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Tuamsomboon P, Charumanee S, Junmahasathien T, Louwakul P. Effect of Vehicles and Irrigation Solutions and Methods on Removal of Double Antibiotic Paste from Root Canals: Insights from High-performance Liquid Chromatography Analysis. J Endod 2024:S0099-2399(24)00344-3. [PMID: 38851482 DOI: 10.1016/j.joen.2024.06.001] [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: 12/23/2023] [Revised: 05/19/2024] [Accepted: 06/02/2024] [Indexed: 06/10/2024]
Abstract
INTRODUCTION In regenerative endodontics, eradicating antibiotic residues from root canals is imperative, given their detrimental effects on human apical papilla stem cells. Previous antibiotic removal studies lacked precision in identifying types and quantities of residual antibiotics. High-performance liquid chromatography (HPLC) enhances sensitivity and specificity, enabling accurate detection and quantification of residual drugs. Using HPLC analysis, this study explored the influence of vehicles and irrigation solutions and methods on double antibiotic paste (DAP) removal from root canals. METHODS Two DAP formulations, each containing 5 mg/mL ciprofloxacin and metronidazole, were created using distinct vehicles: macrogol and propylene glycol (MP) or hydroxypropyl methylcellulose (HPMC). Subsequently, 5 μL of DAP was applied to 200 simulated immature teeth with open apices (n = 100 per formulation) and cultured for 28 days at 37°C. Samples were then divided into 11 groups (n = 20 per group), and canals were irrigated with 17% ethylenediaminetetraacetic acid or 10% citric acid, employing a positive pressure syringe or passive ultrasonic irrigation. The irrigation solution and dentin sample from each tooth were evaluated via HPLC for ciprofloxacin and metronidazole quantification. RESULTS Citric acid exhibited significantly superior efficacy in antibiotic removal from root canals, with no observable effect of irrigation methods on drug removal. The HPMC-based DAP formulation significantly enhanced ciprofloxacin removal compared with MP-based DAP. CONCLUSIONS For antibiotic paste removal from root canals, citric acid is effective, and HPMC is a preferable vehicle over MP. Overall, HPLC is a valuable method for detecting, removing, and quantifying residual antibiotics in root canals.
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Affiliation(s)
- Pornsupa Tuamsomboon
- Postgraduate Student in Endodontics, Faculty of Dentistry, Department of Restorative Dentistry and Periodontology, Chiang Mai University, Mueang, Chiang Mai, Thailand
| | - Suporn Charumanee
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Chiang Mai University, Mueang, Chiang Mai, Thailand
| | - Taepin Junmahasathien
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Chiang Mai University, Mueang, Chiang Mai, Thailand
| | - Phumisak Louwakul
- Faculty of Dentistry, Department of Restorative Dentistry and Periodontology, Chiang Mai University, Mueang, Chiang Mai, Thailand.
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Nasr El-Din S, Hassan R. The efficacy of various irrigation techniques on the removal of double antibiotic paste from simulated immature roots and the amount of apically extruded debris. BDJ Open 2024; 10:2. [PMID: 38182568 PMCID: PMC10770069 DOI: 10.1038/s41405-023-00183-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 01/07/2024] Open
Abstract
OBJECTIVE This study evaluated the effect of the XP-Endo Finisher (XPF), passive ultrasonic irrigation (PUI) and conventional irrigation using side-vented needle (SVN) on the amount of apically extruded debris and canal cleanliness following the removal of double antibiotic paste (DAP) from immature root canal models. MATERIAL AND METHODS Forty-eight extracted mandibular premolars were drilled using peeso drills to simulate immature apices. The canals were filled with DAP and were randomly assigned into 3 groups according to the DAP removal method: XPF, PUI, and SVN (n = 16). The amount of extruded debris was assessed with an analytical balance then roots were split longitudinally and imaged using stereomicroscope to evaluate the residual medicament. Data were statistically analyzed using Kruskal-Wallis and Dunn's test. Spearman's correlation coefficient was used to determine significant correlation between extruded debris and the residual DAP scores. RESULTS There was no significant difference between debris extrusion values for all groups (P value 0.237). For canal cleanliness, the amount of remaining DAP was significantly lower in the XPF and PUI compared to SVN (P value < 0.001). A non-significant positive (direct) correlation was found between the amounts of apically extruded debris and residual DAP scores (P value 0.087). CONCLUSION XPF and PUI were associated with better canal cleanliness during removal of DAP, no difference could be found between the three irrigation techniques regarding the debris extrusion.
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Affiliation(s)
| | - Reham Hassan
- Faculty of Dentistry, The Egyptian Russian University, Badr city, Egypt.
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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.
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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
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Xu X, Li Z, Jiang P, Zheng C, Dou L. Effect of conventional needle irrigation, passive ultrasonic irrigation, sonic irrigation and XP-endo finisher in removing intracanal Vitapex paste. AUST ENDOD J 2023; 49 Suppl 1:374-380. [PMID: 36939113 DOI: 10.1111/aej.12747] [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: 10/06/2022] [Revised: 02/13/2023] [Accepted: 03/06/2023] [Indexed: 03/21/2023]
Abstract
To compare the efficiency of conventional needle irrigation, passive ultrasonic irrigation, sonic irrigation and XP-endo Finisher in removing Vitapex paste from root canals. The root canals of human single-rooted teeth were prepared and obturated with Vitapex paste. After 2 weeks, the 48 teeth were randomly allocated into four groups: conventional needle irrigation (CNI) group, passive ultrasonic irrigation (PUI) group, sonic irrigation (SI) group and XP-endo Finisher (XP) group. The specimens of four groups were scanned using a micro-computed tomography after the Vitapex pastes was removed. The results showed that more residual paste was left in the CNI group than in the other three groups (p < 0.05). There was no significant difference among the PUI, SI and XP group (p > 0.05). And, the majority of the residual Vitapex was found in the apical third, with a small amount in the middle third after using any of the three agitated irrigation techniques.
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Affiliation(s)
- Xiaoqi Xu
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Zheng Li
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Peiru Jiang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chengxiang Zheng
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Lei Dou
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Karasu AE, Goker Kamalı S, Turkaydın D. Comparison of apical extrusion of sodium hypochlorite in immature teeth after needle irrigation, ultrasonic irrigation, EDDY, Er:YAG, and diode lasers. Lasers Med Sci 2022; 38:8. [PMID: 36539627 DOI: 10.1007/s10103-022-03683-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 11/09/2022] [Indexed: 12/24/2022]
Abstract
This study aimed to assess the apical extrusion of sodium hypochlorite in immature teeth caused by needle irrigation, ultrasonic irrigation, EDDY, Er:YAG, and diode lasers. Seventy-five human maxillary anterior teeth were selected. After the apical 3 mm of the roots was resected, the canal lumen was enlarged with #2 to #5 Gates-Glidden burs. The teeth were fixed to the lid of a flat-sided clear plastic container, and the plastic containers were filled with 0.2% agarose gel containing 1 mL of 0.1% m-cresol purple. Then, the specimens were allocated into five groups according to the irrigation activation techniques: needle irrigation, ultrasonic irrigation, EDDY, Er:YAG laser, and diode laser. The apical extrusion of sodium hypochlorite caused the color change in the gel. The containers were digitally photographed, and the percentage of pixels of irrigant extrusion (the color change) in each photograph was calculated. The diode laser group showed a significantly lower percentage of pixels than needle irrigation, EDDY, and Er:YAG laser (p < 0.05). The irrigant extrusion value of the ultrasonic irrigation group was significantly lower than that of the EDDY and Er:YAG laser groups (p < 0.05). There was no significant difference between the other groups (p > 0.05). All the groups caused irrigant extrusion in the immature teeth. The diode laser and ultrasonic irrigation caused less sodium hypochlorite extrusion than EDDY and Er:YAG laser. The needle irrigation showed more irrigant extrusion than the only diode laser group.
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Affiliation(s)
- Alparslan Eren Karasu
- Department of Endodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Selin Goker Kamalı
- Department of Endodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey.
| | - Dilek Turkaydın
- Department of Endodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey
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Alfirdous RA, Alquiria TA, Jacinto RC, Martinho FC. A modified dentin infection model with Fluorescent Lipopolysaccharide and
LPS
sampling technique to compare
XP‐Endo
finisher and passive ultrasonic irrigation. Int Endod J 2022; 55:1081-1090. [DOI: 10.1111/iej.13804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022]
Affiliation(s)
- R. A. Alfirdous
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
- Prince Abdulrahman Advanced Dental Institute Riyadh Kingdom of Saudi Arabia
| | - T. A. Alquiria
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
- Prince Abdulrahman Advanced Dental Institute Riyadh Kingdom of Saudi Arabia
| | - R. C. Jacinto
- Division of Endodontics, Department of preventive and restorative dentistry School of Dentistry, Aracatuba São Paulo SP Brazil
| | - F. C. Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics University of Maryland School of Dentistry Baltimore Maryland USA
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Adigüzel M, Yilmaz K, Pamukçu İİ. Comparison of the efficacy of sonic irrigation and conventional syringe irrigation in the removal of curcumin and triple antibiotic paste from root canals. J Dent Res Dent Clin Dent Prospects 2021; 15:157-162. [PMID: 34712405 PMCID: PMC8538143 DOI: 10.34172/joddd.2021.027] [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: 12/02/2020] [Accepted: 04/15/2021] [Indexed: 11/29/2022] Open
Abstract
Background. The present study aimed to compare the efficacy of sonic irrigation and conventional syringe irrigation (CSI) in terms of curcumin (CUR) and triple antibiotic paste (TAP) removal from a standardized groove artificially created in root canals.
Methods. The root canals of 72 anterior maxillary teeth were prepared using the Reciproc system to size R50. The teeth were split longitudinally, and a standardized groove was created in the apical region of one root half. The standardized grooves were filled with CUR or TAP with the exclusion of six teeth that served as the negative control group, and then the root halves were reassembled. The teeth were divided into two subgroups according to the irrigation protocols used: sonic activation with EndoActivator (EA) or CSI (n=15). After the removal of the medicament, the residual medicament was assessed under a stereomicroscope. Kruskal-Wallis and Mann-Whitney U tests were used for statistical analyses (P = 0.05).
Results. The EA sonic activation method was significantly more efficient in removing CUR medicament from the root canals. Considering the medicament types, more CUR than TAP was removed from the root canals using both CSI and the EA (sonic activation) system (P < 0.05).
Conclusion. As compared with CSI, the EA was not significantly more efficient in removing TAP, but it was significantly more effective than CSI in removing CUR.
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Affiliation(s)
- Mehmet Adigüzel
- Department of Endodontics, Faculty of Dentistry, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Koray Yilmaz
- Department of Endodontics, Faculty of Dentistry, Hatay Mustafa Kemal University, Hatay, Turkey
| | - İsmail İlker Pamukçu
- Department of Endodontics, Faculty of Dentistry, Hatay Mustafa Kemal University, Hatay, Turkey
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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.
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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.)
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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.
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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.
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10
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Güven Y, Uygun AD, Arslan H. Efficacy of EDDY, ultrasonic activation, XP-endo Finisher and needle irrigation on the removal of mTAP from artificially created grooves in root canals. AUST ENDOD J 2021; 47:639-644. [PMID: 34105219 DOI: 10.1111/aej.12535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2021] [Indexed: 11/26/2022]
Abstract
This study analysed the effect of needle irrigation (NI), passive ultrasonic irrigation (PUI), EDDY and the use of the XP-endo Finisher (XPF) on the removal of modified triple antibiotic paste (mTAP) from artificially created grooves in root canals. Forty-eight maxillary incisors were prepared up to size 50, with a standard groove on one surface of the root canal wall and filled with mTAP. Re-attached roots were analysed based on the activation techniques applied for 180 s with 5 ml 3% sodium hypochlorite. The results showed that EDDY was more effective at removing mTAP than PUI, XPF and needle irrigation (P < 0.05), whereas XPF and PUI were significantly more effective than needle irrigation. (P < 0.05). No significant difference in mTAP removal was observed between XPF and PUI (P > 0.05). These findings suggest that the removal of mTAP can be more efficiently achieved with EDDY than with XPF, PUI or NI.
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Affiliation(s)
- Yahya Güven
- Department of Endodontics, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ahmet Demirhan Uygun
- Department of Endodontics, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Hakan Arslan
- Dental Faculty Department of Endodontics, Medeniyet University, Istanbul, Turkey
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Tavella E Silva NC, Gibin JT, Rivera ICMM, Rached Junior FJA, Leoni GB, Raucci-Neto W. Calcium hydroxide paste removal strategies and bond strengths of epoxy- and silicate-based sealers. AUST ENDOD J 2020; 47:236-244. [PMID: 33249663 DOI: 10.1111/aej.12460] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/03/2020] [Accepted: 10/21/2020] [Indexed: 01/19/2023]
Abstract
This study evaluated the syringe/needle (SN), passive ultrasonic irrigation (PUI) and XP-endo Finisher (XP) in the removal of Ca(OH)2 -based paste and the bond strength (BS) values of an epoxy resin (AH Plus) and silicate (MTA)-based sealers to root dentin. Eighty lower premolars were assigned: control group (CT), SN, PUI and XP, and subdivided according to the sealer (n = 10) for BS. SN has the lowest removal followed by PUI and XP. AH Plus had higher BS for CT compared with SN in all root thirds. CT and XP presented similar BS in the apical and middle thirds and higher than SN and PUI. For MTA, similar BS was observed in the cervical and apical thirds, and in the middle third, CT, PUI and XP presented similar values and higher than SN. PUI and XP methods presented higher efficiency in the Ca(OH)2 removal, and the residual Ca(OH)2 provides a reduction in BS of the AH Plus.
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Affiliation(s)
| | | | | | | | | | - Walter Raucci-Neto
- School of Dentistry, University of Ribeirão Preto, Ribeirão Preto, Brazil
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12
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Mandal SS, Margasahayam SV, Shenoy VU. A Comparative Evaluation of the Influence of Three Different Vehicles on the Antimicrobial Efficacy of Triple Antibiotic Paste against Enterococcus faecalis: An In vitro Study. Contemp Clin Dent 2020; 11:150-157. [PMID: 33110328 PMCID: PMC7583540 DOI: 10.4103/ccd.ccd_372_19] [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: 10/30/2019] [Revised: 05/17/2020] [Accepted: 06/22/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction: The root canal is a hub of numerous microorganisms. Routine endodontic procedures fail to remove the resistant microorganisms such as Enterococcus faecalis. Aim: The aim of the present study was to evaluate the influence of different vehicles on the antimicrobial efficacy of triple antibiotic paste (TAP) on E. faecalis infected root canals. Materials and Methods: Eighty single-rooted and freshly extracted human teeth were prepared in radicular portion, and pure culture of E. faecalis (ATCC® 29212™) inoculum was injected into canals of tooth blocks and incubated for 21 days. Tooth blocks were divided into five groups. Each experimental group was then medicated with 0.1 ml of TAP and no medication was added for control groups. After 21 days of incubation at 37°C, colony-forming units per milliliter (CFU/ml) were counted for each group. Results: Group II treated with TAP mixed with propylene glycol revealed a maximum reduction in CFU/ml, and that was followed by Group I and Group III, where TAP was mixed with 2% chlorhexidine (CHX) and 0.9% normal saline, respectively. Data were compared and analyzed using statistics software. The results were considered statistically significant for P < 0.05. There was a statistically significant difference in CFU/ml between propylene glycol and positive control group, between CHX and positive control group, between saline and positive control group. Conclusions: The propylene glycol group with TAP was the most effective vehicle for the elimination of E. faecalis from canals of tooth blocks, followed by 2% CHX solution as the second vehicle of choice over 0.9% normal saline.
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Affiliation(s)
- Shouvik S Mandal
- Department of Conservative Dentistry and Endodontics, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Sumanthini V Margasahayam
- Department of Conservative Dentistry and Endodontics, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Vanitha U Shenoy
- Department of Conservative Dentistry and Endodontics, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Cleaning Efficacy of the XP-Endo® Finisher Instrument Compared to Other Irrigation Activation Procedures: A Systematic Review. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9235001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background. One of the most important aims of an endodontic treatment is to obtain the complete removal or reduction of root canal remaining filling material: Smear layer, bacteria, intra-canal medicaments. To meet this requirement, several irrigation activation techniques have been proposed. Our systematic review examined studies which analyzed the XP-endo Finisher (XPF) instrument efficacy in removing root canal debris during initial endodontic treatment or retreatment, comparing it with the efficacy of other irrigation activation protocols, such as passive ultrasonic irrigation (PUI), laser activation procedure (Er:YAG), and Self-Adjusting File system (SAF). Methods. A systematic review was conducted using PubMed, Chocrane Library, and Scopus databases, identifying 51 items. Thirty-four articles were excluded based on title, abstract, full text, and language. Seventeen randomized controlled trials were selected and consequently submitted to quality assessment and data collection. Results. Conventional needle irrigation (CNI) is the less effective irrigation technique, but it is still unclear whether XPF is able to guarantee greater debris removal than the PUI technique. Er:YAG laser has been proven to be more effective in apical third than XPF instrument. Conclusions. Further investigations are needed in order to establish which final irrigation activation procedure could reach the maximum root canal debris reduction.
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Marques‐da‐Silva B, Alberton CS, Tomazinho FSF, Gabardo MCL, Duarte MAH, Vivan RR, Baratto‐Filho F. Effectiveness of five instruments when removing calcium hydroxide paste from simulated internal root resorption cavities in extracted maxillary central incisors. Int Endod J 2019; 53:366-375. [DOI: 10.1111/iej.13223] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 09/25/2019] [Indexed: 11/29/2022]
Affiliation(s)
| | - C. S. Alberton
- School of Health Sciences Universidade Positivo Curitiba Brazil
| | | | | | - M. A. H. Duarte
- Bauru School of Dentistry Universidade de São Paulo Bauru Brazil
| | - R. R. Vivan
- Bauru School of Dentistry Universidade de São Paulo Bauru Brazil
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Sarraf P, Assadi A, Kiomarsi N, Mohammadian F, Assadi A, Shamshiri AR. Effect of Intracanal Medicaments on Pull-Out Bond Strength of Fiber Post Cemented with a Self-Adhesive System. Eur J Dent 2019; 13:420-425. [PMID: 31450248 PMCID: PMC6890508 DOI: 10.1055/s-0039-1694313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVES This study aimed to assess the effect of four intracanal medicaments on pull-out bond strength of fiber posts. MATERIALS AND METHODS A total of 65 single-rooted, single-canal teeth were selected and decoronated. Root canals were prepared and after rinsing were randomly divided into five groups (n = 13). G1: calcium hydroxide (CH), G2: CH plus chlorhexidine (CH+CHX), G3: triple antibiotic paste (TAP), G4: double antibiotic paste (DAP) were applied in the canals in the four groups. The control group (G5) received no medicament. After 4 weeks, the medicaments were rinsed off and the canals were filled with gutta-percha. Post space was then prepared in root canals for the placement of glass fiber posts and self-adhesive cement (Panavia F2). After cementation, they were subjected to pull-out bond strength test. STATISTICAL ANALYSIS Data were statistically analyzed using one-way analysis of variance and Tukey test.Results The pull-out bond strength values were significantly different in the groups (p < 0.001). The highest values of bond strength were seen in G2, G1, and G3 (359.97 ± 81.26, 333.79 ± 98.96, 309.27 ± 78.07), respectively. There was no significant difference between G4 and G5 (p = 0.75). CONCLUSION The results showed that CH, CH+CHX, and TAP enhanced the pull-out bond strength of fiber post to root canal wall as compared to the control group.
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Affiliation(s)
- Pegah Sarraf
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Nazanin Kiomarsi
- Department of Operative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mohammadian
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ahmad Reza Shamshiri
- Department of Community Oral Health, Research Center for Caries Prevention, Dental Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Pereira AC, Pallone MV, Marciano MA, Cortellazzi KL, Frozoni M, Gomes BPFA, de Almeida JFA, Soares ADJ. Effect of intracanal medications on the interfacial properties of reparative cements. Restor Dent Endod 2019; 44:e21. [PMID: 31149619 PMCID: PMC6529794 DOI: 10.5395/rde.2019.44.e21] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/21/2019] [Accepted: 04/28/2019] [Indexed: 11/11/2022] Open
Abstract
Objectives The purpose of the present study was to evaluate the effect of calcium hydroxide with 2% chlorhexidine gel (HCX) or distilled water (HCA) compared to triple antibiotic paste (TAP) on push-out bond strength and the cement/dentin interface in canals sealed with White MTA Angelus (WMTA) or Biodentine (BD). Materials and Methods A total of 70 extracted human lower premolars were endodontically prepared and randomly divided into 4 groups according to the intracanal medication, as follows: group 1, HCX; group 2, TAP; group 3, HCA; and group 4, control (without intracanal medication). After 7 days, the medications were removed and the cervical third of the specimens was sectioned into five 1-mm sections. The sections were then sealed with WMTA or BD as a reparative material. After 7 days in 100% humidity, a push-out bond strength test was performed. Elemental analysis was performed at the interface, using energy-dispersive spectroscopy. The data were statistically analyzed using analysis of variance and the Tukey test (p < 0.05). Results BD presented a higher bond strength than WMTA (p < 0.05). BD or WMTA in canals treated with calcium hydroxide intracanal medications had the highest bond strength values, with a statistically significant difference compared to TAP in the WMTA group (p < 0.05). There were small amounts of phosphorus in samples exposed to triple antibiotic paste, regardless of the coronal sealing. Conclusions The use of intracanal medications did not affect the bond strength of WMTA and BD, except when TAP was used with WMTA.
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Affiliation(s)
- Andrea Cardoso Pereira
- Department of Restorative Dentistry, Endodontics Area, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Mariana Valerio Pallone
- Department of Restorative Dentistry, Endodontics Area, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Marina Angélica Marciano
- Department of Restorative Dentistry, Endodontics Area, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Karine Laura Cortellazzi
- Department of Social Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Marcos Frozoni
- Department of Endodontics, São Leopoldo Mandic Dental School, Campinas, SP, Brazil
| | - Brenda P F A Gomes
- Department of Restorative Dentistry, Endodontics Area, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - José Flávio Affonso de Almeida
- Department of Restorative Dentistry, Endodontics Area, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Adriana de Jesus Soares
- Department of Restorative Dentistry, Endodontics Area, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
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Sağlam BC, HAZAR E, Koçak S, Koçak MM. Efficacy of XP-Endo Finisher and Passive Ultrasonic Irrigation on Modified Triple Antibiotic Paste Removal. CUMHURIYET DENTAL JOURNAL 2019. [DOI: 10.7126/cumudj.490589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Pattern of Disinfection of Root Canal Dentin by Alternated Acid-Base Irrigating Regimen. ScientificWorldJournal 2019; 2019:9219238. [PMID: 30692877 PMCID: PMC6332882 DOI: 10.1155/2019/9219238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 09/03/2018] [Accepted: 11/06/2018] [Indexed: 12/21/2022] Open
Abstract
Objective To quantify Enterococcus faecalis density in root canal dentin after chemomechanical preparation (CMP) using alternated irrigating regimen. Methodology Root canals (RC) were contaminated with E. faecalis (ATCC 19433) for 3 weeks and evident biofilms were obtained. After initial sampling (S1), the CMP was aided by irrigants: saline solution (control; n=12), a conventional regimen (CR) (group 1; n=12) using 5.25% NaOCl and a final rinse with 17% EDTA, and an alternating regimen (AR) of intercalated use of NaOCl and EDTA (group 2, n=12), followed by a second sampling (S2). After 2 weeks, S3 was obtained. Two roots were analyzed by scanning electron microscopy. Each root was divided into cervical, mild, and apical segments and sampling of the superficial (n=90) and deep (n=90) dentin layers was obtained using Gates-Glidden burs. The E. faecalis density (CFU/mg) in log10 was categorized as residual (0 > 0.2), moderate (0.2 ≥ 0.5), or elevated (> 0.5). The prevalence of positive samples in BHI and BHI-A was analyzed by Pearson's chi-square test. The data were normalized by a log10 transformation of CFU and were analyzed by one-way ANOVA and Tukey's tests. Results Biofilms were observed only in the control root canal walls. Topographically, the controls and CR showed similar distributions of E. faecalis in the dentin. Microbiologically positive root canals harbored much E. faecalis in the adjacent dentin (p < 0.05). Irrigating saline provided moderate density of E. faecalis in the dentin while CR and AR resulted in a residual density of microorganisms (p < 0.05). Conclusions The Enterococcus faecalis density in dentin was influenced by the irrigating regimen and the microbiological status of the root canal. The CMP aided by the alternating regimen interfered with the recolonization of the root canal and topographic distribution of Enterococcus in root dentin.
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Carvalho MC, Zuolo ML, Arruda-Vasconcelos R, Marinho ACS, Louzada LM, Francisco PA, Pecorari VGA, Gomes BPFDA. Effectiveness of XP-Endo Finisher in the reduction of bacterial load in oval-shaped root canals. Braz Oral Res 2019; 33:e021. [DOI: 10.1590/1807-3107bor-2019.vol33.0021] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 02/26/2019] [Indexed: 11/21/2022] Open
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Parhizkar A, Nojehdehian H, Asgary S. Triple antibiotic paste: momentous roles and applications in endodontics: a review. Restor Dent Endod 2018; 43:e28. [PMID: 30135847 PMCID: PMC6103545 DOI: 10.5395/rde.2018.43.e28] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 04/10/2018] [Indexed: 12/23/2022] Open
Abstract
This study investigated the latest findings and notions regarding ‘triple antibiotic paste’ (TAP) and its applications in dentistry, particularly endodontics. TAP is a combination of 3 antibiotics, ciprofloxacin, metronidazole, and minocycline. Despite the problems and pitfalls research pertaining to this paste has unveiled, it has been vastly used in endodontic treatments. The paste's applications vary, from vital pulp therapy to the recently introduced regeneration and revascularisation protocol. Studies have shown that the paste can eliminate the root canal microorganisms and prepare an appropriate matrix for further treatments. This combination is able to remove diverse groups of obligate and facultative gram-positive and gram-negative bacteria, providing an environment for healing. In regeneration protocol cases, this allows the development, disinfection, and possible sterilization of the root canal system, so that new tissue can infiltrate and grow into the radicular area. Moreover, TAP is capable of creating a discipline in which other wanted and needed treatments can be successfully performed. In conclusion, TAP, as an antibacterial intracanal medication, has diverse uses. Nevertheless, despite its positive effects, the paste has shown drawbacks. Further research concerning the combined paste and other intracanal medications to control microbiota is a must.
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Affiliation(s)
- Ardavan Parhizkar
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hanieh Nojehdehian
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Asgary
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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