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Wang Y, Lei L, Huang J, Cai Z, Huang X. Sonic-assisted antibacterial photodynamic therapy: a strategy for enhancing lateral canal disinfection. BMC Oral Health 2024; 24:5. [PMID: 38166876 PMCID: PMC10762957 DOI: 10.1186/s12903-023-03801-6] [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: 10/16/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Bacterial infections in lateral canals pose challenges for root canal treatment. This in vitro study aims to evaluate the antibacterial efficacy of sonic-assisted methylene blue mediated antimicrobial photodynamic therapy (MB-aPDT) against Enterococcus faecalis (E. faecalis) in infected lateral canals. METHODS Sixty-five premolars infected with E. faecalis in lateral canals were randomly divided into five groups (n = 13) and treated with : (1) 5.25% NaOCl (positive control); (2) Saline (negative control); (3) Sonic-assisted MB-aPDT; (4) 3% NaOCl + MB-aPDT; (5) 3% NaOCl + sonic-assisted MB-aPDT, respectively. The antibacterial efficacy was evaluated by the colony- counting method (CCM) and scanning electronic microscope (SEM). RESULTS Both 5.25% NaOCl and the 3% NaOCl + sonic-assisted MB-aPDT exhibited the most effective while comparable antibacterial effects without significant statistical difference (P > 0.05). Furthermore, the antibacterial effect of the 3% NaOCl + MB-aPDT group was significantly higher compared to that of the sonic-assisted MB-aPDT group (P < 0.05). The SEM results demonstrated notable morphological alterations in E. faecalis across all experimental groups, except for the negative control group. CONCLUSION The concentration of NaOCl can be reduced to a safe level while preserving its antibacterial efficacy through the synergism with the sonic-assisted MB-aPDT in this study.
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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, Fuzhou, 350002, PR China
| | - Lishan Lei
- 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, Fuzhou, 350002, PR 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, Fuzhou, 350002, PR China
| | - Zhiyu Cai
- Department of Stomatology, Fujian Medical University Union Hospital, Fuzhou, 350002, PR 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, Fuzhou, 350002, PR China.
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Gomes BPFA, Aveiro E, Kishen A. Irrigants and irrigation activation systems in Endodontics. Braz Dent J 2023; 34:1-33. [PMID: 37909632 PMCID: PMC10642269 DOI: 10.1590/0103-6440202305577] [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: 05/31/2023] [Accepted: 06/12/2023] [Indexed: 11/03/2023] Open
Abstract
Root canal infections are typically polymicrobial and involve strong bacterial interactions. The goal of endodontic treatment is to remove infected content from the root canal system to allow the healing of a pre-existing periapical lesion or to prevent infection of the periradicular tissues. Instrumentation alone is not capable of touching all of the root canal walls. Therefore, the irrigation process is an essential step in the endodontic treatment. However, due to the complex anatomy of the root canal system, this cleaning is very challenging. Although syringe and needle irrigation associated with the use of chemical substances is still the most used method, it does not guarantee optimal cleaning of the root canals. As a result, not only alternative irrigating substances but also numerous activation systems - which are technologies that aim to optimize the action of irrigating substances, both chemically and physically - have been developed. This work aimed to review the characteristics of both classic and current alternatives of irrigating substances and irrigation activation systems.
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Affiliation(s)
- Brenda P. F. A. Gomes
- Department of Restorative Dentistry, Division of Endodontics,
Piracicaba Dental School - State University of Campinas, UNICAMP, Brazil
| | - Emelly Aveiro
- Department of Restorative Dentistry, Division of Endodontics,
Piracicaba Dental School - State University of Campinas, UNICAMP, Brazil
| | - Anil Kishen
- Department of Dentistry, University of Toronto, Canada
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Usta SN, Solana C, Ruiz-Linares M, Baca P, Ferrer-Luque CM, Cabeo M, Arias-Moliz MT. Effectiveness of conservative instrumentation in root canal disinfection. Clin Oral Investig 2023; 27:3181-3188. [PMID: 36867258 PMCID: PMC10264279 DOI: 10.1007/s00784-023-04929-z] [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: 10/17/2022] [Accepted: 02/22/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVES The impact of conservative instrumentation on the disinfection of root canals with different curvatures has not yet been determined. This ex vivo study aimed to evaluate and compare the effect of conservative instrumentation with TruNatomy (TN) and Rotate and a conventional rotary system, ProTaper Gold (PTG), on root canal disinfection during chemomechanical preparation of straight and curved canals. MATERIALS AND METHODS Ninety mandibular molars with straight (n = 45) and curved (n = 45) mesiobuccal root canals were contaminated with polymicrobial clinical samples. Teeth were divided into three subgroups (n = 14) according to the file systems and the curvature. Canals were instrumented with TN, Rotate, and PTG, respectively. Sodium hypochlorite and EDTA were used as irrigants. Intracanal samples were taken before (S1) and after (S2) instrumentation. Six uninfected teeth were used as negative controls. The bacterial reduction between S1 and S2 was measured by ATP assay, flow cytometry, and culture methods. Kruskal-Wallis and ANOVA tests were followed by the Duncan post hoc test (p < 0.05). RESULTS Bacterial reduction percentages were similar for the three file systems in straight canals (p > 0.05). However, PTG showed a lower reduction percentage of intact membrane cells in flow cytometry than TN and Rotate (p = 0.036). For the curved canals, no significant differences were obtained (p > 0.05). CONCLUSION Conservative instrumentation of straight and curved canals using TN and Rotate files resulted in similar bacterial reduction compared to PTG. CLINICAL RELEVANCE The disinfection efficacy of conservative instrumentation is similar to conventional instrumentation in straight and curved root canals.
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Affiliation(s)
- Sıla Nur Usta
- Department of Endodontics, Gulhane Faculty of Dentistry, University of Health Sciences, Etlik, Keçiören, 06018 Ankara Turkey
| | - Carmen Solana
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Matilde Ruiz-Linares
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Pilar Baca
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Carmen María Ferrer-Luque
- Department of Stomatology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Monica Cabeo
- Department of Microbiology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
| | - Maria Teresa Arias-Moliz
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- Department of Microbiology, School of Dentistry, University of Granada, Campus de Cartuja, Colegio Máximo S/N., 18071 Granada, Spain
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Fidan ME, Erdemir A. Effect of different irrigation activation techniques on irrigation penetration into the simulated lateral canals. Odontology 2023; 111:132-141. [PMID: 35834067 DOI: 10.1007/s10266-022-00729-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 07/05/2022] [Indexed: 01/06/2023]
Abstract
This study, in which a hundred human teeth with single straight canal were used, focused on the evaluation of contrast solution penetration ability into the simulated lateral canals activated by XP-endo Finisher (XPF), EDDY, Nd:YAG, and Er:YAG laser systems with three different observation methods. The root canals were prepared up to X4 at working length using the ProTaper Next system. The teeth were decalcified and simulated lateral canals were created with #8 K-file at 2, 4, and 6 mm levels. Then the teeth were cleared using methyl salicylate and divided into 5 equal groups according to irrigation activation techniques (CSI, XPF, EDDY, Nd:YAG, and Er:YAG laser). After the contrast solution was activated, images of the simulated lateral canals were obtained by a dental microscope, digital radiography, and CBCT. The contrast solution penetration scores at the 2, 4, and 6 mm levels according to irrigation activation techniques and observation methods were analyzed statistically using Kruskal-Wallis non-parametric analysis of variance Bonferroni test post hoc comparisons. With the other 2 parameters are ignored, the highest and lowest contrast solution penetration were observed at 6 and 2 mm simulated lateral canal levels (p < 0.05), in Er:YAG irrigation activation and CSI technique (p < 0.05), and in direct visual and digital radiographic observation method (p < 0.05), respectively. Within the limits of this study, it was determined that the contrast solution penetration into the simulated lateral canals decreased from the coronal to the apical and achieved with the most effective Er:YAG laser activation technique. In addition, direct visual observation was found to be the best method for the assessment of contrast solution penetration.
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Affiliation(s)
- Mehmet Eren Fidan
- Department of Endodontics, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey.
| | - Ali Erdemir
- Department of Endodontics, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey
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Kumar RS, Ankola AV, Sankeshwari RM, Hebbal M, Hampiholi V, Kumar S L, Deshpande AP, Choudhury AR, Pai Khot AJ. Effectiveness of various irrigant activation techniques on the penetration of sodium hypochlorite into lateral canals of mature permanent teeth: A systematic review and meta-analysis. Saudi Dent J 2023; 35:1-23. [PMID: 36817024 PMCID: PMC9931519 DOI: 10.1016/j.sdentj.2022.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Objective This review aimed to systematically review the effectiveness of various irrigant activation techniques (IATs) on the penetration of sodium hypochlorite (NaOCl) into the lateral canals of mature permanent teeth. Methods Electronic databases including MEDLINE (via PubMed), Scopus, ProQuest, and Cochrane Library were searched to identify laboratory studies evaluating the penetration of NaOCl into lateral canals following the use of apical negative pressure irrigation (ANP), passive ultrasonic irrigation (PUI), sonic irrigation (SI), and/or manual dynamic activation (MDA) techniques. Meta-analysis was performed for individual IATs in comparison with CNI into the lateral canals of both straight and curved root canals. On the basis of the previous literature and parameters, the risk of bias of the selected studies was evaluated with the help of a customized tool. Results Of the 983 records screened, 12 studies were selected to include in the systematic review, and 10 studies were selected for the meta-analysis. The total quality assessment across the included studies indicated a high quality (83.3%). Overall, the meta-analysis demonstrated IATs had significant improvement in the penetration of NaOCl into the lateral canals of straight canals (34.3%) over CNI. The subgroup analysis of individual IATs demonstrated PUI (60.9%) to be superior in the penetration into lateral canals of straight canals. Conclusions IATs improved the irrigant penetration into lateral canals and therefore their use during routine endodontic practice is recommended. In straight canals, PUI is the most effective IAT followed by ANP, SI, and MDA techniques.
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Affiliation(s)
- Ram Surath Kumar
- Department of Public Health Dentistry, KLE VK Institute of Dental Sciences, KLE Academy of Higher Education and Research, Belagavi 590010, India
| | - Anil V. Ankola
- Department of Public Health Dentistry, KLE VK Institute of Dental Sciences, KLE Academy of Higher Education and Research, Belagavi 590010, India
| | - Roopali M. Sankeshwari
- Department of Public Health Dentistry, KLE VK Institute of Dental Sciences, KLE Academy of Higher Education and Research, Belagavi 590010, India
| | - Mamata Hebbal
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia,Corresponding author at: Division of Community Dentistry, Department of Preventive Dentistry, College of Dentistry, Princess Nourah Bint Abulrahman University, Riyadh, Saudi Arabia.
| | - Vinuta Hampiholi
- Department of Periodontics, KLE VK Institute of Dental Sciences, KLE Academy of Higher Education and Research, Belagavi 590010, India
| | - Lokesh Kumar S
- Department of Oral Medicine and Radiology, KLE VK Institute of Dental Sciences, KLE Academy of Higher Education and Research, Belagavi 590010, India
| | - Apurva Prashant Deshpande
- Department of Public Health Dentistry, KLE VK Institute of Dental Sciences, KLE Academy of Higher Education and Research, Belagavi 590010, India
| | - Abhra Roy Choudhury
- Department of Public Health Dentistry, KLE VK Institute of Dental Sciences, KLE Academy of Higher Education and Research, Belagavi 590010, India
| | - Atrey J. Pai Khot
- Department of Public Health Dentistry, KLE VK Institute of Dental Sciences, KLE Academy of Higher Education and Research, Belagavi 590010, India
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Preclinical Testing of Boron-Doped Diamond Electrodes for Root Canal Disinfection—A Series of Preliminary Studies. Microorganisms 2022; 10:microorganisms10040782. [PMID: 35456832 PMCID: PMC9024724 DOI: 10.3390/microorganisms10040782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/29/2022] [Accepted: 04/04/2022] [Indexed: 11/23/2022] Open
Abstract
While numerous approaches have meanwhile been described, sufficient disinfection of root canals is still challenging, mostly due to limited access and the porous structure of dentin. Instead of using different rinsing solutions and activated irrigation, the electrolysis of saline using boron-doped diamond (BDD) electrodes thereby producing reactive oxygen species may be an alternative approach. In a first step, experiments using extracted human teeth incubated with multispecies bacterial biofilm were conducted. The charge quantities required for electrochemical disinfection of root canals were determined, which were subsequently applied in an animal trial using an intraoral canine model. It could be shown that also under realistic clinical conditions, predictable disinfection of root canals could be achieved using BDD electrodes. The parameters required are in the range of 5.5 to 7.0 V and 9 to 38 mA, applied for 2.5 to 6.0 min with approximately 5 to 8 mL of saline. The direct generation of disinfective agents inside the root canal seems to be advantageous especially in situations with compromised access and limited canal sizes. The biologic effect with respect to the host reaction on BDD-mediated disinfection is yet to be examined.
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