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Choudhari S, Venkata Teja K, Ramesh S, Kumar R, Spagnuolo G. Assessment of Apical Pressures in Single and Joining Canals - An Ex Vivo Study Based on Computational Fluid Dynamic Analysis. Eur Endod J 2024; 9:89-94. [PMID: 37941399 PMCID: PMC10777085 DOI: 10.14744/eej.2023.57060] [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: 10/03/2022] [Revised: 12/27/2022] [Accepted: 01/12/2023] [Indexed: 03/14/2023] Open
Abstract
OBJECTIVE Computational fluid dynamic analysis (CFD) is claimed to be a reliable tool for analysing the fluid flow and the generated apical pressures in the simulated root canal. The current study aimed to analyse the apical pressures in extracted teeth with single and joining canals. METHODS Forty-six freshly extracted teeth were collected for the present study. The power was set at 95%, with an effect size of 0.55 (1-β=95%, α=0.05). Once the root canal anatomy was confirmed with cone-beam computed tomography (CBCT), they were divided into two groups: group I: mandibular second premolars with Vertucci type-I (n=23), and group II: maxillary second premolars with Vertucci type-II (n=23). The instrumentation of the specimens was carried out to a 0.04-taper using rotary instruments. A post-instrumentation CBCT was obtained, and computer-aided design models were obtained. The CFD simulations were then con- ducted with simulated 30-gauge side vented needles at 25, 50, and 75% short of the working length (WL). RESULTS Group I recorded significantly (p<0.05) higher apical pressures at needle positions 25% short of the WL. However, no significant differences were elicited in the groups at other needle positions. CONCLUSION Single canal specimens recorded higher apical pressures at needle positions 25% short of the WL. However, no differences were elicited between single and joining canals at higher needle positions.
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Affiliation(s)
- Sahil Choudhari
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Kavalipurapu Venkata Teja
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Sindhu Ramesh
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Raja Kumar
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Gianrico Spagnuolo
- Department of Neuroscience, Reproductive and Odontostomotological Sciences, University of Naples, Naples, Italy
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Tuttle JJ, Davidson AD, Tuttle GK. Bending 30-gauge needles using a needle guide: fatigue life evaluation. J Dent Anesth Pain Med 2023; 23:281-285. [PMID: 37841519 PMCID: PMC10567543 DOI: 10.17245/jdapm.2023.23.5.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 10/17/2023] Open
Abstract
Background Dentists bend needles prior to certain injections; however, there are concerns regarding needle fracture, lumen occlusion, and sharps handling. A previous study found that a 30-gauge needle fractures after four to nine 90° bends. This fatigue life study evaluated how many 90° bends a 30-gauge dental needle will sustain before fracture when bent using a needle guide. Methods Two operators at Element Materials Technology, an independent testing, inspection, and certification company tested 48 30-gauge needles. After applying the needle guide, the operators bent the needle to a 90° angle and expressed the anesthetic from the tip. The needle was then bent back to a 0° angle, and the functionality was tested again. This process was repeated until the anesthetic failed to pass through the end of the needle due to fracture or obstruction. Each operator tested 24 needles (12 needles from each lot), and the number of sustained bends before the needle fracture was recorded. Results The average number of sustained bends before needle failure was 40.33 (95% confidence interval = 37.41-43.26), with a minimum of 20, median of 40, and a maximum of 54. In each trial, the lumen remained patent until the needle fractured. The difference between the operators was statistically significant (P < 0.001). No significant differences in performance between needle lots were observed (P = 0.504). Conclusion Our results suggest that using a needle guide increases the number of sustained bends before needle fracture (P < 0.000001) than those reported in previous studies. Future studies should further evaluate the use of needle guides with other needle types across a variety of operators. Furthermore, additional opportunities lie in exploring workplace safety considerations and clinical applications of anesthetic delivery using a bent needle.
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Affiliation(s)
- Jared Joseph Tuttle
- University of Texas Health Science Center at San Antonio, Joe R. and Teresa Lozano Long School of Medicine, San Antonio, TX, USA
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Choudhari S, S P, Venkata Teja K. Antimicrobial Efficacy of a Novel Automated Irrigation Device As Compared to Conventional Needle Irrigation Against Enterococcus faecalis: An In Vitro Study. Cureus 2023; 15:e45200. [PMID: 37842411 PMCID: PMC10576167 DOI: 10.7759/cureus.45200] [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: 08/01/2023] [Accepted: 09/13/2023] [Indexed: 10/17/2023] Open
Abstract
Aim The present study aims to compare the antibacterial efficacy of a novel automated endodontic irrigation device with that of a manual irrigation technique. Materials and methods The present study considered 45 extracted single-rooted teeth. After sectioning the teeth, the specimens were inoculated with Enterococcus faecalis (E. faecalis) bacteria for three weeks. Instrumentation was done using ProTaper Gold rotary files to size 50 and 5% taper. Based on the irrigation protocol, the experimental samples were divided into Group I: control (normal saline irrigation) (n = 15); Group II: conventional needle irrigation (n = 15); and Group III: automated irrigation (n = 15). The irrigation in Group III was done using the automated irrigation device. After the experimental irrigation, the pre-weighted dentinal shaving was collected in Eppendorf tubes, diluted 10 times, and incubated in the Petri dish with tryptone soy agar (TSA) for 48 hours. Finally, the colony-forming unit (CFU) counts were assessed. IBM SPSS Statistics for Windows version 23.0 (Armonk, NY, USA, IBM Corp.) was used for data analysis. Intergroup comparisons were made using the non-parametric Kruskal-Wallis test. Results The mean CFU count (CFU/ml) for the groups was: Group 1 (normal saline irrigation): 3.67x101; Group 2 (manual irrigation): 2.69× 101; Group 3 (automated irrigation): 1.57× 101. A statistically significant reduction in E. faecalis CFU count was seen among the groups assessed (p<0.01). The automated irrigation group exhibited the most substantial reduction in E. faecalis CFU count. Group 2 showed a significant difference compared to Group 1 (p<0.05). Conclusions The novel automated endodontic irrigation device was superior to manual irrigation in reducing E. faecalis CFU counts. This indicates that the automated irrigation device has the potential to enhance bacterial elimination efficacy during endodontic treatment.
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Affiliation(s)
- Sahil Choudhari
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
| | - Pradeep S
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
| | - Kavalipurapu Venkata Teja
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
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Iandolo A, Amato A, Pisano M, Sangiovanni G, Abdellatif D, Fornara R, Simeone M. Histological Evaluation of Root Canals by Performing a New Cleaning Protocol “RUA” in Endodontic Surgery. Dent J (Basel) 2023; 11:dj11030078. [PMID: 36975575 PMCID: PMC10047649 DOI: 10.3390/dj11030078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/11/2023] [Accepted: 03/08/2023] [Indexed: 03/12/2023] Open
Abstract
Aim: To enhance cleaning during retro-preparation in endodontic microsurgery. Materials and Methods: Forty mandibular premolars were instrumented, filled with a single cone technique, and then retro-preparation was performed and assigned to experiment A. In group A1, the cavity created by the retro preparation was cleansed with 2 mL of normal sterile saline. In group A2, the retro cavity was cleaned with 2 mL of sterile saline after the retro preparation. All the irrigation solutions mentioned above were delivered using an endodontic needle with a lateral vent and a gauge of 30. Subsequently, in group A2, 17% EDTA gel and 5.25% gel were inserted into the cavity and activated using ultrasonic tips. After the irrigation protocols, the specimens were decalcified for histological evaluation. Results: In the experiment, the amount of hard tissue debris was significantly greater in group A1 compared to group A2 (p < 0.05). Conclusions: The samples in group A2, where the new protocol was performed, showed statistically significant results.
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Affiliation(s)
- Alfredo Iandolo
- Department of Medicine and Surgery, University of Salerno, 84084 Salerno, Italy
- Correspondence: or ; Tel.: +39-3287028233
| | - Alessandra Amato
- Department of Medicine and Surgery, University of Salerno, 84084 Salerno, Italy
| | - Massimo Pisano
- Department of Medicine and Surgery, University of Salerno, 84084 Salerno, Italy
| | | | - Dina Abdellatif
- Department of Endodontics, Faculty of Dentistry, University of Alexandria, Alexandria 21526, Egypt
| | | | - Michele Simeone
- Department of Endodontics, Faculty of Dentistry, University of Naples, Federico II, 80126 Naples, Italy
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Wang Y, Li Y, Huang S, Huang J, Huang X. An easily achievable strategy to promote the penetration of methylene blue into dentinal tubules. Photodiagnosis Photodyn Ther 2023; 41:103237. [PMID: 36496126 DOI: 10.1016/j.pdpdt.2022.103237] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/12/2022] [Accepted: 12/06/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND One critical issue that impairs the therapeutic effects of antimicrobial photodynamic therapy (aPDT) in root canal disinfection is the insufficient penetration of photosensitizer into dentinal tubules. Therefore, this study aimed to compare the treatments in enhancing photosensitizers' penetrability for aPDT in root canal therapy. METHODS Thirty premolars with a single root canal were randomly divided into three groups (n = 10), using Methylene blue (MB) as a photosensitizer and treated with different approaches: sonic-assisted diffusing group, ultrasonic-assisted diffusing group and the control without treatment. All specimens were observed by stereomicroscope to measure the penetration depth of MB into dentinal tubules. RESULTS Both sonic and ultrasonic treatments substantially improved the penetrability of MB. The former achieved a deeper penetration depth than the latter did in the same region of root (P<0.05). Regarding the dye penetration depths at different root regions, the control group showed a declining trend from coronal to apical. In contrast, the penetration depths of sonic and ultrasonic-assisted diffusing groups from highest to lowest were middle > coronal > apical (P<0.05). CONCLUSIONS This study showed that both sonic and ultrasonic treatments remarkably promoted MB's penetration depth into dentinal tubules. Maximum penetration was achieved when treated with a sonic approach.
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Affiliation(s)
- Yanhuang Wang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Yijun Li
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Shan Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Jing Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China
| | - Xiaojing Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, China.
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Iandolo A, Pisano M, Abdellatif D, Sangiovanni G, Pantaleo G, Martina S, Amato A. Smear Layer and Debris Removal from Root Canals Comparing Traditional Syringe Irrigation and 3D Cleaning: An Ex Vivo Study. J Clin Med 2023; 12:jcm12020492. [PMID: 36675419 PMCID: PMC9867447 DOI: 10.3390/jcm12020492] [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: 11/30/2022] [Revised: 12/21/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Background: Endodontic treatment objectives comprise eliminating or decreasing bacterial load inside the complex endodontic space. Removing the smear layer and debris becomes mandatory to achieve good three-dimensional (3D) cleaning. Aim: This study assesses the difference in smear layer removal using the 3D cleaning technique and traditional syringe needle irrigation. The 3D cleaning technique includes the ultrasonic activation of intracanal-heated NaOCl. Materials and Methods: Our current study used single-rooted human mandibular premolar teeth to test the earlier-mentioned technique (n = 30). Initially, an endodontic access cavity was performed. Consequently, specimens were randomly distributed into three study groups according to irrigation protocol. The groups were Group 1, where the traditional syringe needle irrigation system was applied; Group 2, where the 3D cleaning technique was performed; and Group 3, in which teeth remained uncleaned as it was regarded as the control group. Once the experiment was completed, the teeth were decoronated at the cementoenamel junction (CEJ) and examined using scanning electron microscopy (SEM). Debris and smear layers were viewed in 1000× magnification and scored. Results: Statistical analysis was performed with a standard statistical software package (SPSS, version 28.0; SPSS IBM, Armonk, NY, USA). Data were analyzed with a nonparametric analysis of variance (Kruskal−Wallis ANOVA) among the groups tested and among the thirds of the canals. The level of significance was set at p < 0.05. A statistically significant (p < 0.05) lower mean smear layer and debris score was observed in both study groups compared to the control group. Group 2 showed better results compared to Group 1. Conclusions: The present study concluded that the 3D cleaning technique is an effective irrigation method for removing debris and smear layers. Future research, such as CLSM (Confocal Laser Scanning Microscopy) and Histological study, should be employed to confirm this study’s conclusion.
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Affiliation(s)
- Alfredo Iandolo
- Department of Medicine and Surgery, University of Salerno, 84081 Salerno, Italy
- Correspondence: ; Tel.: +39-328-7028-233
| | - Massimo Pisano
- Department of Medicine and Surgery, University of Salerno, 84081 Salerno, Italy
| | - Dina Abdellatif
- Department of Endodontics, Faculty of Dentistry, University of Alexandria, Alexandria 21531, Egypt
| | | | - Giuseppe Pantaleo
- Department of Medicine and Surgery, University of Salerno, 84081 Salerno, Italy
| | - Stefano Martina
- Department of Medicine and Surgery, University of Salerno, 84081 Salerno, Italy
| | - Alessandra Amato
- Department of Medicine and Surgery, University of Salerno, 84081 Salerno, Italy
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Two-Year Healing Success Rates after Endodontic Treatment Using 3D Cleaning Technique: A Prospective Multicenter Clinical Study. J Clin Med 2022; 11:jcm11206213. [PMID: 36294533 PMCID: PMC9604672 DOI: 10.3390/jcm11206213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/16/2022] [Accepted: 10/19/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Various irrigation techniques for cleansing the endodontic space have been proposed, and internal heating combined with ultrasonic activation (3D cleaning technique) is considered an effective technique. This prospective multicenter clinical study aims to evaluate healing rates for teeth after root canal treatment utilizing the 3D cleaning technique and to report predictive values for success. MATERIAL AND METHODS Ninety patients referred for a root canal treatment were included. All enrolled patients were treated with the 3D cleaning protocol. Four endodontists performed the clinical procedures and follow-up evaluations. Preoperative, postoperative and follow-up data were gathered from the consented patients. Each patient was assessed for any clinical signs or symptoms. Afterwards, two trained, blinded, and independent evaluators scored the subject's periapical radiographs. This score was made by checking for the presence or absence of apical periodontitis using the periapical index (PAI). Then, the teeth were classified as healing or healed and were considered a success based on a cumulative success rate of healing. Statistical analysis was performed using the Fisher's exact test, Pearson correlation, and logistic regression analyses of the preoperative prognostic factors at a 0.05 significance level. RESULTS 90 patients were evaluated at two years with a follow-up rate of 97.7%. The cumulative success rate of healing was 95.4%. Eight predicting aspects were identified by employing bivariate analyses. Then, using logistic analyses, the two prognostic significant variables directly correlated to healing were the preoperative presence of periapical index (p value = 0.016). CONCLUSIONS In this two-year clinical study, the cumulative success rate of healing was 95.4% when patients were treated with the 3D cleaning protocol.
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Rajamanickam K, Teja KV, Ramesh S, AbuMelha AS, Alkahtany MF, Almadi KH, Bahammam SA, Janani K, Choudhari S, Jose J, Srivastava KC, Shrivastava D, Patil S. Comparative Study Assessing the Canal Cleanliness Using Automated Device and Conventional Syringe Needle for Root Canal Irrigation-An Ex-Vivo Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6184. [PMID: 36143496 PMCID: PMC9504894 DOI: 10.3390/ma15186184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 06/16/2023]
Abstract
The success of endodontic treatment relies on both apical and coronal sealing. To achieve a good three-dimensional seal, the removal of the smear layer becomes mandatory. This study aims to assess the difference in debris accumulation and smear layer formation while using automated root canal irrigation and conventional syringe needle irrigation. Single-rooted human mandibular premolar teeth (n = 30) which were indicated for orthodontic extractions were selected. An endodontic access cavity was prepared, and a glide path was created. Based on the irrigation protocol decided upon for the study, the teeth were randomly allocated into three study groups, namely Group 1, where the manual syringe needle irrigation method was adopted; Group 2, in which automated root canal irrigation was undertaken; and Group 3, in which teeth remained un-instrumented as it was considered the Control group. The teeth were decoronated at the cement-enamel junction (CEJ) and were subjected for scanning electron microscopy (SEM) examination. Debris and smear layers were viewed in 1000× magnification and scored. A statistically significant (p < 0.05) lower mean debris and smear layer score (p < 0.05) was observed in both study groups when compared with the control group. However, no significant difference (p > 0.05) in the debris and smear layer was observed between the manual syringe needle irrigation and automated irrigation, although automated irrigation devices can be a potential alternative. The present study concluded that the efficacy of smear layer removal remained the same with both automated irrigation and manual syringe irrigation.
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Affiliation(s)
- Keerthika Rajamanickam
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
| | - Kavalipurapu Venkata Teja
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
| | - Sindhu Ramesh
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
| | - Abdulaziz S. AbuMelha
- Restorative Dental Science Department, College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia
| | - Mazen F. Alkahtany
- Department of RDS, Division of Endodontics, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Khalid H. Almadi
- Department of RDS, Division of Endodontics, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Sarah Ahmed Bahammam
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, Taibah University, P.O. Box 344, Medina 42353, Saudi Arabia
| | - Krishnamachari Janani
- Department of Conservative Dentistry and Endodontics, SRM Dental College, SRM Institute of Science & Technology, Chennai 600089, Tamil Nadu, India
| | - Sahil Choudhari
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
| | - Jerry Jose
- Private Practice, Aluva, Ernakulam District, Kochi 683106, Kerala, India
| | - Kumar Chandan Srivastava
- Department of Oral & Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
| | - Deepti Shrivastava
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
- Centre of Molecular Medicine and Diagnostics (COMManD), Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India
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Periapical Healing following Root Canal Treatment Using Different Endodontic Sealers: A Systematic Review. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3569281. [PMID: 35845966 PMCID: PMC9286882 DOI: 10.1155/2022/3569281] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 11/19/2022]
Abstract
The healing of the periapical tissues is crucial to the success of root canal treatment. The review studies effectively examine various endodontic root canal sealants in terms of periapical healing. This systematic review was formulated following the PRISMA 2020 guidelines and registered in the international prospective register of systematic reviews (PROSPERO) number-CRD42021239192. To find relevant articles, PubMed Central and Medline databases (until February 2022) were searched. Studies that evaluated healing following the application of different endodontic sealers were analysed. A primary outcome measure was the resolution of periapical lesions following the endodontic treatment. In vivo studies comparing radiographic treatment outcomes and articles with a minimum of 6-month follow-up were included. A total of 9 clinical trial studies that met all the inclusion criteria were included in the analysis. The overall risk of bias was high in four studies out of nine studies. Periapical lesions showed significant healing after endodontic treatment regardless of sealer type, although bioceramic and bioactive sealers had shown better results.
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Ramesh S, Teja K, Choudhari S, Janani K, Jose J, Vasundhara K. A questionnaire-based cross-sectional survey of Indian postgraduates and endodontists on awareness, attitude, and practice of using conventional syringe needle irrigation during root canal treatment. SAUDI ENDODONTIC JOURNAL 2022. [DOI: 10.4103/sej.sej_26_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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