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Kiraz G, Kaya BÜ, Ocak M, Uzuner MB, Çelik HH. Micro-CT evaluation of the removal of root fillings using rotary and reciprocating systems supplemented by XP-Endo Finisher, the Self-Adjusting File, or Er,Cr:YSGG laser. Restor Dent Endod 2023; 48:e36. [PMID: 38053777 PMCID: PMC10695726 DOI: 10.5395/rde.2023.48.e36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 12/07/2023] Open
Abstract
Objectives This study aimed to compare the effectiveness of a single-file reciprocating system (WaveOne Gold, WOG) and a multi-file rotary system (ProTaper Universal Retreatment, PTUR) in removing canal filling from severely curved canals and to evaluate the possible adjunctive effects of XP-Endo Finisher (XPF), the Self-Adjusting File (SAF), and an erbium, chromium: yttrium, scandium, gallium garnet (Er,Cr:YSGG) laser using micro-computed tomography (μCT). Materials and Methods Sixty-six curved mandibular molars were divided into 2 groups based on the retreatment technique and then into 3 based on the supplementary method. The residual filling volumes and root canals were evaluated with μCT before and after retreatment, and after the supplementary steps. The data were statistically analyzed with the t-test, Mann-Whitney U test, analysis of covariance, and factorial analysis of variance (p < 0.05). Results PTUR and WOG showed no significant difference in removing filling materials (p > 0.05). The supplementary techniques were significantly more effective than reciprocating or rotary systems only (p < 0.01). The supplementary steps showed no significant differences in canal filling removal effectiveness (p > 0.05), but XPF showed less dentin reduction than the SAF and Er,Cr:YSGG laser (p < 0.01). Conclusions The supplementary methods significantly decreased the volume of residual filling materials. XPF caused minimal changes in root canal volume and might be preferred for retreatment in curved root canals. Supplementary approaches after retreatment procedures may improve root canal cleanliness.
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Affiliation(s)
- Gülsen Kiraz
- Department of Endodontics, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Turkey
| | - Bulem Üreyen Kaya
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
| | - Mert Ocak
- Department of Anatomy, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Muhammet Bora Uzuner
- Department of Anatomy, Faculty of Medicine, Bandırma Onyedi Eylül University, Balıkesir, Turkey
| | - Hakan Hamdi Çelik
- Department of Anatomy, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Jose J, Teja KV, Silva EJNL, Janani K, Siddique R, Rossi-Fedele G. Centric versus eccentric engine-driven endodontic instrument design for microbial load reduction-A systematic review and meta-analysis of randomised clinical trials. AUST ENDOD J 2023; 49 Suppl 1:515-527. [PMID: 36514265 DOI: 10.1111/aej.12726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/09/2022] [Accepted: 11/24/2022] [Indexed: 12/15/2022]
Abstract
This systematic review assessed the clinical influence of centric and eccentric engine-driven instrument design for reduction in microbial load in infected root canal system. The literature search was conducted in electronic databases (PubMed, Cochrane Library, Scopus, Lilacs and Google Scholar) and grey literature till June 2022. The search strategy followed the PRISMA 2020 guidelines. Qualitative and quantitative synthesis was conducted based on the guidelines of the Cochrane Handbook. The risk of bias was assessed using the revised Cochrane criteria and quality of evidence was conducted using the Grading of Recommendation Assessment, Development and Evaluation tool. Out of 28 papers, only five papers met the inclusion criteria of this review. Studies showed reduction in microbial load after instrumentation using centric or eccentric instruments with no statistically significant difference in the meta-analysis. In conclusion, there is low-grade evidence suggesting that microbial reduction is similar using centric and eccentric instruments.
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Affiliation(s)
| | - Kavalipurapu Venkata Teja
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Duque de Caxias, Brazil
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Krishnamachari Janani
- Department of Conservative Dentistry and Endodontics, SRM Dental College, Chennai, India
| | - Riluwan Siddique
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
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Loyola-Fonseca SC, Campello AF, Rodrigues RCV, Alves FRF, Brasil SC, Vilela CLS, Gonçalves LS, Provenzano JC, Siqueira JF, Rôças IN. Disinfection and Shaping of Vertucci Class II Root Canals after Preparation with Two Instrument Systems and Supplementary Ultrasonic Activation of Sodium Hypochlorite. J Endod 2023; 49:1183-1190. [PMID: 37419243 DOI: 10.1016/j.joen.2023.06.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/09/2023]
Abstract
INTRODUCTION This study compared disinfection and shaping after root canal preparation with either XP-endo Shaper or TruNatomy instrument systems, supplemented by ultrasonic activation of sodium hypochlorite (NaOCl) with either stainless-steel (SS) or nickel-titanium (NiTi) inserts. METHODS Mesial roots from mandibular molars with Vertucci class II configuration were divided into 2 groups (n = 24) based on anatomically paired micro-computed tomography (micro-CT) analyses. Pre and postpreparation micro-CT scans were obtained to evaluate the shaping performance. The canals were contaminated with a mixed bacterial culture for 30 days and then subjected to preparation with either XP-endo Shaper or TruNatomy instruments using NaOCl irrigation. Supplementary ultrasonic activation of NaOCl was conducted using either an SS (TruNatomy group) or NiTi (XP-endo Shaper group) insert. Bacteriological samples were taken from the canals before preparation (S1), after preparation (S2), and after the supplementary approach (S3). Bacterial reduction was evaluated using a quantitative real-time polymerase chain reaction. RESULTS Preparation with both instrument systems significantly reduced bacterial counts (P < .01). After preparation, 36% (TruNatomy) and 35% (XP-endo Shaper) were negative for bacteria. These values increased to 59% and 65% after ultrasonic activation with the SS and NiTi inserts, respectively. The quantitative data in S2 showed that XP-endo Shaper promoted a significantly higher bacterial reduction than TruNatomy (P < .05). No significant intragroup differences were observed after ultrasonic activation (P > .05), probably because the SS insert promoted a significantly higher S2-to-S3 reduction than the NiTi insert (P < .01). Micro-CT analysis revealed no significant differences in the unprepared areas between the groups (P > .05). CONCLUSIONS The XP-endo Shaper caused a significantly higher bacterial reduction than TruNatomy in Vertucci class II canals. Better antibacterial results after ultrasonic activation were observed for the SS ultrasonic inserts than for the NiTi inserts.
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Affiliation(s)
- Simone C Loyola-Fonseca
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Andrea F Campello
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Renata C V Rodrigues
- Department of Endodontics, Faculty of Dentistry, Veiga de Almeida University (UVA), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávio R F Alves
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Sabrina C Brasil
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Caren L S Vilela
- Laboratory of Molecular Microbial Ecology, Institute of Microbiology Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucio S Gonçalves
- Postgraduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - José Claudio Provenzano
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
| | - José F Siqueira
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Isabela N Rôças
- Department of Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Nova Iguaçu, Rio de Janeiro, Brazil; Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
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Versiani MA, Martins J, Ordinola-Zapata R. Anatomical complexities affecting root canal preparation: a narrative review. Aust Dent J 2023; 68 Suppl 1:S5-S23. [PMID: 37984802 DOI: 10.1111/adj.12992] [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] [Accepted: 10/15/2023] [Indexed: 11/22/2023]
Abstract
A fundamental aspect of the Endodontic field is the knowledge of root canal anatomy. Using a variety of techniques, the internal and external anatomy of teeth have been extensively investigated throughout the past century. Recent improvements in three-dimensional computed tomography have enabled more detailed evaluations of root canal morphology in both clinical and laboratory settings. Essentially, researches have unveiled that the root canal constitutes a complex system, comprising not only the main root canal but also lateral components, including isthmuses, fins, accessory canals and apical ramifications. Undoubtedly, this intricate morphology poses a significant challenge when it comes to the process of shaping, cleaning and disinfecting the root canal system. This article aims to explore the anatomical aspects of the root canal system that impact the chemomechanical procedures.
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Affiliation(s)
- M A Versiani
- Dental Specialty Center, Brazilian Military Police, Belo Horizonte, Brazil
| | - Jnr Martins
- Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Grupo de Investigação em Bioquímica e Biologia Oral, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
- Centro de Estudo de Medicina Dentária Baseada na Evidência (CEMDBE) - Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | - R Ordinola-Zapata
- Endodontic Division, Department of Restorative Sciences, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA
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Pinto KP, Barbosa AFA, Silva EJNL, Santos APP, Sassone LM. What is the microbial profile in persistent endodontic infections? A scoping review. J Endod 2023:S0099-2399(23)00280-7. [PMID: 37211309 DOI: 10.1016/j.joen.2023.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/05/2023] [Accepted: 05/11/2023] [Indexed: 05/23/2023]
Abstract
INTRODUCTION This scoping review aimed to map the evidence about the microbiota found in persistent endodontic infections. METHODS The study protocol was prospectively registered and is available at https://osf.io/3g2cp. The electronic search was performed in MEDLINE via PubMed, Lilacs, BBO, Scopus, Web of Science, Cochrane Library and EMBASE. The eligibility criteria were based on the PCC acronym, where P (Population): patients with teeth presenting persistent endodontic infection; C (Concept): microbial profile; and C (Context): undergoing endodontic retreatment. Clinical studies that evaluated the microbial profile of samples collected from root canals of teeth undergoing retreatment, using classical or molecular methods, were included. Studies that did not show a minimum period of one year between primary endodontic treatment and retreatment or did not radiographically evaluate the quality of primary root canal filling were excluded. Two reviewers independently selected the articles and collected data. RESULTS From a total of 957 articles, 161 were read in full and 32 studies were included. The most prevalent species were Enterococcus faecalis, Parvimonas micra, Porphyromonas endodontalis, Porphyromonas gingivalis, Prevotella intermedia, Dialister invisus, Propionibacterium acnes, Tannerella forsythia and Treponema denticola. Cases with symptomatology or inadequate root canal filling presented an increase in specific bacterial species compared to no symptomatology or adequate filling. A greater number of microorganisms was observed in teeth with inadequate coronal restoration compared to adequate restoration. CONCLUSION Persistent endodontic infections have a polymicrobial profile identified by the commonly used methods for bacterial detection/identification and are subject to the limitations present in each of those methods.
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Affiliation(s)
- K P Pinto
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro
| | - A F A Barbosa
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro
| | - E J N L Silva
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro; Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - A P P Santos
- Department of Community and Preventive Dentistry, School of Dentistry, University of the State of Rio de Janeiro, Brazil.
| | - L M Sassone
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro
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Aazzouzi-Raiss K, Ramírez-Muñoz A, Mendez S PM, Vieira GCS, Aranguren J, Pérez AR. Effects of Conservative Access and Apical Enlargement on Shaping and Dentin Preservation with Traditional and Modern Instruments: A Micro-computed Tomographic Study. J Endod 2023; 49:430-437. [PMID: 36646164 DOI: 10.1016/j.joen.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/17/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
INTRODUCTION This ex vivo study aimed to evaluate the shaping abilities and preservation of dentin with traditional and modern instruments after using sizes 25 and 40 in oval canals of mandibular incisors with conservative access. METHOD Thirty mandibular incisors with single straight oval canals were selected and assigned into 2 groups (n = 15) according to the instrument system used during preparation, Slim Shaper (SS) plus Apical Shaper (AS) and Protaper Gold (PG). The samples were subjected to micro-computed tomography before and after preparation with sizes 25 and 40. The shaping parameters evaluated included canal volume and surface area, amount of unprepared root canal walls, and reduction in pericervical dentin. RESULTS Canal volume and surface area were significantly increased after enlargement with each instrument size (P < .01). The percentage of unprepared areas showed a significant intragroup decrease after using PG F2 and F4 or SS 3 and AS (P < .05). Intergroup comparison showed no significant differences. Pericervical dentin was reduced in all groups. The intragroup comparison only revealed a significant reduction (P < .01) between PG F2 and F4. In addition, a significant decrease in pericervical dentin (P < .05) was observed between PG F4 40/.06 and AS 40/.03. No significant differences were observed between PG F2 25/.08 and SS 3 25/.04. CONCLUSION Increasing the instrumentation size from 25 to 40 significantly reduces the percentage of unprepared areas regardless of the system used. In addition, using a modern system with a regressive taper allows the maintenance of pericervical dentin without compromising shaping efficacy in the apical third of the mandibular incisors with oval canals and conservative access.
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Affiliation(s)
| | - Ana Ramírez-Muñoz
- Department of Endodontics, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | | | | | - José Aranguren
- Department of Endodontics, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Alejandro R Pérez
- Department of Endodontics, Rey Juan Carlos University, Alcorcón, Madrid, Spain; Private Practice in Porto, Porto, Portugal.
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Rôças IN, Provenzano JC, Neves MS, Alves FR, Gonçalves LS, Siqueira JF. Effects of calcium hydroxide paste in different vehicles on bacterial reduction during treatment of teeth with apical periodontitis. J Endod 2022; 49:55-61. [DOI: 10.1016/j.joen.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 09/29/2022] [Accepted: 10/14/2022] [Indexed: 11/07/2022]
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Ersahan S, Hepsenoglu YE. Microbial analysis of endodontic infections in teeth with post-treatment apical periodontitis before and after medication. AUST ENDOD J 2022; 49:75-86. [PMID: 35239214 DOI: 10.1111/aej.12613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 02/13/2022] [Indexed: 11/24/2022]
Abstract
This study aimed to determine the intraradicular microbiota of previously root canal-treated teeth with apical periodontitis and to investigate the antibacterial effectiveness of different intracanal medicaments. Sixteen patients with post-treatment apical periodontitis were allocated into two groups according to the intracanal medicament used: calcium hydroxide (CH) and 2% chlorhexidine gluconate gel (CHX) group. Total bacterial loads, as well as the amount of Enterococcus faecalis (E. faecalis) were determined before (S1) and after (S2) chemomechanical preparation and finally, after intracanal medication (S3) by means of ddPCR. The unpaired t test was used to compare parametric. S3-total bacteria copy number of the CH group was lower than the CHX group (p < 0.05). There was no statistical difference between the CHX- and the CH groups in terms of E.faecalis copy number (p > 0.05). But in terms of total bacteria, CH is better than CHX. Consequently, CH can be used to optimise the antibacterial efficiency of chemomechanical preparation in previously root canal-treated teeth with apical periodontitis.
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Affiliation(s)
- Seyda Ersahan
- Faculty of Dentistry, Department of Endodontics, Istanbul Medipol University, Istanbul, Turkey
| | - Yelda Erdem Hepsenoglu
- Faculty of Dentistry, Department of Endodontics, Istanbul Medipol University, Istanbul, Turkey
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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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Fahim MM, Saber SEM, Elkhatib WF, Nagy MM, Schafer E. The antibacterial effect and the incidence of post-operative pain after the application of nano-based intracanal medications during endodontic retreatment: a randomized controlled clinical trial. Clin Oral Investig 2021; 26:2155-2163. [PMID: 34697657 DOI: 10.1007/s00784-021-04196-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/21/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This clinical trial aimed to evaluate the effect of nano-silver and nano-calcium hydroxide intracanal medicaments (ICM) during retreatment regarding their antibacterial effect and their effect on post-operative pain and flare-ups. MATERIALS AND METHODS Sixty-nine patients scheduled for endodontic retreatment were included in this randomized clinical trial and randomly allocated to 3 equal groups (n = 23) according to the type of ICM used. The first microbial sampling (S1) representing the original microbiota was obtained after the removal of the old canal filling. After chemo-mechanical debridement, another sample (S2) was obtained representing the microbial state before ICM application. Patients were randomly allocated to receive either nano-silver (nano-Ag), nano-calcium hydroxide (nano-CH), or calcium hydroxide (CH) as ICM. Patients rated their pain pre-operatively and then after 6, 12, 24, 48, and 72 h. During the second visit (7 days later), the last microbial sample (S3) was obtained after removal of the ICM. Reduction of total bacterial and total E. faecalis counts and the biofilm-forming capability of the existing microbiota were determined. RESULTS Results showed reduction in total bacterial count, total E. faecalis count and the biofilm-forming,capability of the existing microbiota after chemo-mechanical debridement (S1-S2) and after the application of ICM (S3-S2). However, the reduction after cleaning and shaping was significantly more pronounced (p < 0.001) compared to the effect of ICM application, with no difference between the 3 ICM (p > 0.05). Post-operative pain was significantly reduced at the 48- and 72-h intervals after the application of nano-Ag and nano-CH only (p < 0.001), with no significant difference between these two ICM (p > 0.05). The incidence of flare-ups in all groups was similar (p > 0.05). CONCLUSIONS The antibacterial effect of the nano-Ag and nano-CH was equivalent to that of CH, but they contributed to better pain control. CLINICAL RELEVANCE Nanoparticles may have a positive impact on post-endodontic pain.
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Affiliation(s)
- Mahmoud M Fahim
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Shehab Eldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
- Department of Endodontics, Faculty of Dentistry, The British University, Cairo, Egypt.
| | - Walid F Elkhatib
- Department of Microbiology and Immunology, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
- Department of Microbiology and Immunology, Faculty of Pharmacy, Galala University, Galala City, Egypt
| | - Mohamed Mokhtar Nagy
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Edgar Schafer
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany
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Plasma Rich in Growth Factors in the Treatment of Endodontic Periapical Lesions in Adult Patients: A Narrative Review. Pharmaceuticals (Basel) 2021; 14:ph14101041. [PMID: 34681265 PMCID: PMC8539488 DOI: 10.3390/ph14101041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 10/12/2021] [Indexed: 02/07/2023] Open
Abstract
Platelet concentrates have been widely used in regenerative medicine, including endodontics. The aim of this manuscript was to assess critically the efficacy of PRF in the treatment of endodontic periapical lesions in adult patients on the basis of the literature. The PICO approach was used to properly develop literature search strategies. The PubMed database was analyzed with the keywords: "((PRP) OR (PRF) OR (PRGF) OR (CGF)) AND (endodontic) AND ((treatment) OR (therapy))". After screening of 155 results, 14 articles were included in this review. Different types of platelet concentrates are able to stimulate the processes of proliferation and differentiation of mesenchymal stem cells. Platelet rich fibrin (PRF) releases growth factors for at least 7 days at the application site. Growth factors and released cytokines stimulate the activity of osteoblasts. Moreover, the release of growth factors accelerates tissue regeneration by increasing the migration of fibroblasts. It was not possible to assess the efficacy of PRF supplementation in the treatment of endodontic periapical lesions in permanent, mature teeth with closed apexes, due to the lack of well-designed scientific research. Further studies are needed to analyze the effect of PRF on the healing processes in the periapical region.
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Plasma Rich in Growth Factors in the Treatment of Endodontic Periapical Lesions in Adult Patients: Case Reports. Int J Mol Sci 2021; 22:ijms22179458. [PMID: 34502364 PMCID: PMC8431603 DOI: 10.3390/ijms22179458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 08/19/2021] [Accepted: 08/30/2021] [Indexed: 12/17/2022] Open
Abstract
Platelet-rich fibrin (PRF) is an autologous blood concentrate obtained without anticoagulants by centrifugation of patients’ peripheral venous blood. PRF is considered to enhance the formation of new bone. The aim of this manuscript was to present two case reports of permanent teeth with closed apexes with periapical lesions, treated endodontically with the use of PRF. The root canals were mechanically cleaned and shaped with NiTi files and irrigated with 5.25% sodium hypochlorite (NaOCl), 40% citric acid (CA), and triple distillated water. Before the canal systems were obturated, A-PRF was used as a scaffold and was placed below the cementodentinal junction with hand pluggers. Cone beam computerized tomography (CBCT) was used to assess the resolutions of periapical radiolucencies. After 6 months, the measurements of both periapical lesions were significantly reduced. Although the performed root canal treatments (RCTs) can definitely be recognized as successful, it must be emphasized that mechanical shaping and cleaning of the root canals with special disinfecting solutions significantly affect the clinical efficacy of RCT. It seems impossible to state that PRF played a leading role in the healing process of the presented periapical lesions. Further studies must be performed to assess whether RCT of mature teeth with an additional PRF application is superior to RCT performed alone.
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Ferreira I, Babo PS, Braga AC, Lopes MA, Gomes ME, Pina-Vaz I. Supplementary solvent irrigation efficacy on filling remnants removal comparing XP-endo Finisher R vs IrriSafe. Sci Rep 2021; 11:12659. [PMID: 34135434 PMCID: PMC8209217 DOI: 10.1038/s41598-021-92175-2] [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: 03/11/2021] [Accepted: 05/28/2021] [Indexed: 11/22/2022] Open
Abstract
This study aimed to compare the efficacy of XP-endo Finisher R and IrriSafe, with a solvent mixture of Methyl ethyl ketone/Tetrachloroethylene (MEK/TCE), in the removal of root filling residues. Twenty-four human mandibular incisors were pair-matched by micro-computed tomography according to volume and aspect ratio. After retreatment, specimens were allocated to two experimental groups (n = 12), according to the supplementary instrument used. The volume of residual filling material after each irrigating step and the time for retreatment was calculated. Statistical analyses were carried out using Mann-Whitney test, with a significance level of 5%. The volume of initial root canal filling material between the groups was similar (p > 0.05). With the final irrigation protocol (NaOCl and EDTA) the volume of the filling remnants decreased significantly (p < 0.05) with no differences between IrriSafe or XP-endo Finisher R (p > 0.05). The additional solvent mixture MEK/TCE increased the efficiency of filling materials reduction, regardless of the agitating instruments employed, IrriSafe or XP-endo Finisher R (p < 0.05). There was no difference between the two groups regarding the time (p = 0.149). Both supplementary instruments were effective in the reduction of filling remnants. The additional step with a solvent mixture of MEK/TCE enabled a total recovery of patency and the achievement of cleaner canals, independently of the agitation instrument.
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Affiliation(s)
- Inês Ferreira
- CINTESIS, Faculty of Medicine of University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| | - Pedro S Babo
- 3B's Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence On Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência E Tecnologia, Zona Industrial da Gandra, 4805-017, Barco, Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, 4805-017, Braga/Guimarães, Portugal
| | - Ana Cristina Braga
- Department of Production and Systems, ALGORITMI Center, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - Maria Ascensão Lopes
- REQUIMTE-LAQV, Department of Metallurgical and Materials Engineering, Faculty of Engineering, University of Porto, R. Dr. Roberto Frias, 4200-465, Porto, Portugal
| | - Manuela E Gomes
- 3B's Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence On Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência E Tecnologia, Zona Industrial da Gandra, 4805-017, Barco, Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, 4805-017, Braga/Guimarães, Portugal
| | - Irene Pina-Vaz
- CINTESIS, Faculty of Dental Medicine of University of Porto, Rua Dr. Manuel Pereira da Silva, 4200-393, Porto, Portugal
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Silva WO, Vianna Silva Macedo RP, Nevares G, Val Rodrigues RC, Grossi Heleno JF, Braga Pintor AV, Almeida BM. Recommendations for Managing Endodontic Emergencies during Coronavirus Disease 2019 Outbreak. J Endod 2021; 47:3-10. [PMID: 33045270 PMCID: PMC7545210 DOI: 10.1016/j.joen.2020.09.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/15/2020] [Accepted: 09/22/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The management of endodontic emergencies has been particularly challenging during the coronavirus disease 2019 (COVID-19) outbreak because of the possible generation of airborne particles and aerosols. The aim of this report was to contribute to the practice of endodontics by proposing a general protocol for the management of emergencies showing the rationale for remote diagnosis, clinical procedures, and the use of personal protective equipment and barriers at the dental office during the COVID-19 outbreak. METHODS A review of the literature was conducted up to May 2020 on relevant institutional sites, aiming to retrieve the best updated evidence. The reporting considered the Reporting Tool for Practice Guidelines in Health Care statement. RESULTS Recommendations from Cochrane Oral Health, the American Dental Association, and the Centers for Disease Control and Prevention were included along with the American Association of Endodontists resources and scientific articles that addressed the issue. CONCLUSIONS The proposed protocol could contribute to the management of endodontic emergencies at the dental office during the COVID-19 outbreak.
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Affiliation(s)
- Warley Oliveira Silva
- North of Minas United Faculty, Department of Endodontics, Ipatinga, Minas Gerais, Brazil
| | | | - Giselle Nevares
- Department of Endodontics, Center of Studies and Researches in Dentistry, João Pessoa, Paraíba, Brazil
| | - Renata Costa Val Rodrigues
- North of Minas United Faculty, Department of Endodontics, Ipatinga, Minas Gerais, Brazil; Faculty of Dentistry, Department of Endodontics, Veiga de Almeida University, Rio de Janeiro, Brazil
| | | | - Andréa Vaz Braga Pintor
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bernardo Mattos Almeida
- North of Minas United Faculty, Department of Endodontics, Ipatinga, Minas Gerais, Brazil; Faculty of Dentistry, Department of Endodontics, Estácio de Sá University, Rio de Janeiro, Brazil.
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15
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Silva EJNL, Zanon M, Hecksher F, Belladonna FG, de Vasconcelos RA, Fidalgo TKDS. Influence of autoclave sterilization procedures on the cyclic fatigue resistance of heat-treated nickel-titanium instruments: a systematic review. Restor Dent Endod 2020; 45:e25. [PMID: 32483542 PMCID: PMC7239677 DOI: 10.5395/rde.2020.45.e25] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/01/2020] [Accepted: 01/08/2020] [Indexed: 01/05/2023] Open
Abstract
Objectives This systematic review evaluated the influence of autoclave sterilization procedures on the cyclic fatigue resistance of heat-treated nickel-titanium (NiTi) instruments. Materials and Methods A systematic search without restrictions was conducted in the following electronic databases: PubMed, Scopus, Web of Science, ScienceDirect, Cochrane, and Open Grey. The hand search was also performed in the main endodontic journals. The eligible studies were submitted to the methodological assessment and data extraction. Results From 203 abstracts, a total of 10 articles matched the eligible criteria. After reading the full articles, 2 were excluded because of the absence of the heat-treated instruments in the experimental design and 3 due to the lack of a control group using heat-treated instruments without autoclave sterilization. From the 5 included studies, 1 presented a low risk of bias, 3 presented moderate and 1 high risk. It was observed heterogeneous findings in the included studies, with autoclave sterilization cycles increasing, decreasing or not affecting the cyclic fatigue life of heat-treated NiTi instruments. However, the retrieved studies evaluating the cyclic fatigue resistance of endodontic instruments presented different protocols and assessing outcomes, this variability makes the findings less comparable within and also between groups and preclude the establishment of an unbiased scientific evidence base. Conclusions Considering the little scientific evidence and considerable risk of bias, it is still possible to conclude that autoclave sterilization procedures appear to influence the cyclic fatigue resistance of heat-treated NiTi instruments.
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Affiliation(s)
- Emmanuel João Nogueira Leal Silva
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Duque de Caxias, RJ, Brazil.,Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil.,Department of Endodontics, School of Dentistry, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - Mayara Zanon
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Duque de Caxias, RJ, Brazil
| | - Fernanda Hecksher
- Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Duque de Caxias, RJ, Brazil
| | | | | | - Tatiana Kelly da Silva Fidalgo
- Department of Preventive and Community Dentistry, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
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16
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Salas H, Vieira GCS, Palomino I, Valero J, Pacheco-Yanes J, Campello AF, Pérez AR. Outcome of endodontic treatment with chlorhexidine gluconate as main irrigant: A case series. AUST ENDOD J 2020; 46:307-314. [PMID: 32154646 DOI: 10.1111/aej.12401] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2020] [Indexed: 11/27/2022]
Abstract
This study evaluated the overall endodontic therapy success using 0.12% or 2% chlorhexidine gluconate as main irrigant. Seventy-two teeth diagnosed as vital, necrotic or previously treated teeth with apical periodontitis that were consecutively treated by orthograde therapy. All cases were followed clinically and radiographically for at least 1-year period. Success was established in teeth without signs or adverse clinical symptoms and complete or incomplete radiographic healing. Failure was determined in teeth with any sign or adverse clinical symptoms and a new, unchanged or enlarged radiographic periapical lesion. The data were analysed using chi-square and Fischer's exact tests. The overall success rate for teeth undergoing vital pulp was 84.6%, 76.2% as for the necrotic teeth and 84% for the retreatment cases. No significant differences were observed between groups (P > 0.05). Cases treated with CHX as main irrigant showed a high overall endodontic therapy success rate.
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Affiliation(s)
- Hair Salas
- School of Dentistry of the Catholic University of Santa Maria, Arequipa, Perú
| | - Gaya C S Vieira
- Department of Endodontics and Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Brazil
| | - Ivo Palomino
- School of Dentistry of the Catholic University of Santa Maria, Arequipa, Perú
| | - Javier Valero
- School of Dentistry of the Catholic University of Santa Maria, Arequipa, Perú
| | - Juan Pacheco-Yanes
- Post-graduation Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | - Andrea F Campello
- Department of Endodontics and Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Brazil
| | - Alejandro R Pérez
- Department of Endodontics and Dental Research, Iguaçu University (UNIG), Nova Iguaçu, Brazil
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17
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Zandi H, Petronijevic N, Mdala I, Kristoffersen AK, Enersen M, Rôças IN, Siqueira JF, Ørstavik D. Outcome of Endodontic Retreatment Using 2 Root Canal Irrigants and Influence of Infection on Healing as Determined by a Molecular Method: A Randomized Clinical Trial. J Endod 2019; 45:1089-1098.e5. [DOI: 10.1016/j.joen.2019.05.021] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 05/15/2019] [Accepted: 05/28/2019] [Indexed: 11/30/2022]
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18
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Effectiveness of passive ultrasonic irrigation on periapical healing and root canal disinfection: a systematic review. Br Dent J 2019; 227:228-234. [DOI: 10.1038/s41415-019-0532-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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19
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De-Deus G, Belladonna FG, Zuolo AS, Cavalcante DM, Carvalhal JCA, Simões-Carvalho M, Souza EM, Lopes RT, Silva EJNL. XP-endo Finisher R instrument optimizes the removal of root filling remnants in oval-shaped canals. Int Endod J 2019; 52:899-907. [PMID: 30663790 DOI: 10.1111/iej.13077] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/16/2019] [Indexed: 01/06/2023]
Abstract
AIM To evaluate the performance of XP-endo Finisher R instruments when removing root filling remnants from oval-shaped canals using microcomputed tomographic (micro-CT) imaging as the analytical tool. Passive ultrasonic irrigation (PUI) was used as a reference technique for comparison. METHODOLOGY Twenty mandibular incisors with oval-shaped canals were matched based on similar anatomic features of the canal (volume, aspect ratio and 3D configuration) after scanning procedures. The canals were prepared with Reciproc R25 instruments, filled with gutta-percha and AH Plus sealer using the single-cone technique and retreated up to a Reciproc R40 instrument. After retreatment procedures, the specimens were rescanned, and the homogeneity between the specimens, the oval-shaped anatomy and the remaining filling material were confirmed. The pair-matched samples were assigned to two experimental groups (n = 10), according to the supplementary approach used: XP-endo Finisher R or PUI. Each sample was scanned after each endodontic procedure. The volume of remaining root filling material was quantified before and after the use of each supplementary approach. This analysis was performed considering the total canal (Student t-test) and also by thirds (anova procedure followed by a Bonferroni correction). Data were analysed statistically with a significance level of 5%. RESULTS The volume of root filling material at baseline was similar between the groups (t-test, P = 0.787). XP-endo Finisher R removed significantly more root filling material compared to PUI (t-test, P = 0.015), as it removed a mean of ≅32% material compared to 12% for the PUI. There was no difference in the amount of root filling material removed in the root canal thirds after using both supplementary approaches (one-way anova, P = 0.07 for XP-endo Finisher R and P = 0.886 for PUI). CONCLUSIONS Both supplementary approaches significantly reduced the volume of remaining root filling material from oval-shaped canals. The XP-endo Finisher R instrument removed significantly more root filling material than PUI. None of the supplementary approaches was able to render oval-shaped canals completely free from remaining root filling material.
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Affiliation(s)
- G De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - F G Belladonna
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - A S Zuolo
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - D M Cavalcante
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - J C A Carvalhal
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - M Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - E M Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - R T Lopes
- Nuclear Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - E J N L Silva
- Department of Endodontics, Grande Rio University, Duque de Caxias, Rio de Janeiro, Brazil
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20
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Siqueira Junior JF, Rôças IDN, Marceliano-Alves MF, Pérez AR, Ricucci D. Unprepared root canal surface areas: causes, clinical implications, and therapeutic strategies. Braz Oral Res 2018; 32:e65. [PMID: 30365606 DOI: 10.1590/1807-3107bor-2018.vol32.0065] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 06/06/2018] [Indexed: 11/21/2022] Open
Abstract
Chemomechanical preparation is intended to clean, disinfect, and shape the root canal. This step is of utmost importance during treatment of infected teeth with apical periodontitis, because treatment outcome depends on how effectively the clinician eliminates bacteria, their products, and necrotic tissue that would serve as substrate for bacterial regrowth. Nonetheless, curvatures and complex internal anatomical variations of the root canal system can pose a high degree of difficulty in reaching these goals. In infected teeth, bacteria may persist not only in difficult-to-reach areas such as isthmuses, ramifications, dentinal tubules, and recesses from C-shaped or oval/flattened canals, but also in areas of the main canal wall that remain untouched by instruments. If bacteria withstand chemomechanical procedures, there is an augmented risk for post-treatment apical periodontitis. This article discloses the reasons why some areas remain unprepared by instruments and discusses strategies to circumvent this issue and enhance infection control during endodontic treatment/retreatment of teeth with apical periodontitis.
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Affiliation(s)
| | - Isabela das Neves Rôças
- Universidade Estácio de Sá, Faculty of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
| | | | - Alejandro Ron Pérez
- Universidade Estácio de Sá, Faculty of Dentistry, Department of Endodontics, Rio de Janeiro, RJ, Brazil
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21
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Arruda ME, Neves MA, Diogenes A, Mdala I, Guilherme BP, Siqueira JF, Rôças IN. Infection Control in Teeth with Apical Periodontitis Using a Triple Antibiotic Solution or Calcium Hydroxide with Chlorhexidine: A Randomized Clinical Trial. J Endod 2018; 44:1474-1479. [DOI: 10.1016/j.joen.2018.07.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/28/2018] [Accepted: 07/02/2018] [Indexed: 01/03/2023]
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22
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Vieira GC, Antunes HS, Pérez AR, Gonçalves LS, Antunes FE, Siqueira JF, Rôças IN. Molecular Analysis of the Antibacterial Effects of Photodynamic Therapy in Endodontic Surgery: A Case Series. J Endod 2018; 44:1593-1597. [DOI: 10.1016/j.joen.2018.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 05/23/2018] [Accepted: 06/18/2018] [Indexed: 02/04/2023]
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23
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In vitro evaluation by quantitative real-time PCR and culturing of the effectiveness of disinfection of multispecies biofilms in root canals by two irrigation systems. Clin Oral Investig 2018; 23:913-920. [DOI: 10.1007/s00784-018-2515-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/04/2018] [Indexed: 01/11/2023]
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24
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Xavier F, Nevares G, Gominho L, Rodrigues R, Cassimiro M, Romeiro K, Albuquerque D. Bacterial Reduction after Gutta-Percha Removal with Single vs. Multiple Instrument Systems. IRANIAN ENDODONTIC JOURNAL 2018; 13:176-180. [PMID: 29707011 PMCID: PMC5911290 DOI: 10.22037/iej.v13i2.17505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Introduction: The aim of this study was to evaluate the effectiveness of a reciprocating single-instrument system (Reciproc-REC) compared with combined continuously rotating multiple-instrument systems [D-Race (DR) and BioRace (BR)] in reducing Enterococcus faecalis (E.f.) after gutta-percha removal. Methods and Materials: Forty-six extracted human maxillary incisors were prepared and contaminated with E.f. strain (ATCC 29212) for 30 days. The samples were obturated and randomly divided into two experimental groups for gutta-percha removal (n=23): a REC group (R50) and a DR/BR group (DR1, DR2 and BR6). A standardized irrigation with 0.9% saline solution was performed. Root canal samples were taken with paper points before (S1) and after (S2) the removal of gutta-percha to establish bacterial quantification by culture. The time required for gutta-percha removal was also recorded. Positive and negative control groups (n=6) were used to test bacterial viability and control asepsis, respectively. Data were analysed using t-Student and one-way ANOVA tests (5% margin of error). Results: The mean percentage of bacterial reduction was significantly higher in DR/BR group (84.2%) than in REC group (72.3%) (P<0.05). The mean time for obturation removal was 74.00 sec in REC group and 107.53 sec in DR/BR group (P<0.05). Conclusion: The combined continuously rotating multiple-instrument system was more effective in reducing bacteria after the removal of gutta-percha than the single-instrument system. None of the tested systems was able to completely eliminate root canal infection after gutta-percha removal. Thus, additional techniques should be considered.
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Affiliation(s)
- Felipe Xavier
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Pernambuco, Brazil
| | - Giselle Nevares
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Pernambuco, Brazil
| | - Luciana Gominho
- Department of Endodontics, Federal University of Campina Grande, Campina Grande, Brazil
| | - Renata Rodrigues
- Molecular Microbiology Laboratory, Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcely Cassimiro
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Pernambuco, Brazil
| | - Kaline Romeiro
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Pernambuco, Brazil
| | - Diana Albuquerque
- Department of Operative Dentistry and Endodontics, Dental College of Pernambuco, University of Pernambuco, Pernambuco, Brazil
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25
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Microbial Analysis of Endodontic Infections in Root-filled Teeth with Apical Periodontitis before and after Irrigation Using Pyrosequencing. J Endod 2018; 44:372-378. [DOI: 10.1016/j.joen.2017.11.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 10/10/2017] [Accepted: 11/20/2017] [Indexed: 01/01/2023]
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26
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Frequency and levels of candidate endodontic pathogens in acute apical abscesses as compared to asymptomatic apical periodontitis. PLoS One 2018; 13:e0190469. [PMID: 29293651 PMCID: PMC5749828 DOI: 10.1371/journal.pone.0190469] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 12/17/2017] [Indexed: 02/05/2023] Open
Abstract
Introduction Acute apical abscess is caused by bacteria that leave the infected dental root canal to invade the periodontal tissues. Most species occurring in abscesses are also found in asymptomatic infections; therefore, the possibility exists that not only the presence of certain species but also their specific counts influence the appearance of symptoms. This molecular study compared the frequency and levels of several candidate endodontic pathogens in teeth with acute apical abscesses and asymptomatic apical periodontitis. Methods Samples were taken from the root canals of teeth with asymptomatic apical periodontitis (n = 73) and by aspiration of purulent exudate from acute abscesses (n = 55). DNA was extracted from samples and bacterial identifications were performed by a closed-ended semi-quantitative reverse-capture checkerboard approach targeting 40 bacterial species/phylotypes. Results Bacterial DNA was detected in all cases. In abscesses, the most prevalent taxa were Fusobacterium nucleatum (60%), Porphyromonas endodontalis (53%), Parvimonas micra (51%), and Streptococcus species (45%). The most frequently detected taxa in asymptomatic teeth were P. endodontalis (63%), Dialister invisus (58%), Olsenella uli (56%), and F. nucleatum (51%). None of the targeted taxa were significantly associated with abscesses when only mere presence was evaluated (p>0.05). However, semi-quantitative data demonstrated that P. endodontalis, Prevotella baroniae, Treponema denticola and Streptococcus species were significantly more frequent at levels >105 in abscesses than in asymptomatic cases (p<0.05). Conclusion None of the target species/phylotypes were associated with abscesses in terms of frequency. However, some taxa were significantly found in higher levels in abscesses. Presence of a potentially virulent pathogen in high counts may increase the collective pathogenicity of the bacterial community and give rise to symptoms.
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Andrade-Junior CV, Neto ND, Rodrigues RCV, Antunes HDS, Porpino MTM, Carvalhal JCA, Armada L. Transportation Assessment in Simulated Curved Canals after preparation with Twisted File Adaptive and BT-Race instruments. J Clin Exp Dent 2017; 9:e1136-e1140. [PMID: 29075417 PMCID: PMC5650217 DOI: 10.4317/jced.54220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 08/09/2017] [Indexed: 11/25/2022] Open
Abstract
Background This study compared the incidence of deviation along curved canals after preparation with two nickel-titanium (NiTi) rotary systems, Twisted File Adaptive and BT-RaCe. Material and Methods Forty resin training blocks with curved canals were filled with ink and divided into two groups according to the instrumentation technique. Preinstrumentation images were acquired by using a stereomicroscope. The canals were up to an instrument #35/0.04. Postinstrumentation images were captured using the same conditions, and the images were superimposed. The amount of resin removed was measured at 8 different points, beginning at the apical terminus of the canal. Differences in the mesial and distal aspects were measured to evaluate the occurrence of deviation. The Student’s-t test was used for comparison of the intragroup deviation. Intergroup analysis was performed by using one-way ANOVA for each level. For multiple comparisons, the Bonferroni test was used and a cutoff for significance was set at 5%. Results Intragroup analysis showed that both instrumentation techniques promoted some deviation at all levels. BT-RaCe showed significantly lower deviation at 0 and 4-mm levels than Group Twisted File Adaptive (p<0.05). On the other hand BT-RaCe showed worse performance at level 6. Conclusions The results of this study demonstrated that none of the NiTi tested systems was able to instrument curved canals simulated in resin blocks without some deviation during the preparation. There is still need for improvement in the instruments manufacturing aiming the better performance of endodontic files in curved root canals. Key words:BT-RaCe, Curved root canals, Deviation, Twisted File Adaptive.
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Affiliation(s)
- Carlos-Vieira Andrade-Junior
- PhD, Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil.,PhD, Department of Health, Dentistry Division, Southwest State University of Bahia, Jequié,BA, Brazil
| | - Nilton-Dessaune Neto
- PhD, Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil
| | - Renata-Costa-Val Rodrigues
- PhD, Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil
| | | | | | - Júlio-Cesar A Carvalhal
- PhD, Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil
| | - Luciana Armada
- PhD, Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, RJ, Brazil
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Bıçakcı H, Çapar İD, Genç S, İhtiyar A, Sütçü R. Influence of Rotary Instrumentation with Continuous Irrigation on Pain and Neuropeptide Release Levels: A Randomized Clinical Trial. J Endod 2017; 42:1613-1619. [PMID: 27788771 DOI: 10.1016/j.joen.2016.08.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 08/03/2016] [Accepted: 08/11/2016] [Indexed: 01/24/2023]
Abstract
INTRODUCTION The first objective was to determine correlation among various experimental and clinical pain measurement procedures. The second objective was to evaluate the influence of rotary instrumentation with continuous irrigation on pain and neuropeptide release levels. METHODS Forty patients who had preoperative pain at the levels of 3-8 on the visual analogue scale were included. Gingival crevicular fluid (GCF) samples were collected. Patients were randomly assigned to 2 treatment groups, the standard preparation group and the preparation with continuous irrigation group. Apical fluid samples (AFS) were collected after instrumentation. In the second visit, the patients' pain levels were recorded, and GCF and AFS were obtained. Substance P, calcitonin-gene related peptide (CGRP), interleukin (IL)-1β, and IL-10 levels were analyzed from the GCF and AFS samples. For comparison between groups, the Mann-Whitney test was used (P < .05). RESULTS In terms of clinical data, no significant difference was detected in the first and second sessions between groups. The IL-10 level obtained from AFS significantly decreased in the second session in both groups (P < .001). Visual analogue scale scores of spontaneous pain correlated with percussion pain positively (r = 0.718, P < .001). CGRP (GCF) (second session) and IL-10 (GCF) (second session) positively correlated with percussion pain (r = 0.425, P < .01) (r = 0.379, P < .05). CONCLUSIONS Rotary preparation with continuous irrigation has not been more effective than the standard preparation method for reducing pain. Because of determination of the correlation between CGRP and IL-10 with percussion pain, these neuropeptides can be used in further studies.
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Affiliation(s)
| | | | - Selin Genç
- Department of Periodontology, Faculty of Dentistry, İzmir Katip Çelebi University, İzmir, Turkey
| | - Alperen İhtiyar
- Department of Biochemistry and Clinical Biochemistry, School of Medicine, İzmir Katip Çelebi University, İzmir, Turkey
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Rodrigues RCV, Zandi H, Kristoffersen AK, Enersen M, Mdala I, Ørstavik D, Rôças IN, Siqueira JF. Influence of the Apical Preparation Size and the Irrigant Type on Bacterial Reduction in Root Canal–treated Teeth with Apical Periodontitis. J Endod 2017; 43:1058-1063. [DOI: 10.1016/j.joen.2017.02.004] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 02/05/2017] [Accepted: 02/07/2017] [Indexed: 11/30/2022]
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Zandi H, Rodrigues RC, Kristoffersen AK, Enersen M, Mdala I, Ørstavik D, Rôças IN, Siqueira JF. Antibacterial Effectiveness of 2 Root Canal Irrigants in Root-filled Teeth with Infection: A Randomized Clinical Trial. J Endod 2016; 42:1307-13. [DOI: 10.1016/j.joen.2016.06.006] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 06/07/2016] [Accepted: 06/09/2016] [Indexed: 02/02/2023]
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Silva EJNL, Ferreira VM, Silva CC, Herrera DR, De-Deus G, Gomes BP. Influence of apical enlargement and complementary canal preparation with the Self-Adjusting File on endotoxin reduction in retreatment cases. Int Endod J 2016; 50:646-651. [DOI: 10.1111/iej.12677] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 07/08/2016] [Indexed: 12/17/2022]
Affiliation(s)
- E. J. N. L. Silva
- Department of Endodontics; School of Dentistry; Grande Rio University (UNIGRANRIO); Duque de Caxias RJ Brazil
| | - V. M. Ferreira
- Department of Endodontics; School of Dentistry; Grande Rio University (UNIGRANRIO); Duque de Caxias RJ Brazil
| | - C. C. Silva
- Department of Endodontics; School of Dentistry; Grande Rio University (UNIGRANRIO); Duque de Caxias RJ Brazil
| | - D. R. Herrera
- Department of Endodontics; Campinas State University (UNICAMP); Piracicaba SP Brazil
| | - G. De-Deus
- Department of Endodontics; School of Dentistry; Grande Rio University (UNIGRANRIO); Duque de Caxias RJ Brazil
| | - B. P. Gomes
- Department of Endodontics; Campinas State University (UNICAMP); Piracicaba SP Brazil
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Rôças IN, Provenzano JC, Neves MA, Siqueira JF. Disinfecting Effects of Rotary Instrumentation with Either 2.5% Sodium Hypochlorite or 2% Chlorhexidine as the Main Irrigant: A Randomized Clinical Study. J Endod 2016; 42:943-7. [DOI: 10.1016/j.joen.2016.03.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 03/24/2016] [Accepted: 03/25/2016] [Indexed: 01/28/2023]
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Figdor D, Brundin M. Contamination Controls for Analysis of Root Canal Samples by Molecular Methods: An Overlooked and Unsolved Problem. J Endod 2016; 42:1003-8. [PMID: 27236203 DOI: 10.1016/j.joen.2016.04.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 04/18/2016] [Accepted: 04/19/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION It has been almost 20 years since molecular methods were first described for the analysis of root canal microbial flora. Contamination control samples are essential to establish DNA decontamination before taking root canal samples, and this review assessed those studies. METHODS Using PubMed, a search was conducted for studies using molecular microbial analysis for the investigation of endodontic samples. Studies were grouped according to the cleaning protocol, acquisition methods, and processing of control samples taken to check for contamination. RESULTS Of 136 studies applying molecular analysis to root canal samples, 21 studies performed surface cleaning and checking nucleotide decontamination with contamination control samples processed by polymerase chain reaction. Only 1 study described disinfection, sampling from the access cavity, and processing by polymerase chain reaction and reported the result; that study reported that all samples contained contaminating bacterial DNA. CONCLUSIONS Cleaning, disinfection, and checking for contamination are basic scientific prerequisites for this type of investigation; yet, this review identifies it as an overlooked issue. On the basis of this review, we call for improved scientific practice in this field.
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Affiliation(s)
- David Figdor
- Department of Microbiology, Monash University, Melbourne, Australia
| | - Malin Brundin
- Department of Odontology/Endodontics, Faculty of Medicine, Umeå University, Umeå, Sweden.
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Gonçalves LS, Rodrigues RCV, Andrade Junior CV, Soares RG, Vettore MV. The Effect of Sodium Hypochlorite and Chlorhexidine as Irrigant Solutions for Root Canal Disinfection: A Systematic Review of Clinical Trials. J Endod 2016; 42:527-32. [PMID: 26852149 DOI: 10.1016/j.joen.2015.12.021] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 11/26/2015] [Accepted: 12/22/2015] [Indexed: 02/02/2023]
Abstract
INTRODUCTION This systematic review aimed to compare the effectiveness of sodium hypochlorite and chlorhexidine for root canal disinfection during root canal therapy. METHODS A literature search for clinical trials was made on the PubMed (MEDLINE), Web of Knowledge, SCOPUS, and Science Direct databases and in the reference lists of the identified articles up to January 2015. Quality assessment of the selected studies was performed according to the Consolidated Standards of Reporting Trials statement. RESULTS One clinical trial and 4 randomized clinical trials were selected from the 172 articles initially identified. There was heterogeneity in the laboratory methods used to assess the root canal disinfection as well as in the concentrations of the irrigants used. Therefore, meta-analysis was not performed. Two studies reported effective and similar reductions in bacterial levels for both irrigants. Sodium hypochlorite was more effective than chlorhexidine in reducing microorganisms in 1 study, and another reported opposite findings. Both root irrigants were ineffective in eliminating endotoxins from necrotic pulp root canals in 1 study. Trial design and information regarding randomization procedures were not clearly described in the clinical trials. No study compared laboratory results with clinical outcomes. CONCLUSIONS The available evidence on this topic is scarce, and the findings of studies were not consistent. Additional randomized clinical trials using clinical outcomes to compare the use of sodium hypochlorite and chlorhexidine during root canal therapy are needed.
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Affiliation(s)
- Lucio Souza Gonçalves
- Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Renata Costa Val Rodrigues
- Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Endodontics, Faculty of Dentistry, Veiga de Almeida University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carlos Vieira Andrade Junior
- Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Health, Dentistry Division, Southwest State University of Bahia, Jequié, Bahia, Brazil
| | - Renata G Soares
- Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mario Vianna Vettore
- Unit of Dental Public Health, School of Clinical Dentistry, University of Sheffield, Sheffield, England
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Mohammadi Z, Shalavi S, Giardino L, Palazzi F, Asgary S. Impact of Ultrasonic Activation on the Effectiveness of Sodium Hypochlorite: A Review. IRANIAN ENDODONTIC JOURNAL 2015; 10:216-20. [PMID: 26525646 PMCID: PMC4609656 DOI: 10.7508/iej.2015.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Using ultrasonic devices in endodontics can enhance the antibacterial and tissue dissolving ability of different root canal irrigants such as sodium hypochlorite (NaOCl) which is the most common irrigant with excellent antibacterial and tissue dissolving abilities. However, due to its high surface tension, its penetration into the irregularities of the root canal system is a challenge. The purpose of this paper was to review the different ultrasonic devices, different types of ultrasonic irrigation, the effect(s) of ultrasonic activation on the antibacterial and biofilm-removal abilities of NaOCl as well as the effect of ultrasonic activation on the smear layer removal ability of NaOCl.
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Affiliation(s)
- Zahed Mohammadi
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran; ; Iranian National Elites Foundation, Tehran, Iran
| | | | - Luciano Giardino
- Department of Periodontology, Endodontology, Pharmacology and Microbiology, Dental School, University of Brescia, Italy
| | - Flavio Palazzi
- Department of Odontostomatological and Maxillofacial Sciences, Federico II University of Naples, Italy
| | - Saeed Asgary
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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