1
|
Azizi Mazreah S, Shirvani A, Azizi Mazreah H, Dianat O. Evaluation of irrigant extrusion following the use of different root canal irrigation techniques: A systematic review and meta-analysis. AUST ENDOD J 2023; 49:396-417. [PMID: 35988128 DOI: 10.1111/aej.12678] [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: 05/23/2022] [Revised: 07/27/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022]
Abstract
This systematic review investigates whether different irrigation techniques have different effects on irrigant extrusion from mature tooth apices. Articles published between January 2000 and January 2022 were searched in six electronic databases (MEDLINE, Embase, Google Scholar, Web of Science, Scopus and Cochrane) using appropriate keywords. Overall, 2265 articles were screened by their titles and abstracts. Fifty-six full-text articles were selected based on the inclusion criteria. Of them, 17 in vitro studies were included in the systematic review and meta-analysis. The meta-analysis was conducted using the random-effects inverse variance method. The results showed that the negative pressure technique caused a lesser amount (p = 0.00) and frequency (p = 0.00) of extrusion than the open-ended needle irrigation. Sonic and ultrasonic activation caused less amount of extrusion than both open-ended (p = 0.00 or p = 0.01) and closed-ended needle (p = 0.00) irrigation.
Collapse
Affiliation(s)
| | - Armin Shirvani
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Omid Dianat
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Maryland, USA
| |
Collapse
|
2
|
Karasu AE, Goker Kamalı S, Turkaydın D. Comparison of apical extrusion of sodium hypochlorite in immature teeth after needle irrigation, ultrasonic irrigation, EDDY, Er:YAG, and diode lasers. Lasers Med Sci 2022; 38:8. [PMID: 36539627 DOI: 10.1007/s10103-022-03683-0] [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: 05/19/2022] [Accepted: 11/09/2022] [Indexed: 12/24/2022]
Abstract
This study aimed to assess the apical extrusion of sodium hypochlorite in immature teeth caused by needle irrigation, ultrasonic irrigation, EDDY, Er:YAG, and diode lasers. Seventy-five human maxillary anterior teeth were selected. After the apical 3 mm of the roots was resected, the canal lumen was enlarged with #2 to #5 Gates-Glidden burs. The teeth were fixed to the lid of a flat-sided clear plastic container, and the plastic containers were filled with 0.2% agarose gel containing 1 mL of 0.1% m-cresol purple. Then, the specimens were allocated into five groups according to the irrigation activation techniques: needle irrigation, ultrasonic irrigation, EDDY, Er:YAG laser, and diode laser. The apical extrusion of sodium hypochlorite caused the color change in the gel. The containers were digitally photographed, and the percentage of pixels of irrigant extrusion (the color change) in each photograph was calculated. The diode laser group showed a significantly lower percentage of pixels than needle irrigation, EDDY, and Er:YAG laser (p < 0.05). The irrigant extrusion value of the ultrasonic irrigation group was significantly lower than that of the EDDY and Er:YAG laser groups (p < 0.05). There was no significant difference between the other groups (p > 0.05). All the groups caused irrigant extrusion in the immature teeth. The diode laser and ultrasonic irrigation caused less sodium hypochlorite extrusion than EDDY and Er:YAG laser. The needle irrigation showed more irrigant extrusion than the only diode laser group.
Collapse
Affiliation(s)
- Alparslan Eren Karasu
- Department of Endodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Selin Goker Kamalı
- Department of Endodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey.
| | - Dilek Turkaydın
- Department of Endodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| |
Collapse
|
3
|
Tanalp J. A critical analysis of research methods and experimental models to study apical extrusion of debris and irrigants. Int Endod J 2022; 55 Suppl 1:153-177. [DOI: 10.1111/iej.13686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 11/30/2022]
Affiliation(s)
- J Tanalp
- Yeditepe University Faculty of Dentistry Department of Endodontics Istanbul Turkey
| |
Collapse
|
4
|
Uğur Aydın Z, Erdönmez D, Ateş MO, Doğan T. Efficacy of different irrigation activation systems on bacterial extrusion. AUST ENDOD J 2021; 47:137-142. [PMID: 32820601 DOI: 10.1111/aej.12432] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 06/21/2020] [Accepted: 07/26/2020] [Indexed: 01/19/2023]
Abstract
The purpose of this study was to evaluate the quantity of extruded bacteria following with EndoVac, EDDY, EndoActivator (EA) and standard needle irrigation (SNI). Ninety teeth with a single root and canal were included in this study. Fifteen teeth were selected as the negative control group to confirm sterilization. Seventy-five teeth were contaminated with Enterococcus faecalis (E. faecalis) for 4 weeks. Teeth were prepared and divided into five groups (n:15): EndoVac, EDDY, EA, SNI and positive control groups. The extruded bacteria were cultured for bacterial quantification. The counts of extruded bacteria were lower in the EndoVac group compared to the EDDY group (P˂ 0.05). The counts of extrusion bacteria were not different in EA and SNI groups compared to EDDY and EndoVac groups (P > 0.05). Within the limits of this study, EndoVac was found to be more reliable irrigation systems than EDDY in terms of the bacterial extrusion.
Collapse
Affiliation(s)
- Zeliha Uğur Aydın
- Department of Endodontics, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Demet Erdönmez
- Department of Biology, Faculty of Arts and Science, Aksaray University, Aksaray, Turkey
| | - Melis Oya Ateş
- Department of Endodontics, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Tülin Doğan
- Department of Endodontics, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
| |
Collapse
|
5
|
Magni E, Jäggi M, Eggmann F, Weiger R, Connert T. Apical pressures generated by several canal irrigation methods: A laboratory study in a maxillary central incisor with an open apex. Int Endod J 2021; 54:1937-1947. [PMID: 34022070 PMCID: PMC8518727 DOI: 10.1111/iej.13575] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 05/19/2021] [Indexed: 01/13/2023]
Abstract
Aim A laboratory study to determine the apical pressure generated by seven canal irrigation methods in an anterior tooth with an open apex. Methodology Canal irrigation was performed on a 3D‐printed central maxillary incisor with an open apex (maximum diameter of 2.1 mm). Ultrasonically activated irrigation (UAI), sonic activation (EDDY), negative pressure irrigation (EndoVac), the self‐adjusting file (SAF) and the XP‐endo Finisher were employed at tooth length (TL), TL—1 mm, TL—2 mm and TL—3 mm. UAI was tested at three intensity levels additionally. Hydrodynamic irrigation with RinsEndo was performed in the pulp chamber, at the canal orifice, the coronal third, the middle of the canal and at TL. Er:YAG laser activation, at four frequency settings, was performed in the pulp chamber and at the orifice of the canal. The pressure of the fluid towards the canal terminus generated by activation was directly transferred to a pressure sensor with a range of 0 to 120 mmHg and a response time of ≤0.5 ms. The critical threshold for apical extrusion of the irrigant was set at 5.73 mmHg (lower limit of the central venous pressure: 5.88 ± 0.15 mmHg). Each experiment was repeated ten times. The tests were followed by descriptive analyses (maximum, mean, standard deviation, 95% confidence interval). Results EndoVac, the SAF, the XP‐endo Finisher, and UAI never exceeded the critical threshold at any insertion depth or intensity level. Er:YAG laser activation exceeded the critical threshold exclusively at frequency settings that varied from the manufacturer's recommendation. EDDY at TL and RinsEndo at any insertion depth exceeded the critical threshold in 100% of the measurements. EDDY at TL—1,—2, and—3 mm crossed the critical threshold in 30%, 10%, and 20% of the measurements, respectively. Conclusions In a simulated maxillary central incisor with an open apex, irrigation with EndoVac, Er:YAG laser activation, UAI, the SAF, and the XP‐endo Finisher generated apical pressures below the critical threshold of 5.73 mmHg. By contrast, using EDDY and RinsEndo for irrigation produced higher apical pressures that exceeded the critical threshold.
Collapse
Affiliation(s)
- Eva Magni
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Marco Jäggi
- Department of Reconstructive Dentistry, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Florin Eggmann
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Roland Weiger
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Thomas Connert
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| |
Collapse
|
6
|
Panariello BHD, Kindler JK, Spolnik KJ, Ehrlich Y, Eckert GJ, Duarte S. Use of electromagnetic stimulation on an Enterococcus faecalis biofilm on root canal treated teeth in vitro. Sci Rep 2021; 11:8306. [PMID: 33859338 PMCID: PMC8050066 DOI: 10.1038/s41598-021-87922-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/30/2021] [Indexed: 12/02/2022] Open
Abstract
Root canal disinfection is of utmost importance in the success of the treatment, thus, a novel method for achieving root canal disinfection by electromagnetic waves, creating a synergistic reaction via electric and thermal energy, was created. To study electromagnetic stimulation (EMS) for the disinfection of root canal in vitro, single rooted teeth were instrumented with a 45.05 Wave One Gold reciprocating file. Specimens were sterilized and inoculated with Enterococcus faecalis ATCC 29,212, which grew for 15 days to form an established biofilm. Samples were treated with 6% sodium hypochlorite (NaOCl), 1.5% NaOCl 1.5% NaOCl with EMS, 0.9% saline with EMS or 0.9% saline. After treatments, the colony forming units (CFU) was determined. Data was analyzed by Wilcoxon Rank Sums Test (α = 0.05). One sample per group was scored and split for confocal laser scanning microscopy imaging. There was a significant effect with the use of NaOCl with or without EMS versus 0.9% saline with or without EMS (p = 0.012 and 0.003, respectively). CFUs were lower when using 0.9% saline with EMS versus 0.9% saline alone (p = 0.002). Confocal imaging confirmed CFU findings. EMS with saline has an antibiofilm effect against E. faecalis and can potentially be applied for endodontic disinfection.
Collapse
Affiliation(s)
- Beatriz H D Panariello
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry (IUSD), 1121 W Michigan St, DS406, Indianapolis, IN, 46202, USA
| | - Justin K Kindler
- Department of Endodontics, Indiana University School of Dentistry (IUSD), Indianapolis, IN, 46202, USA
| | - Kenneth J Spolnik
- Department of Endodontics, Indiana University School of Dentistry (IUSD), Indianapolis, IN, 46202, USA
| | - Ygal Ehrlich
- Department of Endodontics, Indiana University School of Dentistry (IUSD), Indianapolis, IN, 46202, USA
| | - George J Eckert
- Department of Biostatistics, Indiana University School of Medicine, Indiana University School of Dentistry (IUSD), Indianapolis, IN, 46202, USA
| | - Simone Duarte
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry (IUSD), 1121 W Michigan St, DS406, Indianapolis, IN, 46202, USA.
| |
Collapse
|
7
|
da Silva EJNL, de Moura SG, de Lima CO, Barbosa AFA, Misael WF, Lacerda MFLS, Sassone LM. Shaping ability and apical debris extrusion after root canal preparation with rotary or reciprocating instruments: a micro-CT study. Restor Dent Endod 2021; 46:e16. [PMID: 34123752 PMCID: PMC8170380 DOI: 10.5395/rde.2021.46.e16] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/05/2020] [Accepted: 09/30/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives The aim of this study was to evaluate the shaping ability of the TruShape and Reciproc Blue systems and the apical extrusion of debris after root canal instrumentation. The ProTaper Universal system was used as a reference for comparison. Materials and Methods Thirty-three mandibular premolars with a single canal were scanned using micro-computed tomography and were matched into 3 groups (n = 11) according to the instrumentation system: TruShape, Reciproc Blue and ProTaper Universal. The teeth were accessed and mounted in an apparatus with agarose gel, which simulated apical resistance provided by the periapical tissue and enabled the collection of apically extruded debris. During root canal preparation, 2.5% sodium hypochlorite was used as an irrigant. The samples were scanned again after instrumentation. The percentage of unprepared area, removed dentin, and volume of apically extruded debris were analyzed. The data were analyzed using 1-way analysis of variance and the Tukey test for multiple comparisons at a 5% significance level. Results No significant differences in the percentage of unprepared area were observed among the systems (p > 0.05). ProTaper Universal presented a higher percentage of dentin removal than the TruShape and Reciproc Blue systems (p < 0.05). The systems produced similar volumes of apically extruded debris (p > 0.05). Conclusions All systems caused apically extruded debris, without any significant differences among them. TruShape, Reciproc Blue, and ProTaper Universal presented similar percentages of unprepared area after root canal instrumentation; however, ProTaper Universal was associated with higher dentin removal than the other systems.
Collapse
Affiliation(s)
- Emmanuel João Nogueira Leal da Silva
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil.,Department of Endodontics, Grande Rio University (UNIGRANRIO) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Sara Gomes de Moura
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Carolina Oliveira de Lima
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Ana Flávia Almeida Barbosa
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Waleska Florentino Misael
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| | | | - Luciana Moura Sassone
- Department of Endodontics, State University of Rio de Janeiro (UERJ) School of Dentistry, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
8
|
Pinheiro CLM, Almeida MR, Da Silva DC, Dametto FR, Wanderley Neto A. Development and Characterization of Sodium Hypochlorite Gel for Endodontic Use. J SURFACTANTS DETERG 2020. [DOI: 10.1002/jsde.12461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Dennys Correia Da Silva
- Department of Chemical Engineering Federal University of Rio Grande do Norte 59072‐970 Natal RN Brazil
| | - Fabio Roberto Dametto
- Department of Dentistry Federal University of Rio Grande do Norte 59072‐970 Natal RN Brazil
| | - Alcides Wanderley Neto
- Institute of Chemistry Federal University of Rio Grande do Norte 59078‐970 Natal RN Brazil
| |
Collapse
|
9
|
Uzunoglu-Özyürek E, Dik Güzel C, Dogan Buzoglu H. Effect of different irrigation methods in the presence of a separated instrument: an in vitro study. Acta Odontol Scand 2020; 78:409-416. [PMID: 32105162 DOI: 10.1080/00016357.2020.1733076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: The aim of this study was to evaluate the effect of different irrigation methods on sodium hypochlorite (NaOCl)/debris extrusion and dentinal tubule penetration of 2.5% NaOCl in the presence of an apically separated instrument.Materials and methods: Sixty root canals of freshly extracted mandibular single-rooted premolars were chemomechanically prepared up to ProTaper F2. Manual needle irrigation (30-gauge/side-vented) with 2.5% NaOCl was performed between files and a smear layer was removed with 17% ethylenediaminetetraacetic acid. Three mm of notched ProTaper F3 files were separated in the apical third of the roots. Samples were then randomly divided according to the final irrigation systems as follows: EndoActivator, EndoVac, manual needle irrigation, passive ultrasonic activation, and RinsEndo. Samples were mounted to Eppendorf tubes and root canals were irrigated with 3-mL Rhodamine B-labelled 2.5% NaOCl, which was applied using one of the above-mentioned methods. The extruded NaOCl/debris weight was calculated by extracting pre-irrigation weights of tubes from post-irrigation ones. Samples embedded in acrylic resin were sectioned transversely in 1-mm thicknesses at apical 1- and 3-mm levels. NaOCl's penetration depth and percentage into the dentinal tubules were evaluated with the aid of a confocal laser scanning microscope. Data were analysed statistically with Kruskal-Wallis and post hoc Siegel-Castellan tests (p < .05).Results: EndoVac significantly decreased the extruded NaOCl/debris compared to RinsEndo, passive ultrasonic activation, and EndoActivator in the presence of a separated instrument (p < .05). The penetrability of NaOCl significantly increased with the use of RinsEndo and EndoVac compared to the remaining groups (p < .05).Conclusion: In the presence of an irretrievable separated instrument, it could be suggested that devices with apical negative pressure such as EndoVac may improve the penetrability of irrigation solutions to the apical part of the root while preserving periapical tissues from NaOCl/debris extrusion.
Collapse
Affiliation(s)
- Emel Uzunoglu-Özyürek
- Department of Endodontics, Faculty of Dentistry, University of Hacettepe, Ankara, Turkey
| | | | - Hatice Dogan Buzoglu
- Department of Endodontics, Faculty of Dentistry, University of Hacettepe, Ankara, Turkey
| |
Collapse
|
10
|
De‐Deus G, Simões‐Carvalho M, Belladonna FG, Versiani MA, Silva EJNL, Cavalcante DM, Souza EM, Johnsen GF, Haugen HJ, Paciornik S. Creation of well‐balanced experimental groups for comparative endodontic laboratory studies: a new proposal based on micro‐CT and
in silico
methods. Int Endod J 2020; 53:974-985. [DOI: 10.1111/iej.13288] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 03/09/2020] [Indexed: 11/28/2022]
Affiliation(s)
- G. De‐Deus
- Department of Endodontics Universidade Federal Fluminense NiteróiBrazil
| | | | - F. G. Belladonna
- Department of Endodontics Universidade Federal Fluminense NiteróiBrazil
| | - M. A. Versiani
- Department of Endodontics Universidade Federal Fluminense NiteróiBrazil
| | - E. J. N. L. Silva
- Department of Endodontics Grande Rio University Duque de Caxias Brazil
| | - D. M. Cavalcante
- Department of Endodontics Universidade Federal Fluminense NiteróiBrazil
| | - E. M. Souza
- Department of Dentistry II Federal University of Maranhão São Luís Brazil
| | - G. F. Johnsen
- Department of Biomaterial Faculty of Dentistry University of Oslo Oslo Norway
| | - H. J. Haugen
- Department of Biomaterial Faculty of Dentistry University of Oslo Oslo Norway
| | - S. Paciornik
- Department of Chemical and Materials Engineering Pontifícia Universidade Católica do Rio de Janeiro Rio de Janeiro Brazil
| |
Collapse
|
11
|
Jezeršek M, Jereb T, Lukač N, Tenyi A, Lukač M, Fidler A. Evaluation of Apical Extrusion During Novel Er:YAG Laser-Activated Irrigation Modality. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:544-550. [DOI: 10.1089/photob.2018.4608] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Matija Jezeršek
- Laboratory for Laser Techniques, Faculty of Mechanical Engineering, University of Ljubljana, Ljubljana, Slovenia
| | - Teja Jereb
- Laboratory for Laser Techniques, Faculty of Mechanical Engineering, University of Ljubljana, Ljubljana, Slovenia
| | - Nejc Lukač
- Laboratory for Laser Techniques, Faculty of Mechanical Engineering, University of Ljubljana, Ljubljana, Slovenia
| | - Ana Tenyi
- Department of Endodontics and Restorative Dentistry, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
- Department of Endodontics, University Clinical Centre, Ljubljana, Slovenia
| | | | - Aleš Fidler
- Department of Endodontics and Restorative Dentistry, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
- Department of Endodontics, University Clinical Centre, Ljubljana, Slovenia
| |
Collapse
|
12
|
Sasanakul P, Ampornaramveth RS, Chivatxaranukul P. Influence of Adjuncts to Irrigation in the Disinfection of Large Root Canals. J Endod 2019; 45:332-337. [PMID: 30803542 DOI: 10.1016/j.joen.2018.11.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 11/21/2018] [Accepted: 11/26/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The aims of this study were to evaluate the effectiveness of disinfection methods and determine the most promising irrigation protocol for regenerative endodontics in teeth with large root canals. METHODS Sterilized root samples with 0.8-mm wide apical foramen (n = 94) were prepared from human mandibular premolars. Ninety-two samples were infected with Enterococcus faecalis for 21 days and biofilm formation was verified using scanning electron microscopy (n = 2). The 90 infected samples were randomly assigned into 9 groups: no intervention (initial), 1.5% NaOCl irrigation (1.5 N), 2.5% NaOCl irrigation (2.5 N), 1.5 N + intermittent passive ultrasonic irrigation (PUI), 1.5 N + intermittent canal brushing with Navitip FX (NFX), 1.5 N + intermittent XP-endo Finisher (XPF), 1.5 N + circumferential filing (CF), 1.5 N + 1-min Self-adjusting File (SAF), and 1.5 N + mechanical instrumentation using #90‒110 files (MI). Subsequently, the root canal walls were shaved for microbial analysis. The mean colony-forming units (CFUs) were determined and analyzed using 1-way analysis of variance. RESULTS The mean CFU count was lowest in the MI group (63.5 CFU/mL), followed by the NFX, XPF, SAF, 2.5 N, CF, PUI, 1.5 N, and initial groups. The remaining bacteria in the 1.5 N group was 3.6-fold higher than that of the PUI group; 4- to 5-fold higher than that of the 2.5 N, CF, and SAF groups; and 22-fold and 36-fold higher than that of the XPF and NFX groups, respectively. The 2.5 N and 1.5 N groups with adjunctive treatments, excluding the PUI group, had significantly fewer remaining bacteria compared with the 1.5 N group (P < .05). CONCLUSIONS Performing various procedures supplemental to 1.5 N improved large root canal disinfection. Adjunctive NFX most effectively reduced the number of bacteria without dentin removal.
Collapse
Affiliation(s)
- Parnwad Sasanakul
- Department of Operative Dentistry, Chulalongkorn University, Bangkok, Thailand
| | | | | |
Collapse
|
13
|
Cytotoxicity and Genotoxicity of a New Intracanal Medicament, 2-hydroxyisocaproic Acid–An In Vitro Study. J Endod 2019; 45:578-583. [DOI: 10.1016/j.joen.2019.01.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 01/09/2019] [Accepted: 01/14/2019] [Indexed: 12/18/2022]
|
14
|
Pucinelli CM, Silva LABD, Cohenca N, Romualdo PC, Silva RABD, Consolaro A, Queiroz AMD, Nelson P. Apical Negative Pressure irrigation presents tissue compatibility in immature teeth. J Appl Oral Sci 2018; 25:612-619. [PMID: 29211282 PMCID: PMC5701531 DOI: 10.1590/1678-7757-2016-0599] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 06/02/2017] [Indexed: 11/22/2022] Open
Abstract
Aim: To compare the apical negative pressure irrigation (ANP) with conventional irrigation in the teeth of immature dogs with apical periodontitis. Methods: Fifty-two immature pre-molar root canals were randomly assigned into 4 groups: ANP (n=15); conventional irrigation (n=17); healthy teeth (control) (n = 10); and teeth with untreated apical periodontitis (control) (n=10). After induction of apical periodontitis, teeth were instrumented using EndoVac® (apical negative pressure irrigation) or conventional irrigation. The animals were euthanized after 90 days. The sections were stained by HE and analyzed under conventional and fluorescence microscopy. TRAP histoenzymology was also performed. Statistical analyses were performed with the significance level set at 5%. Results: There was difference in the histopathological parameters between ANP and conventional groups (p<0.05). The ANP group showed a predominance of low magnitude inflammatory infiltrate, a smaller periodontal ligament, and lower mineralized tissue resorption. There were no differences in the periapical lesion extensions between the ANP and conventional groups (p>0.05). However, a lower number of osteoclasts was observed in the ANP group (p<0.05). Conclusion: The EndoVac® irrigation system presented better biological results and more advanced repair process in immature teeth with apical periodontitis than the conventional irrigation system, confirming the hypothesis.
Collapse
Affiliation(s)
- Carolina Maschietto Pucinelli
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, SP, Brasil
| | - Léa Assed Bezerra da Silva
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, SP, Brasil
| | - Nestor Cohenca
- University of Washington & Seattle Children's, Department of Endodontics, Seattle, USA
| | - Priscilla Coutinho Romualdo
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, SP, Brasil
| | - Raquel Assed Bezerra da Silva
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, SP, Brasil
| | - Alberto Consolaro
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Cirurgia, Estomatologia, Patologia e Radiologia, Bauru, SP, Brasil
| | - Alexandra Mussolino de Queiroz
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, SP, Brasil
| | - Paulo Nelson
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, SP, Brasil
| |
Collapse
|
15
|
Comparison of the Antimicrobial Efficacy of the EndoVac System and Conventional Needle Irrigation in Primary Molar Root Canals. J Clin Pediatr Dent 2017. [PMID: 28650788 DOI: 10.17796/1053-4628-41.4.284] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The purpose of this study was to compare the antimicrobial efficacy of the EndoVac system and conventional needle irrigation to eliminate E faecalis in primary molar root canals. STUDY DESIGN 60 extracted human primary second molar roots were instrumented up to an apical size .04/35 and randomly divided into two groups; Group 1: conventional needle (n=30) and Group 2: EndoVac (n=30), and four subgroups (two experimental subgroups; (a) 2.5% sodium hypochlorite (NaOCl) + ethylenediaminetetraacetic acid (EDTA) (n=20), (b) ozonated water (OW) + EDTA (n=20), and control groups (c) 5.25% NaOCl (n=10) and (d) saline (n=10). All roots were sterilized and then inoculated with E.faecalis. Before and after final irrigation procedures, root canals were sampled and the grown colony forming units (CFUs) were counted. Data were analyzed by Kruskall-Wallis and Mann-Whitney U tests using a 0.05 significance level. RESULTS The EndoVac reduced more bacteria than the conventional needle did but it was not statistically significant (p>0.05). NaOCl alone or followed by EDTA totally eliminated bacteria. OW + EDTA showed higher reduction of bacteria but could not totally eliminate bacterias. CONCLUSIONS In the context of bacterial elimination, the EndoVac was not significantly better than the conventional needle. Although, there were fewer CFU/mg when using EndoVac, there was not any statistically significant superiority to conventional needle irrigation. An OW+EDTA regimen showed antibacterial effect in the primary molar root canals but it was significantly less effective than NaOCl+EDTA.
Collapse
|
16
|
Azim AA, Aksel H, Margaret Jefferson M, Huang GTJ. Comparison of sodium hypochlorite extrusion by five irrigation systems using an artificial root socket model and a quantitative chemical method. Clin Oral Investig 2017; 22:1055-1061. [PMID: 28748298 DOI: 10.1007/s00784-017-2187-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 07/18/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVES This is to compare the volumes of irrigant apically extruded by five irrigation systems in an artificial socket model simulating clinical conditions. MATERIALS AND METHODS Twenty extracted human single-rooted teeth were enlarged to size 40/04 and then embedded in silicone impression material. The root canal space was irrigated with nominal 3% sodium hypochlorite (NaOCl) using standard needle irrigation (SNI) with a 30-gauge notched needle, EndoActivator (EA), XP Endo Finisher (XP Endo), EndoVac (EV), and photon-induced photoacoustic streaming (PIPS). Extruded NaOCl was collected, reacted with taurine to form taurine-monochloramine, and absorbance of taurine-monochloramine was measured at 252 nm using a spectrophotometer. The five irrigation systems were compared with repeated measures ANOVA and pairwise comparisons. RESULTS The EV group had very low extrusion (mean ± SD = 0.12 ± 0.2 μL) and differed significantly from the other four groups (P ≤ 0.001). Larger volumes of irrigant were extruded in the other irrigation groups. There were no significant differences in the extruded volumes among the SNI (7.4 ± 3.4 μL), EA (7.0 ± 6.1 μL), and XP Endo (7.8 ± 4.1 μL) groups (P = 1). The PIPS group had the highest mean extruded volume (12.9 ± 6.8 μL) and differed significantly from SNI (P = 0.030), EV (P < 0.0005), and EA (P = 0.02), but not XP Endo (P = 0.154). CONCLUSION Under the in vitro conditions of this study, irrigant extrusion appears unavoidable unless negative pressure irrigation such as EV is used. PIPS extrudes more irrigant than other systems, while SNI, EA, and XP Endo extrude similar volumes of irrigant. CLINICAL RELEVANCE The findings help clinicians select the optimal irrigation system to avoid irrigant extrusion.
Collapse
Affiliation(s)
- Adham A Azim
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, 875 Union Avenue, Laboratory, Cancer Research Building, 19 S. Manassas St. Lab Rm 255, office 256, Memphis, TN, 38163, USA.,Department of Periodontics & Endodontics, School of Dental Medicine, University at Buffalo, Buffalo, NY, USA
| | - Hacer Aksel
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, 875 Union Avenue, Laboratory, Cancer Research Building, 19 S. Manassas St. Lab Rm 255, office 256, Memphis, TN, 38163, USA.,Department of Endodontics, School of Dentistry, Hacettepe University, Ankara, Turkey
| | - M Margaret Jefferson
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, 875 Union Avenue, Laboratory, Cancer Research Building, 19 S. Manassas St. Lab Rm 255, office 256, Memphis, TN, 38163, USA
| | - George T-J Huang
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, 875 Union Avenue, Laboratory, Cancer Research Building, 19 S. Manassas St. Lab Rm 255, office 256, Memphis, TN, 38163, USA.
| |
Collapse
|
17
|
Romualdo PC, de Oliveira KMH, Nemezio MA, Küchler EC, Silva RAB, Nelson-Filho P, Silva LAB. Does apical negative pressure prevent the apical extrusion of debris and irrigant compared with conventional irrigation? A systematic review and meta-analysis. AUST ENDOD J 2017; 43:129-137. [DOI: 10.1111/aej.12162] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Priscilla Coutinho Romualdo
- Department of Pediatric Dentistry; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | | | - Mariana Alencar Nemezio
- Department of Pediatric Dentistry; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - Erika Calvano Küchler
- Department of Pediatric Dentistry; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - Raquel Assed Bezerra Silva
- Department of Pediatric Dentistry; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - Paulo Nelson-Filho
- Department of Pediatric Dentistry; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - Lea Assed Bezerra Silva
- Department of Pediatric Dentistry; School of Dentistry of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| |
Collapse
|
18
|
Silva EJNL, Brito ME, Ferreira VD, Belladonna FG, Neves AA, Senna PM, De-Deus G. Cytotoxic effect of the debris apically extruded during three different retreatment procedures. J Oral Sci 2016; 58:211-7. [DOI: 10.2334/josnusd.15-0658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
| | - Mônica E. Brito
- Department of Endodontics, Health Sciences Center, Grande Rio University
| | - Vivian D. Ferreira
- Department of Endodontics, Health Sciences Center, Grande Rio University
| | | | - Aline A. Neves
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro
| | - Plinio M. Senna
- Department of Endodontics, Health Sciences Center, Grande Rio University
| | - Gustavo De-Deus
- Department of Endodontics, Health Sciences Center, Grande Rio University
| |
Collapse
|
19
|
Jiang S, Zou T, Li D, Chang JWW, Huang X, Zhang C. Effectiveness of Sonic, Ultrasonic, and Photon-Induced Photoacoustic Streaming Activation of NaOCl on Filling Material Removal Following Retreatment in Oval Canal Anatomy. Photomed Laser Surg 2015; 34:3-10. [PMID: 26682489 DOI: 10.1089/pho.2015.3937] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study aimed to assess the effectiveness of sonic, ultrasonic and laser [photon-induced photoacoustic streaming (PIPS)] irrigation activation in removing filling remnants from oval root canals after standard canal retreatment procedures with the ProTaper universal rotary retreatment system. METHODS Twenty-eight maxillary first premolars were instrumented with ProTaper NiTi rotary instruments and obturated with gutta-percha and AH Plus sealer using the continuous wave of condensation technique. After storage at 37°C and 100% humidity for 1 week, the specimens were retreated with the ProTaper universal retreatment system for the removal of filling material. Teeth were then randomly assigned into four groups (n = 7): group 1, positive control; group 2, retreated with sonic irrigation; group 3, retreated with ultrasonic irrigation; and group 4, retreated with laser irradiation. The specimens were scanned using micro-CT before instrumentation, after obturation and mechanical retreatment, and after additional activation procedures. The percentage volume of the filling remnants was measured. Specimens were split longitudinally after micro-CT scan, canal walls were examined using scanning electron microscopy (SEM), and the amount of residual filling material was scored. RESULTS The filling materials' removal efficacy in the three experimental groups was higher than that of the control group (p < 0.05), whereas filling materials ranging from 1.46 ± 0.30 to 2.21 ± 0.46 mm(3) remained in the canal in all three experimental groups. Additionally, there was a significantly greater reduction in the amount of filling remnants in the PIPS group than in the sonic and ultrasonic groups (both p < 0.05), and significantly greater reduction in the ultrasonic group than the sonic group (p < 0.05). CONCLUSIONS Activation of NaOCl with PIPS showed significantly better performance than sonic and ultrasonic techniques in removing the filling remnants following mechanical retreatment of oval root canals. The ultrasonic technique also performed better than the sonic technique. However, none of the additional activation procedures was able to completely eliminate the filling remnants.
Collapse
Affiliation(s)
- Shan Jiang
- 1 Department of Endodontics and Operative Dentistry I, School and Hospital of Stomatology, Fujian Medical University , Fujian, China
| | - Ting Zou
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Hong Kong SAR, China
| | - Dongxia Li
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Hong Kong SAR, China .,3 Department of Stomatology, Air Force General Hospital of the PLA , Haidian District, Beijing, China
| | - Jeffery W W Chang
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Hong Kong SAR, China
| | - Xiaojing Huang
- 1 Department of Endodontics and Operative Dentistry I, School and Hospital of Stomatology, Fujian Medical University , Fujian, China
| | - Chengfei Zhang
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Hong Kong SAR, China
| |
Collapse
|
20
|
Versiani MA, Alves FRF, Andrade-Junior CV, Marceliano-Alves MF, Provenzano JC, Rôças IN, Sousa-Neto MD, Siqueira JF. Micro-CT evaluation of the efficacy of hard-tissue removal from the root canal and isthmus area by positive and negative pressure irrigation systems. Int Endod J 2015; 49:1079-1087. [DOI: 10.1111/iej.12559] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 10/08/2015] [Indexed: 11/30/2022]
Affiliation(s)
- M. A. Versiani
- Department of Restorative Dentistry; Dental School of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP Brazil
| | - F. R. F. Alves
- Department of Endodontics; Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro RJ Brazil
| | - C. V. Andrade-Junior
- Department of Health; Dentistry Division; Southwest State University of Bahia; Jequié Brazil
| | - M. F. Marceliano-Alves
- Department of Endodontics; Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro RJ Brazil
| | - J. C. Provenzano
- Department of Endodontics; Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro RJ Brazil
| | - I. N. Rôças
- Department of Endodontics; Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro RJ Brazil
| | - M. D. Sousa-Neto
- Department of Restorative Dentistry; Dental School of Ribeirão Preto; University of São Paulo; Ribeirão Preto SP Brazil
| | - J. F. Siqueira
- Department of Endodontics; Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro RJ Brazil
| |
Collapse
|