1
|
Teulé-Trull M, Demiquels-Punzano E, Pérez RA, Aparicio C, Durán-Sindreu F, Sánchez-López E, González-Sánchez JA, Delgado LM. Revision of ex vivo endodontic biofilm model using computer aided design. J Dent 2024; 149:105270. [PMID: 39084546 DOI: 10.1016/j.jdent.2024.105270] [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: 06/10/2024] [Revised: 07/16/2024] [Accepted: 07/26/2024] [Indexed: 08/02/2024] Open
Abstract
OBJECTIVE Most endodontic diseases are bacterium-mediated inflammatory or necrotic process induced by contaminated dental pulp. Although great advances are being performed to obtain more efficient antibacterial strategies for persistent infections, most studies lack of representative models to test their antibacterial effects and their outcomes cannot be promptly translated to clinical practice. Therefore, this study aimed to refine an ex vivo endodontic biofilm model combining human tooth, computer guided design and 3D printing to obtain a more reproducible and predictable model. METHODS Monoradicular teeth were cut using three different methods: hand-held (HCC), mechanical precision (MPC) and computer aid guided cutting (CGC). Then, blocks were reassembled. The different model preparations were assessed in terms of dimensional tolerance, surface analysis, liquid tightness and Enterococcus faecalis biofilm development for 21 days, which was studied by metabolic assays and confocal microscopy. Then, the proposed model was validated using different commercial disinfecting treatments. RESULTS CGC exhibited significantly lower deviation and surface without defects compared to HHC and MPC, leading to superior liquid tightness. Similarly, mature biofilms with high metabolic activity and vitality were observed in all conditions, CGC showing the lowest variation. Regarding the model validation, all antibacterial treatments resulted in the complete eradication of bacteria in the standard 2D model, whereas commercial treatments exhibited varying levels of efficacy in the proposed ex vivo model, from moderately reduction of metabolic activity to complete elimination of biofilm. CONCLUSIONS The novel guided approach represents a more reliable, standardized, and reproducible model for the evaluation of endodontic disinfecting therapies. CLINICAL SIGNIFICANCE During antibacterial treatment development, challenging 3D models using teeth substrates to test antibacterial treatments novel guided approach represents a more reliable, standardized, and reproducible model for the evaluation of endodontic disinfecting therapies.
Collapse
Affiliation(s)
- Miriam Teulé-Trull
- Department of Endodontics, Faculty of Dentistry, Universitat Internacional de Catalunya, 08017, Barcelona, Spain
| | - Elena Demiquels-Punzano
- Bioengineering Institute of Technology (BIT), Universitat Internacional de Catalunya, 08017, Barcelona, Spain; Basic Sciences Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08017, Barcelona, Spain
| | - Román A Pérez
- Bioengineering Institute of Technology (BIT), Universitat Internacional de Catalunya, 08017, Barcelona, Spain; Basic Sciences Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08017, Barcelona, Spain
| | - Conrado Aparicio
- Basic and Translational Research Division, Faculty of Dentistry, Universitat Internacional de Catalunya, 08017, Barcelona, Spain; Institute for Bioengineering of Catalonia (IBEC), Barcelona Institute of Science and Technology (BIST), 08028, Barcelona, Spain
| | - Fernando Durán-Sindreu
- Department of Endodontics, Faculty of Dentistry, Universitat Internacional de Catalunya, 08017, Barcelona, Spain
| | - Elena Sánchez-López
- Department of Pharmacy, Pharmaceutical Technology and Physical Chemistry, University of Barcelona, 08028 Barcelona, Spain; Institute of Nanoscience and Nanotechnology (IN2UB), University of Barcelona, 08028 Barcelona, Spain
| | | | - Luis M Delgado
- Bioengineering Institute of Technology (BIT), Universitat Internacional de Catalunya, 08017, Barcelona, Spain; Basic Sciences Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08017, Barcelona, Spain.
| |
Collapse
|
2
|
Genc Sen O, Erdemir A. The Effectiveness of Three Different Irrigant Activation Methods in the Elimination of Enterococcus faecalis from Root Canals. Photobiomodul Photomed Laser Surg 2024. [PMID: 39007181 DOI: 10.1089/pho.2023.0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024] Open
Abstract
Background and Objective: Eliminating intracanal Enterococcus faecalis (E. faecalis) is challenging because of its ability to penetrate deep dentinal tubules and its high resistance to many chemicals. This study evaluated the effectiveness of conventional needle irrigation and three different irrigant activation methods in reducing E. faecalis. Methods: The root canals of extracted teeth were shaped, contaminated with E. faecalis, and incubated for three weeks. They were randomly allocated to four experimental groups of 15 teeth each according to the final irrigation method: group 1, conventional needle irrigation; group 2, passive ultrasonic (PU) irrigation; group 3, XP-endo Finisher (XPF); and group 4, laser-activated (LA) irrigation. Bacterial samples were taken and cultured before and after these final irrigation procedures. The colony-forming units were counted, and the bacterial reduction percentages of each group were calculated. The Kruskal-Wallis and Dunnet tests were used for statistical analysis. Results: All irrigant activation methods were significantly more effective than conventional needle irrigation. Although the LA group generated more negative samples than PU, there was no statistically significant difference between the LA and PU groups. LA was significantly more effective than the XPF, whereas PU and XPF were statistically similar. Conclusions: Within the limitations of this study, the final irrigation with LA and PU showed the best reductive effect on E. faecalis colonies. Considering that the LA group had more negative samples, it may be chosen as an alternative to enhance root canal disinfection, especially in difficult cases.
Collapse
Affiliation(s)
- Ozgur Genc Sen
- Dentistry Faculty, Department of Endodontics, Van Yuzuncu Yil University, Van, Turkey
| | | |
Collapse
|
3
|
Vieira WDA, de-Jesus-Soares A, Lopes EM, Gomes BPFA, Lima BP. Effect of supplementary sodium hypochlorite agitation techniques on an ex vivo oral multispecies biofilm during passive disinfection of simulated immature roots. Int Endod J 2024; 57:966-980. [PMID: 38387884 DOI: 10.1111/iej.14053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 02/24/2024]
Abstract
AIM To compare the effect of different sodium hypochlorite (NaOCl) agitation techniques on an ex vivo oral multispecies biofilm during passive disinfection of simulated immature roots. METHODOLOGY Extracted human teeth were prepared to simulate immature roots. They were infected with a dental plaque-derived multispecies biofilm and cultured for 14 days. The roots were randomly designated into four groups: (1) negative control (PBS), (2) 1.5% NaOCl (CNI), (3) CNI + Ultrasonic activation (UA), (4) CNI + EasyClean agitation (ECA), (5) CNI + XP-endo finisher agitation (XPF), and (6) positive control (6% NaOCl). Biofilm samples were collected from the root canals and used to determine the number of viable cells (colony-forming units), scanning electron microscopy, and 16S rRNA gene sequencing. The mean colony-forming units per mL (CFU/mL) were analysed using One-way anova. 16S rRNA sequencing data were analysed for alpha (observed OTUs, Shannon index, and Chao1) and beta diversity (Bray-Curtis dissimilarities). The LEfSe analysis was used to determine the effect of treatment procedures on the abundance of root canal microbiota. The significance was set at .05. RESULTS PBS and CNI samples had significantly higher CFU/mL counts than UA, ECA, XPF, and 6% NaOCl samples (p < .05). The pre-treatment, PBS, and CNI groups had significantly greater alpha diversity than the UA, ECA, XPF, and 6% NaOCl groups (p < .05). NaOCl agitation groups and the 6% NaOCl group achieved a more pronounced reduction in bacteria from the genera Fusobacterium, Actinomyces, Porphyromonas, and Capnocytophaga. CONCLUSIONS The effectiveness of passive disinfection protocols was enhanced by NaOCl agitation techniques, suggesting that this supplementary method can improve the outcome of revitalization procedures.
Collapse
Affiliation(s)
- Walbert de Andrade Vieira
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, Brazil
| | - Adriana de-Jesus-Soares
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, Brazil
| | - Erica M Lopes
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, Brazil
| | - Brenda P F A Gomes
- Division of Endodontics, Department of Restorative Dentistry, Piracicaba Dental School, Universidade Estadual de Campinas - UNICAMP, Piracicaba, Brazil
| | - Bruno P Lima
- Division of Basic Sciences, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
4
|
Nabeshima CK, Caballero-Flores H, Vicente EJ, Gavini G, Machado MEDL. Antibacterial ability of different activated irrigation after root canal preparation: intratubular analyses. Braz Dent J 2024; 35:e245883. [PMID: 38775594 PMCID: PMC11086613 DOI: 10.1590/0103-6440202405883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/15/2024] [Indexed: 05/25/2024] Open
Abstract
This study assessed the intratubular antibacterial ability of different activated irrigations after chemical mechanical preparation. Seventy-two palatal root canals of upper molars were infected with Enterococcus faecalis for 4 weeks, and then initial bacterial collection from the main root canal was performed. The root canals were prepared by using a WaveOne Gold large (45/.05) and distributed into 6 groups according to the activation of the final irrigation: ultrasonic activation (UA), XP-Endo Finisher (25/.00), XP Clean (25/.02), EasyClean (25/.04) in reciprocating motion and continuous rotary motion (ECRot), and conventional irrigation. After final irrigation, another bacterial collection from the main root canal was performed, and the root was sectioned transversely in three-thirds and stained for analysis by confocal laser microscopy. Intratubular bacteria were collected through dentin powder and plated for bacterial viability analysis. Intergroup and intragroup comparisons were performed by using analysis of variance and repeated measures analysis of variance, respectively, both at 5% significance. ECRot had higher antibacterial ability than UA (p<0.05), and both were superior to the other groups (p<0.05) in both methodologies. It can be concluded that activation of final irrigation enhances the disinfection of the root canal system, and activators have different efficacies.
Collapse
Affiliation(s)
- Cleber Keiti Nabeshima
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Hector Caballero-Flores
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Elisabete José Vicente
- Department of Microbiology, Institute of Biological Science, University of São Paulo, São Paulo, SP, Brazil
| | - Giulio Gavini
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | | |
Collapse
|
5
|
Zou X, Zheng X, Liang Y, Zhang C, Fan B, Liang J, Ling J, Bian Z, Yu Q, Hou B, Chen Z, Wei X, Qiu L, Chen W, He W, Xu X, Meng L, Zhang C, Chen L, Deng S, Lei Y, Xie X, Wang X, Yu J, Zhao J, Shen S, Zhou X, Yue L. Expert consensus on irrigation and intracanal medication in root canal therapy. Int J Oral Sci 2024; 16:23. [PMID: 38429299 PMCID: PMC10907616 DOI: 10.1038/s41368-024-00280-5] [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: 11/05/2023] [Revised: 12/22/2023] [Accepted: 01/03/2024] [Indexed: 03/03/2024] Open
Abstract
Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment. However, irrigant selection or irrigation procedures are far from clear. The vapor lock effect in the apical region has yet to be solved, impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes. Additionally, ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified. Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes. Indeed, clinicians have been aware of these concerns for years. Based on the current evidence of studies, this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions. The evolution of different kinetic irrigation methods, their effects, limitations, the paradigm shift, current indications, and effective operational procedures regarding intracanal medication are also discussed. This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication, thus facilitating a better understanding of infection control, standardizing clinical practice, and ultimately improving the success of endodontic therapy.
Collapse
Affiliation(s)
- Xiaoying Zou
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
- Center of Stomatology, Peking University Hospital, Beijing, China
| | - Xin Zheng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuhong Liang
- Department of Emergency, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Chengfei Zhang
- Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Bing Fan
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jingping Liang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Clinical Research Center for Oral Diseases; National Center for Stomatology; Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Junqi Ling
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology , Guangzhou, China
| | - Zhuan Bian
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qing Yu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xián, China
| | - Benxiang Hou
- Center for Microscope Enhanced Dentistry, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Zhi Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xi Wei
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology , Guangzhou, China
| | - Lihong Qiu
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Wenxia Chen
- College & Hospital of Stomatology, Guangxi Medical University, Nanning, China
| | - Wenxi He
- Department of Stomatology, Air Force Medical Center, The Air Force Medical University, Beijing, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liuyan Meng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Chen Zhang
- Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Liming Chen
- Department of Endodontics, Guiyang Stomatological Hospital, Guiyang, China
| | - Shuli Deng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Yayan Lei
- Department of Endodontics, the Affiliated Stomatological Hospital of Kunming Medical University, Kunming, China
| | - Xiaoli Xie
- Department of Endodontology, Hunan Xiangya Stomatological Hospital, Central South University, Changsha, China
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Jinhua Yu
- Institute of Stomatology, Nanjing Medical University & Department of Endodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Jin Zhao
- Department of Endodontics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Song Shen
- Center of Stomatology, Peking University Hospital, Beijing, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Lin Yue
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.
| |
Collapse
|
6
|
Bao P, Liu H, Yang L, Zhang L, Yang L, Xiao N, Shen J, Deng J, Shen Y. In vitro efficacy of Er:YAG laser-activated irrigation versus passive ultrasonic irrigation and sonic-powered irrigation for treating multispecies biofilms in artificial grooves and dentinal tubules: an SEM and CLSM study. BMC Oral Health 2024; 24:261. [PMID: 38389109 PMCID: PMC10882935 DOI: 10.1186/s12903-024-04042-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/17/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Multispecies biofilms located in the anatomical intricacies of the root canal system remain the greatest challenge in root canal disinfection. The efficacy of Er:YAG laser-activated irrigation techniques for treating multispecies biofilms in these hard-to-reach areas has not been proved. The objective of this laboratory study was to evaluate the effectiveness of two Er:YAG laser-activated irrigation techniques, namely, photon-induced photoacoustic streaming (PIPS) and shock wave-enhanced emission photoacoustic streaming (SWEEPS), in treating multispecies biofilms within apical artificial grooves and dentinal tubules, in comparison with conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI), and sonic-powered irrigation (EDDY). Two types of multispecies root canal biofilm models were established in combination with two assessment methods using scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM) with the aim to obtain more meaningful results. METHODS Ninety extracted human single-rooted premolars were chosen for two multispecies biofilm models. Each tooth was longitudinally split into two halves. In the first model, a deep narrow groove was created in the apical segment of the canal wall. After cultivating a mixed bacterial biofilm for 4 weeks, the split halves were reassembled and subjected to five irrigation techniques: CNI, PUI, EDD, PIPS, and SWEEPS. The residual biofilms inside and outside the groove in Model 1 were analyzed using SEM. For Model 2, the specimens were split longitudinally once more to evaluate the percentage of killed bacteria in the dentinal tubules across different canal sections (apical, middle, and coronal thirds) using CLSM. One-way analysis of variance and post hoc multiple comparisons were used to assess the antibiofilm efficacy of the 5 irrigation techniques. RESULTS Robust biofilm growth was observed in all negative controls after 4 weeks. In Model 1, within each group, significantly fewer bacteria remained outside the groove than inside the groove (P < 0.05). SWEEPS, PIPS and EDDY had significantly greater biofilm removal efficacy than CNI and PUI, both from the outside and inside the groove (P < 0.05). Although SWEEPS was more effective than both PIPS and EDDY at removing biofilms inside the groove (P < 0.05), there were no significant differences among these methods outside the groove (P > 0.05). In Model 2, SWEEPS and EDDY exhibited superior bacterial killing efficacy within the dentinal tubules, followed by PIPS, PUI, and CNI (P < 0.05). CONCLUSION Er:YAG laser-activated irrigation techniques, along with EDDY, demonstrated significant antibiofilm efficacy in apical artificial grooves and dentinal tubules, areas that are typically challenging to access.
Collapse
Affiliation(s)
- Pingping Bao
- School and Hospital of Stomatology, Tianjin Medical University, Tianjin, 300070, China
- Department of Endodontics, School of Medicine, Tianjin Stomatological Hospital, Nankai University, Tianjin, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China
| | - He Liu
- Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Lan Yang
- Hangzhou Stomatological Hospital, Hangzhou, China
| | - Lulu Zhang
- Department of Endodontics, School of Medicine, Tianjin Stomatological Hospital, Nankai University, Tianjin, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China
| | - Liwei Yang
- Department of Endodontics, School of Medicine, Tianjin Stomatological Hospital, Nankai University, Tianjin, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China
| | - Nannan Xiao
- State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China
| | - Jing Shen
- Department of Endodontics, School of Medicine, Tianjin Stomatological Hospital, Nankai University, Tianjin, China.
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China.
| | - Jiayin Deng
- School and Hospital of Stomatology, Tianjin Medical University, Tianjin, 300070, China.
| | - Ya Shen
- Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
| |
Collapse
|
7
|
Timponi Goes Cruz A, Antoniw Klemz A, Ribeiro Rosa EA, Soares Grecca F, Mattos B, Piasecki L, Machado R, Ignácio SA, da Silva Neto UX. Cleaning and disinfection of the root canal system provided by four active supplementary irrigation methods. Sci Rep 2024; 14:3795. [PMID: 38361036 PMCID: PMC10869831 DOI: 10.1038/s41598-024-53375-8] [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: 11/08/2023] [Accepted: 01/31/2024] [Indexed: 02/17/2024] Open
Abstract
This in vitro study evaluated the bacterial reduction provided by the EndoActivator (EA), Easy Clean (EC), passive ultrasonic irrigation (PUI), and XP-Endo Finisher. Eight-four mesial roots of mandibular first molars were instrumented, inoculated with Enterococcus faecalis, and divided into four groups (n. 20). Bacterial reduction in the main canals and dentinal tubules were respectively determined by MTT assays and Live/Dead BackLight technique through confocal laser scanning microscopy (CLSM) at 50, 100, and 150 µm in-depth (n. 10 per group). Statistical analyses were conducted following a significance level of 95% (P < 0.05). A significant statistical difference was just identified between XPF and EC in the main canals. In the dentinal tubules from the main root canals, at 100 and 150 µm in-depths, significant statistical differences were only observed between XPF and EC (P = 0.027) for the former and between XPF and EC (P = 0.011) and XPF and PUI (P = 0.021) for the latter. In the dentinal tubules from the isthmus, at 100 µm in-depth, statistically relevant differences did occur between XPF and EC (P = 0.038) and EC and EA (P = 0.029). At 150 µm in-depth, these differences were only significant by comparing XPF and PUI (P = 0.025) and XPF and EC (P = 0.036). Although no irrigation method could thoroughly disinfect the RCS, bacterial reduction indexes were generally better after using XPF.
Collapse
Affiliation(s)
- Alessandra Timponi Goes Cruz
- Department of Endodontics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Adriane Antoniw Klemz
- Department of Endodontics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Edvaldo Antônio Ribeiro Rosa
- Department of Biosciences, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Fabiana Soares Grecca
- Department of Endodontics, College of Dentistry, Federal University of Rio Grande do Sul-UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
| | - Bianca Mattos
- Department of Endodontics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Lucila Piasecki
- Department of Periodontics & Endodontics, College of Dentistry, University at Buffalo, Buffalo, NY, USA
| | - Ricardo Machado
- Clinical practice limited to Endodontics, Navegantes, Santa Catarina, Brazil.
| | - Sérgio Aparecido Ignácio
- Department of Statistics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| | - Ulisses Xavier da Silva Neto
- Department of Endodontics, College of Dentistry, Pontifical Catholic University of Paraná-PUC/PR, Curitiba, Paraná, Brazil
| |
Collapse
|
8
|
Chavate PR, Ponnappa KC, Nanjappa AS. Comparative evaluation of the effect of ultrasonic and rotary agitation of herbal irrigating solutions on smear layer: A SEM study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:164-169. [PMID: 38463471 PMCID: PMC10923225 DOI: 10.4103/jcde.jcde_277_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/29/2023] [Accepted: 12/31/2023] [Indexed: 03/12/2024]
Abstract
Context Instrumentation and irrigation balance helps in effective removal of endodontic microbes housing inside the smear layer. Aim This study aimed to (1) evaluate whether activation of the irrigating solutions with two different systems during the final irrigation step can lead to smear layer formation in the middle and apical third of the root canal and (2) evaluate and compare the smear layer removal ability of the aqueous extracts of Emblica officinalis and Morinda citrifolia. Materials and Methods A total of 72 single-rooted teeth were prepared up to F4 ProTaper. The specimens were assigned into eight groups of nine teeth each, according to the final irrigant and activation techniques. Further, the teeth were evaluated under SEM for endodontic smear layer at the middle and apical third. Statistical Analysis Inferential statistics included Pearson's Chi-square. Level of significance was set at 0.05 at 95% confidence level. Results Ultrasonic activation system showed significant (P = 0.000) amount of smear layer compared to XP-Endo Finisher file. A significant difference (P = 0.00) in the smear layer removal was observed when 6% M. citrifolia was activated with XP-Endo Finisher file both in the middle and apical third. Conclusion Within the limitations of this in vitro study, it can be concluded that smear layer formation was noted with ultrasonic and XP-Endo Finisher file when saline was used as an irrigant. 6% M. citrifolia when activated with XP-Endo Finisher file showed best results among all other experimental groups.
Collapse
Affiliation(s)
- Prajhna R. Chavate
- Department of Conservative Dentistry and Endodontics, Coorg Institute of Dental Sciences, KK Campus, Virajpet, Karnataka, India
| | - K. C. Ponnappa
- Department of Conservative Dentistry and Endodontics, Coorg Institute of Dental Sciences, KK Campus, Virajpet, Karnataka, India
| | - A. Salin Nanjappa
- Department of Conservative Dentistry and Endodontics, Coorg Institute of Dental Sciences, KK Campus, Virajpet, Karnataka, India
| |
Collapse
|
9
|
Mohite P, Gupta D, Gupta R, Kamat S, Shaw AK. Assessment of the impact of XP-Endo Finisher file on push-out bond strength of various endodontic sealers. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:36-41. [PMID: 38389740 PMCID: PMC10880469 DOI: 10.4103/jcde.jcde_189_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/06/2023] [Accepted: 10/25/2023] [Indexed: 02/24/2024]
Abstract
Background An endodontic treatment is considered a success after thorough chemomechanical debridement coupled with obturating root canals in a concrete way thereby providing hermetic seal. Gutta-percha being nonadherent necessitates use of a sealer to achieve hermetic seal. Adequate adhesion of root canal sealer with gutta-percha core and radicular dentin ensures lack of apical leakage. Materials and Methods Sixty extracted mandibular premolars with single root canal decoronated at cementoenamel junction were selected and randomly allocated to two groups (n = 30). Samples in Group 1 were prepared with BT Race file, while Group 2 samples were prepared with BT Race alongwith XP Endo file. Absorbent paper points were used for canal drying and samples were randomly divided into six subgroups. In Subgroup I, obturation was done with bio-ceramic (BC) sealer (Endosequence BC) and BC gutta-percha. In Subgroup II, resin-based (AH plus) sealer and gutta-percha were used. In Subgroup III, calcium hydroxide-based (Sealapex) sealer and gutta-percha were used. Sectioning of root samples was done perpendicularly into coronal, middle, and apical segments of 3 mm each. A universal testing machine was used for sample testing, in which push-out bond strength corresponded to the highest value obtained. Stereomicroscopic (×20) study of the samples determined the failure mode at dentin/sealer/main cone interface. Statistical Analysis Analysis of variance and post hoc Tukey's tests were used for data analysis. Results Endosequence BC with XP-Endo files showed the highest mean push-out bond strength (16.31 MPa), whereas Sealapex without XP-Endo file had the lowest values (12.76 MPa). Mixed failure of adhesive and cohesive mode was observed for most samples. Conclusion Adjunctive irrigation agitation technique utilizing XP-Endo Finisher facilitates biofilm eradication from difficult niches in root canals, thereby improving adhesion of sealer and subsequently the sealer bond strength.
Collapse
Affiliation(s)
- Pramod Mohite
- Department of Conservative Dentistry and Endodontics, Vasantdada Patil Dental College, Pune, Maharashtra, India
| | - Divya Gupta
- Department of Conservative Dentistry and Endodontics, D. Y. Patil Dental School, Pune, Maharashtra, India
| | - Ruchika Gupta
- Department of Conservative Dentistry and Endodontics, D. Y. Patil Dental School, Pune, Maharashtra, India
| | - Sharad Kamat
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Pune, Dental College and Hospital, Sangli, Maharashtra, India
| | - Amar Kumar Shaw
- Department of Public Health Dentistry, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Pune, Maharashtra, India
| |
Collapse
|
10
|
de Jesus Oliveira LS, de Figueiredo FED, Dantas JA, Ribeiro MAG, Estrela C, Sousa-Neto MD, Faria-E-Silva AL. Impact XP-endo finisher on the 1-year follow-up success of posterior root canal treatments: a randomized clinical trial. Clin Oral Investig 2023; 27:7595-7603. [PMID: 37867163 DOI: 10.1007/s00784-023-05349-9] [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: 06/29/2023] [Accepted: 10/16/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE To evaluate the clinical relevance of using the XP-endo Finisher as a supplementary tool to improve the success of root canal treatment of posterior teeth with apical periodontitis, as assessed by 1-year follow-up. METHODS A randomized clinical trial was conducted with 92 posterior teeth with apical periodontitis. Root canal treatment was performed using a single reciprocating file, with or without the supplementary use of the XP-endo Finisher. The status of apical periodontitis was assessed using the periapical index (PAI) at baseline and 1 year follow-up. Changes on PAI indicated that the lesions were healed, healing, or not healed. Successful treatments were defined as healed or healing lesions without clinical symptoms. Chi-square analysis and logistic regression were used for data analysis (α = 0.05). RESULTS There was no significant difference in the distribution of healing status between the XP-endo Finisher group and the control group (p = 0.690). The success rates were also similar, with 81% in the XP-endo Finisher group and 78% in the control group. However, gender had a significant impact on success rates, with higher rates observed in females. CONCLUSIONS The use of the XP-endo Finisher file as a supplementary tool did not affect the success rate of root canal treatment in posterior teeth with apical periodontitis. The findings indicate that the XP-endo Finisher file has limited clinical relevance in improving treatment outcomes for root canal treatment in posterior teeth with apical periodontitis. CLINICAL TRIAL REGISTRATION The study protocol was registered in the Brazilian Clinical Trials Registry under identification number RBR-76w7cj (June 19, 2018).
Collapse
Affiliation(s)
- Ludmila Smith de Jesus Oliveira
- Graduate Program in Health Sciences, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil
| | - Fabricio Eneas Diniz de Figueiredo
- Graduate Program in Health Sciences, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil
| | - Janaina Araújo Dantas
- Department of Dentistry, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil
| | - Maria Amália Gonzaga Ribeiro
- Department of Dentistry, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Av. Universitária, s/n - Setor Leste Universitário, Goiânia, GO, 74605-020, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Av. do Café, s/n, Ribeirão Preto, SP, 14020-904, Brazil
| | - André Luis Faria-E-Silva
- Graduate Program in Health Sciences, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil.
- Department of Dentistry, Federal University of Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil.
- Departamento de Odontologia, Campus da Saúde, Universidade Federal de Sergipe, Rua Cláudio Batista, s/n - Sanatório, Aracaju, SE, 49060-100, Brazil.
| |
Collapse
|
11
|
Hepsenoglu YE, Ersahan S. Is XP-endo Finisher a better treatment option for its efficacy against intracanal bacteria for post-treatment apical periodontitis cases than EndoActivator? AUST ENDOD J 2023; 49 Suppl 1:399-412. [PMID: 37026533 DOI: 10.1111/aej.12756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/01/2023] [Accepted: 03/21/2023] [Indexed: 04/08/2023]
Abstract
To investigate the efficacy of the supplementary use of a rotary agitation method [XP-endo Finisher (XPF)] and sonically-activated irrigation [EndoActivator (EA)], using droplet digital PCR (ddPCR) on reducing the bacterial load in previously root canal treated teeth with apical periodontitis. Twenty patients with post-treatment apical periodontitis were allocated into two groups according to the irrigation activation method used: XPF and EA group. Total bacterial loads, as well as the amount of Enterococcus faecalis (E. faecalis) were determined before (S1) and after (S2) chemomechanical preparation, and after final irrigation activation (S3) by means of ddPCR. The bacterial copy numbers were compared between groups using the Friedman test (Nonparametric Repeated Measures ANOVA). When the groups were examined in terms of gender, age, number of root canals, periapical index score, sterility control total bacteria (SCTB), S1- and S2-total bacteria copy number, it was found that there was no statistical difference between the XPF group and the EA group (p > 0.05). Subsequent activation (S3) resulted in a significant microbial reduction in both XPF and EA groups, both of which reduced significantly more bacteria than chemomechanical instrumentation (S2) (p < 0.0001). On the contrary, S3-total bacteria copy number of the EA group was lower than the XPF group (p < 0.0147). There was no statistical difference between the XPF group and the EA group in terms of E. faecalis copy number (p > 0.05). Although both the XPF and the EA optimised the antibacterial efficiency of chemomechanical preparation in previously root canal-treated teeth with apical periodontitis, a lower total bacterial copy number was achieved with the EA application than the XPF application.
Collapse
Affiliation(s)
- Yelda Erdem Hepsenoglu
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| | - Seyda Ersahan
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| |
Collapse
|
12
|
Chinta PR, Kalla N, Dhavala PC, Satyavathi DPS, Rolla SA, Uppalapati P. Comparative Evaluation of Different Irrigant Agitating Devices for Debris Removal from the Mesial Roots of Mandibular Molars: An In Vitro Study. J Contemp Dent Pract 2023; 24:449-453. [PMID: 37622621 DOI: 10.5005/jp-journals-10024-3533] [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] [Indexed: 08/26/2023]
Abstract
AIM To evaluate the efficiency of debris removal from the mesial root canals and isthmus of mesial roots of mandibular molars after final irrigant agitation with XP-endo Shaper, EndoVac (EV), plastic finishing file, and conventional needle irrigation. METHODS AND MATERIALS Forty extracted human mandibular first molar teeth with the isthmus between the mesial roots were selected, access cavities were prepared and distal roots were decoronated. All the mesial root specimens were mounted in acrylic, sectioned at the coronal, middle, and apical thirds, along with the resin block, and examined for debris in the canals and isthmus before the start of the procedure using a stereomicroscope and were mounted back in a custom-made jig. After determination of the working length, they were allocated to the following four different irrigant activation groups (n = 10): Group I-XP-endo Finisher; group II-EndoVac; group III-plastic finishing file; and group IV-standard needle irrigation. After biomechanical preparation (BMP) till F3, final agitation was done for debris removal with the respective agitating devices, and all the samples were examined under a stereomicroscope for the amount of debris in the canal after final agitation. RESULTS Of all the irrigation devices used, the XP-endo Finisher and EV showed more debris removal when compared to other groups (p < 0.05). The plastic finishing file in continuous rotation was more efficient in cleaning debris compared with conventional needle irrigation (p < 0.05). CONCLUSION The XP-endo Finisher and EV showed a significant difference in cleaning efficacy than the plastic finishing files. So, these can be used as adjunctive for agitating the final irrigant. CLINICAL SIGNIFICANCE The irrigant agitation devices promote the penetration of irrigants into the intricate root canal anatomy and increase their antibacterial and tissue-dissolving effectiveness thereby improving the success rate and treatment outcome.
Collapse
Affiliation(s)
- Priyanka Reddy Chinta
- Department of Conservative Dentistry and Endodontics, GSL Dental College & Hospital, Rajanagaram, Andhra Pradesh, India, Phone: +91 9493672455, e-mail: , Orcid: https://orcid.org/0000-0002-7463-9443
| | - Nagalakshmi Kalla
- Department of Conservative Dentistry and Endodontics, GSL Dental College & Hospital, Rajanagaram, Andhra Pradesh, India
| | - Padma Chaitanya Dhavala
- Master of Dental Surgery in Department of Conservative Dentistry and Endodontics, Drs Sudha & Nageswara rao Siddhartha institute of dental sciences, Gannavaram, Andhra Pradesh, India
| | - Damarla Poorna Samudra Satyavathi
- Master of Dental Surgery in Department of Conservative Dentistry and Endodontics, Drs Sudha & Nageswara rao Siddhartha institute of dental sciences, Gannavaram, Andhra Pradesh, India
| | - Sanjay Adarsh Rolla
- Department of Conservative Dentistry and Endodontics, GSL Dental College & Hospital, Rajanagaram, Andhra Pradesh, India
| | - Pragnya Uppalapati
- Department of Conservative Dentistry and Endodontics, GSL Dental College & Hospital, Rajanagaram, Andhra Pradesh, India
| |
Collapse
|
13
|
Matoso FB, Montagner F, Jardine AP, Quintana RM, Grecca FS, Kopper PMP. Effect of different disinfection protocols in bacterial viability of an intraradicular biofilm formed in situ. Braz Dent J 2023; 34:42-49. [PMID: 37466524 PMCID: PMC10355264 DOI: 10.1590/0103-6440202305244] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/18/2023] [Indexed: 07/20/2023] Open
Abstract
The present study aimed to evaluate bacterial viability after the use of different disinfection protocols in root canals infected with a multispecies biofilm (MB) formed in situ. Palatal roots with a single canal were obtained from extracted maxillary molars and sterilized before being inserted into the mouth. The roots were contaminated with a MB in an intraoral appliance worn by ten volunteers. All volunteers wore six roots simultaneously in two intraoral devices for 21 days. One root from each volunteer was assigned to each group (n=10): PUI - passive ultrasonic irrigation; EC - Easy Clean; XPF - XP-endo Finisher; aPDT - antimicrobial photodynamic therapy; CI - conventional irrigation; and NC - negative control. The samples were evaluated under confocal laser scanning microscopy. The percentage of viable cells (VC) was calculated over the total percentage of MB biovolume. Data were statistically analyzed (α=5%). The cell viability in the entire root canal or for each third was compared between groups (Kruskal-Wallis test, Dunn post-hoc test) and for the same group (Friedman test, Dunn post-hoc test). Disinfection protocols were not significantly different from each other (P>.05). Samples in EC, PUI, and aPDT had lower cell viability than in NC (P<.05). In the coronal third of samples in the EC, XPF, PUI and aPDT, the percentage of VC biovolume was lower than in the NC (P<.05). The percentage of VC in EC samples was lower in the coronal and middle thirds than in the apical third (P<.05). EC, PUI and aPDT had significant effects on cell viability in intraradicular multispecies biofilm formed in situ when compared with untreated samples.
Collapse
Affiliation(s)
- Felipe Barros Matoso
- Graduate Program in Dentistry, Federal University of Rio Grande
do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Francisco Montagner
- Graduate Program in Dentistry, Federal University of Rio Grande
do Sul (UFRGS), Porto Alegre, RS, Brazil
| | | | - Ramiro Martins Quintana
- Graduate Program in Dentistry, Federal University of Rio Grande
do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Fabiana Soares Grecca
- Graduate Program in Dentistry, Federal University of Rio Grande
do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Patricia Maria Poli Kopper
- Graduate Program in Dentistry, Federal University of Rio Grande
do Sul (UFRGS), Porto Alegre, RS, Brazil
| |
Collapse
|
14
|
Akdere SK, Aydin ZU, Erdönmez D. Antimicrobial effectiveness of different irrigation activation techniques on teeth with artificial internal root resorption and contaminated with Enterococcus faecalis: a confocal laser scanning,icroscopy analysis. Lasers Med Sci 2023; 38:89. [PMID: 36943498 DOI: 10.1007/s10103-023-03748-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/09/2023] [Indexed: 03/23/2023]
Abstract
This study aimed to compare the antibacterial efficacy of standard needle irrigation (SNI), EDDY, passive ultrasonic irrigation (PUI), photon-induced photoacoustic streaming (PIPS), and shock wave enhanced emission photoacoustic streaming (SWEEPS) activation on the teeth with simulated internal root resorption (IRR) and contaminated with Enterococcus faecalis (E. faecalis) using confocal laser scanning microscopy (CLSM) analyses. A total of 79 human maxillary central incisors with a single canal were selected. The canals were accessed, and then, the roots were split in the bucco-lingual direction. Artificial IRR cavities (depth of 0.8 mm and a diameter of 1.6 mm) were prepared using round burs and 20% nitric acid in the middle region of the root halves. The root halves were reconstructed with cyanoacrylate glue, and the canals were contaminated with a culture of E. faecalis for 30 days. Root canal preparation was performed using the ProTaper Next rotary files up to X5 and 2.5% NaOCl irrigation. Teeth were randomly assigned to five groups according to the irrigation activation method (n = 15): SNI, EDDY, PUI, PIPS, and SWEEPS. The final irrigation procedures were performed using a total of 6 mL of 2.5% NaOCl for each tooth with an activation time of 3 × 30 s. The canals were stained with LIVE/DEAD BacLight dye and analyzed with CLSM to determine the percentages of dead bacteria in the biofilm. Two-way ANOVA and post hoc Tukey tests were used for statistical analysis (P < .05). None of the irrigation activation methods tested provided 100% bacterial elimination. There was no significant difference between the irrigation activation methods tested in terms of the percentage of dead bacteria (P > 0.05). In irrigation activation methods other than PIPS, there was no significant difference in the percentage of dead bacteria between the coronal, middle, and apical regions of the roots (P > 0.05). A higher percentage of dead bacteria was found in the middle region compared to the apical region in the PIPS (P < 0.05). Within the limitations of this study, SII, EDDY, PUI, PIPS, and SWEEPS have a similar antimicrobial effect on the teeth with IRR and contaminated with E. faecalis.
Collapse
Affiliation(s)
- S Koşumcu Akdere
- Department of Endodontics, Faculty of Dentistry, University of Abant İzzet Baysal, Bolu, Turkey
| | - Z Uğur Aydin
- Department of Endodontics, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey.
| | - D Erdönmez
- Department of Biology, Faculty of Arts and Science, Düzce University, Düzce, Turkey
| |
Collapse
|
15
|
Advances in the Role of Sodium Hypochlorite Irrigant in Chemical Preparation of Root Canal Treatment. BIOMED RESEARCH INTERNATIONAL 2023; 2023:8858283. [PMID: 36685672 PMCID: PMC9859704 DOI: 10.1155/2023/8858283] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 01/15/2023]
Abstract
Irrigation of root canal system is of great significance to the success of endodontic treatment, where sodium hypochlorite (NaOCl) is the most widely used irrigant in chemical preparation. NaOCl functions by eliminating bacterial biofilms and dissolving organic tissue, which may vary according to several factors such as the microbiology of root canal infection and the concentration of the irrigant. It has been proposed that the effectiveness of NaOCl could be enhanced via several methods, including heating the irrigant, applying in conjunction with certain reagents, or activating by agitation techniques. Despite its antibacterial and tissue-dissolving capacities, NaOCl should be used with caution to avoid detrimental effect due to its cytotoxicity and negative effect on dentin properties. In this narrative review, we discussed the factors that affect the properties of NaOCl, the methods to improve its efficacy, and the side effects that might occur in clinical practice.
Collapse
|
16
|
Takagi BAR, Kopper PMP, Luz L, Luisi SB, Scarparo RK. Apical extrusion of sodium hypochlorite in immature teeth: comparison of three different cleaning protocols. AUST ENDOD J 2022; 48:380-385. [PMID: 34617648 DOI: 10.1111/aej.12574] [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: 06/29/2021] [Revised: 08/02/2021] [Accepted: 09/26/2021] [Indexed: 12/14/2022]
Abstract
This study compared standard needle irrigation, passive ultrasonic irrigation, XP-Endo Finisher and Easy Clean in the apical extrusion of sodium hypochlorite (NaOCl) in a model simulating immature teeth. Ten bovine teeth were maintained in suspension in a container with the apical portion in contact with 0.2% agarose gel containing 0.1% metacresol purple. The canals were irrigated with 2.5% NaOCl, according to each irrigation protocol. After 3 min, apical extrusion of NaOCl was observed by the colour gel change when in contact with NaOCl. The containers were photographed, and the NaOCl extrusion area was measured. All protocols showed NaOCl extrusion, providing similar area (P > 0.05). Considering the similarity among the studied protocols, all of them can be considered during the endodontic treatment of immature teeth. Further studies on the particularities of immature teeth should be performed to evaluate cell viability, cleaning efficiency, disinfection capacity and dentin removal promoted by the irrigation protocols.
Collapse
Affiliation(s)
- Brenda Ai Refosco Takagi
- Consevative Dentistry Department, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Patrícia Maria Poli Kopper
- Consevative Dentistry Department, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Graduate Dentistry Program, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Luciana Luz
- Consevative Dentistry Department, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Simone Bonato Luisi
- Consevative Dentistry Department, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Roberta Kochenborger Scarparo
- Consevative Dentistry Department, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Graduate Dentistry Program, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| |
Collapse
|
17
|
Hachem CE, Nehme W, Kaloustian MK, Ghosn N, Daou M, Zogheib C, Karam M, Mhanna R, Macaluso V, Kharouf N, Chedid JCA. The Effectiveness of Different Irrigation Techniques on Debris and Smear Layer Removal in Primary Mandibular Second Molars: An In Vitro Study. J Contemp Dent Pract 2022; 23:1173-1179. [PMID: 37073943 DOI: 10.5005/jp-journals-10024-3440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
AIMS The aim of the present in vitro study was to compare the effectiveness of passive ultrasonic irrigation (PUI), sonic irrigation, and mechanic dynamic activation on the removal of debris and smear layer from primary mandibular second molars during pulpectomy. MATERIALS AND METHODS Mesial roots of 48 primary mandibular second molars were prepared with an R-motion 21 mm file (30/0.04) (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland), irrigated with 1% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA), and divided into four groups (n = 24 canals) according to the final irrigation activation technique: control group without activation, PUI with Ultra-X (Eighteeth, Changzhou, China), mechanical activation with XP-endo Finisher (FKG), and sonic irrigation with EQ-S (Meta Biomed, Chungcheongbuk-do, Korea). The roots were split longitudinally and analyzed using scanning electron microscopy (SEM). The presence of debris and smear layer was assessed using a 5-grade scoring scale with 200× and 1000× magnification, respectively. The Kruskal-Wallis and Friedman tests were used for data analysis. RESULTS The activation of the irrigant significantly improved debris and smear layer removal (p < 0.001). There was no significant difference between Ultra-X, XP-endo Finisher, and EQ-S (p > 0.05). No activation technique was able to completely eliminate debris and smear layer from the root canals of primary mandibular second molars. CONCLUSIONS During pediatric pulpectomy, the irrigation protocol must include activation of the irrigation solutions using either ultrasonic, sonic, or mechanical activation techniques to enhance the removal of debris and smear layer for a better prognosis. CLINICAL SIGNIFICANCE During root canal treatment on primary teeth, the clinician must incorporate an activation technique in the irrigation protocol to enhance the removal of debris and smear layer and increase the success of the treatment.
Collapse
Affiliation(s)
- Claire El Hachem
- Department of Pediatric and Community Dentistry, Saint Joseph University, Beirut, Lebanon, Phone: +0096170107702, e-mail:
| | - Walid Nehme
- Department of Endodontics, Saint Joseph University, Beirut, Lebanon; Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, United States of America, Orcid: https://orcid.org/0000-0002-1589-1454
| | - Marc Krikor Kaloustian
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University, Beirut, Lebanon, Orcid: https://orcid.org/0000-0002-0811-6935
| | - Nabil Ghosn
- Faculty of Dental Medicine, Craniofacial Research Laboratory, Saint Joseph University, Beirut, Lebanon, Orcid: https://orcid.org/0000-0003-1524-5310
| | - Maha Daou
- Faculty of Dental Medicine, Saint Joseph University, Beirut, Lebanon; McGill University, Montreal, Canada, Orcid: https://orcid.org/0000-0001-6882-9227
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University, Beirut, Lebanon, Orcid: https://orcid.org/0000-0003-0857-6998
| | - Mia Karam
- Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon, Orcid: https://orcid.org/0000-0002-9783-3334
| | - Rami Mhanna
- Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon, Orcid: https://orcid.org/0000-0003-0345-625X
| | - Valentina Macaluso
- ESTA, School of Business & Technology, Belfort, France, Orcid: https://orcid.org/0000-0002-6503-9841
| | - Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S1121, Strasbourg University, Strasbourg, France; Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, Strasbourg, France, Orcid: https://orcid.org/0000-0001-6768-138X
| | - Jean Claude Abou Chedid
- Department of Pediatric and Community Dentistry, Faculty of Dental Medicine, Saint Joseph University, Beirut, Lebanon, Orcid: https://orcid.org/0000-0001-5161-8693
| |
Collapse
|
18
|
Ashraf A, Hussein W, Hashem A, Soliman A. The Effect of Passive Ultrasonic Irrigation and XP-Endo Finisher on Post-operative Pain after Endodontic Retreatment on Patients (Randomized Controlled Clinical Trial). Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIM: To evaluate the effect of passive ultrasonic irrigation or XP-Endo Finisher on postoperative pain in patients with underextended filling in previously endodontically treated mandibular first molar teeth requiring endodontic retreatment using visual analog scale (VAS) scale at 6, 12, 24, 48, 72 h, and 7 daytime intervals.
METHODS: Seventy-eight patients with mandibular first molars which need endodontic retreatment were randomly allocated into one of three separate groups (n = 26); NaviTip group (control), XP-Endo Finisher group, or Ultra X group. Data were statistically analyzed with a significance level of p ≤ 0.05.
RESULTS: XP-Endo Finisher agitation and ultrasonic agitation as a final irrigation protocol showed significantly lower pain values than the control group, but there was no significant difference in pain values between the experimental groups.
CONCLUSION: Within the limitation of this study, it can be concluded that agitation techniques used during endodontic retreatment decreased the incidence and intensity of post-operative pain.
Collapse
|
19
|
Alfirdous RA, Alquiria TA, Jacinto RC, Martinho FC. A modified dentin infection model with Fluorescent Lipopolysaccharide and
LPS
sampling technique to compare
XP‐Endo
finisher and passive ultrasonic irrigation. Int Endod J 2022; 55:1081-1090. [DOI: 10.1111/iej.13804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022]
Affiliation(s)
- R. A. Alfirdous
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
- Prince Abdulrahman Advanced Dental Institute Riyadh Kingdom of Saudi Arabia
| | - T. A. Alquiria
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
- Prince Abdulrahman Advanced Dental Institute Riyadh Kingdom of Saudi Arabia
| | - R. C. Jacinto
- Division of Endodontics, Department of preventive and restorative dentistry School of Dentistry, Aracatuba São Paulo SP Brazil
| | - F. C. Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
| |
Collapse
|
20
|
Enhancing the intracanal antibacterial effects of sodium hypochlorite with etidronic acid or citric acid. J Endod 2022; 48:1161-1168. [PMID: 35750221 DOI: 10.1016/j.joen.2022.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 11/20/2022]
Abstract
INTRODUCTION This study evaluated the bacterial reduction promoted by root canal preparation using irrigation with sodium hypochlorite (NaOCl) alone, associated with etidronic acid (HEDP) or alternated with citric acid, and after a supplementary agitation step. METHODS Extracted mandibular premolars were selected and distributed into 3 groups based on anatomically paired micro-computed tomographic analyses. The canals were contaminated with Enterococcus faecalis for 30 days and then subjected to chemomechanical preparation with a reciprocating instrument under irrigation with NaOCl alone, mixed with HEDP (NaOCl/HEDP), or alternated with citric acid (NaOCl/CA). A supplementary agitation step with the XP-endo Finisher was performed in all groups. Intracanal bacteriological samples were taken before (S1) and after preparation (S2), and after the supplementary approach (S3). DNA was extracted from the samples and subjected to quantitative real-time polymerase chain reaction. RESULTS Intragroup analyses revealed a substantial bacterial reduction from S1 to S2 or S3 in all groups (p<0.01). The supplementary agitation resulted in S2-to-S3 bacterial reduction of 6%, 68%, and 80% in the NaOCl, NaOCl/HEDP, and NaOCl/CA groups, respectively. Irrigation with NaOCl alone resulted in 53% and 47% of samples negative for bacteria in S2 and S3, respectively. Corresponding figures for NaOCl/HEDP were 75% and 85%, and 44% and 72% for NaOCl/CA. Intergroup analyses of S2 samples showed that NaOCl/HEDP was significantly more effective than the other two in reducing the bacterial levels (p<0.05). After the supplementary approach, both NaOCl/HEDP and NaOCl/CA were significantly more effective than NaOCl alone (p<0.05), with no significant differences between them (p>0.05). CONCLUSION Both the freshly combined NaOCl/HEDP solution and the alternate use of NaOCl and citric acid followed by XP-endo Finisher agitation resulted in significantly higher intracanal bacterial reduction than NaOCl alone.
Collapse
|
21
|
de Mattos de Araujo BM, Cruz ATG, Piasecki L, Webber M, Carneiro E, Westphalen VPD, da Silva Neto UX. Micro-CT evaluation of four final irrigation protocols on hard-tissue debris removal from mesial roots of mandibular molars containing isthmus. Clin Oral Investig 2022; 26:6121-6128. [PMID: 35650363 DOI: 10.1007/s00784-022-04561-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 05/21/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To evaluate by means of microcomputed tomography (micro-CT), the efficacy of four final irrigation protocols in the removal of hard-tissue debris (HTD) in mesial roots of mandibular molars containing isthmus. MATERIALS AND METHODS Forty standardized mesial roots of extracted mandibular molars presenting isthmus were selected. The root canals were prepared and randomly divided into 4 groups (n = 10): EA, EndoActivator (Dentsply Sirona); EC, Easy Clean (Easy Dental Equipment, Belo Horizonte, Brazil); XPF, XP-Endo Finisher (FKG Dentaire, La Chaus-de Fonds, Switzerland); and PUI, passive ultrasonic irrigation using Irrisafe tip (Satelec Acteon, Merignac, France). Each final irrigation protocol was performed in two cycles (60 s), using, respectively, 2.5% sodium hypochlorite and 17% EDTA. Micro-CT scans were obtained pre-operatory, post-preparation, and post-irrigation. The percentage of HTD reduction was calculated. Data was analyzed statistically (ANOVA and Kruskal-Wallis, significance set at 5%). RESULTS The percentage of HTD reduction was greatest for the XPF group (77.92%), followed by EA (62.92%), PUI (47.48%), and EC (32.65%). Statistical differences (p < .05) were found between XPF and EC only. A significant difference (p < .05) was found between XPF and EC in all thirds and between PUI and EC in the middle third. CONCLUSIONS XPF, EA, and PUI were similarly effective in HTD reduction. However, none of the evaluated protocols was able to completely remove all the debris. CLINICAL RELEVANCE Final irrigation protocols aim to clean the canal complexities that are not addressed by the shaping procedures. Micro-CT allowed to assess the removal of hard-tissue debris in the isthmus and canals of mandibular molars.
Collapse
Affiliation(s)
| | | | - Lucila Piasecki
- Department of Periodontics & Endodontics, University at Buffalo, Buffalo, NY, USA.
| | - Mariel Webber
- Department of Periodontics & Endodontics, University at Buffalo, Buffalo, NY, USA
| | - Everdan Carneiro
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | | | | |
Collapse
|
22
|
Endodontic Rotary Files, What Should an Endodontist Know? Medicina (B Aires) 2022; 58:medicina58060719. [PMID: 35743982 PMCID: PMC9230915 DOI: 10.3390/medicina58060719] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/18/2022] [Accepted: 05/25/2022] [Indexed: 11/17/2022] Open
Abstract
Clinicians should be aware of all the characteristics and capacities of the instruments that are possible to use when conducting a root canal treatment. The wide variety of nickel–titanium (Ni-Ti) rotary systems on the market and the lack of standardisation of this type of instrument makes the choice in each specific case difficult. Therefore, this review is intended to summarize the characteristics that should be taken into account when choosing one instrument over another. It will be essential to know characteristics, of alloy from which the instrument is made. Moreover, the geometry of the instrument will determine its behaviour, being the mass, the one that marks its resistance to a greater extent. The movement performed by the file is another of the fundamental keys to understand rotary instruments. In conclusion, when performing root canal treatment, the characteristics of the instrument and the tooth must be taken into account, and the operator’s own limitations should be known. This paper provides the key points to keep in mind when making this type of treatment.
Collapse
|
23
|
Elsaka S, Hussein W, Hashem A, Soliman A. The Effect of Passive Ultrasonic Irrigation or XP-Endo Finisher on Post-Operative Pain in Patients with Necrotic Teeth with Apical Periodontitis (Randomized Controlled Clinical Trial). Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9222] [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 effect of passive ultrasonic irrigation or XP-Endo Finisher on post-operative pain in patients with necrotic teeth with apical periodontitis using (VAS) scale at 6, 12, 24, 48, 72 hours, and 7 day time intervals.
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); Navitip group (control), XP-Endo Finisher group, or Ultra X group. 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 the patient would mark the degree of pain in a scale from 0 to 10 at 6, 12, 24, 48, 72 hours and 7 days post-obturation. Data were statistically analyzed with a significance level of P ≤ 0.05.
Results Ultrasonic agitation and XP-Endo Finisher agitation as a final irrigation protocol showed significantly lower pain values than the control group, but there was no significant difference in pain values between the experimental groups.
Conclusion There was significantly less pain associated with ultrasonic and XP-Endo Finisher agitation compared to Navitip irrigation.
Collapse
|
24
|
Josic U, Mazzitelli C, Maravic T, Fidler A, Breschi L, Mazzoni A. Biofilm in Endodontics: In Vitro Cultivation Possibilities, Sonic-, Ultrasonic- and Laser-Assisted Removal Techniques and Evaluation of the Cleaning Efficacy. Polymers (Basel) 2022; 14:polym14071334. [PMID: 35406207 PMCID: PMC9003475 DOI: 10.3390/polym14071334] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 01/27/2023] Open
Abstract
Incomplete and inadequate removal of endodontic biofilm during root canal treatment often leads to the clinical failure. Over the past decade, biofilm eradication techniques, such as sonication of irrigant solutions, ultrasonic and laser devices have been investigated in laboratory settings. This review aimed to give an overview of endodontic biofilm cultivation methods described in papers which investigated sonic-, ultrasonic- and Er:Yag laser-assisted biofilm removal techniques. Furthermore, the effectiveness of these removal techniques was discussed, as well as methods used for the evaluation of the cleaning efficacy. In general, laser assisted agitation, as well as ultrasonic and sonic activation of the irrigants provide a more efficient biofilm removal compared to conventional irrigation conducted by syringe/needle. The choice of irrigant is an important factor for reducing the bacterial contamination inside the root canal, with water and saline being the least effective. Due to heterogeneity in methods among the reviewed studies, it is difficult to compare sonic-, ultrasonic- and Er:Yag laser-assisted techniques among each other and give recommendations for the most efficient method in biofilm removal. Future studies should standardize the methodology regarding biofilm cultivation and cleaning methods, root canals with complex morphology should be introduced in research, with the aim of simulating the clinical scenario more closely.
Collapse
Affiliation(s)
- Uros Josic
- Department for Biomedical and Neuromotor Sciences, University of Bologna-Alma Mater Studiorum, 40139 Bologna, Italy; (U.J.); (C.M.); (T.M.); (A.M.)
| | - Claudia Mazzitelli
- Department for Biomedical and Neuromotor Sciences, University of Bologna-Alma Mater Studiorum, 40139 Bologna, Italy; (U.J.); (C.M.); (T.M.); (A.M.)
| | - Tatjana Maravic
- Department for Biomedical and Neuromotor Sciences, University of Bologna-Alma Mater Studiorum, 40139 Bologna, Italy; (U.J.); (C.M.); (T.M.); (A.M.)
| | - Ales Fidler
- Dental Clinic, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Lorenzo Breschi
- Department for Biomedical and Neuromotor Sciences, University of Bologna-Alma Mater Studiorum, 40139 Bologna, Italy; (U.J.); (C.M.); (T.M.); (A.M.)
- Correspondence:
| | - Annalisa Mazzoni
- Department for Biomedical and Neuromotor Sciences, University of Bologna-Alma Mater Studiorum, 40139 Bologna, Italy; (U.J.); (C.M.); (T.M.); (A.M.)
| |
Collapse
|
25
|
Chinchiyanont P, Yanpiset K, Banomyong D, Thongbai-On N. Shaping ability of non-adaptive and adaptive core nickel-titanium single-file systems with supplementary file in ribbon-shaped canals analysed by micro-computed tomography. AUST ENDOD J 2022; 49:38-47. [PMID: 35255157 DOI: 10.1111/aej.12609] [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: 06/29/2021] [Revised: 01/17/2022] [Accepted: 02/02/2022] [Indexed: 11/28/2022]
Abstract
This study compared shaping ability between two single-file systems and before/after using supplementary file in untouched area, volume of removed dentin, maximum cut depth (the highest cut depth by main file) and remaining thinnest dentin (the thinnest root dentin after preparation). Ribbon-shaped distal canals of mandibular molars were prepared with non-adaptive core (WaveOne Gold) or adaptive core (XP-endo Shaper) files (n = 15/group) and additionally prepared with a supplementary file (XP-endo Finisher), and the shaping ability was investigated using micro-computed tomography. XP-endo Shaper group demonstrated significantly less overall untouched area than WaveOne Gold group (38.21 ± 6.98% vs. 47.68 ± 9.16%) (p < 0.05). No significant difference was detected between XP-endo Shaper and WaveOne Gold groups in volume of removed dentin (1.85 ± 0.53 vs. 1.66 ± 0.33 mm3 ), maximum cut depth (0.10-0.28 vs. 0.10-0.29 mm) and remaining thinnest dentin (0.66-0.80 vs. 0.78-0.88 mm). Supplementary XP-endo Finisher treatment significantly decreased untouched area (11%-23% reduction) (p < 0.05) with minimally cut root dentin (0.01-0.02 mm).
Collapse
Affiliation(s)
- Parichat Chinchiyanont
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Kallaya Yanpiset
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Danuchit Banomyong
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | |
Collapse
|
26
|
Galvani LD, Costa JLDSG, Besegato JF, Zaniboni JF, Escalante-Otárola WG, Kuga MC. Influence of agitation methods of irrigants after methylene blue-mediated PDT on the bonding interface of a fiber post cementation system. Photodiagnosis Photodyn Ther 2022; 37:102708. [PMID: 34971820 DOI: 10.1016/j.pdpdt.2021.102708] [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: 08/29/2021] [Revised: 12/09/2021] [Accepted: 12/27/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study evaluated the effects of final agitation methods of irrigants to remove methylene blue and sodium hypochlorite residues after PDT-assisted endodontic treatment on the bond strength of fiber posts cemented with etch-and-rinse adhesive and conventional resin cement. METHODS Ninety bovine teeth were endodontically treated. In sequence, post space preparation followed by methylene blue-mediated PDT and sodium hypochlorite (NaOCl) irrigation were performed. Six final irrigations protocols for dye and NaOCl removal were performed prior to cementation with etch-and-rinse adhesive (Adper Scocthbond Multipurpose) and conventional dual resin cement (RelyX ARC): Conventional endodontic irrigation (CEI), passive ultrasonic irrigation (PUI), mechanical agitation with XP Endo Finisher (XPF), XP Clean (XPC) or Easy Clean (ECL) and distilled water (NCO - control). After fiber post cementation, push-out bond strength test was performed at different thirds of the post space. Failure mode was also analyzed. ANOVA and Tukey's post-hoc test was used for data analysis (α=5%). RESULTS PUI, XPF e XPC protocols showed the highest bond strength values with no difference among them (p > 0.05), although they were similar to NCO, regardless of the post space third. CEI e ECL showed similar bond strength values, regardless of the third (p > 0.05). Adhesive failure was the most incident for CEI and ECL, while mixed and cohesive failures were predominant in PUI, XPF, XPC and NCO groups. CONCLUSIONS Mechanical agitation of distilled water with XPF, XPC and PUI after methylene blue-mediated PDT and irrigation with 2.5% sodium hypochlorite promoted bond strength of the resin cementation system in post space dentin comparable to control group.
Collapse
Affiliation(s)
- Lucas David Galvani
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, SP, Brazil.
| | | | - João Felipe Besegato
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, SP, Brazil.
| | - Joissi Ferrari Zaniboni
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, SP, Brazil.
| | | | - Milton Carlos Kuga
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, SP, Brazil.
| |
Collapse
|
27
|
Chaniotis A, Ordinola Zapata R. Present status and future directions -Management of curved and calcified root canals. Int Endod J 2022; 55 Suppl 3:656-684. [PMID: 35106792 DOI: 10.1111/iej.13685] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 12/01/2022]
Abstract
Root canal curvature and calcification introduce factors that increase the risk of procedural accidents during root canal treatment. The inability to achieve patency to the apical third, asymmetrical dentine removal leading to transportation, perforation and instrument fracture inside the curved trajectories are some of the procedural problems that might jeopardize the management of intraradicular infection and result in poor treatment outcomes. In fact, curved and constricted canals introduce such complexity that total instrumentation concepts and specially designed instruments have been developed to deal with the challenge. This narrative review seeks to provide and consolidate the principles necessary for understanding the dynamics of curved and constricted canal management and to improve the understanding for future developments in this field.
Collapse
Affiliation(s)
- Antonis Chaniotis
- Private practice, National and Kapodistrian University of Athens, Dental School, Athens, Greece
| | - Ronald Ordinola Zapata
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
28
|
Tonini R, Salvadori M, Audino E, Sauro S, Garo ML, Salgarello S. Irrigating Solutions and Activation Methods Used in Clinical Endodontics: A Systematic Review. FRONTIERS IN ORAL HEALTH 2022; 3:838043. [PMID: 35174355 PMCID: PMC8841673 DOI: 10.3389/froh.2022.838043] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/06/2022] [Indexed: 12/03/2022] Open
Abstract
Background Ex vivo and in vitro studies have demonstrated the effectiveness of some irrigation protocols in reducing the bacterial load in the root canal system. However, standardized protocols have not yet been defined for the real clinical context due to many irrigation procedures available. Objective To evaluate the clinical endodontic protocols and limitations of irrigating solutions in the disinfection of the root canal system in patients with apical periodontitis. Methods PubMed, Scopus, Embase, Web of Science, and Cochrane databases were searched for randomized controlled trials (RCT) published until January 2021. Hand searching was also performed. Studies focused on evaluating the effectiveness of irrigating solutions and/or irrigation activation methods in reducing the bacterial load in the root canal system were considered. The Cochrane risk-of-bias tool for randomized trials (RoB2) was used to assess the quality of the studies. Results Four hundred and twenty eight published articles were identified. After removing the duplicate studies and analyzing full texts, seven RCTs were selected. Two studies compared pure NaOCl with some combination of NaOCl with HEDP and MTAD. Two studies analyzed the antibacterial efficacy of NaOCl and chlorhexidine (CHX). Three studies compared conventional needle irrigation with different irrigation activation methods (PUI, XP-endo finisher, F-file activator, EndoVac activator). The review attained a satisfactory methodology. The main results of each included study were described. Discussion Activation methods provide significantly higher biofilm reduction than conventional needle irrigation methods. Combinations of NaOCl with different chelating agents were ineffective in terms of antimicrobial, but it could potentially increase the risk of irrigant extrusion. However, the irrigating protocols were not carefully detailed, especially those regarding the irrigants application time or total volume. The existing literature lacks high-quality studies. The level of evidence is moderate. Conclusions The available data is too heterogeneous to compare and identify the superiority of specific valuable irrigation protocols in each clinical context. Application time, volume, and activation methods should be standardized to determine the optimal irrigating procedures to reduce the bacterial load and ensure higher predictability of the endodontic treatment. Systematic Review Registration (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=218555), PROSPERO registration: CRD42020218555.
Collapse
Affiliation(s)
- Riccardo Tonini
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy
| | - Matteo Salvadori
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy
| | - Elisabetta Audino
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy
| | - Salvatore Sauro
- Department of Dentistry, Dental Biomaterials and Minimally Invasive Dentistry, Cardenal Herrera-CEU University, Alfara del Patriarca, Spain
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Maria Luisa Garo
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy
- *Correspondence: Maria Luisa Garo
| | - Stefano Salgarello
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, Dental School, University of Brescia, Brescia, Italy
| |
Collapse
|
29
|
Matoso FB, Quintana RM, Jardine AP, Delai D, Fontanella VRC, Grazziotin-Soares R, Kopper PMP. XP Endo Finisher-R and PUI as supplementary methods to remove root filling materials from curved canals. Braz Oral Res 2022; 36:e053. [DOI: 10.1590/1807-3107bor-2022.vol36.0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 01/17/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | - Debora Delai
- Universidade Federal do Rio Grande do Sul, Brazil
| | | | | | | |
Collapse
|
30
|
Hazar E, Sağlam B, Ulusoy-Atasoy Ö, Koçak M, Koçak S. Evaluation of irrigation techniques in the removal of root canal filling material: Micro-CT and SEM study. BALKAN JOURNAL OF DENTAL MEDICINE 2022. [DOI: 10.5937/bjdm2202075h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background/Aim: This study aimed to compare the different irrigation activation methods in retreatment of oval-shaped root canals. Material and Methods: Forty distal canals from mandibular molars were filled. After the removal of filling material, specimens were assigned to four groups as follows; control, passive ultrasonic irrigation (PUI), self-adjusting file (SAF), and XP-endo Finisher (XPF). The amount of residual filling material was assessed by micro-computed tomography (micro-CT) and root canal walls were examined by using scanning electrom microscopy (SEM). Data were analyzed using the Kruskal-Wallis and Dunn test. Results: None of the activation techniques removed root canal remnants completely. The amount of filling material significantly decreased in all activation techniques compared to the control group (p<0.05). There was no significant difference between the PUI, SAF, and XPF groups in the micro-CT analysis (p>0.05). SEM evaluation showed higher scores in the apical region in all groups (p<0.05). Conclusions: The use of activation methods reduces the amount of residual filling material.
Collapse
|
31
|
Macedo LMDD, Silva-Sousa YTC, Olivato Junior O, Baltazar AF, Rached-Junior FJA. Different biomechanical preparation protocols on the penetration and bond strength of the filling material to dentin. Braz Dent J 2021; 32:12-22. [PMID: 34877974 DOI: 10.1590/0103-6440202104472] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 10/13/2021] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the influence of different instruments and mechanisms of agitation of the irrigating solution on the penetration by confocal laser scanning microscopy (CLSM), and the bond strength (BS) of the filling material to the dentin by push-out test. Human premolars were distributed in two experimental groups (n=30), according to the instrumentation system: ProTaper Next (PN) or XP-endo Shaper (XS) and three irrigation protocol (n=10): NaviTip (Nv), XP-endo Finisher (XF), passive ultrasonic irrigation/ XP-endo Finisher (PUIXF). The 2.5% NaOCl and 17% EDTA were the irrigating solutions used. The filling was performed using a lateral condensation technique, with AH Plus added to 0.1% rodhamine B. The roots were sectioned, obtaining 2 slices for each third of the root. The first slice was submitted to the sealer penetration analysis and the push-out test. The second slice was submitted to qualitative analysis (SEM) of the union interface. For the penetration (%) Tukey showed that PNXF (82.38±13.48), PNPUIXF (82.48± 12.02), XSXF (82.24±11.28) and XSPUIXP (86.23±10.45) presented the highest values, different (p<0.05) from PNNv (68.29±15.12) and XSNv (71.41±16.50). The BS (MPa) test evidenced that in the cervical third, PNPF (4.92±1.04) and XPSPF (5.03±0.70) obtained the highest values differing from the others groups (p<0.05). CSLM and SEM showed greater penetration of the sealer on the entire length of the root canal when the irrigation solution was stirred. In conclusion that the association PUI and XP-endo Finisher favored the penetration and bond strength of the filling material to the root dentin.
Collapse
|
32
|
Pedrinha VF, Cardenas Cuellar MR, Velásquez-Espedilla EG, Duarte MAH, Andrade FBD, Rodrigues PDA. Impact of irrigation protocols with some chelators and mechanical agitation on intratubular decontamination. Braz Oral Res 2021; 35:e127. [PMID: 34878082 DOI: 10.1590/1807-3107bor-2021.vol35.0127] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 05/05/2021] [Indexed: 11/21/2022] Open
Abstract
This study evaluated main canal and intratubular decontamination using different irrigation solutions followed by adjunctive agitation steps for infected root canals. Sixty-eight lower incisors were contaminated with Enterococcus faecalis and allocated to groups according to canal treatment (n = 10): G1, NaOCl followed by ethylenediaminetetraacetic acid (EDTA); G2, a mixture of NaOCl with hydroxyethylidene bisphosphonate (HEBP); and G3, NaOCl followed by EDTA-T (EDTA with sodium lauryl ether sulfate). All three groups of teeth were agitated with passive ultrasonic irrigation (PUI) using saline solution, whereby G4, G5, and G6 were prepared as above, and agitation was performed using an XP-Endo Finisher instrument. Microbiological samples were collected from the root canals with paper points at three times: before and after chemomechanical preparation and after agitation. The colony-forming units (CFU)/mL count was determined, and bacterial intratubular viability was analyzed via confocal laser scanning microscopy using Live/Dead staining. Statistical analysis was performed using a Kruskal-Wallis test followed by Dunn tests. A Friedman test was applied for colony-counting data (α = 0.05). CFU/mL counting indicated equally effective decontamination in the experimental groups (p > 0.05). According to microscopy images, the use of irrigation solutions followed by agitation with the XP-Endo Finisher yielded better results. Moreover, NaOCl+EDTA-T followed by XP-Endo Finisher resulted in significantly lower viability than in the PUI-activated groups (p < 0.05). The cervical and medium thirds of the specimens presented similar results. Overall, NaOCl+EDTA-T exhibited the best intratubular antibacterial activity, mainly for canals that were subsequently agitated using XP-Endo Finisher.
Collapse
Affiliation(s)
- Victor Feliz Pedrinha
- Universidade Federal do Pará - UFPA, Graduate Program in Dentistry, Laboratory of Dental Materials, Belém, PA, Brazil
| | - Maricel Rosario Cardenas Cuellar
- Universidade de São Paulo - USP, Bauru Dental School, Department of Operative Dentistry, Dental Materials and Endodontics, Bauru, SP, Brazil
| | - Evelyn Giuliana Velásquez-Espedilla
- Universidade de São Paulo - USP, Bauru Dental School, Department of Operative Dentistry, Dental Materials and Endodontics, Bauru, SP, Brazil
| | - Marco Antonio Hungaro Duarte
- Universidade de São Paulo - USP, Bauru Dental School, Department of Operative Dentistry, Dental Materials and Endodontics, Bauru, SP, Brazil
| | - Flaviana Bombarda de Andrade
- Universidade de São Paulo - USP, Bauru Dental School, Department of Operative Dentistry, Dental Materials and Endodontics, Bauru, SP, Brazil
| | - Patrícia de Almeida Rodrigues
- Universidade Federal do Pará - UFPA, Graduate Program in Dentistry, Laboratory of Dental Materials, Belém, PA, Brazil
| |
Collapse
|
33
|
Bago I, Batelja-Vuletić L, Tarle A, Sesar A, Anić I. Novel laser activated photoacoustic streaming for removing pulp remnants from round root canals after single file reciprocating instrumentation: Photoacoustic streaming for removing pulp. Photodiagnosis Photodyn Ther 2021; 37:102631. [PMID: 34798349 DOI: 10.1016/j.pdpdt.2021.102631] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/07/2021] [Accepted: 11/12/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study evaluated the efficacy of a new laser-assisted irrigation system, the shock wave enhanced emission photo-acoustic streaming (SWEEPS) technique in removing pulp tissue from single-rooted premolars. METHODS Freshly extracted mandibular premolars with round root canals (n=40), scanned using cone beam computed tomography, were randomly divided into control and four experimental (according to the irrigation technique used) groups (n=8/group). Groups 1, 2, and 3 were instrumented using Reciproc Blue (RB25/.06) followed by final irrigation protocol (FIP), activated by SWEEPS, ultrasonically activated irrigation (UAI), and conventional irrigation (CI), respectively. In these groups, 7 mL 3% NaOCl in total was used during instrumentation; for FIP, 3% NaOCl (60 s), ethylenediaminotetraacetic acid (60s), and 3% NaOCl (30s). In group 4, SWEEPS activation of 3% NaOCl for 6 × 30 s alone was performed. The untreated control group specimens were processed for histological evaluation of remaining pulp tissue (RPT) in each canal third. The results were analyzed using the Mann-Whitney U test (α =0.05). RESULTS Significant differences were observed between the control group and the experimental groups (p<0.05). In the middle third, the UIA and SWEEPS showed similar efficacy (p=0.171), superior to CI and SWEEPS without instrumentation (p<0.05). In the apical third, SWEEPS was the most efficient (p=0.002), and UIA and CI showed no difference (p=0.643). CONCLUSION SWEEPS was superior to UIA and CI in removing RPT in the apical region of round canals after single instrument root canal preparation; SWEEPS without instrumentation was inefficient in removing pulp tissue.
Collapse
Affiliation(s)
- Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia.
| | | | | | - Anja Sesar
- Dental Polyclinic Zagreb, Zagreb, Croatia
| | - Ivica Anić
- Dental Polyclinic Zagreb, Zagreb, Croatia
| |
Collapse
|
34
|
Oliveira LSDJ, de Bragança RMF, Sarkis-Onofre R, Faria-E-Silva AL. The effectiveness of the supplementary use of the XP-endo Finisher on bacteria content reduction: a systematic review and meta-analysis. Restor Dent Endod 2021; 46:e37. [PMID: 34513643 PMCID: PMC8411000 DOI: 10.5395/rde.2021.46.e37] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/16/2020] [Indexed: 12/31/2022] Open
Abstract
Objectives This systematic review evaluated the efficacy of the supplementary use of the XP-endo Finisher on bacteria content reduction in the root canal system. Materials and Methods In-vitro studies evaluating the use of the XP-endo Finisher on bacteria content were searched in four databases in July 2020. Two authors independently screened the studies for eligibility. Data were extracted, and risk of bias was assessed. Data were meta-analyzed by using random-effects model to compare the effect of the supplementary use (experimental) or not (control) of the XP-endo Finisher on bacteria counting reduction, and results from different endodontic protocols were combined. Four studies met the inclusion criteria while 1 study was excluded from the meta-analysis due to its high risk of bias and outlier data. The 3 studies that made it to the meta-analysis had an unclear risk of bias for at least one criterion. Results No heterogeneity was observed among the results of the studies included in the meta-analysis. The study excluded from the meta-analysis assessing the bacteria counting deep in the dentin demonstrated further bacteria reduction upon the use of the XP-endo Finisher. Conclusions This systematic review found no evidence supporting the supplementary use of the XP-endo Finisher on further bacteria counting the reduction in the root canal.
Collapse
Affiliation(s)
| | | | | | - André Luis Faria-E-Silva
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Brazil.,Graduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
| |
Collapse
|
35
|
Alsofi L, Al Harbi M, Al-Habib M, Stauber M, Balto K. Micro-cleanliness of Hard Tissue Debris After Advanced Irrigation and Comparison Between EndoVac and XP-endo Finisher: A Microcomputed Tomographic Study. J Int Soc Prev Community Dent 2021; 11:457-462. [PMID: 34430508 PMCID: PMC8352053 DOI: 10.4103/jispcd.jispcd_430_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/25/2021] [Accepted: 04/24/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction: Conventional irrigation techniques do not remove debris adequately. The remaining tissue debris cause infection inside the root canal and may also affect the seal of the root canal. The study aimed to compare the ability of EndoVac (EV) with XP-endo finisher (XPF) in debris removal using micro-CT analysis. Materials and Methods: We used 12 lower first permanent molar human teeth for this study. The root canals were instrumented using a small TF adaptive system. Then, the volume of debris was calculated. Teeth were divided into two groups, according to advanced irrigation methods, with six teeth per group: EV group and XPF group. The volume of debris was calculated again. The paired-sample t-test was used to compare the volume of the debris before and after the use of advanced irrigation methods with the statistical significance of P < 0.05. The percentage of debris reduction was also calculated. Results: Both EV and XPF showed a significant decrease of debris in the mesial canals (P < 0.05), whereas EV only showed a significant reduction of debris in the distal canals. Conclusion: Both EV and XPF were able to significantly reduce debris after instrumentation in the mesial canals of lower first mandibular molars. Clinical Significance: The study provides insight into the recent advanced methods used in debris removal and canal disinfection.
Collapse
Affiliation(s)
- Loai Alsofi
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Muhanad Al Harbi
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Ministry of Health, Dental Division, Jeddah, Saudi Arabia
| | - Mey Al-Habib
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Khaled Balto
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
36
|
Teves A, Blanco D, Casaretto M, Torres J, Alvarado DE, Coaguila-Llerena H, Faria G, Jaramillo DE. Multispecies biofilm removal by XP-endo Finisher and passive ultrasonic irrigation: A scanning electron microscopy study. AUST ENDOD J 2021; 48:91-97. [PMID: 34310795 DOI: 10.1111/aej.12549] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 07/18/2021] [Indexed: 12/21/2022]
Abstract
The aim was to assess the effect of XP-endo Finisher (XPF) on multispecies biofilm removal, in comparison with passive ultrasonic irrigation (PUI) and conventional syringe irrigation (CSI), by scanning electron microscope (SEM). Fifty mandibular first premolars were instrumented, longitudinally sectioned. The split halves were incubated for 4 days with a broth obtained from three bacteria strains: Enterococcus faecalis, Eikenella corrodens and Streptococcus anginosus. Subsequently, the re-approximated split halves were irrigated with 4% sodium hypochlorite (NaOCl) or water using CSI, and the final irrigation protocols were CSI with 4% NaOCl (CSI+4%NaOCl), PUI+4%NaOCl, XPF+4%NaOCl and CSI+water. The analysis of biofilm removal was performed using SEM images. There were no differences between PUI and XPF (P > 0.05), and both groups promoted higher biofilm removal than CSI+4%NaOCl and CSI+water groups (P < 0.05). It can be concluded the multispecies biofilm removal was significantly improved using XPF and PUI when compared to CSI.
Collapse
Affiliation(s)
- Abel Teves
- Stomatological research and training center, Lima, Peru
| | - Daniel Blanco
- Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia - UPCH, Lima, Peru
| | - Mario Casaretto
- Department of Endodontics, Universidad Nacional Mayor de San Marcos - UNMSM. Lima, Peru
| | - John Torres
- Department of Endodontics, Universidad Privada San Juan Bautista - UPSJB, Lima, Peru
| | - Débora E Alvarado
- Faculty of Biological Sciences, Universidad Nacional Mayor de San Marcos - UNMSM, Lima, Peru
| | - Hernán Coaguila-Llerena
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Gisele Faria
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - David E Jaramillo
- Department of Endodontics, University of Texas Health Science Center at Houston, Houston, Texas, USA
| |
Collapse
|
37
|
Herce-Ros N, Álvarez-Sagües A, Álvarez-Losa L, Nistal-Villan E, Amador U, Presa J, Azabal M. Antibacterial Ability of Sodium Hypochlorite Activated with PUI vs. XPF File against Bacteria Growth on Enterococcus faecalis Mature Biofilm. Dent J (Basel) 2021; 9:dj9060067. [PMID: 34200637 PMCID: PMC8228713 DOI: 10.3390/dj9060067] [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: 05/10/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 12/12/2022] Open
Abstract
The objectives of the present study were to assess the antibacterial effectiveness of two sodium hypochlorite (NaOCl) concentrations (2.5% and 5.25%) activated by means of two techniques, passive ultrasonic irrigation (PUI) and XP-endo® Finisher (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) (XPF) against bacteria growth in intracanal mature biofilm. Our aim was to determine if the effect of heating up NaOCl at body temperature (BT) contributed to an improvement of the efficacy of XPF. Sixty-two single-canal human roots previously instrumented were infected with E. faecalis inoculum at 0.5 McFarland and incubated at 37 °C for two weeks. Twelve specimens were randomly selected as positive control, and the remaining fifty were divided into five experimental groups (n = 10). The first two were irrigated with 2.5 vs. 5.25% NaOCl at room temperature (RT), activated with PUI, and the other three were irrigated with XPF. Of these three, two were irrigated using 2.5 vs. 5.25% NaOCl at RT and one was irrigated with 5.25% NaOCl at BT. Our results showed that NaOCl was effective in biofilm removal for all experimental groups (p > 0.05), especially in the groups irrigated with 5.25% NaOCl at room temperature (RT) activated with PUI and the group treated with 5.25% NaOCl at BT with XPF. These groups were the most successful ones (p < 0.001). NaOCl, activated with XPF, was as effective as PUI in biofilm removal from the apical third of the canal when it was used at higher concentration and heated up. This study indicates that XPF only reached the efficacy of PUI when NaOCl was heated up.
Collapse
Affiliation(s)
- Nerea Herce-Ros
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (A.Á.-S.); (M.A.)
- Correspondence: (N.H.-R.); (L.Á.-L.); Tel.: +34-67-938-2974 (N.H.-R.)
| | - Alejandro Álvarez-Sagües
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (A.Á.-S.); (M.A.)
| | - Laura Álvarez-Losa
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (A.Á.-S.); (M.A.)
- Correspondence: (N.H.-R.); (L.Á.-L.); Tel.: +34-67-938-2974 (N.H.-R.)
| | - Estanislao Nistal-Villan
- Microbiology Section, Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, San Pablo CEU University, 28668 Madrid, Spain;
| | - Ulises Amador
- Department of Chemistry and Biochemistry, Faculty of Pharmacy, San Pablo CEU University, 28668 Madrid, Spain;
| | - Jesús Presa
- Independent Researcher, 28003 Madrid, Spain;
| | - Magdalena Azabal
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (A.Á.-S.); (M.A.)
| |
Collapse
|
38
|
Zhou J, Liu T, Guo L. Effectiveness of XP-Endo Finisher and passive ultrasonic irrigation on intracanal medicament removal from root canals: a systematic review and meta-analysis. BMC Oral Health 2021; 21:294. [PMID: 34107959 PMCID: PMC8191128 DOI: 10.1186/s12903-021-01644-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/27/2021] [Indexed: 01/07/2023] Open
Abstract
Background XP-Endo Finisher (XPF) and passive ultrasonic irrigation (PUI) are commonly used in intracanal medicament removal. The effectiveness of these two techniques needs to be compared, and evidence-based research should be conducted. Methods A comprehensive literature search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar up to December 20th, 2020. The outcomes of the included trials were pooled into the Cochrane Collaboration’s Review Manager 5.3 software. Cochrane’s risk-of-bias tool 2.0 was applied to assess the risk of bias. Results Nine articles were included in this systematic review and processed for data extraction, and eight studies were identified for meta-analysis. In general, the use of PUI showed better medicament removal effectiveness than XPF (odds ratio [OR]: 3.09; 95% confidence interval [CI], 1.96–4.86; P < 0.001). PUI was also significantly more efficient than XPF in the apical third (OR: 3.42; 95% CI, 1.32–8.84; P = 0.01). For trials using sodium hypochlorite (NaOCl) alone, PUI was also significantly more effective than XPF on intracanal medicaments removal (OR: 5.23; 95% CI, 2.79–9.82; P < 0.001). However, there was no significant difference between PUI and XPF when NaOCl and ethylenediaminetetraacetic acid (EDTA) were used in combination (OR: 1.51; 95% CI, 0.74–3.09; P = 0.26). In addition, for studies whose intracanal medicament periods were two weeks, the effectiveness of PUI was statistically better than the XPF (OR: 7.73; 95% CI, 3.71–16.07; P < 0.001). Nevertheless, for trials whose intracanal medicament time was one week or over two weeks, no differences between the XPF and PUI were found (OR: 1.54; 95% CI, 0.74–3.22; P = 0.25) (OR: 1.42; 95% CI, 0.44–4.61; P = 0.56). Conclusions The meta-analysis is the first study to quantitatively compare the effectiveness of XPF and PUI techniques on intracanal medicaments removal. With rigorous eligibility criteria, the study only included high-quality randomised controlled trials. The study indicated that PUI might be superior over XPF techniques for removing intracanal medicaments from artificial standardized grooves and cavities in the root canal system. The anatomical areas, irrigation protocol, and intracanal medicaments time may influence the cleaning efficacy. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01644-7.
Collapse
Affiliation(s)
- Jiani Zhou
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Lingyuanxi Road, Guangzhou, 510055, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Tingjun Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Lingyuanxi Road, Guangzhou, 510055, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Lihong Guo
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Lingyuanxi Road, Guangzhou, 510055, China. .,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
| |
Collapse
|
39
|
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.
Collapse
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
| |
Collapse
|
40
|
Álvarez-Sagües A, Herce N, Amador U, Llinares-Pinel F, Nistal-Villan E, Presa J, Álvarez L, Azabal M. Efficacy of EDTA and HEDP Chelators in the Removal of Mature Biofilm of Enterococcus faecalis by PUI and XPF File Activation. Dent J (Basel) 2021; 9:41. [PMID: 33918842 PMCID: PMC8068811 DOI: 10.3390/dj9040041] [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: 03/07/2021] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Biofilm removal from the root canal during endodontic treatment is necessary to prevent further complications. Irrigation is essential to success. Several irrigants have been proposed without a proper comparison. The aim of the study is to compare the antibacterial capacity of different activated irrigants using passive ultrasonic activation (PUI) or XP-Endo finisher (XPF). METHODS A total of 100 instrumented teeth were incubated in an Eppendorf tube containing 0.5 McFarland of Enterococcus faecalis and incubated for 2 weeks at 37 °C. Roots were divided into 5 groups (n = 20) according to the irrigant type: ethylenediaminetetraacetic acid (EDTA) (17%), ethydronic acid (HEDP) (9%) mixed with 5.25% sodium hypochlorite (NaOCl), EDTA (17%) mixed with 5.25% NaOCl, PBS, and a control group. Each group was divided into two subgroups (n = 10): PUI and XPF. RESULTS As compared to the untreated control group, the irrigators included in the study had a significant effect in bacteria reduction. The obtained results show HEDP to be the most effective irrigant, since no bacteria were recovered after treatment of this group, followed by EDTA mixed with NaOCl and, finally, the EDTA-irrigated group. CONCLUSIONS HEDP is the best irrigating agent in combination with XPF or PUI file activation to eliminate bacteria in our experimental model.
Collapse
Affiliation(s)
- Alejandro Álvarez-Sagües
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (N.H.); (M.A.)
| | - Nerea Herce
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (N.H.); (M.A.)
| | - Ulises Amador
- Departamento de Química y Bioquímica, Facultad de Farmacia, Universidad San Pablo-CEU, Urbanización Montepríncipe, Boadilla del Monte, 28668 Madrid, Spain;
| | - Francisco Llinares-Pinel
- Microbiology Section, Departamento CC, Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad CEU San Pablo, Boadilla del Monte, 28668 Madrid, Spain; (F.L.-P.); (E.N.-V.)
| | - Estanislao Nistal-Villan
- Microbiology Section, Departamento CC, Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad CEU San Pablo, Boadilla del Monte, 28668 Madrid, Spain; (F.L.-P.); (E.N.-V.)
| | - Jesús Presa
- Independent Researcher, 28668 Madrid, Spain;
| | - Laura Álvarez
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (N.H.); (M.A.)
| | - Magdalena Azabal
- Dentistry Department, Faculty of Medicine, San Pablo CEU University, 28668 Madrid, Spain; (N.H.); (M.A.)
| |
Collapse
|
41
|
Uzunoglu-Özyürek E, Küçükkaya Eren S, Karahan S. Contribution of XP-Endo files to the root canal filling removal: A systematic review and meta-analysis of in vitro studies. AUST ENDOD J 2021; 47:703-714. [PMID: 33713515 DOI: 10.1111/aej.12503] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/18/2021] [Accepted: 02/25/2021] [Indexed: 12/11/2022]
Abstract
This review was designed to analyse whether the supplementary use of XP-Endo Finisher and XP-Endo Finisher R contributes to the removal of root canal filling materials. Databases were searched up to November 2020. Studies were critically assessed according to inclusion and exclusion criteria. Risk of bias evaluation was performed. Pooled standardised mean differences (SMD) and 95% confidence intervals (95% CI) were calculated. Ten studies involving 192 teeth were eligible for systematic review and meta-analysis could be performed with eight of these studies. Strong evidence showed that XP-Endo Finisher R file contributed significantly to filling material removal from root canals (SMD (95% CI): 0.41 (0.06-0.76)). Although the evidence was conflicting, XP-Endo Finisher R file was superior than other irrigant activation techniques (SMD (95% CI): 0.47 (0.02-0.93)). The supplementary use of XP-Endo Finisher and XP-Endo Finisher R is beneficial in further removal of root canal filling materials from root canal system.
Collapse
Affiliation(s)
- Emel Uzunoglu-Özyürek
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Selen Küçükkaya Eren
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sevilay Karahan
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| |
Collapse
|
42
|
Andreani Y, Gad BT, Cocks TC, Harrison J, Keresztes ME, Pomfret JK, Rees EB, Ma D, Baloun BL, Rahimi M. Comparison of irrigant activation devices and conventional needle irrigation on smear layer and debris removal in curved canals. (Smear layer removal from irrigant activation using SEM). AUST ENDOD J 2021; 47:143-149. [PMID: 33682268 DOI: 10.1111/aej.12482] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 01/16/2023]
Abstract
AIM To compare the effectiveness of smear layer and debris removal in the final rinse of curved canals of permanent molars using different commercially available irrigant activation devices. METHODS The mesial roots of 74 extracted maxillary and mandibular molars were instrumented using the Mtwo nickel-titanium rotary system (VDW GmbH, Munich, Germany). They were then randomly assigned to one of three groups, varying in their final rinse protocol. Group 1 (n = 15) - conventional needle irrigation with 4% NaOCl; Group 2 (n = 19) - EndoActivator® (Dentsply Tulsa Dental Specialties, Tulsa, OK, USA) with 4% NaOCl; Group 3 (n = 17) - XP-endo® Finisher (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) with 4% NaOCl. After the final rinse, all canals were flushed with 1 mL 15% EDTA for 60 s and then flushed with saline. The roots were split longitudinally and prepared for scanning electron microscope imaging. ImageJ for Windows was utilised to assess the images for smear layer removal, while two blinded investigators assessed debris presence in the middle and apical thirds using a 5-point scale. RESULTS There was no significant difference in smear layer and debris removal between treatment and control groups in the same canal zones. A significant difference was noted across different canal zones both within and across the groups. CONCLUSION There is no statistically significant difference in effectiveness between activated irrigation techniques and manual activation. Further investigations are required to evaluate all methods available and determine the most efficient technique to irrigate successfully.
Collapse
Affiliation(s)
- Yasmina Andreani
- School of Dentistry - Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW, Australia
| | - Benjamin Thomas Gad
- School of Dentistry - Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW, Australia
| | - Thomas Charles Cocks
- School of Dentistry - Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW, Australia
| | - Jonathan Harrison
- School of Dentistry - Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW, Australia
| | - Mark Edward Keresztes
- School of Dentistry - Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW, Australia
| | - James Kennan Pomfret
- School of Dentistry - Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW, Australia
| | - Evan Benjamin Rees
- School of Dentistry - Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW, Australia
| | - Duoduo Ma
- School of Dentistry - Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW, Australia
| | - Brett Lindsay Baloun
- School of Dentistry - Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW, Australia
| | - Mehdi Rahimi
- School of Dentistry and Health Sciences - Faculty of Science, Charles Sturt University, Orange, NSW, Australia
| |
Collapse
|
43
|
Pérez Morales MDLN, González Sánchez JA, Olivieri JG, Elmsmari F, Salmon P, Jaramillo DE, Terol FDS. Micro-computed Tomographic Assessment and Comparative Study of the Shaping Ability of 6 Nickel-Titanium Files: An In Vitro Study. J Endod 2021; 47:812-819. [PMID: 33549630 DOI: 10.1016/j.joen.2020.12.021] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/23/2020] [Accepted: 12/15/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION This research studies and compares the shaping ability of WaveOne Gold (WG; Dentsply Tulsa Dental Specialties, Tulsa, OK), the Reciproc Blue (RB; VDW, Munich, Germany), TRUShape (TS, Dentsply Tulsa Dental Specialties), XP-endo Shaper (XP; FKG, La Chaux-de-Fonds, Switzerland), iRace (IR, FKG), and TruNatomy (TN; Dentsply Sirona, Ballaigues, Switzerland) in the preparation of moderately curved canals and using micro-computed tomographic technology. METHODS Sixty lower molars with 2 mesial canals were randomly distributed into 6 groups of 10 molars and 20 canals per group (n = 20). Specimens were scanned before and after preparation using the SkyScan 1275 (Bruker microCT, Kontich, Belgium). Group 1 was treated with WG, group 2 with RB, group 3 with TS, group 4 with XP, group 5 with IR, and group 6 with TN. After instrumentation, researchers quantified the changes produced in the canal geometry in terms of surface, volume, structure thickness, surface convexity index, structure model index, percentage of surface touched, and centroids. Wilcoxon and analysis of variance tests were performed to compare the values before and after preparation and the differences between groups. The significance level was established at 5%. RESULTS There were no significant differences between WG and RB (P > .05) and between TN and XP (P > .05). TN had significant differences with WG, RB, TS, and IR (P < .05). All the files produced similar apical transportation (P > .05). CONCLUSIONS WG and RB and TN and XP had similar shaping effectivity. TS and WG touched the highest percentages of canal surfaces (81% and 73%, respectively) but produced the biggest changes in the canal anatomy. TN and XP better kept the canal anatomy, but TN touched the lowest percentage of canal surface (50%). All the files used were able to clean and to shape moderately curved canals with minimal apical transportation.
Collapse
Affiliation(s)
- María de Las Nieves Pérez Morales
- Departments of Endodontics and Dental Research, International University of Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain
| | - José Antonio González Sánchez
- Departments of Endodontics and Dental Research, International University of Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain.
| | - Juan Gonzalo Olivieri
- Departments of Endodontics and Dental Research, International University of Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain
| | - Firas Elmsmari
- Departments of Endodontics and Dental Research, International University of Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain
| | | | - David E Jaramillo
- Department of Endodontics, University of Texas Health Science Center at Houston, Houston, Texas
| | - Fernando Durán-Sindreu Terol
- Departments of Endodontics and Dental Research, International University of Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain
| |
Collapse
|
44
|
Hydrodynamics and surface properties influence biofilm proliferation. Adv Colloid Interface Sci 2021; 288:102336. [PMID: 33421727 DOI: 10.1016/j.cis.2020.102336] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/02/2020] [Accepted: 12/02/2020] [Indexed: 12/20/2022]
Abstract
A biofilm is an interface-associated colloidal dispersion of bacterial cells and excreted polymers in which microorganisms find protection from their environment. Successful colonization of a surface by a bacterial community is typically a detriment to human health and property. Insight into the biofilm life-cycle provides clues on how their proliferation can be suppressed. In this review, we follow a cell through the cycle of attachment, growth, and departure from a colony. Among the abundance of factors that guide the three phases, we focus on hydrodynamics and stratum properties due to the synergistic effect such properties have on bacteria rejection and removal. Cell motion, whether facilitated by the environment via medium flow or self-actuated by use of an appendage, drastically improves the survivability of a bacterium. Once in the vicinity of a stratum, a single cell is exposed to near-surface interactions, such as van der Waals, electrostatic and specific interactions, similarly to any other colloidal particle. The success of the attachment and the potential for detachment is heavily influenced by surface properties such as material type and topography. The growth of the colony is similarly guided by mainstream flow and the convective transport throughout the biofilm. Beyond the growth phase, hydrodynamic traction forces on a biofilm can elicit strongly non-linear viscoelastic responses from the biofilm soft matter. As the colony exhausts the means of survival at a particular location, a set of trigger signals activates mechanisms of bacterial release, a life-cycle phase also facilitated by fluid flow. A review of biofilm-relevant hydrodynamics and startum properties provides insight into future research avenues.
Collapse
|
45
|
Postoperative pain in endodontic retreatment of one visit versus multiple visits: a systematic review and meta-analysis of randomized controlled trials. Clin Oral Investig 2021; 25:455-468. [PMID: 33399930 DOI: 10.1007/s00784-020-03767-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 12/23/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The aim of this systematic review and meta-analysis (SRM) was to assess the postoperative pain (PP) after non-surgical endodontic retreatment (NSER) in a one visit compared to multiple visits. The PICO question used was "Does NSER in patients with unsatisfactory endodontic treatment in a one-visit visit have a similar PP to that of NSER in multiple visits?" MATERIALS AND METHODS This systematic review followed PRISMA and was registered in PROSPERO (CRD42019136700). Searches were performed in the PubMed/MEDLINE, Scopus, and the Cochrane Library databases for articles published until September 2020. The eligible criteria were randomized clinical trials (RCTs). The meta-analysis was based on the Mantel-Haenszel. The PP after the retreatment was analyzed using a dichotomous outcome, measured according to risk ratio (RR) when p < 0.05. The Cochrane scale was used to assess risk of bias, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. RESULTS Four studies were included. In general analysis without considering intensity, one-visit NSER presented lower PP than the multiple visits only for 1 and 30 days [(RR = 0.67; CI: 0.48 to 0.93; p = 0.02), and (RR = 0.09; CI: 0.01 to 0.66; p = 0.02)], respectively. Regarding sub-analysis considering the intensity, one visit present lower mild PP when compared with multiple visits [(RR = 0.54; CI: 0.30, 0.96; p = 0.04); (RR = 0.33; CI: 0.12, 0.88; p = 0.03); and (RR = 0.12; CI: 0.02, 0.86; p = 0.03)], respectively. However, sub-analysis for moderate and severe PP showed no significant difference, independently of period evaluated (p > 0.05). Regarding the risk of bias analysis, a low risk was observed for most domains, except allocation that was considered unclear, while the certainty of evidence for each analysis was considered low. CONCLUSION Within the limitations of study, the one and multiple visit can be considered adequate, because both present a similar occurrence of PP, except for mild pain. However, due to the low number of studies, further well conducted and standardized RCTs are needed to reassess these results. CLINICAL RELEVANCE Both therapies of endodontic retreatment can be considered in clinical practice. Therefore, the endodontist must consider the patient's individual characteristics and experience to consider the best treatment approach.
Collapse
|
46
|
Gazzaneo I, Amoroso-Silva P, Pacheco-Yanes J, Alves FRF, Marceliano-Alves M, Olivares P, Meto A, Mdala I, Siqueira JF, Rôças IN. Disinfecting and Shaping Type I C-shaped Root Canals: A Correlative Micro-computed Tomographic and Molecular Microbiology Study. J Endod 2020; 47:621-630. [PMID: 33220400 DOI: 10.1016/j.joen.2020.11.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION This ex vivo study compared the disinfection and shaping abilities of 2 preparation protocols in C-shaped canals. METHODS Mandibular second molars with type I C-shaped canals were pair matched based on micro-computed tomographic (micro-CT) analysis and distributed into 2 groups. The canals were contaminated with a mixed bacterial culture and prepared using 2 protocols, both with 2.5% sodium hypochlorite irrigation: XP-endo Shaper (FKG Dentaire, La Chaux-de-Fonds, Switzerland) supplemented with XP-endo Finisher (FKG Dentaire) (XP-E) and BioRaCe (FKG Dentaire) supplemented with a Hedström file (Dentsply/Sirona, Tulsa, OK) (BR-Hed). Micro-CT scans and intracanal bacteriologic samples were taken before (scan #1 and sample 1) and after preparation (scan #2 and sample 2) and after the supplementary step (scan #3 and sample 3). Canal shaping was evaluated by micro-CT imaging, and disinfection was assessed by quantitative polymerase chain reaction. RESULTS Micro-CT data from the XP-E (n = 21) and BR-Hed (n = 23) protocols revealed no significant differences between groups regarding shaping parameters (canal volume, surface area, structure model index, and prepared walls) after preparation and after the supplementary step (P > .05). All these parameters significantly increased after each preparation step (P < .05), except for structure model index changes after the XP-endo Finisher (P > .05). Bacteriologic data from the XP-E (n = 21) and BR-Hed (n = 22) groups showed that 14 (66.7%) and 10 (45.5%) S2 samples still had detectable bacteria, respectively. The corresponding figures for supplementary steps with the XP-endo Finisher and Hedström file were 11 (52.4%) and 10 (45.5%), respectively. Bacterial counts in sample 1 significantly decreased in samples 2 and 3 in both groups (P < .01). Intragroup comparison between sample 2 and sample 3 showed a 66% reduction in counts after using the Hedström file and 18% after using the XP-endo Finisher (P > .05 for both groups). The quantitative bacterial reduction was not different between groups (P > .05). CONCLUSIONS The XP-endo Shaper and BioRaCe systems have similar disinfecting and shaping abilities in C-shaped canals. Supplementary steps with the Hedström file and the XP-endo Finisher were similarly effective in improving shaping, but this was not sufficient to enhance disinfection. About half of the cases, in both groups, still harbored detectable amounts of bacteria.
Collapse
Affiliation(s)
- Isbelia Gazzaneo
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pablo Amoroso-Silva
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Restorative Dentistry, Londrina State University, Paraná, Brazil
| | - Juan Pacheco-Yanes
- Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Flávio R F Alves
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil.
| | - Marilia Marceliano-Alves
- Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Patricia Olivares
- Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Aida Meto
- Laboratory of Microbiology and Virology, University of Modena and Reggio Emilia, Modena, Italy
| | - Ibrahimu Mdala
- Department of General Practice, University of Oslo, Oslo, Norway
| | - José F Siqueira
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| | - Isabela N Rôças
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Endodontics, Faculty of Dentistry, Iguaçu University, Nova Iguaçu, Rio de Janeiro, Brazil
| |
Collapse
|
47
|
Li Q, Zhang Q, Zou X, Yue L. Evaluation of four final irrigation protocols for cleaning root canal walls. Int J Oral Sci 2020; 12:29. [PMID: 33077718 PMCID: PMC7573610 DOI: 10.1038/s41368-020-00091-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 02/11/2019] [Accepted: 07/28/2020] [Indexed: 11/29/2022] Open
Abstract
The aim of this study was to compare the efficiency of four final irrigation protocols in smear layer removal and bacterial inhibition in root canal systems. Thirty roots inoculated with Enterococcus faecalis were prepared with ProTaper Universal files. The teeth were disinfected by conventional needle irrigation, sonic agitation using the EndoActivator device, passive ultrasonic irrigation, or an M3 Max file. Teeth with no root canal preparation served as blank controls for the establishment of the infection baseline. Teeth with preparation but no final irrigation served as a post-instrumentation baseline. After the final irrigation, the teeth were sectioned in half. One half of each tooth was examined by scanning electron microscopy (SEM) to assess smear layer removal using a five-point scale. The other half was examined by confocal laser scanning microscopy (CLSM) using the LIVE/DEAD BackLight bacterial viability kit to evaluate the depth of bacterial survival in dentinal tubules. SEM analysis revealed no significant difference in smear layer removal throughout the whole canal among the EA, PUI, and M3 Max groups (P > 0.05). CLSM revealed that PUI achieved the greatest bacterial inhibition depth in the coronal ((174.27 ± 31.63) μm), middle ((160.94 ± 37.77) μm), and apical ((119.53 ± 28.49) μm) thirds of the canal (all P < 0.05 vs. other groups). According to this comprehensive SEM and CLSM evaluation, PUI appears to have the best infection control ability in root canal systems.
Collapse
Affiliation(s)
- Qiang Li
- Department of Cariology, Endodontology and Operative Dentistry, School and Hospital of Stomatology, Peking University, Beijing, PR China
| | - Qian Zhang
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, 100081, PR China
| | - Xiaoying Zou
- Department of Cariology, Endodontology and Operative Dentistry, School and Hospital of Stomatology, Peking University, Beijing, PR China.
| | - Lin Yue
- Department of Cariology, Endodontology and Operative Dentistry, School and Hospital of Stomatology, Peking University, Beijing, PR China.
| |
Collapse
|
48
|
Villalta-Briones N, Baca P, Bravo M, Solana C, Aguado-Pérez B, Ruiz-Linares M, Arias-Moliz MT. A laboratory study of root canal and isthmus disinfection in extracted teeth using various activation methods with a mixture of sodium hypochlorite and etidronic acid. Int Endod J 2020; 54:268-278. [PMID: 32970865 DOI: 10.1111/iej.13417] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 09/10/2020] [Accepted: 09/17/2020] [Indexed: 12/29/2022]
Abstract
AIM To evaluate in a laboratory setting the antibiofilm activity of several irrigating protocols including conventional irrigation, ultrasonic activation and XP-endo Finisher, with a mixture of sodium hypochlorite and etidronic acid in infected isthmuses and root canals of extracted human mandibular molar teeth. METHODOLOGY Fifty-six mesial roots of mandibular molars, half of them with a continuous isthmus from the cervical to the apical third between the two root canals (type 1), and the other half with a continuous isthmus from the cervical to the middle third and one canal in the apical third (type 2), were included. The root canals were contaminated for 7 days with an Enterococcus faecalis suspension. There were three experimental groups plus a control group (n = 7 per type of root canal anatomy). All the root canals, except for the control group that was not treated, were chemomechanically prepared and then assigned to one of the experimental groups according to the final adjunctive procedure: conventional irrigation, ultrasonic activation or XP-endo Finisher activation. The irrigating solution used was a combination of 2.5% sodium hypochlorite and 9% etidronic acid, and the final protocols were applied for three cycles of 30 s with a 3 mL volume. The antibiofilm activity was evaluated at each location (root canal and isthmus) and third (cervical, middle and apical) using confocal laser scanning microscopy and the live/dead technique. Statistical analysis was performed using SPSS (descriptive statistics) and SUDAAN (P-value calculations). RESULTS Root canals had significantly lower biovolume values than the isthmuses (P < 0.05). The biovolume in the root canals was significantly reduced in all the experimental groups in all the thirds except for conventional irrigation in the apical third (P > 0.05). In the cervical and middle thirds, ultrasonic activation was associated with the lowest biovolumes (P < 0.05), followed by XP-endo Finisher. In the isthmus, disinfection was similar in all the thirds for all the protocols. Conventional irrigation was associated with intermediate values with no significant differences from the control group or from the activated protocols (P > 0.05), although the latter were significantly different from the control group (P < 0.05). No differences were found between ultrasonic activation and XP-endo Finisher in the middle and apical thirds (P > 0.05) in the isthmuses. CONCLUSIONS In this laboratory study on extracted teeth, the isthmus was more difficult to disinfect than root canals. In the root canals, ultrasonic activation and XP-endo Finisher had a greater effectiveness than conventional irrigation. In the isthmuses, no differences were observed between the two activation techniques and conventional irrigation.
Collapse
Affiliation(s)
- N Villalta-Briones
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - P Baca
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - M Bravo
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - C Solana
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - B Aguado-Pérez
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - M Ruiz-Linares
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - M T Arias-Moliz
- Department of Microbiology, School of Dentistry, University of Granada, Granada, Spain
| |
Collapse
|
49
|
Kharouf N, Pedullà E, La Rosa GRM, Bukiet F, Sauro S, Haikel Y, Mancino D. In Vitro Evaluation of Different Irrigation Protocols on Intracanal Smear Layer Removal in Teeth with or without Pre-Endodontic Proximal Wall Restoration. J Clin Med 2020; 9:jcm9103325. [PMID: 33081209 PMCID: PMC7602818 DOI: 10.3390/jcm9103325] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 12/20/2022] Open
Abstract
To investigate the influence of pre-endodontic coronal wall restoration on smear layer removal during different root canal irrigation strategies, single-root premolars were prepared with a mesio-occlusal cavity. Half were left untreated (G1), while the mesial walls of the remaining half were reconstructed using a resin composite (G2). The specimens were divided into control (ctrl) groups, which used the conventional needle irrigation method, and four experimental subgroups according to irrigation strategy: Sonic activation using the Endoactivator, sonic activation using the EQ-S, mechanical activation using the XP-Endo finisher, and ultrasonic activation using the EndoUltra. Smear layer removal was assessed through SEM and the results were statistically analyzed. At the coronal and middle thirds, no significant difference (p > 0.05) was detected for G1 and G2, except for the control subgroups (G1ctrl vs G2 ctrl) at the middle third. At the apical third, the smear layer removal was significantly greater for G2 than G1. In G1, both at the middle and apical level, EQ-S and EndoUltra showed greater smear layer removal (p < 0.05) compared to the others G1 subgroups. In G2, at the apical level, the EQ-S and EndoUltra were the most effective in smear layer removal. Pre-endodontic coronal wall restoration may improve the smear layer removal during root canal irrigation.
Collapse
Affiliation(s)
- Naji Kharouf
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Sainte Elisabeth, 67000 Strasbourg, France; (Y.H.); (D.M.)
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1121, 11 rue Humann, 67085 Strasbourg, France
- Correspondence: ; Tel.: +33-667-522-841
| | - Eugenio Pedullà
- Department of General Surgery and Medical–Surgical Specialties, University of Catania, 95128 Catania, Italy; (E.P.); (G.R.M.L.R.)
| | - Giusy Rita Maria La Rosa
- Department of General Surgery and Medical–Surgical Specialties, University of Catania, 95128 Catania, Italy; (E.P.); (G.R.M.L.R.)
| | - Frédéric Bukiet
- Department of Endodontics, Aix Marseille Université, CNRS, ISM, Inst Movement Sci, 13385 Marseille, France;
- Assistance Publique des Hôpitaux de Marseille, 13005 Marseille, France
| | - Salvatore Sauro
- Departamento de Odontología, Facultad de Ciencias de la Salud, Universidad CEU-Cardenal Herrera, C/Del Pozo (s/n), Alfara del Patriarca, 46115 Valencia, Spain;
- Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia
| | - Youssef Haikel
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Sainte Elisabeth, 67000 Strasbourg, France; (Y.H.); (D.M.)
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1121, 11 rue Humann, 67085 Strasbourg, France
| | - Davide Mancino
- Faculté de Chirurgie Dentaire, Université de Strasbourg, 8 rue Sainte Elisabeth, 67000 Strasbourg, France; (Y.H.); (D.M.)
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1121, 11 rue Humann, 67085 Strasbourg, France
| |
Collapse
|
50
|
Alakshar A, Saleh ARM, Gorduysus MO. Debris and Smear Layer Removal from Oval Root Canals Comparing XP-Endo Finisher, EndoActivator, and Manual Irrigation: A SEM Evaluation. Eur J Dent 2020; 14:626-633. [PMID: 32777834 PMCID: PMC7535965 DOI: 10.1055/s-0040-1714762] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective
This study aimed to assess and compare XP-Endo Finisher (XP) cleaning efficiency with respect to the amount of remaining debris and smear layer versus Max-I-Probe needle (CI), EndoActivator device (EA), and combination of XP-Endo Finisher file with EndoActivator device (XP+EA) in oval root canals.
Materials and Methods
This
in vitro
study was performed on 36 extracted single root/canal mandibular premolars. Radiographic images were taken in buccolingual and mesiodistal projections to evaluate the shape of the root canal and determine whether it met exclusion criteria. All teeth were decoronated and prepared using Reciproc (R40). The samples were divided randomly into four groups: CI, EA, XP, and XP + EA. The root canals were irrigated with 5 mL of 17% EDTA and 2.5% NaOCl, respectively. Apart from the CI group, both solutions were activated by using the tested techniques for 1 minute.
The teeth were split longitudinally, and the best visible identified sections of the roots were used as the representing samples for scanning electron microscope (SEM) evaluation. Each half was divided into the following three parts: 1 mm from the anatomic apex and a standardized photomicrograph with 500x and 1500x magnifications for debris and smear layer were obtained. A five-grade scoring system was utilized to quantify the results at the coronal, middle, and apical regions. Statistical analysis was performed by using the Kruskal–Wallis and Mann–Whitney U tests. Results
Group differences in debris and smear layer scores were found statistically significant for all locations as well as for overall assessment, except for the coronal third. Intragroup comparison of debris and smear layer in CI, EA, and XP had the minimum score at the middle third, with no significant difference compared with the coronal and apical thirds. XP + EA had less debris and smear layer score at the coronal third, significantly different from apical third.
CI and EA had less debris and smear layer compared with XP and XP + EA at all locations with a significant difference at the middle and apical third (
p
< 0.05).
Conclusion
EA and CI showed less debris and smear layer than XP and XP + EA in the middle and apical third. The use of the XP in conjunction with the present irrigation protocol failed to have debris-free dentin surface in the apical portion of most of the root canals.
Collapse
Affiliation(s)
- Asmaa Alakshar
- Department of Restorative Dentistry, Ajman University, Ajman, United Arab Emirates
| | | | - Mehmet Omer Gorduysus
- Preventive and Restorative Dentistry Department, College of Dental Medicine, University of Sharjah, United Arab Emirates
| |
Collapse
|