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Hepsenoglu YE, Ersahan S, Erkan E, Gundogar M, Ozcelik F. Is SWEEPS better than PUI in reducing intracanal bacteria and inflammation in cases of apical periodontitis? Lasers Med Sci 2024; 39:182. [PMID: 39012553 PMCID: PMC11252177 DOI: 10.1007/s10103-024-04117-9] [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: 10/26/2023] [Accepted: 06/24/2024] [Indexed: 07/17/2024]
Abstract
To evaluate the efficacy of SWEEPS mode of the Er: YAG laser(SL) and passive ultrasonic irrigation(PUI) in the eradication of microorganisms and in the inflammation detection by IL-1β. Thirty patients with chronic apical periodontitis(AP) were allocated into two groups: Group SL-SWEEPS laser activated irrigation(n = 15) and Group PUI-passive ultrasonic irrigation(n = 15). Bacteriological samples were taken before(S1) and after chemomechanical preparation(S2), and then after final irrigation activation(S3). The levels of total bacteria and Streptococci were measured by means of PCR. Blood samples were collected before and 3rd day after treatment. Enzyme-linked immunosorbent assay was used to measure the levels of IL-1β. The bacterial reduction showed no differences between groups after chemo-mechanical treatment and after irrigant activation(p = 0.590). Post-treatment IL-1β levels were lower than pretreatment levels in both groups(p < 0.001). SL or PUI application in addition to chemomechanical preparation has similar effects on total bacterial level and inflammation detected by IL-1β in patients with AP.
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Affiliation(s)
- Yelda Erdem Hepsenoglu
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey
| | - Seyda Ersahan
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey.
| | - Erhan Erkan
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey
| | - Mustafa Gundogar
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey
| | - Fatih Ozcelik
- Department of Medical Biochemistry Department, Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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Doğan MU, Arıcıoğlu B, Köse TE, Çıkman AŞ, Öksüzer MÇ. Association between the irrigation-agitation techniques and Periapical Healing of large periapical lesions: a Randomized Controlled Trial. Clin Oral Investig 2024; 28:376. [PMID: 38878107 PMCID: PMC11180158 DOI: 10.1007/s00784-024-05758-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/30/2024] [Indexed: 06/19/2024]
Abstract
OBJECTIVES The aim of this study was to evaluate the effects of manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), and laser-activated irrigation (shock wave-enhanced emission photoacoustic streaming (SWEEPS)) on the periapical healing of large periapical lesions following nonsurgical root canal treatment. MATERIALS AND METHODS A total of fifty-six systemically healthy patients with a mandibular single-rooted tooth with periapical lesions of endodontic origin and a periapical index score of 3 or higher were included in the study. Before the treatment procedures, lesion volumes were determined volumetrically using cone-beam computed tomography (CBCT). Patients were randomized into treatment (MDA, PUI, SWEEPS) and control groups (n = 14). Root canal treatment and irrigation procedures were performed by a calibrated postgraduate operator and completed at one visit. For routine follow-up, clinical and radiographic evaluations were performed by a blinded evaluator using periapical (PA) radiographs according to Molven's criteria at 3, 6, and 9 months. At 12 months, lesion volumes were quantified volumetrically using CBCT (ITK-SNAP). The data were statistically analyzed with the Wilcoxon test. The significance level was set at p < 0.05. RESULTS In all groups, the mean lesion volume after treatment was significantly smaller than the mean volume before treatment (p = 0.001). Among the 56 teeth, 11 teeth were 'totally healed', and 39 teeth were 'reduced' on PA radiographs. No 'enlargement' was detected in any group. On CBCT, the lesion volume decreased in the following order: LAI-SWEEPS (86.9%) > PUI (85.4%) > MDA (80.4%) > control (74.5%), with no statistically significant difference (p > 0.05). CONCLUSIONS Despite the limitations of the present study, although a greater percentage of healing was observed in the LAI-SWEEPS and PUI groups, irrigation procedures had no statistically significant effect on the healing of periapical lesions with a single root canal at the 12-month follow-up. On the other hand, the outcome may change in multirooted teeth with curved and complex root canal systems. CLINICAL RELEVANCE In the short term and in single-canal teeth, advanced irrigation agitation methods such as laser and ultrasonic did not make a difference in healing other than manual irrigation agitation.
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Affiliation(s)
- Mehmet Umutcan Doğan
- Faculty of Dentistry, Department of Endodontics, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Banu Arıcıoğlu
- Faculty of Dentistry, Department of Endodontics, Istanbul Medeniyet University, İstanbul, Turkey
| | - Taha Emre Köse
- Faculty of Dentistry, Department of Endodontics, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Ahter Şanal Çıkman
- Faculty of Dentistry, Department of Endodontics, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Merve Çoban Öksüzer
- Faculty of Dentistry, Department of Endodontics, Recep Tayyip Erdoğan University, Rize, Turkey.
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Katunarić A, Grgac SF, Gabrić D, Pavelić B, Bago I. Effect of sodium hypochlorite and ethylenediaminotetraacetic acid activated by laser and ultrasonic energy on surface morphology and chemical composition of intracanal dentin. Microsc Res Tech 2024; 87:818-831. [PMID: 38100184 DOI: 10.1002/jemt.24474] [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: 06/18/2023] [Revised: 11/03/2023] [Accepted: 12/05/2023] [Indexed: 03/02/2024]
Abstract
The aim of the study was to evaluate the structural and chemical changes in intracanal dentin after root canal irrigation with sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) using additional activation with a novel Er:YAG Shock Wave-Enhanced Emission Photoacoustic Streaming (SWEEPS), ultrasonic irrigation (UI), and Nd:YAG irradiation. Root canals of extracted human premolars were instrumented with distilled water and distributed into groups according to the irrigation protocol used: Group 1: conventional needle irrigation (CI) with 3% NaOCl; group 2: CI with 15% EDTA; and group 3: CI with NaOCl+EDTA. In group 4, root canals were irrigated with NaOCl+EDTA+NaOCl using the following techniques: CI (group 4A), SWEEPS (group 4B), UI (group 4C). In group 4D, root canals were finally irradiated with Nd:YAG laser. After the irrigation, the intracanal dentin sample was collected and analyzed using spectroscope with a Fourier transformation of infrared spectrum in Attenuated total reflection technique (FTIR-ATR) to calculate apatite/collagen ratio. Scanning electron microscopy (SEM) and energy dispersive x-ray spectrometry (EDS) were used to determine its chemical composition. FTIR-ATR showed no significant difference in the phosphate/amid I ratio between the control and the experimental groups (p > 0.05). SWEEPS and UI of NaOCl+EDTA+NaOCl caused the most pronounced decrease of Ca and P (p < 0.05) value compared to CI and control group, and canal wall erosion. SWEEPS and UI of NaOCl+EDTA+NaOCl caused the most pronounced decrease of Ca and P value and significant canal wall erosion. However, no difference in phosphate/amide ratio was reported among groups. RESEARCH HIGHLIGHTS: SWEEPS and UI of NaOCl+EDTA+NaOCl caused the most pronounced decrease of Ca and P values and significant canal wall erosion. There was no difference in phosphate/amide ratio among the irrigation protocols.
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Affiliation(s)
- Adriana Katunarić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Dragana Gabrić
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Božidar Pavelić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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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.
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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.
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Zhang SH, Gao ZR, Zhou YH, Tan L, Feng Y, Ye Q, Zhao J, Zhao YQ, Hu J, Chen Y, Liu Q, Aimee DM, Guo Y, Feng YZ. Comparison of Easydo Activator, ultrasonic and needle irrigation techniques on sealer penetration and smear layer removal in vitro. BMC Oral Health 2024; 24:56. [PMID: 38195412 PMCID: PMC10775461 DOI: 10.1186/s12903-023-03833-y] [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: 01/29/2023] [Accepted: 12/26/2023] [Indexed: 01/11/2024] Open
Abstract
The effects of Easydo Activator (EA), a new sonic irrigation system, on sealer penetration at the root apex were compared to needle irrigation (NI) and passive ultrasonic irrigation (PUI) in this study. Forty-two single-rooted teeth were prepared and randomly divided into three groups (n = 14): group 1: NI; group 2: PUI; and group 3: EA. A solution of 3% sodium hypochlorite (NaOCl) was used for irrigation. Nine teeth in each group were filled with AH Plus sealer mixed with CY5 fluorescent dye and a single gutta-percha cone. The sealer penetration area, maximum penetration depth and percentage of sealer penetration at 5 mm and 1 mm from the apex were analyzed by confocal laser scanning microscopy (CLSM). The remaining 5 teeth in each group were subjected to test smear layer scores by scanning electron microscopy (SEM). The CLSM evaluation showed that increases in the area, depth and percentage of sealer penetration were detected at 1 and 5 mm from the root apex in the PUI group compared with the NI group, and greater increases were observed in the EA group (P < 0.05). The SEM experiment showed that the lowest scores for the smear layer and debris removal were achieved by the EA group when compared with the PUI and NI groups (P < 0.05). In conclusion, EA was superior to PUI and NI regarding sealer penetration at the root apex during endodontic treatment, and it could provide a new technical idea for clinical root canal therapy.
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Affiliation(s)
- Shao-Hui Zhang
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
- Department of Stomatology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, 441000, China
| | - Zheng-Rong Gao
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Ying-Hui Zhou
- Department of Ultrasound Diagnosis, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Li Tan
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Yao Feng
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Qin Ye
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Jie Zhao
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Ya-Qiong Zhao
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Jing Hu
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Yun Chen
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Qiong Liu
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Dusenge Marie Aimee
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Yue Guo
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
| | - Yun-Zhi Feng
- Hunan Provincial Clinical Research Center for Oral Diseases, Hunan Provincial Engineering Research Center of Digital Oral and Maxillofacial Defect Repair, Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
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Shahi Ardakani A, Afrasiabi S, Sarraf P, Benedicenti S, Solimei L, Chiniforush N. In Vitro Assessment of SWEEPS and Antimicrobial Photodynamic Therapy Alone or in Combination for Eradicating Enterococcus faecalis Biofilm in Root Canals. Pharmaceutics 2023; 15:2628. [PMID: 38004605 PMCID: PMC10674832 DOI: 10.3390/pharmaceutics15112628] [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: 10/12/2023] [Revised: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVES This study investigates the efficacy of antimicrobial photodynamic therapy (aPDT) using riboflavin and a blue diode laser (BDL), combined with shock wave-enhanced emission photoacoustic streaming (SWEEPS), against Enterococcus faecalis. MATERIALS AND METHODS A total of 48 extracted single-rooted human teeth were used. The root canals were instrumented, sealed at their apices, had the smear layer removed, and then underwent autoclave sterilization. Subsequently, each canal was inoculated with E. faecalis bacterial suspension and allowed to incubate for ten days. After confirming the presence of biofilms through scanning electron microscopy (SEM) in three teeth, the remaining teeth were randomly allocated into nine groups, each containing five teeth: control, 5.25% sodium hypochlorite (NaOCl), BDL, SWEEPS + normal saline, SWEEPS + NaOCl, riboflavin, riboflavin + SWEEPS, riboflavin + BDL, and riboflavin + BDL + SWEEPS. After the treatment, the numbers of colony-forming units (CFUs)/mL were calculated. The data were analysed using one-way ANOVA followed by Tukey's test for comparisons. RESULTS All groups, with the exception of the BDL group, exhibited a significant reduction in E. faecalis CFU/mL when compared to the control group (p < 0.001). The difference in CFU/mL value between riboflavin + BDL + SWEEPS and riboflavin + SWEEPS was significant (p = 0.029), whereas there was no significant difference between riboflavin + BDL + SWEEPS and riboflavin + BDL (p = 0.397). Moreover, there was no statistically significant difference between the riboflavin + SWEEPS group and the riboflavin + BDL group (p = 0.893). CONCLUSIONS The results demonstrated that combining the SWEEPS technique with riboflavin as a photosensitizer activated by BDL in aPDT effectively reduced the presence of E. faecalis in root canals.
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Affiliation(s)
- Ali Shahi Ardakani
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1441987566, Iran;
| | - Shima Afrasiabi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1441987566, Iran;
| | - Pegah Sarraf
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran 1441987566, Iran;
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (S.B.); (L.S.)
| | - Luca Solimei
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (S.B.); (L.S.)
| | - Nasim Chiniforush
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (S.B.); (L.S.)
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Rödig T, Westbomke V, Haupt F, Münster M, Baxter S. Effect of preparation size on the removal of accumulated hard-tissue debris from the mesial root canal system of mandibular molars using SWEEPS technology. Clin Oral Investig 2023; 27:2787-2796. [PMID: 36642725 PMCID: PMC10264281 DOI: 10.1007/s00784-023-04862-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 01/06/2023] [Indexed: 01/17/2023]
Abstract
OBJECTIVES This study assessed the influence of preparation size on the efficacy of shock wave-enhanced emission photoacoustic streaming (SWEEPS) and conventional irrigation (CI) on removal of accumulated hard tissue debris (AHTD) from isthmus-containing mandibular molars using micro-computed tomographic analysis. MATERIALS AND METHODS Sixty extracted mandibular molars with two mesial canals connected by an isthmus were selected. Canals were shaped with Mtwo instruments (VDW, Munich, Germany) up to sizes 25/.06, 40/.04 or 40/.06 (n = 20), and specimens were distributed into 2 final irrigation groups (n = 10): SWEEPS and CI. Roots were scanned at a resolution of 10.5 µm before and after preparation and final irrigation. Data sets were co-registered, and the percentage reduction of AHTD calculated for each specimen was statistically compared using analysis of variance with a of 5% significance level. RESULTS The preparation size did not significantly influence the percentage reduction of AHTD (p < 0.05), whereas the final irrigation technique had a significant effect on debris removal (p < 0.05). A significant reduction of AHTD was achieved after final irrigation in all groups (p < 0.05); however, SWEEPS was associated with a significantly greater percentage reduction of debris than CI (p < 0.05). None of the specimens presented a completely clean isthmus. CONCLUSIONS Removal of AHTD was not significantly affected by the preparation size. SWEEPS was associated with significantly less debris than CI. CLINICAL RELEVANCE SWEEPS performed significantly better than CI regarding the removal of AHTD from isthmus-containing mandibular molars irrespective of the preparation size.
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Affiliation(s)
- Tina Rödig
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
| | - Valerie Westbomke
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Franziska Haupt
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Marc Münster
- Endopur, Clinic for Endodontology, Frankfurt, Germany
| | - Steffi Baxter
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
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8
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Uslu G, Gündoğar M, Üngör M, Özyürek T, Erkan E, Keskin NB. Investigation of the effectiveness of sonic, ultrasonic and new laser-assisted irrigation activation methods on smear removal and tubular penetration. Lasers Med Sci 2023; 38:30. [PMID: 36595139 DOI: 10.1007/s10103-022-03697-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/19/2022] [Indexed: 01/04/2023]
Abstract
The aim of this study was to examine the effectiveness of different irrigation activation methods on smear layer removal and tubular penetration. One hundred-five distal roots of mandibular molar teeth in total; 50 for smear removal efficiency (n = 10) analysis using scanning electron microscopy (SEM), and 55 roots were used to examine tubular penetration using confocal laser scanning microscope (CLSM). Five different irrigation activation methods were used in this study; conventional needle irrigation (CNI), sonic irrigation device of EDDY, passive ultrasonic irrigation (PUI), PIPS and SWEEPS techniques, which are two different laser irrigation activation methods. The obtained data were statistically analyzed and the significance level was determined as p < 0.05. At the apical level, the cleanest canal walls were observed when laser methods PIPS and SWEEPS were used, while in the middle third, there was no difference in smear removal efficiencies between all groups except for the CNI (p > 0.05). Penetration depths and percentages increased from apically to coronally in all groups. The PUI and EDDY generally showed similar penetration depths and percentages to the CNI, except at the coronal root level (p > 0.05). In all groups, when PIPS was used, it showed greater penetration depth and percentage (p < 0.05). PIPS and SWEEPS techniques showed lowest and similar smear scores compared to PUI and EDDY in the apical area where access and effectiveness of the irrigation solution are difficult.
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Affiliation(s)
- Gülşah Uslu
- Faculty of Dentistry, Department of Endodontics, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Mustafa Gündoğar
- Faculty of Dentistry, Department of Endodontics, Medipol University, Istanbul, Turkey
| | - Mete Üngör
- Faculty of Dentistry, Department of Endodontics, Medipol University, Istanbul, Turkey
| | - Taha Özyürek
- Faculty of Dentistry, Department of Endodontics, Bahçeşehir University, Istanbul, Turkey
| | - Erhan Erkan
- Faculty of Dentistry, Department of Endodontics, Medipol University, Istanbul, Turkey
| | - Neslihan Büşra Keskin
- Faculty of Dentistry, Department of Endodontics, Yıldırım Beyazıt University, Ankara, Turkey.
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Kapetanović Petričević G, Katić M, Brzović Rajić V, Anić I, Bago I. The Efficacy of Er:YAG Laser-Activated Shock Wave-Enhanced Emission Photoacoustic Streaming Compared to Ultrasonically Activated Irrigation and Needle Irrigation in the Removal of Bioceramic Filling Remnants from Oval Root Canals-An Ex Vivo Study. Bioengineering (Basel) 2022; 9:bioengineering9120820. [PMID: 36551026 PMCID: PMC9774814 DOI: 10.3390/bioengineering9120820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/27/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
The removal of filling material is important for successful root canal retreatment. The aim of the study was to compare the efficiency of two activated irrigation techniques, the shock wave-enhanced emission photoacoustic streaming (SWEEPS) mode of the Er:YAG laser and ultrasonically activated irrigation (UAI) and a conventional syringe-needle technique (SNI), in the removal of bioceramic sealer/gutta-percha during conventional retreatment in oval root canals. The study sample consisted of distal root canals of 42 extracted human mandibular molars, which were prepared using a ProTaper Next system up to size 40/0.06 and filled with bioceramic sealer using a single-cone obturation technique. The teeth were then re-treated with a Reciproc Blue RB40 file and 3% sodium hypochlorite solution. The prepared teeth were randomly divided into three groups (n = 14 per group) and subjected to one of the three irrigation methods. Micro-CT scans were performed at different stages to assess the amount of filling material after each retreatment phase. The results of the study showed that all the tested irrigation techniques reduced a statistically significant amount of the remnant filling material at retreatment (p < 0.05), and there were no statistically significant differences in efficacy between the three methods. All tested techniques had similar efficacy in the removal of the remaining filling remnants.
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Affiliation(s)
- Gabrijela Kapetanović Petričević
- Department of Endodontics and Restorative Dental Medicine, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marko Katić
- Department of Materials, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, 10000 Zagreb, Croatia
| | - Valentina Brzović Rajić
- Department of Dental Diseases, Dentistry Clinic, University Hospital Centre, 10000 Zagreb, Croatia
| | - Ivica Anić
- Department of Endodontics and Restorative Dental Medicine, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Ivona Bago
- Department of Endodontics and Restorative Dental Medicine, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Correspondence: ; Tel.: +385-1-4802128
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Liu J, Watanabe S, Mochizuki S, Kouno A, Okiji T. Comparison of vapor bubble kinetics and cleaning efficacy of different root canal irrigation techniques in the apical area beyond the fractured instrument. J Dent Sci 2022. [DOI: 10.1016/j.jds.2022.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Translational Applications of Extracorporeal Shock Waves in Dental Medicine: A Literature Review. Biomedicines 2022; 10:biomedicines10040902. [PMID: 35453651 PMCID: PMC9030023 DOI: 10.3390/biomedicines10040902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/04/2022] [Accepted: 04/12/2022] [Indexed: 12/04/2022] Open
Abstract
Extracorporeal shock wave therapy (ESWT) has been studied and applied extensively in medical practice for various applications including musculoskeletal, dermal, vascular, and cardiac indications. These indications have emerged from primary ESWT use in treating urolithiasis and cholelithiasis. Likewise, dental medicine has had its share of utilizing ESWT in various investigations. This review aimed to provide an up-to-date summary of ESWT use in preclinical and clinical dental medicine. There is growing interest in ESWT use stemming from its non-invasiveness, low cost, and safe qualities in addition to its proven regenerative biostimulating aspects. Targeted tissue and parameters of ESWT delivery continue to be an integral part of successful ESWT treatment to attain the clinical value of the anticipated dose’s effect.
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