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Kaşıkçı S, Türker SA, Güven B. Effect of different retreatment files using different kinematics on the release of inflammatory mediators in root canal retreatment of single-rooted teeth: a randomized clinical trial. Clin Oral Investig 2023:10.1007/s00784-023-04930-6. [PMID: 36856848 DOI: 10.1007/s00784-023-04930-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 02/22/2023] [Indexed: 03/02/2023]
Abstract
OBJECTIVES This randomized clinical trial aimed to evaluate the effect of two rotaries (ProTaper Universal Retreatment (PTUR)), D-Race (DR) + XP-Endo Finisher R (XPFR) and one reciprocating (Reciproc Blue (RB) retreatment techniques on the release of neuropeptides (Substance P, calcitonin gene-related peptide (CGRP)), and cytokines (IL-6 and IL-10) in periapical fluid in root canal retreatment of single-rooted teeth. MATERIALS AND METHODS In this randomized clinical trial (ClinicalTrials.gov ID: NCT05039502), seventy-five patients scheduled for retreatment were randomly divided into 3 groups according to the file system used to remove root canal filling materials (n = 25): PTUR, RB, and DR + XPFR. After reshaping and disinfection of the root canals, periapical fluid samples were taken, and the levels of Substance P, CGRP, IL-6, and IL-10 were measured by enzyme-linked immunosorbent assay (ELISA) test. Data were analyzed using the Kruskal-Wallis and chi-square tests. The level of significance was set as p = 0. 05. RESULTS All the allocated participants received the intervention and were analyzed. There was no statistically significant difference among groups in terms of gender, age, tooth localization, and the distribution of analgesic use after treatment (p values 0.799, 0.095, 0.637, 1.000, respectively). No statistically significant difference was found in terms of the levels of Substance P, CGRP, and IL-10 among groups (p > .05), except IL-6. CONCLUSIONS PTUR, RB, and DR + XPFR files have comparable results in the expression of inflammatory mediators. CLINICAL RELEVANCE Retreatment files powered with rotary or reciprocating motion produced similar neuropeptide and cytokine levels in patients.
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Affiliation(s)
- Sena Kaşıkçı
- Department of Endodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Sevinç Aktemur Türker
- Department of Endodontics, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.
| | - Berrak Güven
- Department of Biochemistry, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
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Bhardwaj A, Gupta RK, Ates AA, Wahjuningrum DA, Arıcan B, AlOmari T, Luke AM, Pawar AM. Comparison of Postoperative Pain After the Utilization of Different File Systems in Single Visit Endodontics. Patient Prefer Adherence 2023; 17:1025-1034. [PMID: 37090182 PMCID: PMC10115180 DOI: 10.2147/ppa.s405723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/30/2023] [Indexed: 04/25/2023] Open
Abstract
Purpose This prospective single-blind, parallel-group, randomized clinical trial was aimed to compare the effect of three different rotary instrumentation systems ProTaper Next (PTN), Self-Adjusting File (SAF) and XP-endo Shaper (XPS) on postoperative pain and analgesic intakes. Patients and Methods A total of 159 molars diagnosed with symptomatic irreversible pulpitis were randomly divided into three study groups according to the instrumentation techniques: PTN (n = 54), SAF (n = 52), and XPS (n = 53). The preoperative pain scores were taken before the onset of treatment in the groups. After a single appointment for root canal treatment, the patients were asked to rate the level of their pain according to the Visual Analog Scale (VAS) of 100 mm at 6, 24, 48, and 72-hour post-treatment intervals. Ibuprofen was prescribed to be taken while experiencing pain; patients were requested to note the number of pills consumed at intervals after treatment. Results The patients in SAF and XPS groups had lower mean VAS scores than the PTN group at 24-, 48-, and 72-hour intervals (p < 0.05). The most common analgesic intake was optimally seen in the PTN group at a 6-hour interval. All shaping procedures caused postoperative pain, whose intensity decreased with time. Conclusion The SAF and XPS groups had a lesser intensity of pain as well as minimum analgesic intakes as compared to the PTN group. All instrumentation systems moderately caused pain, and the PTN group experienced the highest pain among others.
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Affiliation(s)
- Anuj Bhardwaj
- Department of Conservative Dentistry and Endodontics, College of Dental Science and Hospital, Indore, India
- Department of Conservative Dentistry, Universitas Airlangga, Surabaya, Indonesia
| | - Rudra Kumar Gupta
- Department of Conservative Dentistry and Endodontics, College of Dental Science and Hospital, Indore, India
| | - Ayfer Atav Ates
- Department of Endodontics, Istinye University, Faculty of Dentistry, Istanbul, Turkey
| | - Dian Agustin Wahjuningrum
- Department of Conservative Dentistry, Universitas Airlangga, Surabaya, Indonesia
- Correspondence: Dian Agustin Wahjuningrum, Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia, Email
| | - Burçin Arıcan
- Department of Endodontics, Bahçeşehir University, School of Dental Medicine, Istanbul, Turkey
| | - Taher AlOmari
- Department of Conservative Dentistry, Jordan University of Science and Technology, Al-Ramtha, Jordan
| | - Alexander Maniangat Luke
- Department of Clinical Science, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Alexander Maniangat Luke, Department of Clinical Science, College of Dentistry, Ajman University, J1 Building C Block, Al-Jurf 346, Ajman, United Arab Emirates, Email
| | - Ajinkya M Pawar
- Department of Conservative Dentistry, Universitas Airlangga, Surabaya, Indonesia
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, 400008, India
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Quantitative Assessment of Apically Extruded Debris after Single-Files Supplemental Retreatment considering Apical Patency Influence: In Vitro Study. Int J Biomater 2022; 2022:7544813. [PMID: 36589768 PMCID: PMC9797296 DOI: 10.1155/2022/7544813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/05/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
Objective This study aims to assess the impact of re-establishing apical patency on the quantity of debris extruded through the apex after three supplementary retreatment files (TruNatomy (TRN), WaveOne Gold (WOG), and XP endo Finisher R (XPFR)). Materials and Methods Eighty single-rooted mandibular premolars were prepared with ProTaper Universal rotary systems (PTU) up to F3 and obturated. The samples were divided into two main groups according to the presence or absence of the apical patency (n = 40), GI with apical patency and GII without apical patency. Based on the file system, which was adopted to eliminate the previous filling, each group had four subgroups (n = 10). In GI PTUR and GII PTUR, ProTaper Universal retreatment files (PTUR) were utilized only to remove the most primary filling material (control groups). In the other groups (PTUR) used, it was first followed by supplementary files. The quantity of debris extruded by different retreatment file systems was determined and compared to the corresponding control group with or without apical patency. Data were analyzed using a two-way ANOVA with a post hoc Tukey's multiple comparison test at a 5% significance level. Results There was a statistically significant difference among the control and experimental groups. XPFR had the least quantity of extruded debris. Apical patency did not affect the debris extrusion. Conclusion All tested files led to a significant apical debris extrusion regardless of apical patency.
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Elzainy P, Hussein W, Hashem A, Badr M. Post-operative Pain after Different Root Canal Irrigant Activation Methods in Patients with Acute Apical Periodontitis (Randomized Clinical Trial). Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective To evaluate the degree of postoperative pain in patients with necrotic teeth with symptomatic apical periodontitis after applying ultrasonic irrigation or manual dynamic agitation.
Methods Seventy-eight patients diagnosed with necrotic mandibular first molar with symptomatic apical periodontitis were randomly allocated into 1 of 3 separate groups (n=26); Manual Dynamic Agitation group, Ultra X group, or NaviTip group (control). After a single-visit root canal treatment and a specific method of agitation, depending on each group, the patients were given a questionnaire on which they would mark the degree of pain in a scale from 0 to 10 at 6, 12, 24, 48, 72 hours and 7 days post-operative. Data were statistically analyzed with a significance level of P ≤ 0.05.
Results Final irrigation protocol including Ultrasonic agitation and NaviTip (control) groups showed significantly lower values of pain than the MDA group. There was a reduction in pain values by time in all groups.
Conclusion There was significantly less pain associated with passive ultrasonic agitation and side vented needle (NaviTip) irrigation compared to Manual Dynamic Agitation.
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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
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Sarwar H, Qazi F, Ahmed S, Abidi Y, Naeem M, Shabbir J, Khurshid Z. Efficacy of Handpiece Mounted Continuous Irrigation System for the Removal of Residual Pulpal Debris During Root Canal Preparation. Eur J Dent 2021; 15:551-556. [PMID: 33975373 PMCID: PMC8382463 DOI: 10.1055/s-0041-1726160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective
The removal of residual pulpal debris (RPD) from the root canal walls, especially in necrotic teeth is important for successful endodontic outcome. The aim of this study was to evaluate the RPD removal efficacy of handpiece mounted continuous irrigation with simultaneous root canal preparation from the apical third of root canals as compared to conventional syringe irrigation (SI).
Materials and Methods
Ninety extracted teeth were randomly divided into three groups: SI; handpiece mounted continuous irrigation (CI); and both syringe and continuous irrigation (CI+SI). After root canal preparation, roots were sectioned at 1 (a), 3 (b) and 5 (c) mm from apex and prepared for Hematoxylin-Eosin staining. Sections were microscopically examined for presence of RPD.
Statistical Analysis
Intergroup difference in average percentage of RPD at different root levels was calculated by using analysis of variance test (ANOVA). Tuckey test was used for pairwise comparison.
Results
ANOVA showed significant difference between all three groups (
p
< 0.05). SI group showed a significantly higher percentage of RPD as compared with CI and CI+ SI groups at all root levels (
p
< 0.01). At root level a, CI showed a significantly higher percentage of RPD as compared with CI+SI (
p
< 0.01).
Conclusion
Handpiece mounted CI during rotary instrumentation showed a significant reduction in RPD as compared with conventional syringe irrigation. This technique was found to be an effective method for an enhanced root canal debridement.
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Affiliation(s)
- Huma Sarwar
- Department of Operative Dentistry & Endodontics, Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan.,Department of Periodontology, Dr Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Fazal Qazi
- Department of Operative Dentistry & Endodontics, Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan.,Department of Periodontology, Dr Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Shahbaz Ahmed
- Department of Operative Dentistry & Endodontics, Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan.,Department of Periodontology, Dr Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Yawar Abidi
- Department of Operative Dentistry & Endodontics, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Meshal Naeem
- Department of Operative Dentistry & Endodontics, Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan.,Department of Periodontology, Dr Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Juzer Shabbir
- Department of Operative Dentistry & Endodontics, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al Ahsa, Saudi Arabia
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Debris Extrusion Using Reciproc Blue and XP Endo Shaper Systems in Root Canal Retreatment. Int J Dent 2021; 2021:6697587. [PMID: 33833804 PMCID: PMC8012141 DOI: 10.1155/2021/6697587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 03/08/2021] [Accepted: 03/18/2021] [Indexed: 11/18/2022] Open
Abstract
This study aimed at assessing the performance of Reciproc Blue (RB) and XP Endo Shaper (XPS), used for canal retreatment on extracted teeth, in terms of debris extrusion and obturating materials removal. Thirty mandibular premolars were prepared to ProTaper X2 file, obturated using warm vertical compaction, and then incubated for 28 days at 100% humidity at 37°C. Teeth were randomly assigned into two groups, according to the system used for retreatment (RB and XPS). During retreatment, debris extruded beyond the apex was collected in preweighed Eppendorf tubes, and the retreatment time was measured. Afterward, the teeth were longitudinally sectioned to assess the remaining obturating materials. Data were statistically analyzed using the Mann-Whitney test and chi-square test at a 95% confidence level. All the samples had extruded debris at varying weights ranging from 0.125 mg to 3.680 mg. XPS extruded less debris than RB, but no difference was detected (Mann-Whitney test; P > 0.05). RB and XPS required 54.9 ± 17.9 and 22.3 ± 9.3 seconds to perform retreatment procedures, respectively (Mann-Whitney test; P < 0.05). The sealer was found in all the samples. Compared to the RB group, fewer samples with remaining gutta-percha were found in the XPS group (Chi-square test; P < 0.05). None of the files fractured during the retreatment procedure. The tested files appear to extrude debris beyond the apex. Although XPS was able to remove the gutta-percha completely from the majority of the canals, it was unable to remove the sealer.
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Bamini L, Anand Sherwood I, Abbott PV, Uthandakalaipandian R, Velu V. Influence of anti-inflammatory irrigant on substance P expression for single-visit root canal treatment of teeth with irreversible pulpitis. AUST ENDOD J 2019; 46:73-81. [PMID: 31270901 DOI: 10.1111/aej.12353] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2019] [Indexed: 11/28/2022]
Abstract
One of the main objectives of root canal treatment is to alleviate the pain associated with irreversibly inflamed pulps. However, some patients may have moderate to severe pain following treatment. The aim of this study was to compare and assess the effect of ketorolac tromethamine on substance P expression in the pulp and periapical tissues when used as a root canal irrigant for single-visit root canal treatment in teeth with irreversible pulpitis. Thirty-six patients were randomly allotted to three irrigant groups - saline (n = 14), 3% sodium hypochlorite (n = 11) and ketorolac tromethamine (n = 11). Pulp blood samples (S1) were collected on gaining access to the pulp, and periapical blood samples (S2) were collected after root canal preparation. Quantification of substance P was done by ELISA test. The ketorolac tromethamine group had greater reduction in substance P expression (S2). Post-operative pain levels were not significantly influenced by the different root canal irrigants.
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Affiliation(s)
- Lavanya Bamini
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences, Madurai, India
| | - I Anand Sherwood
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences, Madurai, India
| | - Paul V Abbott
- University of Western Australia, Perth, Western Australia, Australia
| | - Ramesh Uthandakalaipandian
- Department of Molecular Biology, School of Biological Sciences, Madurai Kamaraj University, Madurai, India
| | - Vijay Velu
- Department of Molecular Biology, School of Biological Sciences, Madurai Kamaraj University, Madurai, India
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Decurcio DA, Rossi-Fedele G, Estrela C, Pulikkotil SJ, Nagendrababu V. Machine-assisted Agitation Reduces Postoperative Pain during Root Canal Treatment: A Systematic Review and Meta-analysis from Randomized Clinical Trials. J Endod 2019; 45:387-393.e2. [DOI: 10.1016/j.joen.2019.01.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 01/07/2019] [Accepted: 01/15/2019] [Indexed: 11/30/2022]
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