In parallel with these developments, endodontic motors have undergone improvements in terms of torque control and kinematics that are adjustable in different directions. This review presents an overview of the advancements in instrumentation kinematics and the effect of instrumentation kinematics on root canal shaping procedures and instrument performance. The literature search for this narrative review was conducted in Google Scholar, Scopus, PubMed and Web of Science using the keywords 'kinematics and endodontics' and 'reciprocation and endodontics'. In addition, historical literature was searched using the keyword 'nickel-titanium and endodontics'. Overall, 143 articles were included up to 2015.
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Affiliation(s)
- I D Çapar
- Department of Endodontics, Faculty of Dentistry, İzmir Katip Çelebi University, İzmir, Turkey
| | - H Arslan
- Department of Endodontics, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
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37
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Martinho FC, Freitas LF, Nascimento GG, Fernandes AM, Leite FRM, Gomes APM, Camões ICG. Endodontic retreatment: clinical comparison of reciprocating systems versus rotary system in disinfecting root canals. Clin Oral Investig 2014; 19:1411-7. [DOI: 10.1007/s00784-014-1360-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 11/13/2014] [Indexed: 11/30/2022]
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