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Rathke A, Frehse H, Bechtold M. Ex vivo investigation on the effect of minimally invasive endodontic treatment on vertical root fracture resistance and crack formation. Sci Rep 2024; 14:13205. [PMID: 38851745 PMCID: PMC11162497 DOI: 10.1038/s41598-024-63396-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: 03/06/2024] [Accepted: 05/28/2024] [Indexed: 06/10/2024] Open
Abstract
The evidence base on minimally invasive endodontic (MIE) treatment is limited. This study investigated the influence of MIE shaping on vertical root fracture (VRF) resistance and crack formation of root canal filled teeth. Human maxillary central incisors were randomized into six groups (n = 18, power = 0.9) and embedded in acrylic blocks with artificial periodontal ligaments. The root canals were either instrumented to size #40 and 0.04 taper (+MIE) or enlarged to ISO size #80 (-MIE). The canals were filled with cement-based (C) or adhesive resin-based (A) sealers in single-cone technique. The controls received no treatment or were left unfilled. After chewing simulation (staircase method, 25-150 N, 120,000×), the crack formation on the root surface was analyzed using stereomicroscope/digital imaging and classified (no defect, craze line, vertical crack, horizontal crack). Subsequently, the samples were loaded until fracture. The incidence of defects (56% vertical cracks) was not significantly different between the groups (p ≥ 0.077). VRF resistance was significantly higher in untreated teeth than in +MIE/C (p = 0.020) but did not significantly differ between the other groups (p ≥ 0.068). Minimal canal shaping did not reduce the risk of vertical root fracture and defects of root canal filled teeth.
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Affiliation(s)
- Andreas Rathke
- Faculty of Medicine, University of Ulm, Albert-Einstein-Allee 7, 89081, Ulm, Germany.
- Dentsply Sirona, DeTrey-Strasse 1, 78467, Konstanz, Germany.
| | - Henry Frehse
- Faculty of Medicine, University of Ulm, Albert-Einstein-Allee 7, 89081, Ulm, Germany
| | - Maria Bechtold
- Private Practice, Münchener Straße 1, 82362, Weilheim, Germany
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Knapp J, Kirkpatrick T, Ontiveros JC, Jaramillo DE, Kim HC, Jeong JW. Efficacy of root-end filling techniques using premixed putty type bioceramic cements: an ex vivo study. Clin Oral Investig 2024; 28:365. [PMID: 38849637 DOI: 10.1007/s00784-024-05759-3] [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: 03/06/2024] [Accepted: 05/30/2024] [Indexed: 06/09/2024]
Abstract
OBJECTIVES Currently, premixed putty-type bioceramic cements (PPBCs) have become popular materials for root-end fillings. This study investigated three root-end filling techniques using PPBCs and calcium silicate-based sealers including EDTA pretreatment. MATERIALS AND METHODS Ninety root segments were prepared and standardized with an artificial fin and lateral canal, and assigned to three groups (n = 30). Root-end fillings were placed using BC-RRM Putty alone (Group PA), injection of BC sealer followed by BC-RRM Putty (Lid Technique: Group LT) or BC-RRM Putty with BC sealer coating (Deep putty packing technique: Group DP). Half of each group was pretreated with 17% EDTA. The radiographic images of the specimens were assessed by five graders and push-out bond strength tests were conducted. The data were analyzed with a general linear model including two-way ANOVA and chi-square test at a significance level of 5%. RESULTS DP approach demonstrated significantly higher bond strength than LT (P < 0.05). However, there was no statistically significant difference in bond strength between PA and either DP or LT. EDTA pretreatment had no significant effect on push-out bond strength. Radiographically, for the main canal, PA and DP scored significantly higher than LT. In the fin, PA scored significantly higher than others (P < 0.05). CONCLUSION Our study highlights variations in root-end filling techniques. Injecting a bulk of bioceramic sealer before the placement of PPBCs may reduce bond strength and radiopacity. The application of PPBCs alone or in the deep putty technique demonstrates potential for favorable outcomes. EDTA pretreatment did not enhance bond-strength. CLINICAL RELEVANCE Careful selection and application of bioceramic materials and techniques in root-end fillings may influence the outcome of endodontic root-end surgery. When PPBCs and calcium silicate-based sealers are used together for root-end fillings, sealer followed by deep putty application may offer improved bond strength and radiographic fill compared to the lid technique.
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Affiliation(s)
- Jason Knapp
- Department of Endodontics, School of Dentistry, The University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 6400, Houston, TX, USA
| | - Timothy Kirkpatrick
- Department of Endodontics, School of Dentistry, The University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 6400, Houston, TX, USA
| | - Joe C Ontiveros
- Department of Restorative Dentistry and Prosthodontics, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - David E Jaramillo
- Department of Endodontics, School of Dentistry, The University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 6400, Houston, TX, USA
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Pusan National University, Geumo-ro 20, Mulgeum, Yangsan, Gyeongsangnam-do, 50612, South Korea.
| | - Ji Wook Jeong
- Department of Endodontics, School of Dentistry, The University of Texas Health Science Center at Houston, 7500 Cambridge Street, Suite 6400, Houston, TX, USA.
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Amhmed M, Liu H, Häkkinen L, Haapasalo M, Shen Y. Antimicrobial efficacy of DJK-5 peptide in combination with EDTA against biofilms in dentinal tubules: Primary irrigation, recovery and re-irrigation. Int Endod J 2024. [PMID: 38837723 DOI: 10.1111/iej.14104] [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: 01/16/2024] [Revised: 05/10/2024] [Accepted: 05/20/2024] [Indexed: 06/07/2024]
Abstract
AIM To investigate the dynamic recovery of biofilms within dentinal tubules after primary irrigation with different protocols, and to evaluate the efficacy of various re-irrigation protocols on recovered biofilm, considering factors such as smear layer, nutrient conditions, and primary irrigants. METHODOLOGY A total of 416 mono or multi-species biofilms samples were prepared from human teeth and incubated for 3 weeks. After inducing a smear layer on half of the samples, all specimens were irrigated with one of the following irrigant sequences: (1) 6% NaOCl +17% EDTA, (2) 6% NaOCl +8.5% EDTA, (3) 6% NaOCl and (8.5% EDTA +10 μg/mL DJK-5 antimicrobial peptide), or (4) sterile water. Thirty-two samples were used to assess immediate effect, whilst the rest were re-incubated to assess biofilms recovery. Nutrient conditions were defined based on whether culture media were changed (nutrient-rich) or not (nutrient-poor) during re-incubation. After 16 weeks, recovered biofilms underwent re-irrigation using four additional protocols, with or without DJK-5 peptide, based on primary irrigants. Confocal laser scanning microscopy was employed to evaluate immediate irrigant effects, biofilms recovery intervals (1, 3, 5, 8, 12, and 16 weeks after primary irrigation), and re-irrigation effects at the 16-week. Statistical analysis included one-way anova and two-way mixed anova tests. RESULTS The DJK-5 peptide irrigation protocols demonstrated the highest killing rates during primary irrigation and resulted in a longer biofilms recovery time of 16 weeks compared to non-peptide protocols (p < .001). Both primary irrigation type and smear layer presence significantly influenced biofilms recovery (p < .001). In the absence of smear layer, re-irrigation efficacy didn't significantly differ from primary irrigation, regardless of primary irrigation type or nutrient conditions. However, with a smear layer present, re-irrigation led to significantly higher proportion of dead bacteria compared to primary irrigation (p < .05). Inclusion of the DJK-5 peptide into the re-irrigation protocol displayed superior killing rate compared to other protocols (p < .001). CONCLUSIONS Biofilms exhibited susceptibility to both peptide and non-peptide protocols during re-irrigation, irrespective of nutrient conditions or primary irrigation protocols. The DJK-5 peptide irrigation protocols consistently displayed superior effectiveness compared to non-peptide protocols.
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Affiliation(s)
- Mohamed Amhmed
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
- Division of Prosthodontics, Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
- Department of Oral Biology, Faculty of Dentistry, The University of Sebha, Sebha, Libya
| | - He Liu
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Lari Häkkinen
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Markus Haapasalo
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Ya Shen
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
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Johansson L, Sjögren JJ, Wirén A, Eliasson A, Frisk F. Frequency of apical periodontitis in root-filled teeth restored with post and core: A 5-year retrospective study. Clin Exp Dent Res 2024; 10:e881. [PMID: 38798057 PMCID: PMC11128751 DOI: 10.1002/cre2.881] [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: 11/01/2023] [Revised: 03/11/2024] [Accepted: 03/17/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND In conjunction with post placement in root-filled teeth with periapical healthy conditions, root canal retreatment may be performed to improve the seal of the root canal. Whether root canal retreatment for technical reasons (retreatments in teeth without apical periodontitis (AP)) results in lower frequency of AP is unknown. OBJECTIVE To examine whether there is a difference in frequency of AP between roots with root canals retreated for technical reasons, and roots with root canals not retreated before post placement, with a minimum follow-up of 5 years. Also, to examine changes in root filling quality following root canal retreatment for technical reasons. METHODS This retrospective study included radiographs of 441 root-filled roots without periapical radiolucencies at baseline, scheduled for post and core treatment. Follow-up data for a minimum of 5 years were available for 305 roots (loss to follow-up 30.8%), 46 of which were retreated for technical reasons. Two calibrated observers assessed root filling sealing quality and length, respectively, and periapical status according to the Periapical Index. The main outcome of the study, AP, was used as the dependent variable and all analyses were performed at root level. RESULTS The overall frequency of AP at follow-up was 13.8%. The difference in frequency of AP between retreated (4.3%) and nonretreated (15.4%) root canals was not statistically significant, p = .061. Analyses including only roots with preoperatively inadequate root filling quality showed a statistically significant difference (p = .017) between the two treatment groups (2.4% vs. 22.9%). CONCLUSIONS Root canal retreatment for technical reasons before post and core placement significantly reduces the frequency of AP in roots with inadequate root filling quality.
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Affiliation(s)
- Louise Johansson
- Dental Research DepartmentÖrebro UniversityÖrebroSweden
- Specialist Clinic of EndodontologyPublic Dental Health ServiceRegion Örebro CountySweden
| | - Jakob Jonsson Sjögren
- Dental Research DepartmentÖrebro UniversityÖrebroSweden
- Department of EndodonticsMalmö UniversityMalmöSweden
| | - Anders Wirén
- Clinical Epidemiology and BiostatisticsÖrebro UniversityÖrebroSweden
| | - Alf Eliasson
- Dental Research DepartmentÖrebro UniversityÖrebroSweden
| | - Fredrik Frisk
- Department of EndodontologyInstitute for Postgraduate Dental EducationJönköpingSweden
- School of Health and WelfareJönköping UniversityJönköpingSweden
- Department of Endodontology, Institute of Odontology, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
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Gandhe P, Aravelli S, Penigalapati S, Kasam S, Ramachandruni N, Alam S. Effect of apical foraminal enlargement on postoperative pain and inflammatory markers in asymtomatic single-rooted mandibular teeth with apical periodontitis - An in vivo randomized controlled trial. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:584-590. [PMID: 38989502 PMCID: PMC11232762 DOI: 10.4103/jcde.jcde_138_24] [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: 03/16/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 07/12/2024]
Abstract
Aim of the Study This study aims to assess the effect of apical foraminal enlargement on inflammatory markers and pain in patients with asymptomatic single-rooted mandibular teeth with apical periodontitis. Materials and Methods The study included 60 patients based on inclusion and exclusion criteria. Before beginning root canal treatment (RCT), a blood sample was obtained from the antecubital fossa to evaluate the inflammatory markers, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Access opening was done and initial irrigation was done. Working length (WL) was determined with an electronic apex locator and verified with a radiograph. In the control group, the determined WL was maintained, while in the experimental group, the WL was set till the apical foramen. Biomechanical preparation was done in both groups till F2 or F3 based on the initial apical file, followed by final irrigation and obturation based on the master apical file size. Patients were given a Visual Analog Scale to record pain sensations at 24, 48, and 72 h postoperative. After 72 h, patients were recalled for follow-up appointments, and blood was taken from the antecubital fossa again to evaluate inflammatory markers. Statistical Analysis The resultant findings for the reduction in inflammatory markers before and after RCT with or without foraminal enlargement were statistically analyzed using the Student's t-test. The pain was statistically examined with one-way "analysis of variance" and Tukey's post hoc test for inter-group comparison of pain. The level of significance was set at P < 0.05. The statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 23 for Windows (SPSS Inc., Chicago, IL, USA). As pain in the control groups is zero before and after RCT, statistical analysis is not required as the overall pain score is zero. Results The P values of the CRP and ESR of the control group were 0.02 and 0.03, respectively, which indicates it is significant whereas the P values of the ESR and CRP of the experimental group were 0.0002 and 0.0008 which indicates it is highly significant. Results indicate that the experimental group is more effective compared to the control group in reducing inflammatory markers. Pain in the control group after RCT was zero at the end of 24, 48, and 72 h. In the experimental group, where RCT was done with apical foraminal enlargement, mild pain was present at the end of 24 h which gradually decreased at the end of 48 h and no pain was reported at the end of 72 h. Conclusion Reduction in inflammatory markers was more effective in RCT with apical enlargement than without apical enlargement. RCT with apical enlargement caused mild pain in the patients immediately after treatment which gradually decreased over time.
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Affiliation(s)
- Pooja Gandhe
- Department of Conservative Dentistry and Endodontics, Malla Reddy Dental College for Women, Hyderabad, Telangana, India
| | - Swathi Aravelli
- Department of Conservative Dentistry and Endodontics, Malla Reddy Dental College for Women, Hyderabad, Telangana, India
| | - Sivaram Penigalapati
- Department of Conservative Dentistry and Endodontics, Malla Reddy Dental College for Women, Hyderabad, Telangana, India
| | - Swetha Kasam
- Department of Conservative Dentistry and Endodontics, Malla Reddy Dental College for Women, Hyderabad, Telangana, India
| | - Nimeshika Ramachandruni
- Department of Conservative Dentistry and Endodontics, Malla Reddy Dental College for Women, Hyderabad, Telangana, India
| | - Sindhura Alam
- Department of Conservative Dentistry and Endodontics, Malla Reddy Dental College for Women, Hyderabad, Telangana, India
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Hackbarth M, Montoya M, Noblett WC, Lima BP, Dietz M, Staley C, Ordinola-Zapata R. An In Vitro Evaluation of the Antimicrobial Efficacy of a Novel Irrigant Using Next-Generation Sequencing. J Endod 2024:S0099-2399(24)00305-4. [PMID: 38815857 DOI: 10.1016/j.joen.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 05/19/2024] [Accepted: 05/20/2024] [Indexed: 06/01/2024]
Abstract
INTRODUCTION To evaluate the antimicrobial activity of Triton irrigation versus 4% sodium hypochlorite (NaOCl) utilizing a direct contact test and an extracted tooth model. METHODS In the first experiment, a direct contact test was conducted to compare bacterial DNA removal and microbial diversity changes following irrigation with 4% NaOCl or Triton. Hydroxyapatite and dentin discs were inoculated with subgingival human-derived dental plaque for 2 weeks utilizing the Center for Disease Control biofilm reactor and subsequently challenged with the root canal irrigants for 5 minutes. In the second experiment, teeth contaminated with a multispecies biofilm (n = 24) were assigned into two treatment groups, NaOCl or Triton irrigation. Samples were obtained for quantitative real-time polymerase chain reaction and next-generation sequencing analysis before and after instrumentation. The Shannon and Chao1 indices were used to measure alpha diversity. The Bray-Curtis dissimilarity and ANOSIM was used to measure beta diversity. Differences in abundances of genera were evaluated using Kruskal-Wallis test with Bonferroni corrections. RESULTS The direct contact test revealed no significant differences in the bacterial load based on 16S rRNA gene molecules/μL, reads, or differences in the Shannon index among groups. In the extracted tooth model, a bacterial load reduction of log10 3.08 ± 0.69 and 2.76 ± 0.91 were found for NaOCl and Triton, respectively (P = .348). Next-generation sequencing showed fewer reads, lower Chao1, and beta diversity values when pretreatment and post-treatment samples were assessed in both experimental groups (P < .0001). The Kruskal-Wallis analysis found that 17 genera of bacteria were over-represented in minimal values in the Triton post-treatment group, 14 of these genera represented less than 1% of the microbial community. CONCLUSIONS Both irrigants had limited antimicrobial activity in the direct contact test. When used in conjunction with mechanical instrumentation both irrigants were able to reduce the bacterial DNA load and diversity in comparison with pretreatment communities. The NaOCl irrigation, followed by ethylenediaminetetraacetic acid flush, was more effective in decreasing DNA counts from low-abundance organisms.
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Affiliation(s)
- Mallory Hackbarth
- Division of Endodontics, University of Minnesota School of Dentistry, Minneapolis, Minnesota
| | - Meghan Montoya
- Division of Endodontics, University of Minnesota School of Dentistry, Minneapolis, Minnesota
| | - W Craig Noblett
- Division of Endodontics, University of Minnesota School of Dentistry, Minneapolis, Minnesota
| | - Bruno P Lima
- Division of Basic Sciences, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota
| | - Matthew Dietz
- Division of Basic & Translational Research, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Christopher Staley
- Division of Basic & Translational Research, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Ronald Ordinola-Zapata
- Division of Endodontics, University of Minnesota School of Dentistry, Minneapolis, Minnesota.
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Alsalleeh F, Albishry FY, Aleyiydi AS, Aldossari FS, Alharbi NH, Alghofaily M, Althumairy R. Outcomes of nonsurgical endodontic treatment under general anesthesia in special health care needs: An observational study. BDJ Open 2024; 10:36. [PMID: 38773084 PMCID: PMC11109185 DOI: 10.1038/s41405-024-00224-5] [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: 02/15/2024] [Revised: 04/03/2024] [Accepted: 05/03/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND AND AIM The alarming rise in the number of people with special health care needs (SHCNs) necessitates a paradigm shift in how to approach their oral health needs. General anesthesia (GA) is a valuable technique for facilitating dental procedures in patients with SHCNs who may not be able to tolerate treatment without it. The aim was to assess nonsurgical endodontic treatment and outcomes in patients with SHCNs performed under GA. METHOD Seventy-eight permanent teeth in 33 patients who received nonsurgical endodontic treatment under GA were included between 2018 and 2022 in SHCNs hospital clinics. The demographic data, types of SHCNs, pulpal and periapical diagnosis, type of treatment, and material used were analyzed. All patients were recalled for clinical and radiographic examinations. Pre-treatment and recall periapical radiographs were evaluated and scored using the Periapical Index (PAI). RESULTS Autism and Attention deficit hyperactivity disorder were 39.4% of patients treated. Most treatments delivered were primary nonsurgical root canal treatment (95%). Warm vertical compaction of gutta-percha for obturation accounted for 88% of cases treated. Single cone obturation technique was used in 9 cases (12%) utilizing tricalcium silicate sealer. At the recall visits, 98.7% of teeth treated had survived. Twelve teeth have pre-treatment periapical lesions, and all healed except one. Female patients were found to have higher scores of PAI compared to male patients (23.7% vs 7.5%), yet insignificant. Only 10 patients with nonsurgical root canal treatment reported recurrent caries. CONCLUSION This study demonstrates a high survival rate for nonsurgical endodontic treatment performed under GA in a cohort of patients with SHCNs. Interestingly, patients with social and communication disorders received the highest proportion of treatments under GA. These findings highlight the potential of GA-facilitated endodontics for this population. However, further research is warranted to explore additional methods for optimizing oral health outcomes in SHCNs.
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Affiliation(s)
- Fahd Alsalleeh
- Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
| | - Fatima Y Albishry
- King Saud University Medical City - Dental University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Asrar S Aleyiydi
- Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Farah S Aldossari
- Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Norah H Alharbi
- Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Maha Alghofaily
- Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Riyadh Althumairy
- Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Donnermeyer D, Dust PC, Schäfer E, Bürklein S. Comparative Analysis of Irrigation Techniques for Cleaning Efficiency in Isthmus Structures. J Endod 2024; 50:644-650.e1. [PMID: 38382735 DOI: 10.1016/j.joen.2024.02.008] [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: 12/20/2023] [Revised: 02/06/2024] [Accepted: 02/12/2024] [Indexed: 02/23/2024]
Abstract
INTRODUCTION This study aimed to evaluate the removal of a biofilm-mimicking hydrogel from isthmus structures in a simulated complex root canal system consisting of 2 curved root canals by Laser-activated irrigation (LAI, AdvErl Evo, Morita) and mechanical activation techniques. METHODS A 3D-printed root canal model with 2 parallel root canals (60°-curvature, radius 5 mm, dimension 25/.06) with a total length of 20 mm connected via isthmuses (2.5 × 0.4 × 0.2 mm) at 5 mm and 8 mm from the apical endpoint and with lateral canals (diameter 0.2 mm) in all directions at 2, 5, and 8 mm from the apex was filled with a colored biofilm-mimicking hydrogel. Irrigation protocols under continuous irrigation with distilled water (3 × 20s per root canal; 3 ml/20s; n = 20) included conventional needle irrigation (=NI); manual agitation (=MA, gutta-percha point 25/.06); EndoActivator (=SAI-EA, 25/.04); EDDY (=SAI-E, 25/.04); ultrasonically-activated irrigation (=UAI) and LAI (Er:YAG-laser; P400FL tip at canal entrance; 25pps, 50 mJ, 300μs). Removal of the hydrogel was determined as a percentage via standardized photos through a microscope. Statistical analysis was performed using Kruskal-Wallis and Conover tests (P = .05). RESULTS Laser-activated irrigation (LAI) was associated with the greatest removal of hydrogel from the entire root canal system (P < .05), followed by SAI-E. No significant differences were reported for the coronal isthmus between LAI, SAI-E, NI, and MA (P > .05), but inferior results for SAI-EA and UAI (P < .05). In the apical isthmus, all techniques outperformed UAI (P < .05), with LAI, SAI-E, and NI showing the best results (P < .05). CONCLUSIONS Laser-activated irrigation (LAI) was superior to other irrigation techniques in the entire root canal system. SAI-E and NI performed comparable to LAI in the isthmuses.
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Affiliation(s)
- David Donnermeyer
- Department of Periodontology and Operative Dentistry, University of Münster, Münster, Germany
| | - Patricia Claire Dust
- Department of Periodontology and Operative Dentistry, University of Münster, Münster, Germany
| | - Edgar Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany
| | - Sebastian Bürklein
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany.
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Laajala A, Nuutinen M, Luttinen A, Vähänikkilä H, Tanner T, Laitala ML, Karki S. Survival of endodontically treated teeth in public dental service in Northern Finland: a practise-based register study. Acta Odontol Scand 2024; 83:190-196. [PMID: 38660831 DOI: 10.2340/aos.v83.40491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 01/06/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE The aim of this study was to explore the factors associated with the survival of root canal treated teeth in a practise-based study setting in a 5-year period. MATERIAL AND METHODS This retrospective study used data from the electronic patient registration system of the public dental services of the City of Oulu, Finland. The inclusion criteria for this study were patients aged ≥ 20 years who had root canal treatment (RCT) that was initiated in 2014. One RCT per patient was included in the study. A total of 713 patients met the inclusion criteria. The outcome variable for this study was the extraction of the RCT tooth during the 5-year period. Explanatory variables included age, diagnosis, tooth type (incisive, canine, premolar, molar), RCT technique (manual, motorized), time from RCT initiation to final restoration and type of final restoration (composite, glass ionomer, fixed dental prosthesis). To evaluate the association between the outcome variable and explanatory variables, Cox regression analyses were performed. RESULTS The overall survival rate was 91%. The middle-aged (40-59-years-old) and the oldest (60 and older) patients had a two-fold risk of extraction compared to younger (20-40-years-old) patients. Similarly, a short length of time from RCT initiation to final restoration (0-14 days) resulted in a nearly three times higher risk of extraction compared to a longer period (≥ 90 days). CONCLUSIONS The 5-year survival rate of RCTs seems high. Extractions were more common among patients over 40 years of age and if the RCT was completed shortly after its initiation.
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Affiliation(s)
- Anne Laajala
- Cariology, Endodontology and Paediatric Dentistry, Research Unit of Population Health, University of Oulu, City of Oulu, Finland; Medical Research Center and Oulu University Hospital, City of Oulu, Finland.
| | - Matti Nuutinen
- Cariology, Endodontology and Paediatric Dentistry, Research Unit of Population Health, University of Oulu, City of Oulu, Finland
| | - Atso Luttinen
- Cariology, Endodontology and Paediatric Dentistry, Research Unit of Population Health, University of Oulu, City of Oulu, Finland
| | - Hannu Vähänikkilä
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Tarja Tanner
- Cariology, Endodontology and Paediatric Dentistry, Research Unit of Population Health, University of Oulu, City of Oulu, Finland; The Wellbeing Services County of North Ostrobothnia, Oulu, Finland
| | - Marja-Liisa Laitala
- Cariology, Endodontology and Paediatric Dentistry, Research Unit of Population Health, University of Oulu, City of Oulu, Finland; Medical Research Center and Oulu University Hospital, City of Oulu, Finland
| | - Saujanya Karki
- Cariology, Endodontology and Paediatric Dentistry, Research Unit of Population Health, University of Oulu, City of Oulu, Finland
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Korsós SA, Staszyk C, Boone M, Josipovic I, Vogelsberg J, Vlaminck L. Micro-CT and histological examination of accessory canals in 34 equine cheek teeth. Front Vet Sci 2024; 11:1396871. [PMID: 38659446 PMCID: PMC11039908 DOI: 10.3389/fvets.2024.1396871] [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: 03/06/2024] [Accepted: 03/27/2024] [Indexed: 04/26/2024] Open
Abstract
Accessory canals and apical deltas have been extensively studied in human dentistry. Their clinical role as a difficult to clean reservoir for bacteria during endodontic treatments has been well described. Many papers describe in detail the pulp anatomy of equine dentition but little attention has been given to their apical ramifications. The goal of this paper is to describe the presence and anatomy of these accessory canals and apical deltas in healthy equine cheek teeth and discuss their possible relevance in the light of equine endodontics. To accomplish this, 15 maxillary and 19 mandibular healthy cheek teeth were collected ranging from Triadan 06 s to 11 s with eruption ages from 4 to 9 years. Their root anatomy was documented in detail based on micro computed tomography images. A subset of 3 teeth also underwent histological examination. Accessory canals were found in all but two teeth examined. Up to 44 accessory canals per tooth have been found with locations ranging from the root furcation down to the apex of the root and with highly variable diameters. Apical deltas in different stages of development were found in 84% of the roots. The presence of accessory canals identified on microCT images could be confirmed using histological examination although some of them were obliterated by reparative dentin. Accessory canals can be found in most equine cheek teeth and add complexity to their endodontic anatomy. This could have important implications for their treatment in case of pulp pathology. In humans, failure to remove bacterial biofilm from such canals has been associated with failure of endodontic treatment. Research on diseased equine teeth is required to gain a better understanding of their clinical relevance in horses.
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Affiliation(s)
- Szabolcs A. Korsós
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Carsten Staszyk
- Institute of Veterinary-Anatomy,-Histology and -Embryology, Faculty of Veterinary Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - Matthieu Boone
- Department of Physics and Astronomy – Radiation Physics, Faculty of Science, Radiation Physics Research Group – Centre for X-ray Tomography of the UGent, Ghent University, Ghent, Belgium
| | - Iván Josipovic
- Department of Physics and Astronomy – Radiation Physics, Faculty of Science, Radiation Physics Research Group – Centre for X-ray Tomography of the UGent, Ghent University, Ghent, Belgium
| | - Jörg Vogelsberg
- Institute of Veterinary-Anatomy,-Histology and -Embryology, Faculty of Veterinary Medicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - Lieven Vlaminck
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
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Alkahtany SM, Alabdulkareem SE, Alharbi WH, Alrebdi NF, Askar TS, Bukhary SM, Almohaimede AA, Al-Manei KK. Assessment of dental students' knowledge and performance of master gutta-percha cone selection and fitting during root canal treatment: a pilot study. BMC MEDICAL EDUCATION 2024; 24:371. [PMID: 38575914 PMCID: PMC10996191 DOI: 10.1186/s12909-024-05347-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 03/25/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Misconceptions should be detected early in dental students' training to improve their clinical performance. Accordingly, this study aimed to assess undergraduate dental students' knowledge and performance of master gutta-percha (GP) cone selection and fitting during clinical endodontic courses at the College of Dentistry, King Saud University. METHODS Ninety-nine undergraduate dental students completed an online survey about their knowledge of master GP cone selection. Forty-five of these students were observed by faculty members in clinical endodontic courses while they fitted master GP cones during root canal treatments. The observers recorded the details of each student's cone-fitting techniques. The data were analysed using t-tests, one-way analysis of variance, and chi-square tests (p < 0.05). Inter- and intra-observer reliability were tested using Fliess' Kappa. RESULTS SURVEY All participants had good knowledge of over-extended cone management, while 80.8% knew how to properly manage a short cone. The proper flaring assessment method was selected by 86.9% of the female and 34.2% of the male students, and this difference was statistically significant (p = 0.0001). OBSERVATION The students labelled the working length on the master GP cone with an indentation in 64.4% of the cases and by bending the cone 35.6% of the time. Of all students, 84.4% encountered an apical stop, and this rate correlated significantly with the length of the cone on the master apical cone radiograph (p = 0.001). Improper shaping of the canal was the most common cause of ill-fitting cones (83.3%), while 16.7% of the students chose the wrong cone size. The final obturation length was adequate in 80% of the cases; 57.8% of the students were helped by instructors. CONCLUSIONS Most students had the basic knowledge required to solve problems related to the selection of master GP cones. However, in the clinical setting, more than half of the students required the assistance of an instructor to adjust their cone's fit. The presence of an apical stop had the most significant effect on the length of the fitted master GP cone on radiography. The most common cause of ill-fitting master cones was improper shaping of the canal.
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Affiliation(s)
- Sarah M Alkahtany
- Department of Restorative Dental Sciences, Division of Endodontics, College of Dentistry, King Saud University, 11527, Riyadh, PO Box 68004, Saudi Arabia.
| | - Shaima E Alabdulkareem
- General Dentist, College of Dentistry, King Saud University, 11527, Riyadh, PO Box 68004, Saudi Arabia
| | - Wajd H Alharbi
- General Dentist, College of Dentistry, King Saud University, 11527, Riyadh, PO Box 68004, Saudi Arabia
| | - Norah F Alrebdi
- General Dentist, College of Dentistry, King Saud University, 11527, Riyadh, PO Box 68004, Saudi Arabia
| | - Tomather Sultan Askar
- General Dentist, College of Dentistry, King Saud University, 11527, Riyadh, PO Box 68004, Saudi Arabia
| | - Sundus M Bukhary
- Department of Restorative Dental Sciences, Division of Endodontics, College of Dentistry, King Saud University, 11527, Riyadh, PO Box 68004, Saudi Arabia
| | - Amal A Almohaimede
- Department of Restorative Dental Sciences, Division of Endodontics, College of Dentistry, King Saud University, 11527, Riyadh, PO Box 68004, Saudi Arabia
| | - Kholod Khalil Al-Manei
- Department of Restorative Dental Sciences, Division of Endodontics, College of Dentistry, King Saud University, 11527, Riyadh, PO Box 68004, Saudi Arabia
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Ahmed S, Jehad Hassan S, Gajdhar S, Saleh Alhazmi L, Yahya Khalifah R, Alhusain Alrifai J, Salem Aljhdali S, Sheriff Maqbul M. Prevalence of Enterococcus faecalis and Candida albicans in endodontic retreatment Cases: A comprehensive study. Saudi Dent J 2024; 36:539-545. [PMID: 38690386 PMCID: PMC11056411 DOI: 10.1016/j.sdentj.2024.01.009] [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: 10/29/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction Endodontic treatment failures often stem from the presence of microbial pathogens, particularly Enterococcus faecalis and Candida albicans. This study systematically assesses the prevalence of E. faecalis and C. albicans in endodontic retreatment cases, aiming to explore their impact on treatment outcomes. Methods Employing a systematic sampling approach, 30 patients with a history of previous endodontic treatment were selected. Rigorous clinical and radiographic assessments were conducted, following standardized protocols for root canal sample collection. Microbiological analysis, utilizing selective culture media, was employed to identify and quantify E. faecalis and C. albicans. Statistical analyses, including chi-square and logistic regression tests, were performed. Results The study involved 30 patients undergoing endodontic retreatment, with comprehensive clinical and radiographic evaluations for cases with and without periradicular lesions. Microbiological analysis unveiled a significant prevalence of E. faecalis and C. albicans, establishing a robust association between these pathogens and retreatment failure. These findings underscore the critical need for targeted antimicrobial interventions to enhance the overall success rates of endodontic retreatment procedures. Conclusion This study highlights the substantial prevalence of E. faecalis and C. albicans in endodontic retreatment cases, emphasizing the importance of identifying and effectively managing these pathogens for successful treatment outcomes. The notable association between these microbial agents and retreatment failure underscores the imperative for tailored antimicrobial strategies to enhance the efficacy of endodontic retreatment procedures.
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Affiliation(s)
- Siddiq Ahmed
- Department of Conservative Dental Sciences, Ibn Sina national College for medical studies, Jeddah, Saudi Arabia
| | - Sami Jehad Hassan
- Department of Conservative Dental Sciences, Ibn Sina national College for medical studies, Jeddah, Saudi Arabia
| | - Shaiq Gajdhar
- Department of Prosthodontics, Ibn Sina National College for Medical Studies, Jeddah, Saudi Arabia
| | - Lama Saleh Alhazmi
- Dental interns, Ibn Sina national College for medical studies, Jeddah, Saudi Arabia
| | - Rawan Yahya Khalifah
- Dental interns, Ibn Sina national College for medical studies, Jeddah, Saudi Arabia
| | | | | | - Muazam Sheriff Maqbul
- Department of Microbiology and Immunology, Ibn Sina national College for medical studies, Jeddah, Saudi Arabia
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Sharma J, Bhushan J, Mehta M, Sidhu K, Jhamb S, Panwar D, Kakkar V, Kumari P. Comparative evaluation of the antibacterial activity of curcumin-coated gutta-percha versus nanocurcumin-coated gutta-percha against Escherichia coli: An in vitro study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:383-387. [PMID: 38779203 PMCID: PMC11108422 DOI: 10.4103/jcde.jcde_342_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: 12/25/2023] [Revised: 02/07/2024] [Accepted: 02/13/2024] [Indexed: 05/25/2024]
Abstract
Introduction Due to its biological and antibacterial qualities, many plants, including curcumin, are used as phytomedicines in dentistry. They are primarily used as intracanal medication in endodontics to prevent probable chemical side effects and also to address antimicrobial resistance. Curcumin nanoformulations have improved antibacterial activity and improved dispersion, making them the superior form of curcumin. The purpose of this study was to assess curcumin and nanocurcumin's antibacterial properties. As a gutta-percha coating, they are to be tested against Escherichia coli. Materials and Methods The study employs the standard strain of E. coli, ATCC 25922. The antibacterial activity of gutta-percha cones against E. coli is assessed after coating them with suspensions of curcumin and nanocurcumin. Scanning electron microscopy is utilized to evaluate the coatings' continuity. Results The gutta-percha cones that are untreated, coated with curcumin, and coated with nanocurcumin exhibit significantly different levels of antibacterial activity. There is statistically significant variation in their antibacterial activity. Conclusion (1) Compared to curcumin-coated and untreated gutta-percha cones, those coated with nanocurcumin exhibit a stronger antibacterial activity. (2) Compared to uncoated gutta-percha cones, gutta-percha cones coated with curcumin exhibit more antibacterial action.
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Affiliation(s)
- Jyoti Sharma
- Department of Microbiology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Jagat Bhushan
- Department of Conservative Dentistry and Endodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Manjula Mehta
- Department of Microbiology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Kitty Sidhu
- Department of Conservative Dentistry and Endodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Swaty Jhamb
- Department of Conservative Dentistry and Endodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Deepika Panwar
- Department of Conservative Dentistry and Endodontics, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Vandita Kakkar
- Department of Pharmaceutics, University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India
| | - Parina Kumari
- Department of Pharmaceutics, University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India
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Bhargava T, Jain N, Reddy P, Vijaywargiya N, Reddy V, Nigam H. Assessment of Mesiobuccal Canals in Endodontically Treated Teeth in Indore Population by Cone Beam Computed Tomography: A Cross-Sectional Study. Cureus 2024; 16:e58265. [PMID: 38752089 PMCID: PMC11094347 DOI: 10.7759/cureus.58265] [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] [Accepted: 04/14/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Owing to the complicated anatomical nature of maxillary molars, untreated root canals may directly affect the outcome of root canal therapy. Therefore, cone beam computed tomography (CBCT) scan is an important tool in the evaluation of root canal systems, particularly for the detection of the second mesiobuccal (MB2) canal in maxillary molars. AIMS AND OBJECTIVES The current study was undertaken to detect and evaluate filled/unfilled MB2 canals in endodontically treated, asymptomatic maxillary molars, and its correlation with periapical pathology by utilizing cone beam computed tomography (CBCT). MATERIAL AND METHOD A retrospective study of 80 CBCTs of patients underwent scanning for various treatment modalities, with asymptomatic endodontically treated permanent maxillary first molars selected. Data collection occurred between January and June 2023. CBCT machine used was KODAK 9000 (Rochester, NY: Carestream Health) (Complementary Metal Oxide Semiconductor {CMOS} sensor, continuous mode and 12-28 sec scan time, 90-500 μm voxel size, and 5x3.5 cm field of view {FOV}). The axial images at mid-root level were used to assess the presence of the MB2 canal. RESULT The study included 39 (48.8%) right maxillary first molars and 41 (51.3%) left maxillary first molars. Overall, in 62 (77.5%) maxillary first molars, MB2 was missed by the practicing dentist, and in 13 (16.3%) maxillary first molars MB2 canal was not present. Of all the maxillary first molars with MB2 canal (n=67), 53 (79.1%) canals had a periapical infection, five (7.5%) showed widening of periodontal ligament space whereas nine (13.4%) had no abnormality. CONCLUSION MB2 canals were present in the majority of cases and most of the unfilled MB2 canals showed evidence of periapical radiolucencies and showed a direct impact on the prognosis.
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Affiliation(s)
- Triveni Bhargava
- Oral and Maxillofacial Surgery, Government College of Dentistry, Indore, IND
| | - Nimesh Jain
- Oral Medicine and Radiology, College of Dental Science and Hospital, Indore, IND
| | - Prashanthi Reddy
- Oral Medicine and Radiology, Government College of Dentistry, Indore, IND
| | - Neelam Vijaywargiya
- Conservative Dentistry and Endodontics, Government College of Dentistry, Indore, IND
| | - Vanaja Reddy
- Oral Medicine and Radiology, Modern Dental College and Research Centre, Indore, IND
| | - Haritima Nigam
- Oral Medicine and Radiology, Pacific Dental College, Kanpur, IND
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15
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Jayakumar S, Sridhar D, John BM, Arumugam K, Ponnusamy P, Pulidindi H. Biofilm in Endodontic Infection and its Advanced Therapeutic Options - An Updated Review. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S1104-S1109. [PMID: 38882733 PMCID: PMC11174291 DOI: 10.4103/jpbs.jpbs_394_23] [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: 07/06/2023] [Revised: 10/20/2023] [Accepted: 11/12/2023] [Indexed: 06/18/2024] Open
Abstract
Pulpal and periapical pathosis are biofilm-induced infections. Understanding the complex nature of endodontic biofilm would help to create a new disinfection strategy to eliminate the microorganism from the root canal system. The intricate canal structure creates challenges for proper disinfection, necessitating the need to understand the biofilm structure, composition, and mechanism within the biofilm community. This paper describes the endodontic biofilm structure, formation of biofilm, and advanced therapeutic options for combating the biofilm community within the root canal system.
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Affiliation(s)
- Srilekha Jayakumar
- Reader, Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Kelambakkam, Chengalpettu, Tamil Nadu, India
| | - Dinesh Sridhar
- Department of Conservative Dentistry and Endodontics, Sri Venkateshwaraa Group of Institutions, Sri Venkateshwaraa Dental College and Hospital, Ariyur, Puducherry, India
| | - Bindu M John
- Department of Conservative Dentistry and Endodontics, Sri Venkateshwaraa Group of Institutions, Sri Venkateshwaraa Dental College and Hospital, Ariyur, Puducherry, India
| | - Karthikeyan Arumugam
- Department of Conservative Dentistry and Endodontics, Sri Venkateshwaraa Group of Institutions, Sri Venkateshwaraa Dental College and Hospital, Ariyur, Puducherry, India
| | - Prashanth Ponnusamy
- Department of Conservative Dentistry and Endodontics, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Puducherry, India
| | - Hema Pulidindi
- Department of Conservative Dentistry and Endodontics, Sri Venkateshwaraa Group of Institutions, Sri Venkateshwaraa Dental College and Hospital, Ariyur, Puducherry, India
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16
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Duraisamy AK, Logani A, Kumar V, Chawla A, Sharma S, Pandey RM. Influence of the severity of periodontal disease on the outcome of non-surgical endodontic therapy: A prospective cohort study. Clin Oral Investig 2024; 28:217. [PMID: 38489130 DOI: 10.1007/s00784-024-05611-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/09/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVE To investigate the influence of severity of periodontal disease on periapical healing after non-surgical endodontic therapy (NSET). MATERIAL AND METHODS In this prospective study, subjects (n = 45) requiring NSET in a mandibular molar tooth with the diagnosis of pulp necrosis and asymptomatic apical periodontitis exhibiting radiographic periapical index (PAI) score ≥ 3 and concomitant endodontic periodontal lesion (CEPL) without communication were enrolled. After dividing as per the classification of Periodontal and Peri-Implant Diseases and Conditions, subjects were equally allocated into three groups. Group I- only endodontic lesion {control: healthy periodontium (n = 15)}, Group II- CEPL having stage I and II periodontitis (n = 15) and Group III- CEPL having stage III periodontitis (n = 15). Standardized two-visit NSET was performed with 2% chlorhexidine gel as an intracanal medicament. Periodontal therapy was instituted wherever required. Subjects were recalled at 6-and 12-months for clinical and radiographic assessment. Chi-square test was performed to evaluate the difference between the groups. RESULTS At 12-month follow-up, all teeth in the three study groups were asymptomatic. On radiographic evaluation of the periapical region, healing was observed in 80%, 47% and 50% of teeth in Groups I, Group II and Group III, respectively. However, the difference was not statistically significant between the groups (p = 0.150). CONCLUSION The severity of periodontal disease had no influence on periapical healing after NSET in teeth with concomitant endodontic periodontal lesions without communication. CLINICAL RELEVANCE Periodontal disease has significant impact on apical periodontitis however severity of the periodontitis does not negatively impact the apical periodontitis.
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Affiliation(s)
- Arun Kumar Duraisamy
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India, 110029
| | - Ajay Logani
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India, 110029.
| | - Vijay Kumar
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India, 110029
| | - Amrita Chawla
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India, 110029
| | - Sidhartha Sharma
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India, 110029
| | - R M Pandey
- Department of Biostatistics, All India Institute of Medical Science and Research, New Delhi, India, 110029
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Jang YE, Kim Y, Kim SY, Kim BS. Predicting early endodontic treatment failure following primary root canal treatment. BMC Oral Health 2024; 24:327. [PMID: 38475776 DOI: 10.1186/s12903-024-03974-8] [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: 12/14/2023] [Accepted: 02/02/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Understanding when and why endodontic treatments fail could help clinicians make prognoses and thus improve treatment outcomes. This study was aimed to assess potential predictors of early endodontic treatment failure. We explored factors contributing to the failure of initial root canal treatment were explored, with a specific emphasis on evaluating the influence of the time elapsed since the initial treatment. METHODS This retrospective cohort study enrolled 1262 patients who sought endodontic treatment at our department and 175 patients were included for analysis. Potential causes of endodontic treatment failure were investigated, such as inadequate obturation quality, inadequate coronal status, the presence of additional untreated canals, anatomical complexity, instrument separation, iatrogenic perforation, cracks, and endodontic-periodontal lesions. The patients were divided into "short-term" and "long-term" groups depending on the time that had passed since the initial treatment (i.e., < 5 and > 10 years, respectively). The causes of failure in the short-term and long-term group were analyzed and compared using logistic regression analyses. Subgroup analysis was performed according to the number of years since the initial treatment in the short-term group to further investigate the association between the time and cause of failure (i.e., < 1, 2, 3, and 4 years, respectively). RESULTS Untreated additional canals were present in 21.7% of all cases, and in 36.9 and 6.4% of cases in the short-term and long-term groups, respectively. Multivariable analysis showed that the presence of untreated additional canals was significantly associated with short-term compared to long-term failure. Untreated additional canals were also associated with endodontic failure within 1, 2, 3, and 4 years. CONCLUSIONS The presence of untreated additional canals was a predictor of endodontic failure within 5 years following initial root canal treatment. To optimize long-term prognosis, it is important to detect and treat all root canals during the initial treatment.
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Affiliation(s)
- Young-Eun Jang
- Department of Conservative Dentistry, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Yemi Kim
- Department of Conservative Dentistry, College of Medicine, Ewha Womans University, Seoul, South Korea.
| | - Sin-Young Kim
- Department of Conservative Dentistry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
| | - Bom Sahn Kim
- Department of Nuclear Medicine, College of Medicine, Ewha Womans University, Seoul, South Korea
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Yang X, Chen X, Zhang Y, Huang L, Chen D, Zeng Q, Qiu X. Clinical outcomes of endodontic microsurgery in complicated cases with large or through-and-through lesions: a retrospective longitudinal study. Clin Oral Investig 2024; 28:172. [PMID: 38400913 DOI: 10.1007/s00784-024-05557-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: 05/14/2023] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVES To investigate the clinical outcomes of endodontic microsurgery in complicated cases presenting with large or through-and-through lesions. MATERIALS AND METHODS We retrospectively collected and analyzed preoperative, intraoperative, and follow-up data from 143 complicated cases that underwent endodontic microsurgery. Clinical outcomes were assessed in terms of tooth survival and surgery success. Cox regression analysis was used to evaluate the survival rate and identify associated risk factors. Additionally, the success rate was compared across different postoperative periods, and potential factors contributing to surgical failure were identified through binary logistic regression. RESULTS The overall survival and success rates were 93.0% and 91.7%, respectively. The Cox regression model identified four risk factors affecting tooth survival, including apicoectomy of four teeth (HR = 35.488; P = 0.0002), an open apex observed on preoperative radiographs (HR = 6.300; P = 0.025), the performance of guided tissue regeneration technique (HR = 8.846; P = 0.028), and a palatal surgical approach (HR = 8.685; P = 0.030). The success rate demonstrated an initial increase in the early postoperative period (from 0.5 to 2 years; P = 5.8124e-30), followed by stabilization (from 2 to 9 years; P = 0.298). Surgery success rate significantly declined when apicoectomy involved four teeth (OR = 109.412; P = 0.002). CONCLUSIONS Endodontic microsurgery demonstrates satisfactory outcomes in complicated cases, maintaining a stable success rate after two years. However, tooth survival and surgery success are significantly compromised when apicoectomy involves four teeth. Factors such as guided tissue regeneration, an open apex, and the palatal surgical approach are associated with an increased risk of tooth extraction. CLINICAL RELEVANCE Despite achieving acceptable outcomes in complicated cases, endodontic microsurgery is adversely affected by the apicoectomy of four teeth.
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Affiliation(s)
- Xiaoxia Yang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Xuan Chen
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Yinchun Zhang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Lei Huang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Dongjie Chen
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Qinfang Zeng
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China
| | - Xiaoling Qiu
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, No. 366 South Jiangnan Avenue, Haizhu District, Guangzhou, 510280, China.
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Alotaibi BB, Khan KI, Javed MQ, Dutta SD, Shaikh SS, Almutairi NM. Relationship between apical periodontitis and missed canals in mesio-buccal roots of maxillary molars: CBCT study. J Taibah Univ Med Sci 2024; 19:18-27. [PMID: 37868101 PMCID: PMC10585297 DOI: 10.1016/j.jtumed.2023.08.009] [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: 06/09/2023] [Revised: 08/02/2023] [Accepted: 08/30/2023] [Indexed: 10/24/2023] Open
Abstract
Objectives The objectives of this study were to: (1) assess the frequency of missed canals in the mesiobuccal root (MB) of endodontically treated maxillary molars and its association with apical periodontitis (AP); (2) examine the correlation between the presence of a confluent or separate missed MB2 canal and the prevalence of AP; and (3) examine the correlation between the technical quality of endodontic treatment in the MB1 canal and the prevalence of AP. Methods We obtained and examined 800 cone-beam computed tomography (CBCT) scans from 800 patient records over 6 months. The parameters noted for each tooth included the tooth number; presence of missed canals in the MB root; configuration of missed MB2 canals (confluent or separate); technical acceptability of root canal treatment (RCT) of treated MB1 canals; and the CBCT periapical index score. Data were analyzed in SPSS version 24. Results A total of 203 maxillary molars from 148 CBCT scans were included. The MB2 canal prevalence was 88.2% in maxillary first molars and 62.7% in maxillary second molars. MB2 was found in 164 endodontically treated maxillary molars. During treatment, MB2 was missed in 150 (91.5%) and treated in 14 (8.5%) teeth. A total of 103 teeth (50.73%) had AP, which was observed in 67.3% of teeth with a missed MB2 canal but only 14.3% of teeth with a treated MB2 canal. The prevalence of AP was 43.7% in teeth with confluent MB2 canals and 80.9% in teeth with separate MB2 canals. Conclusion The MB2 canal frequency was significantly higher in the examined maxillary first molars than the maxillary second molars. The MB2 canal was missed in most teeth that underwent endodontic treatment. The AP prevalence was relatively higher in endodontically treated maxillary molars with missed MB2 canals.
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Affiliation(s)
- Badi B. Alotaibi
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, KSA
| | - Kiran I. Khan
- Department of Operative Dentistry, Frontier Medical and Dental College, Abbottabad, Pakistan
| | - Muhammad Q. Javed
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, KSA
| | - Smita D. Dutta
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, KSA
| | - Safia S. Shaikh
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Buraidah, KSA
| | - Nawaf M. Almutairi
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, KSA
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Yang G, Chen W. In vitro effects of Er: YAG laser-activated photodynamic therapy on Enterococcus faecalis in root canal treatment. Photodiagnosis Photodyn Ther 2024; 45:103992. [PMID: 38281611 DOI: 10.1016/j.pdpdt.2024.103992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/03/2024] [Accepted: 01/23/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVE Photodynamic therapy (PDT) plays an important role for root canal disinfection. Nevertheless, the effect of photosensitizers penetrating dentin tubules is limited, which ultimately impedes the disinfection effect of PDT. The study implements an Er: YAG laser to activate methylene blue, the photosensitizer, to determine the bactericidal impact of PDT on Enterococcus faecalis in vitro root canals. METHODS We obtained 53 single root canal teeth with intact roots, standardized the root to 9 mm. The root canals were prepared using ProTaper rotary files. Subsequently, the teeth were sterilized, and Enterococcus faecalis was cultured for 3 weeks in vitro using brain heart infusion (BHI). The model of Enterococcus faecalis root canal infection of teeth was constructed by observing Enterococcus faecalis through electron microscope scanning. The teeth were randomly allocated to five treatment groups (n = 10): control, NaOCl, NaOCl + Er: YAG, PDT, and PDT + Er: YAG. Following treatment, the number of colony forming units (CFU)/ml was assessed for each group. Statistical analysis was conducted using one-way ANOVA, with post-hoc analysis using Tukey's test for multiple comparisons. RESULTS The colony counts in the remaining groups were significantly lower compared to the control group (P<0.001). Using PDT alone had the least impact on reducing colonies, while using PDT and Er: YAG laser together resulted in a significant reduction in colony counts (P<0.001). There was no significant difference in colony counts reduction between the NaOCl + Er: YAG group and the PDT + Er: YAG group (P = 1.000). CONCLUSIONS The combination of Er: YAG laser and PDT significantly enhanced the bactericidal efficacy of PDT against Enterococcus faecalis in root canals. It had a similar impact on eliminating Enterococcus faecalis when compared to the effect of using Er: YAG laser and NaOCl.
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Affiliation(s)
- Guofeng Yang
- Department of Endodontics, Shanghai Stomatological Hospital, Fudan University, Shanghai, China; Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China.
| | - Weiting Chen
- Department of Stomatology, Shanghai Xuhui District Dental Center, Shanghai 200032, China
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21
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Pažin B, Lauc T, Bago I. Effect of photodynamic therapy on the healing of periapical lesions after root canal retreatment: 1-year follow up randomized clinical trial. Photodiagnosis Photodyn Ther 2024; 45:103907. [PMID: 38013016 DOI: 10.1016/j.pdpdt.2023.103907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 11/22/2023] [Accepted: 11/22/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND The aim of this randomized clinical trial was to evaluate the effects of photodynamic therapy (PDT) after traditional activated final irrigation protocol (ultrasonically activated irrigation, UAI) on periapical lesion healing after single-visit root canal retreatment. METHODS We included 36 patients with asymptomatic chronic apical periodontitis with periapical lesions larger than 5 mm and teeth sensitive to percussion and palpation, who had previous root canal treatment. All patients who signed informed consent underwent cone-beam computed tomography (CBCT) to determine and calculate the preoperative volume of the periapical lesion. Patients were randomly distributed into two groups according to the final disinfection protocol: Group 1; UAI (NaOCl, EDTA, and NaOCl), Group 2; UAI + PDT. All patients underwent single-visit root canal retreatment using rotary instrumentation and standardized irrigation (3 %NaOCl) by the same endodontist. The root canals were filled with epoxy resin-based sealer and single-cone gutta-percha, followed by control radiography. After one year, a new CBCT scan of the teeth was performed to calculate the reduction in the initial periapical lesion as a measure of periapical healing. For the statistical analysis, the chi-square test variants, Fisher's exact test and the Fisher-Freeman-Halton test were used at the level of significance set at 5 %. RESULTS There were no significant differences between the groups in terms of age, sex, preoperative and postoperative lesion volume (p > 0.05), and reduction of periapical lesion volume (median, 86.98 % for UAI and 79.72 % for UAI+PDT) (p = 0.970). Additional use of PDT after UAI did not contribute to the healing of periapical lesions. CONCLUSION The UAI and UAI+PDT protocols had equal effects on healing of periapical lesion.
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Affiliation(s)
- Boris Pažin
- Department of Endodontics, Oral Patology and Periodontology, Dental Polyclinic Zagreb, Croatia
| | | | - Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb 10 000, Croatia.
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22
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Sarı M, Yılmaz K. The Effect of Different Obturation Techniques Using Different Root Canal Sealers on the Residual Filling Material After Retreatment Procedures. Niger J Clin Pract 2024; 27:174-179. [PMID: 38409144 DOI: 10.4103/njcp.njcp_33_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 01/08/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND This study aimed to compare the effect of different obturation techniques with root canal sealers on the residual filling material after retreatment using SEM. MATERIAL AND METHOD Sixty (60) single rooted mandibular premolars were selected and instrumented with rotary files using the Mtwo system up to file size 30/.05 taper. The samples were randomly divided to two groups based on the type of sealer and three sub-groups (n=10) based on the obturating technique used. The root fillings were removed using the PTUR system files and the specimens were longitudinally sectioned while digital images were obtained from the root canals with SEM. The time required to reach working lenght were recorded. RESULTS There was no difference in terms of the smear score when comparing both sealer and obturation technique groups in the apical third. Smear scores were significantly affected by the type of sealer and obturation technique in the medium and coronal thirds of root canals (p<0.05). Higher smear scores were obtained with GFB than AH Plus (p<0.05). The time required to reach working length with GFB was longer than AH Plus (p<0.05). CONCLUSION Residual filling material was observed in all samples, regardless of the root canal sealer or the obturation technique used. There was a significantly lower smear scores in the AH Plus groups as compared to the GFB.
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Affiliation(s)
- M Sarı
- Department of Endodontics, Faculty of Dentistry, Hatay Mustafa Kemal University, Hatay, Turkey
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23
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Duan X, Tan Y, Zhang D, Wu H. Effects of Superfine Tricalcium Silicate Powder on the Physicochemical and Mechanical Properties of Its Premixed Cement as a Root Canal Filling Material. MATERIALS (BASEL, SWITZERLAND) 2024; 17:347. [PMID: 38255515 PMCID: PMC10820792 DOI: 10.3390/ma17020347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/07/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024]
Abstract
Calcium silicate-based cement is a promising material for filling root canals. However, it has several drawbacks to its clinical application, including difficult operation and low curing strength. In this study, we successfully prepared an ultrafine tricalcium silicate powder and investigated the effects of this ultrafine powder on the performance of the premixed tricalcium silicate cement, including the curing process, setting time, hydration products, microstructure, injectivity, fluidity, and compressive strength. The results demonstrate that the addition of ultrafine tricalcium silicate powder alters the hydration product content and product morphology of the premixed cement. By increasing the content of the ultrafine powder, the injectable property of the cement can be increased to more than 95%, the fluidity can be increased from 18 mm to 35 mm, and the curing time can be shortened from 13 h to 11 h. Notably, the addition of the ultrafine powder greatly enhances the compressive strength of the hardened cement, which increases from 20.6 MPa to 51.0 MPa. These results indicate that altering the particle size distribution of the powder is an effective method for enhancing the physicochemical and mechanical properties of tricalcium silicate cement as a root canal filling material.
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Affiliation(s)
| | - Yanni Tan
- State Key Laboratory of Powder Metallurgy, Central South University, Changsha 410083, China; (X.D.); (D.Z.); (H.W.)
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24
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Chanapairin B, Kulvitit S, Sathorn C. Post retention strength of apical and conventional coating obturation methods using bioceramic sealer: a laboratory investigation. BMC Oral Health 2024; 24:3. [PMID: 38167313 PMCID: PMC10763468 DOI: 10.1186/s12903-023-03778-2] [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: 11/04/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Once bioceramic sealer (BCS) enters the dentinal tubules, it cannot be reliably removed. BCS-occupied dentinal tubules reduce fibre post retention strength. Coating gutta-percha with BCS only on the apical portion may improve post retention strength due to increased retention strength between the dentin and resin cement interface. The aim of the study was to test this hypothesis. METHODS Root canals of 27 extracted human mandibular premolars were instrumented and randomly assigned to three obturation methods: conventional coating (CC), non-coating (NC), and apical coating (AC). The root canals were obturated with gutta-percha to 4 mm from the working length under an operating microscope. After the BCS was completely set, post spaces were prepared, and quartz fibre posts were cemented. The apical 4.5 mm of the roots were removed. Two samples were prepared at the apical, middle, and coronal root levels (one for scanning electron microscope (SEM) study and another for the push out bond strength (PBS) test). After the PBS test, the samples were examined with a stereo microscope to determine the failure mode: dentine-cement (DC), post-cement (PC) and mixed. The PBS data were analysed by One way ANOVA for the specific obturation method effects. Repeated ANOVA was used for the specific effects of the root levels on PBS in different obturation methods. RESULTS At all three root levels, more continuous hybrid layers and denser resin tags were found in the NC and AC than the CC group. The AC and NC groups' PBS was significantly higher than the CC group at the apical 1/3 (p = 0.002 and p = 0.001) and coronal 1/3 (p = 0.016 and p = 0.041). The PBS in the CC group at the middle 1/3 was significantly higher than the apical 1/3 (p = 0.022). DC failure mode was most commonly found in the CC group, while PC failure mode was found most frequently in the NC and AC groups. CONCLUSIONS The apical coating obturation method significantly increased PBS over the conventional coating method, potentially reducing fiber post dislodgement. However, this study was only preliminary. Clinical studies are required to confirm the results.
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Affiliation(s)
- Benjarat Chanapairin
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Sirinya Kulvitit
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand.
- Center of Excellence in Genomics and Precision Dentistry, Faculty of Dentistry, Chulalongkorn university, Bangkok, 10330, Thailand.
| | - Chankhrit Sathorn
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
- School of Dentistry, La Trobe University, Melbourne, VIC, Australia
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25
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Wang Y, Zhang X, Zheng H, Zhou Z, Li S, Jiang J, Li M, Fu B. Remineralization of Dentin with Cerium Oxide and Its Potential Use for Root Canal Disinfection. Int J Nanomedicine 2023; 19:1-17. [PMID: 38179219 PMCID: PMC10763684 DOI: 10.2147/ijn.s441060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/12/2023] [Indexed: 01/06/2024] Open
Abstract
Objective This study was to investigate a novel antibacterial biomimetic mineralization strategy for exploring its potential application for root canal disinfection when stabilized cerium oxide was used. Material and Methods A biomimetic mineralization solution (BMS) consisting of cerium nitrate and dextran was prepared. Single-layer collagen fibrils, collagen membranes, demineralized dentin, and root canal system were treated with the BMS for mineralization. The mineralized samples underwent comprehensive characterization using various techniques, including transmission electron microscopy (TEM), high-resolution TEM (HRTEM), Fourier transform infrared spectroscopy (FTIR), scanning transmission electron microscopy (STEM), selected-area electron diffraction (SAED), energy-dispersive X-ray spectroscopy (EDX), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), and micro-CT. Additionally, the antimicrobial properties of the BMS and the remineralized dentin were also analyzed with broth microdilution method, live/dead staining, and SEM. Results Cerium ions in the BMS underwent a transformation into cerium oxide nanoparticles, which were deposited in the inter- and intra-fibrillar collagen spaces through a meticulous bottom-up process. XPS analysis disclosed the presence of both Ce (III) and Ce (IV) of the generated cerium oxides. A comprehensive examination utilizing SEM and micro-CT identified the presence of cerium oxide nanoparticles deposited within the dentinal tubules and lateral canals of the root canal system. The BMS and remineralized dentin exhibited substantial antibacterial efficacy against E. faecalis, as substantiated by assessments involving the broth dilution method and live/dead staining technique. The SEM findings revealed the cell morphological changes of deceased E. faecalis. Conclusion This study successfully demonstrated antibacterial biomimetic mineralization as well as sealing dentinal tubules and lateral branches of root canals using cerium nitrate and dextran. This novel biomimetic mineralization could be used as an alternative strategy for root canal disinfection.
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Affiliation(s)
- Yinlin Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People’s Republic of China
| | - Xinyue Zhang
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Haiyan Zheng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People’s Republic of China
| | - Zihuai Zhou
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People’s Republic of China
| | - Si Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People’s Republic of China
| | - Jimin Jiang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People’s Republic of China
| | - Mingxing Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People’s Republic of China
| | - Baiping Fu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, People’s Republic of China
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26
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Sevgi U, Johnsen GF, Hussain B, Piasecki L, Nogueira LP, Haugen HJ. Morphometric micro-CT study of contralateral mandibular incisors. Clin Oral Investig 2023; 28:20. [PMID: 38147175 PMCID: PMC10751267 DOI: 10.1007/s00784-023-05419-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: 07/19/2023] [Accepted: 11/27/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVES This study aimed to determine the degree of similarity and symmetry in the anatomy of contralateral mandibular incisors. Three-dimensional (3D) models of extracted teeth were obtained from microtomography (micro-CT) scans. Qualitative and quantitative assessments of the morphology and comparison of contralateral pairs were made. The null hypothesis was that contralateral mandibular incisors could not be considered identical in simple morphometric measurements. METHODS Sixty pairs of mandibular incisors were extracted from 30 patients and scanned with micro-CT. Virtual models of the cemento-enamel junction to the root apex were rendered. Parameters such as length, canal width, dentinal thicknesses, tortuosity, centerline length, accessory canals, root canal configurations, and root canal orifice cross-sections were used to compare the teeth. Width and thickness comparisons between paired teeth in the same individual were made by paired t-test (Wilcoxon signed-rank test for variables not normally distributed). An online randomization tool generated randomized pairs (independent of the individual/patient). Subsequently, an unpaired t-test (or Mann-Whitney U test for non-normally distributed parameters) and a correlation analysis were conducted. Canal configurations were classified according to preexisting classification schemes. The number and location of accessory canals and apical foramina were registered and compared. RESULTS Utilizing advanced imaging techniques and quantitative analyses, our study establishes that contralateral mandibular incisors exhibit a remarkable degree of symmetry in multiple morphological parameters, including length, canal width, and dentinal thicknesses. The apical third showed a high degree of inter-variability for the contralateral pairs. The rigorous statistical analysis of the normalized parameters by Z-score showed no statistically significant differences between the contralateral mandibular incisors. Comparisons between central and lateral teeth revealed differences in root length but no significant disparity in the distribution of accessory canals. Central teeth, on average, were longer, while accessory canals were distributed relatively evenly between central and lateral teeth. CONCLUSIONS The findings of this study further establish the significant similarities between contralateral mandibular incisors, reinforcing their suitability as a reliable substrate for root canal comparison studies. CLINICAL RELEVANCE The absence of statistically significant differences between contralateral pairs in normalized parameters underscores their potential as a reliable reference point for root canal comparison studies in clinical dentistry. Furthermore, our findings emphasize the importance of individualized treatment planning, considering the natural symmetry in mandibular incisors to enhance clinical decision-making. This research contributes valuable insights to the field of endodontics, offering a standardized approach to sample selection and enriching the understanding of dental anatomy.
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Affiliation(s)
- Usame Sevgi
- DF Dental Group, Istanbul, Turkey
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Gaute Floer Johnsen
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
- Tanngarden AS, Sørumsand, Norway
| | - Badra Hussain
- Oral Research Laboratory Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Lucila Piasecki
- Department of Periodontics and Endodontics, University at Buffalo, Buffalo, NY, USA
| | - Liebert Parreiras Nogueira
- Oral Research Laboratory Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Håvard Jostein Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway.
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Yan Y, Li Y, Chi Y, Ji M, Shen Y, Zou L. A comparative study of biological properties of three root canal sealers. Clin Oral Investig 2023; 28:11. [PMID: 38129367 DOI: 10.1007/s00784-023-05402-7] [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: 08/27/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the effects of Hiflow with other two kinds of root canal sealers on the biological behavior of stem cells from the apical papilla (SCAP), the influence on inflammatory cytokines release and its antibacterial effects. MATERIALS AND METHODS Material extracts of Hiflow, iRoot SP, and AH Plus were prepared. Then, SCAP was incubated with extracts. The effects were evaluated by CCK-8, wound healing assay, ALP staining, alizarin red staining, and qRT-PCR. Meanwhile, polymorphonuclears (PMNs) and monocytes were isolated and treated with extracts for 4 h and 24 h respectively. Cell viability was analyzed by Annexin-V/PI double staining flow cytometry. The effects on the release of cytokines were observed by ELISA. The antibacterial effects of different sealers were tested against three kinds of bacteria found in chronic apical periodontitis. RESULTS A series of results of SCAP showed that Hiflow and iRoot SP could promote cell proliferation, migration, and osteogenesis (p < 0.05). Although Hiflow was associated with greater cell apoptosis and necrosis when incubated with PMNs and monocytes (p < 0.05), it had an approximate release of anti-inflammatory cytokines with iRoot SP, which was higher than AH plus (p < 0.05). The co-culture showed that Hiflow and iRoot SP inhibited the colony formation of F. nucleatum (p < 0.05). However, both sealers had no obvious antibacterial effect on E. faecalis and P. gingivalis (p > 0.05). CONCLUSIONS In summary, Hiflow and iRoot SP both had positive biological stimulus on SCAP. Meanwhile, Hiflow showed a better induction on anti-inflammatory cytokines over the others. All the properties mentioned above and its antibacterial effect of F. nucleatum promise Hiflow a bright application prospect in endodontic uses. CLINICAL RELEVANCE References for clinical work to use BC Sealer Hiflow as a good biological root canal sealer.
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Affiliation(s)
- Yujia Yan
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yanyao Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yaqi Chi
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Mengzhen Ji
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada.
| | - Ling Zou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
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28
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Wei X, Du Y, Zhou X, Yue L, Yu Q, Hou B, Chen Z, Liang J, Chen W, Qiu L, Huang X, Meng L, Huang D, Wang X, Tian Y, Tang Z, Zhang Q, Miao L, Zhao J, Yang D, Yang J, Ling J. Expert consensus on digital guided therapy for endodontic diseases. Int J Oral Sci 2023; 15:54. [PMID: 38052782 DOI: 10.1038/s41368-023-00261-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/12/2023] [Accepted: 11/12/2023] [Indexed: 12/07/2023] Open
Abstract
Digital guided therapy (DGT) has been advocated as a contemporary computer-aided technique for treating endodontic diseases in recent decades. The concept of DGT for endodontic diseases is categorized into static guided endodontics (SGE), necessitating a meticulously designed template, and dynamic guided endodontics (DGE), which utilizes an optical triangulation tracking system. Based on cone-beam computed tomography (CBCT) images superimposed with or without oral scan (OS) data, a virtual template is crafted through software and subsequently translated into a 3-dimensional (3D) printing for SGE, while the system guides the drilling path with a real-time navigation in DGE. DGT was reported to resolve a series of challenging endodontic cases, including teeth with pulp obliteration, teeth with anatomical abnormalities, teeth requiring retreatment, posterior teeth needing endodontic microsurgery, and tooth autotransplantation. Case reports and basic researches all demonstrate that DGT stand as a precise, time-saving, and minimally invasive approach in contrast to conventional freehand method. This expert consensus mainly introduces the case selection, general workflow, evaluation, and impact factor of DGT, which could provide an alternative working strategy in endodontic treatment.
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Affiliation(s)
- Xi Wei
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yu Du
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lin Yue
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Qing Yu
- Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Benxiang Hou
- Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Zhi Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jingping Liang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Clinical Research Center for Oral Diseases; National Center for Stomatology; Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Wenxia Chen
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, China
| | - Lihong Qiu
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Xiangya Huang
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Liuyan Meng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Dingming Huang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Yu Tian
- Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Zisheng Tang
- Department of Stomatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qi Zhang
- Department of Endodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Leiying Miao
- Department of Cariology and Endodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jin Zhao
- Department of Endodontics, First Affiliated Hospital of Xinjiang Medical University, and College of Stomatology of Xinjiang Medical University, Urumqi, China
| | - Deqin Yang
- Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Jian Yang
- Department of Endodontics, The Affiliated Stomatological Hospital of Nanchang University, Nanchang, China
| | - Junqi Ling
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
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Chan CY, Vishwanath V, Cheung HY, Cheng YTJ, Ki K, Airis Mok HM, Pudipeddi A, Lee AHC, Cheung GSP, Neelakantan P. Tissue Stabilization, Bacterial Adhesion, and Stem Cell Viability in Trans-cinnamaldehyde-conditioned Dentin. J Endod 2023; 49:1634-1640. [PMID: 37793567 DOI: 10.1016/j.joen.2023.09.011] [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: 07/14/2023] [Revised: 09/11/2023] [Accepted: 09/26/2023] [Indexed: 10/06/2023]
Abstract
INTRODUCTION This laboratory study aimed to evaluate the effect of trans-cinnamaldehyde (TC) conditioning on dentin tissue stabilization, bacterial adhesion, and stem cell toxicity. METHODS Dentin beams (n = 204) from extracted human molars were demineralized in phosphoric acid and treated with TC (2.5, 5, and 7.5%), 50% ethanol-water mixture (vehicle control) or 2.5% glutaraldehyde (GA) (positive control) for 30 minutes. Demineralized but untreated specimens served as the negative control. After treatment, collagen crosslinking was characterized by measuring the elastic modulus (Er) and hardness (n = 5). Biodegradation resistance was examined by determining the loss of dry mass (n = 8), hydroxyproline release (n = 4) and scanning electron microscopy (n = 2), after exposure to bacterial collagenase. Inhibition of bacterial adhesion was investigated by colony counting assay (n = 12) and scanning electron microscopy (n = 2). Viability of stem cells of the apical papilla on TC-conditioned dentin was determined using the Cell Counting Kit-8 assay (n = 8). Data were statistically analyzed using one-way analysis of variance (ANOVA) test followed by Dunnett's multiple comparisons at a significance level of 5%. RESULTS TC-conditioned dentin showed a concentration-dependent increase in Er and hardness. The Er and hardness of 5% and 7.5% TC-conditioned dentin were significantly greater than that of the negative control and vehicle control groups (P < .05). There was no significant difference in the biodegradation resistance between GA and 5% TC-conditioned dentin (P > .05). TC-conditioned dentin showed a well-preserved collagen fibril network with clear cross-banding, comparable to GA-conditioned dentin. All concentrations of TC inhibited bacterial adhesion on dentin, significantly greater than the negative control (P < .05). There was no reduction in viability of stem cells of the apical papilla viability on TC-conditioned dentin compared to the negative control (P > .05). CONCLUSIONS TC conditioning stabilized the dentin and protected it from enzymatic degradation. TC prevented bacterial adhesion on the dentin but maintained stem cell viability.
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Affiliation(s)
- Chi Yan Chan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | | | - Hoi Yin Cheung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | | | - Kei Ki
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | | | - Akhila Pudipeddi
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | | | - Gary Shun Pan Cheung
- Department of Dental Surgery, University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
| | - Prasanna Neelakantan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR; Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California.
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Liu X, He G, Qiu Z, Chen F, Wang J, Huang Z, Zhang P, Zhang J, Zhong L, Ding C, Chen X. Diabetes Mellitus Increases the Risk of Apical Periodontitis in Endodontically-Treated Teeth: A Meta-Analysis from 15 Studies. J Endod 2023; 49:1605-1616. [PMID: 37506763 DOI: 10.1016/j.joen.2023.07.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 06/11/2023] [Accepted: 07/02/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION At present, the incidence of diabetes mellitus (DM) is gradually increasing globally. In clinical practice, many patients with diabetes with apical periodontitis (AP) have poor and slow healing of periapical lesions. However, the potential relationship between the 2 is still unclear and controversial. The consensus is that DM can be deemed a risk factor for AP in endodontically-treated teeth. Therefore, we pooled existing studies and carried out a meta-analysis to explore the potential association between the 2. METHODS Studies that met the inclusion criteria were selected from the database, and relevant data were extracted. Stata SE 17.0 software was used to analyze the relevant data, and the Newcastle-Ottawa Scale was used to assess the literature's quality. The pooled odds ratio (OR) with a 95% confidence interval (CI) was used to determine the strength of the association between DM and the prevalence of AP after root canal treatment (RCT). RESULTS After searching, 262 relevant studies were retrieved, fifteen of which met the inclusion criteria. A total of 1087 patients with 2226 teeth were included in this meta-analysis. According to the findings, diabetics showed a higher prevalence of AP after RCT than controls at the tooth level (OR = 1.51, 95% CI = 1.22-1.87, P < .01). At the patient level, DM increased the probability of developing AP in RCT teeth more than 3 times (OR = 3.38, 95% CI = 1.65-6.93, P < .01). Additionally, subgroup analysis was performed by blood glucose status, preoperative AP, and study design. Except for the status of blood glucose, the results were significant in the other 2 groups (P < .05). CONCLUSIONS Available scientific evidence suggests that DM may increase the risk of AP in endodontically-treated teeth. In teeth with preoperative AP, DM might promote the development of AP.
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Affiliation(s)
- Xinyue Liu
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Guiying He
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Zhengjie Qiu
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Feng Chen
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Jiapeng Wang
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Zheng Huang
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Pengtao Zhang
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Jian Zhang
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; College of Materials, Chemistry and Chemical Engineering, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Liangjun Zhong
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Cheng Ding
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China.
| | - Xing Chen
- Stomatology Center, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China; School of Stomatology, Hangzhou Normal University, Hangzhou, Zhejiang Province, China.
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Ahlat M, Aydin C, Kaya S, Baysallar M. Identification of root canal microbiota profiles of periapical tissue diseases using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Anaerobe 2023; 84:102791. [PMID: 37925063 DOI: 10.1016/j.anaerobe.2023.102791] [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: 05/08/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVES The purpose of this study was to identify microorganisms isolated from various periapical tissue diseases using Matrix-Assisted Laser Desorption Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF-MS) and classify them via an unsupervised machine learning approach. METHODS A total of 150 patients with various apical conditions and teeth in need of endodontic retreatment were divided into five groups, including Retreatment, Acute Apical Abscess, Chronic Apical Abscess, Acute Apical Periodontitis, and Chronic Apical Periodontitis. Samples were collected from root canals using paper points after agitating with a #10 K file then microorganisms were identified using MALDI-TOF-MS. Data were analyzed using a hierarchical clustering method. Quadruple clusters and dendrograms were formed according to similarities and dissimilarities. RESULTS A total of 80 species were identified representative of six different phyla. The most similar microorganism species identified were: ''Enterococcus faecalis'' between 21 and 23-year-old female cases in Retreatment group; ''Lactobacillus rhamnosus'' between 20 and 18-year-old male cases in Symptomatic Apical Abscess cases; ''Lactobacillus paracasei'' between 26 and 40-year-old male cases in Asymptomatic Apical Abscess cases; ''Enterococcus faecalis'' between 48 and 50-year-old female cases in Symptomatic Apical Periodontitis cases; ''Lactobacillus rhamnosus'' between 48 and 60-year-old male cases in Asymptomatic Apical Periodontitis cases. CONCLUSIONS MALDI-TOF MS can be considered a fast and high-throughput screening technique for microbial species identification in endodontics. Thus, it will provide valuable data for future research designs regarding periapical tissue diseases. As the MALDI-TOF MS database expands and comprehensive data becomes available, the relationship between microbial profiles and disease progression will become increasingly apparent.
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Affiliation(s)
- Mete Ahlat
- University of Health Sciences, Gulhane Faculty of Dentistry, Department of Endodontics, Ankara, Turkey.
| | - Cumhur Aydin
- University of Health Sciences, Gulhane Faculty of Dentistry, Department of Endodontics, Ankara, Turkey.
| | - Sinem Kaya
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey.
| | - Mehmet Baysallar
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey.
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Keskin C, Pirimoğlu B, Çiftçioğlu E, Dinger E, Kömeç O, Keleş A. Shaping outcomes of Reciproc Blue and Rotate in roots canals with band-shaped isthmuses: micro-CT study. Clin Oral Investig 2023; 27:7337-7344. [PMID: 37861748 DOI: 10.1007/s00784-023-05324-4] [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: 05/29/2023] [Accepted: 10/10/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE This study assessed the outcome of shaping the mesial roots of mandibular first molars containing band-shaped isthmuses with an isthmus floor located at the apical third with Reciproc Blue and Rotate instruments in terms of canal transportation, canal aberrations and unprepared apical canals. MATERIALS AND METHODS Pair-matched mesial roots of mandibular first molars according to their isthmus location (distance from apical foramina) and size were constructed based on quantitative measurements (length, major and minor diameter at isthmus roof and floor) on preoperative micro-CT scanning (n = 10). The pair-matched specimens were prepared either using Reciproc Blue R25 (25.08v) or Rotate (15.04, 20.05, 25.06) instruments and then subjected to a second micro-CT scanning. Micro-CT scans were analysed to evaluate the canal transportation at the apical foramen and isthmus floor levels and the frequency of procedural errors (separated instruments, artificial canal preparation, cross shaping and unprepared apical canals). Canal transportation values were compared using Mann-Whitney U, and the distribution of procedural errors was compared with chi-square tests with a 5% significance threshold. RESULTS Greater transportation values were detected in the apical foramen level compared to the isthmus floor in both groups. No significant difference was detected between Rotate and Reciproc Blue groups in terms of absolute transportation values and the incidence of procedural errors (p > .05). CONCLUSION Preparation of mesial root canals containing a band-shaped isthmus at the apical portion with Reciproc Blue and Rotate instruments caused transportation of the original canal position at the isthmus floor and the apical foramen levels and resulted in procedural errors. CLINICAL RELEVANCE This ex vivo micro-CT study using controlled pair-matched specimens showed that presence of a band-shaped isthmus complicates canal preparation procedure irrespective of the preparation systems.
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Affiliation(s)
- Cangül Keskin
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey.
| | - Burcu Pirimoğlu
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey
| | - Elif Çiftçioğlu
- Department of Endodontics, Faculty of Dentistry, Okan University, Istanbul, Turkey
| | - Esma Dinger
- Department of Endodontics, Faculty of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey
| | | | - Ali Keleş
- Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey
- Department of Endodontics, Faculty of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey
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Wang G, Yuan F, Ying W, Xu J. The effects of different regenerative technologies and materials on wound healing after surgical endodontic therapy: A meta-analysis. Int Wound J 2023; 20:4340-4348. [PMID: 37437962 PMCID: PMC10681480 DOI: 10.1111/iwj.14293] [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: 05/29/2023] [Revised: 06/08/2023] [Accepted: 06/16/2023] [Indexed: 07/14/2023] Open
Abstract
A meta-analysis was performed to assess the effects of different regenerative technologies and materials on wound healing after surgical endodontic therapy and provide a reference for surgical endodontic treatment. We searched for studies on the use of regenerative technologies and materials in surgical endodontic therapy via PubMed, MEDLINE, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Data from the time of database creation to December 2022. Two researchers independently screened the literature, extracted information based on the inclusion and exclusion criteria, and evaluated the quality of the included studies. A meta-analysis was performed using Review Manager 5.4. The results showed that the use of regenerative technologies and materials significantly reduced wound healing failures (risk ratio [RR]: 0.30, 95% confidence intervals [CI]: 0.22-0.40, p < 0.001). Moreover, autologous platelet concentrations (APCs) (RR: 0.28, 95% CI: 0.15-0.53, p < 0.001) and collagen membrane plus bovine-derived hydroxyapatite (RR: 0.27, 95% CI. 0.12-0.61, p = 0.002) were more effective in improving wound healing failure rates than collagen membrane alone (RR: 0.51, 95% CI: 0.20-1.25, p = 0.140). Our findings showed that APCs, as well as collagen membrane plus bovine-derived hydroxyapatite, significantly improved wound healing after surgical endodontic therapy. In contrast, collagen membrane alone did not significantly improve wound healing outcomes. However, currently available studies vary significantly in sample size and methodologies. Hence, high-quality randomised controlled studies with large sample sizes are necessary to validate our findings.
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Affiliation(s)
- Ge Wang
- Department of EndodonticsJinan Stomatological HospitalJinanChina
| | - Fang Yuan
- Department of ProsthodonticsJinan Stomatological HospitalJinanChina
| | - Wanggui Ying
- Shungeng BranchJinan Stomatological HospitalJinanChina
| | - Jie Xu
- Oral Implantology Center of Jinan Stomatological HospitalJinanChina
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Quintana RM, Scarparo RK, Münchow EA, Pinheiro LS, Tavares CO, Kopper PMP. Does aPDT reduce bacterial load in endodontic infected teeth? A systematic review and meta-analysis. Lasers Med Sci 2023; 38:268. [PMID: 37981598 DOI: 10.1007/s10103-023-03938-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/14/2023] [Indexed: 11/21/2023]
Abstract
This systematic review investigated whether antimicrobial photodynamic therapy (aPDT) after chemomechanical root canal disinfection (CD) yields a greater microbial load reduction than only CD. An electronic literature search was conducted on four databases up to November 2022, with no language or publication date restrictions. Randomized and non-randomized clinical trials were included if participants had a primary endodontic infection in permanent teeth, and if microbial loads before and after using aPDT were compared. Two researchers independently screened titles and abstracts to determine study eligibility. Assessments included risk of bias and methodological quality. This review was registered in PROSPERO (CRD42020181783). Eight studies were included in the qualitative analysis, and six were eligible for meta-analysis. In the random effects model, aPDT significantly improved the results of root canal disinfection when compared with standard protocols for cleaning and shaping (p = 0.04, 95% CI -1.72, -0.05). Subgroup analysis suggested that aPDT has a better effect on reducing the load of anaerobic microorganisms (p = 0.003, 95% CI -3.36, -0.69). The use of aPDT as an adjunct to chemomechanical disinfection promotes additional reduction of the microbial load and, therefore, seems to improve the results of root canal treatments in permanent teeth with a primary endodontic infection. However, certainty of evidence should be improved.
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Affiliation(s)
- Ramiro Martins Quintana
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Ramiro Barcellos, 2492. Santa Cecícila, Porto Alegre, RS, Brazil
| | - Roberta Kochenborger Scarparo
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Ramiro Barcellos, 2492. Santa Cecícila, Porto Alegre, RS, Brazil
| | - Eliseu Aldrighi Münchow
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Ramiro Barcellos, 2492. Santa Cecícila, Porto Alegre, RS, Brazil
| | - Lucas Siqueira Pinheiro
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Ramiro Barcellos, 2492. Santa Cecícila, Porto Alegre, RS, Brazil
| | - Cauana Oliva Tavares
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Ramiro Barcellos, 2492. Santa Cecícila, Porto Alegre, RS, Brazil
| | - Patricia Maria Poli Kopper
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Ramiro Barcellos, 2492. Santa Cecícila, Porto Alegre, RS, Brazil.
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Sfeir G, Bukiet F, Kaloustian MK, Kharouf N, Slimani L, Casel B, Zogheib C. Evaluation of the Impact of Calcium Silicate-Based Sealer Insertion Technique on Root Canal Obturation Quality: A Micro-Computed Tomography Study. Bioengineering (Basel) 2023; 10:1331. [PMID: 38002455 PMCID: PMC10669346 DOI: 10.3390/bioengineering10111331] [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: 10/19/2023] [Revised: 11/10/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Calcium silicate-based sealers have gained in popularity over time due to their physicochemical/biological properties and their possible use with single-cone obturation. The single cone technique is a sealer-based obturation and there is still a knowledge gap regarding the potential impact of the sealer insertion method on the root canal-filling quality. Therefore, the aim of this micro-CT study was to assess the impact of the calcium silicate-based sealer insertion technique on void occurrence and on the sealer extrusion following single-cone obturation. METHODS Thirty-six single-rooted mandibular premolars with one canal were shaped with Reciproc® R25 (VDW, Munich, Germany) then divided randomly into four groups of nine canals, each depending on the TotalFill® BC Sealer insertion technique used with single cone obturation: injection in the coronal two-thirds (group A); injection in the coronal two-thirds followed by direct sonic activation (group B); injection in the coronal two-thirds followed by indirect ultrasonic activation on tweezers (group C); sealer applied only on the master-cone (control group D). Samples were then scanned using micro-CT for voids and sealer extrusion calculation. Data were statistically analyzed using v.26 IBM; Results: No statistically significant differences were noted between the four groups in terms of voids; nevertheless, sonic activation (group B) followed by ultrasonic activation on the tweezers (group C) showed the best results (p = 0.066). Group D showed significantly less sealer extrusion when compared with group C (p = 0.044), with no statistically significant differences between groups D, A and B (p > 0.05). CONCLUSIONS Despite no significant differences observed between the different sealer placement techniques, the use of sonic and ultrasonic activation might be promising to reduce void occurrence. Further investigations are needed to demonstrate the potential benefit of calcium silicate-based sealer activation especially in wide and oval root canals in order to improve the quality of the single-cone obturation.
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Affiliation(s)
- Germain Sfeir
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon; (G.S.); (M.K.K.); (C.Z.)
| | - Frédéric Bukiet
- Assistance Publique des Hôpitaux de Marseille, 13005 France, Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, 13288 Marseille, France;
| | - Marc Krikor Kaloustian
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon; (G.S.); (M.K.K.); (C.Z.)
| | - Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
| | - Lotfi Slimani
- Plateforme Imageries du Vivant, Faculté de Chirurgie Dentaire, Université de Paris, 92120 Montrouge, France
| | - Baptiste Casel
- Plateforme Imageries du Vivant, Faculté de Chirurgie Dentaire, Université de Paris, 92120 Montrouge, France
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut 17-5208, Lebanon; (G.S.); (M.K.K.); (C.Z.)
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Eskibağlar M, Özata MY, Ocak MS, Öztekin F. Investigation of fracture prevalence of instruments used in root canal treatments at a faculty of dentistry: a prospective study. Restor Dent Endod 2023; 48:e38. [PMID: 38053782 PMCID: PMC10695725 DOI: 10.5395/rde.2023.48.e38] [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: 06/13/2023] [Revised: 08/13/2023] [Accepted: 09/18/2023] [Indexed: 12/07/2023] Open
Abstract
Objectives The aim of this study was to examine the use of hand or rotary files by pre-graduation (fourth- and fifth-year) and postgraduate students in endodontic treatments and to determine the incidence of file fracture and the management of cases with broken instruments. Materials and Methods A total of 2,168 teeth undergoing primary endodontic treatment were included in this study. It was determined that 79 of these teeth resulted in broken tools. In the case of broken tools, the education level of the treating clinician, the tooth that was being treated, the canal and fracture level, the curvature of the tooth and the management of the broken instrument were recorded. Periapical radiographs of the patients were used to calculate curvature following the Schneider method. Results There was no significant difference in the incidence of broken tools according to education level (p > 0.05). The incidence of file fracture in molar teeth (73.4%) was higher than in other teeth (p < 0.05). More files were broken in the mandibular molar MB canal (20.25%) and in the apical third of the canals (72.1%). The risk of instrument fracture was high in teeth with moderate (44.3%) and severe (38%) curvature canals. The management of apically broken (80%) files mostly involved lefting (p < 0.05). Conclusions There was no statistically significant difference between fourth-year students, fifth-year students and postgraduate students in terms of instrument fracture.
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Affiliation(s)
- Mehmet Eskibağlar
- Department of Endodontics, Faculty of Dentistry, Fırat University, Elazığ, Turkey
| | - Merve Yeniçeri Özata
- Department of Endodontics, Faculty of Dentistry, Dicle University, Diyarbakır, Turkey
| | - Mevlüt Sinan Ocak
- Department of Endodontics, Faculty of Dentistry, Fırat University, Elazığ, Turkey
| | - Faruk Öztekin
- Department of Endodontics, Faculty of Dentistry, Fırat University, Elazığ, Turkey
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Gaeta C, Marruganti C, Mignosa E, Malvicini G, Verniani G, Tonini R, Grandini S. Comparison of physico-chemical properties of zinc oxide eugenol cement and a bioceramic sealer. AUST ENDOD J 2023; 49 Suppl 1:187-193. [PMID: 36409203 DOI: 10.1111/aej.12715] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/22/2022] [Accepted: 11/06/2022] [Indexed: 11/23/2022]
Abstract
The aim of the present study was to compare the physico-chemical properties of EssenSeal with AH PLUS bioceramic and Pulp Canal Sealer EWT. Flow, solubility, film thickness, radiopacity and setting time were evaluated according to ISO 6876 (2012) specifications. External and cross-section surface characteristics were analysed under a scanning electron microscope. Statistical analysis was performed using Shapiro-Wilk's test, one-way ANOVA and the Tukey HSD test. All the sealers conformed to the ISO 6876 (2012) standards, except for the setting time for AH plus bioceramic, which exceeded more than 10% of the time indicated by the manufacturer. Statistically significant differences were found between the three study sealers regarding the physico-chemical properties tested (p < 0.05). EssenSeal demonstrated characteristics respecting the ISO 6876 (2012) standards and can be considered a predictable alternative in root canal sealing.
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Affiliation(s)
- Carlo Gaeta
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Unit of Prosthodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Crystal Marruganti
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Unit of Prosthodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Emanuele Mignosa
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Unit of Prosthodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Giulia Malvicini
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Unit of Prosthodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Giulia Verniani
- Unit of Prosthodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | | | - Simone Grandini
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
- Unit of Prosthodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy
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Tavares KIMC, Pinto JC, Santos-Junior AO, Duarte MAH, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Effect of Additional Apical Preparation on Retreatment of Curved Root Canals Filled with Different Sealers. Eur J Dent 2023; 17:636-641. [PMID: 36075266 PMCID: PMC10569835 DOI: 10.1055/s-0042-1750693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
OBJECTIVE This study assessed the influence of additional apical preparation on material removal during retreatment of curved root canals filled with different sealers. MATERIALS AND METHODS Twelve mesial roots of mandibular molars with two separate canals and curvature between 25 and 35 degrees were selected. The working length was established 1-mm short of the apical foramen, and all the root canals were prepared using ProDesign R (PDR) 25/0.06. After preparation, the root canals were divided in two groups (n = 12) and filled by continuous wave condensation technique with NeoMTA Plus or AH Plus. All the root canals were retreated using rotary ProDesign Logic RT 25/0.08, reciprocating PDR 25/0.06 and apical preparation with PDR 35/0.05. Additional apical preparation was performed with ProDesign Logic (PDL) 50/0.01. The samples were scanned using a Skycan 1176 micro-computed tomography (micro-CT), voxel size 8.74 µm, before and after the retreatment procedures. Percentages of remaining filling material were evaluated. STATISTICAL ANALYSIS The data were submitted to paired and unpaired t-tests (α = 0.05). RESULTS Percentage of remaining filling material was similar between the root canals filled with NeoMTA Plus or AH Plus sealer after retreatment using PDR 35/0.05, and after additional apical preparation using PDL 50/0.01 (p > 0.05). However, PDL 50/0.01 significantly decreased the percentage of remaining filling material in the apical third after the additional apical preparation for both sealers (p < 0.05). CONCLUSION NeoMTA Plus or AH Plus did not influence the retreatment of curved root canals. ProDesign Logic 50/0.01 promoted greater filling material removal in the apical third.
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Affiliation(s)
- Karina I. M. C. Tavares
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Jader C. Pinto
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Airton O. Santos-Junior
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Marco A. H. Duarte
- Department of Dentistry, Endodontics and Dental Materials, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
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Olivieri JG, Feijoo Pato N, Labraca P, Tomàs J, Miró Q, Duran-Sindreu F. Outcome of non-surgical root canal retreatment procedures obturated with warm gutta-percha techniques: A longitudinal clinical study. J Endod 2023:S0099-2399(23)00322-9. [PMID: 37315780 DOI: 10.1016/j.joen.2023.06.002] [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: 01/31/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To evaluate the success rate of non-surgical root canal retreatment at the 2- to 3-year follow-up and identify the possible prognostic factors. METHODS Patients who underwent root canal retreatment at a university dental clinic were contacted for clinical and radiographic follow-up. The retreatment outcomes in these cases were based on clinical signs, symptoms, and radiographic criteria. Inter- and intra-examiner concordance were calculated using Cohen's kappa coefficient. The retreatment outcome was dichotomized into success or failure according to strict and loose criteria. The radiographic success criteria consisted of complete resolution or absence of a periapical lesion (strict criteria) or a reduction in the size of an existing periapical lesion at recall (loose criteria). χ2 tests were used to evaluate possible variables associated with retreatment outcomes (age, sex, tooth type, location, contact points, periapical status, quality of previous and final root canal filling, previous and final restoration, number of visits, and complications). RESULTS Overall, 129 teeth (113 patients) were included in the final evaluation. The success rate was 80.6% under strict criteria and 93% under loose criteria. Molars, teeth with an initially higher periapical index (PAI) score, and teeth with > 5 mm periapical radiolucency had a lower success rate according to the strict criteria model (p < 0.05). When the loose success criteria were used, teeth with larger (> 5 mm) periapical lesions and those that had been perforated during retreatment showed a lower success rate (p < 0.05). CONCLUSIONS The present study demonstrated that non-surgical root canal retreatment is a highly successful procedure after an observation period of 2-3 years. Treatment success is primarily affected by the presence of periapical lesions.
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Affiliation(s)
- Juan Gonzalo Olivieri
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain.
| | - Nancy Feijoo Pato
- School of Medicine and Dentistry, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Patricia Labraca
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Jordi Tomàs
- Department of Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Queralt Miró
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
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Jamleh A, Nassar M, Alfadley A, Alanazi A, Alotiabi H, Alghilan M, Alfouzan K. Retreatment of oval-shaped root canals filled with TotalFill bioceramic or AH plus sealer. Sci Rep 2023; 13:9357. [PMID: 37291272 PMCID: PMC10250336 DOI: 10.1038/s41598-023-36608-0] [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: 02/16/2023] [Accepted: 06/07/2023] [Indexed: 06/10/2023] Open
Abstract
This study investigated retreatment of oval canals filled with gutta-percha and different sealers using WaveOne Gold (WOG). Single oval canals were prepared to size 30, 0.04 and obturated with gutta percha and AH Plus (AHP) or TotalFill bioceramic (TFBC) sealer. After 6-month incubation, the canals were retreated with WOG Primary (25, 0.07) under simulated body temperature, and the developed load and torque were simultaneously measured. The time and regaining the apical patency were checked. Micro-computed tomography scanning was performed to calculate the remaining obturating materials. An independent t-test and chi-square test were performed at a 95% confidence level. A shorter retreatment time was needed in TFBC than in AHP (P = 0.003). However, a higher maximum apical load was reported with AHP (P = 0.000). Meanwhile, comparable maximum coronal load and maximum torque values were observed. Apical patency was regained in all TFBC roots and only 75% of the AHP samples (P = 0.217). The remaining obturating materials were comparable in TFBC (13.02 ± 8.12%) and AHP (10.11 ± 8.46%) (P = 0.398). WOG was able to remove 89.89% and 86.98% of obturating materials in TFBC and AHP, respectively. The TFBC presented lower apical loads and faster retreatment compared to AHP.
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Affiliation(s)
- Ahmed Jamleh
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia.
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia.
| | - Mohannad Nassar
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Abdulmohsen Alfadley
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Azhar Alanazi
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia
- Endodontic Division, Dental Services, Central Region, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Hadeel Alotiabi
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Maryam Alghilan
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Khalid Alfouzan
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, P.O. Box 22490, 11426, Riyadh, Kingdom of Saudi Arabia
- King Abdullah International Medical Research Centre, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
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41
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Zhang X, Li D, Yang M, Wang W, Yang F. Comparable Effectiveness of Photon-Induced Photoacoustic Streaming with XP-Endo Finisher and Passive Ultrasonic Irrigation on Removing Residual Root Canal Filling Materials from Oval Canals. Photobiomodul Photomed Laser Surg 2023; 41:291-296. [PMID: 37335620 DOI: 10.1089/photob.2022.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
Objective: This study aimed to evaluate the effectiveness of photon-induced photoacoustic streaming (PIPS), XP-endo Finisher (XPF), and passive ultrasonic irrigation (PUI) for the removal of root canal filling materials from oval root canals. Background: Various adjunctive irrigation techniques following mechanical preparation have been applied to enhance removal of fillings during root canal retreatment. However, whether there is superiority of one approach over others remains controversial. Methods: Thirty extracted single-rooted teeth with oval-shaped canals were instrumented with the ProTaper Next (PTN) system and obturated with the warm vertical compaction technique. After storage at 37°C for 1 month, retreatment was performed with the PTN system up to size X4. The teeth were then randomly assigned into three groups (n = 10) that were, respectively, subjected to supplementary irrigation with different protocols: PIPS, PUI, and XPF, followed by measurement of filling material volumes using high-resolution micro-computed tomography. Results: The PTN preparation resulted in significant reductions in residual filling materials (p < 0.05), whereas PIPS, PUI, and XPF moderately improved the removal of the remnants (p > 0.05). The residual filling materials after supplementary irrigation ranged from 0.384 ± 0.181 to 0.421 ± 0.143 mm3 in oval canals. There was no significant difference in the effectiveness among the PIPS, PUI, and XPF approaches (p > 0.05). Conclusions: Mechanical preparations are useful for removing most root fillings during retreatment in oval-shaped canals. PIPS can reduce residual root-filling materials to the similar extent as PUI and XPF.
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Affiliation(s)
- Xiao Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of Operative Dentistry and Endodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, China
| | - Dongmei Li
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of VIP Dental Care, and School of Stomatology, the Fourth Military Medical University, Xi'an, China
| | - Mengjiang Yang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of Operative Dentistry and Endodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, China
| | - Wei Wang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of Operative Dentistry and Endodontics, School of Stomatology, the Fourth Military Medical University, Xi'an, China
| | - Fan Yang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of Medical Rehabilitation, School of Stomatology, the Fourth Military Medical University, Xi'an, China
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Wylie ME, Parashos P, Fernando JR, Palamara J, Sloan AJ. Biological considerations of dental materials as orifice barriers for restoring root-filled teeth. Aust Dent J 2023; 68 Suppl 1:S82-S95. [PMID: 37607102 DOI: 10.1111/adj.12970] [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] [Accepted: 08/02/2023] [Indexed: 08/24/2023]
Abstract
There is ample published literature regarding the technical aspects of restoring root-filled teeth, but little concerning the biological impacts, consequences, and criteria for the selection of direct restorative materials following endodontic treatment. The provision of an effective coronal seal in addition to a sound root filling is known to be important in the prevention of root canal infection. This review seeks to explore the evidence concerning the selection of dental materials in the restoration of root-filled teeth, specifically with a close examination of the properties of commonly used materials as orifice barriers. © 2023 Australian Dental Association.
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Affiliation(s)
- M E Wylie
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - P Parashos
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - J R Fernando
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Oral Health Research, Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jea Palamara
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - A J Sloan
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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Wang FM, Rudman J, Walsh RM, Jalali P. A retrospective study of initial root canal treatment failure in maxillary premolars via using cone-beam computed tomography. J Am Dent Assoc 2023; 154:471-478. [PMID: 37236705 DOI: 10.1016/j.adaj.2023.02.012] [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: 11/04/2022] [Revised: 02/19/2023] [Accepted: 02/22/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND This case-series study examined canal morphology and common factors for endodontic failure in maxillary first and second premolars that were referred for retreatment owing to clinical symptoms or radiographic signs. METHODS Records were retrospectively searched using Current Dental Terminology codes to identify maxillary first and second premolars with endodontic failure. Periapical and cone-beam computed tomographic images were examined to determine Vertucci classifications and suspected factors related to treatment failure. RESULTS A total of 235 teeth from 213 patients were included for evaluation. The following Vertucci classification of canal configurations were observed for maxillary first and second premolars: type I (1-1) (4.6% and 32.0%, respectively), type II (2-1) (15.9% and 27.9%, respectively), type III (2-2) (76.1% and 36.1%, respectively), type IV (1-2) (0% and 2%, respectively), and type V (3) (3.4% and 2%, respectively). More treatment failures were noticed in maxillary second premolars than first premolars and in females than in males. The 4 most common factors related to failure were inadequate filling, restorative failure, vertical root fracture, and missed canals. Missed canals were more frequently identified in maxillary second premolars (21.8%) than first premolars (11.4%) (P = .044). CONCLUSIONS Multiple factors are associated with primary root canal treatment failures in maxillary premolars. Variations in canal morphology appear to be underappreciated in maxillary second premolars. PRACTICAL IMPLICATIONS Maxillary second premolars have more complicated canal configurations than first premolars. Besides adequate filling, clinicians should give extra attention to anatomic variability in second premolars owing to higher failure incidence.
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Tartari T, Wichnieski C, Silva RM, Letra A, Duarte MAH, Bramante CM. Final irrigation protocols can be used to promote stable long-term bond strength of AH Plus to dentin. J Appl Oral Sci 2023; 31:e20230005. [PMID: 37255081 DOI: 10.1590/1678-7757-2023-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/23/2023] [Indexed: 06/01/2023] Open
Abstract
Irrigation solutions might affect dentin surface characteristics and, consequently, endodontic sealers adhesion. This study analyzed the effect of different final irrigation protocols on push-out bond strength (BS) of AH Plus to dentin seven days and 20 months after obturation. Scanning electron micrographs were obtained from the dentin surface of one sample/group after final irrigation. Canals of bovine incisors were instrumented and received final irrigation with (n=21): G1 - 2.5% sodium hypochlorite (NaOCl) + distilled water; G2 - 2.5% NaOCl + 17% EDTA; G3 - 2.5% NaOCl + 17% EDTA + 2.5% NaOCl; G4 - 2.5% NaOCl + 17% EDTA + 2% chlorhexidine (CHX); G5 - mixture 5% NaOCl + 18% etidronate (HEDP); and G6 - mixture 5% NaOCl + 10% tetrasodium EDTA (Na4EDTA). After irrigation, one root/group was split and images were obtained by scanning electron microscopy (SEM). The other 20 roots/group were filled with only AH Plus sealer. Three slices/root were used for push-out assessment seven days and 20 months after obturation. One-way analysis of variance and Tukey (α<0.05) were used to compare the results among experimental groups, and unpaired t-test (α<0.05) was used to compare the results of the same group over time. The photomicrographs showed that, excepting G1, all groups completely removed the smear layer from the samples. In G2 and G4, the opening of the dentin tubules enlarged. In G3, erosion was observed in the peritubular and intertubular dentin. Values of the BS in the seven days were G2=G3=G4=G5>G6=G1 and in the 20 months were G3=G5>G6=G4>G1=G2. G3, G5, and G6 presented values of BS in 20 months similar to the values of seven days (P>0.05). The final irrigation protocols tested produced dentin surfaces with different characteristics. Only G3 and G5 presented high BS values that were stable over time.
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Affiliation(s)
- Talita Tartari
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Odontologia Restauradora, Piracicaba, SP, Brasil
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística Operatória, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | - Caroline Wichnieski
- Faculdade Herrero, Curso de Odontologia, Curitiba, PR, Brasil
- Pontifícia Universidade Católica, Departamento de Endodontia, Curitiba, PR, Brasil
| | - Renato Menezes Silva
- University of Pittsburgh, School of Dental Medicine, Department of Endodontics, Pittsburgh, PA, USA
| | - Ariadne Letra
- University of Pittsburgh, School of Dental Medicine, Department of Endodontics, Pittsburgh, PA, USA
- University of Pittsburgh, School of Dental Medicine, Department of Oral and Craniofacial Sciences, Pittsburgh, PA, USA
| | - Marco Antonio Hungaro Duarte
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística Operatória, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | - Clovis Monteiro Bramante
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística Operatória, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
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Sangita I, Vishwanath S, Sadasiva K, Ramachandran A, Thanikachalam Y, Ramya V. Influence of Simulated Wound Exudate on the Antimicrobial Efficacy of Various Intracanal Medicaments Against Enterococcus faecalis: An In Vitro Study. Cureus 2023; 15:e38677. [PMID: 37288182 PMCID: PMC10243671 DOI: 10.7759/cureus.38677] [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] [Accepted: 05/07/2023] [Indexed: 06/09/2023] Open
Abstract
Aim The aim of this study is to compare and evaluate the antimicrobial efficacy of chlorhexidine, calcium hydroxide, and cetylpyridinium chloride against Enterococcus faecalis in the presence and absence of contamination with simulated periapical exudate at different time intervals. Methods Simulated wound exudate and cetylpyridinium chloride gel were prepared prior to testing. The test groups were divided into groups A and B based on the presence and absence of simulated wound exudate. They were further divided into four subgroups as follows: subgroup 1: calcium hydroxide; subgroup 2: 2% chlorhexidine gel; subgroup 3: 0.5% cetylpyridinium chloride gel; subgroup 4: 0.9% saline as control. E. faecalis was inoculated, and the test groups were evaluated at different time periods of six, 12, and 24 hours. Aliquots were then obtained and subjected to 10-fold serial dilutions. A total of 10 µl of individual samples was spread onto the nutrient agar medium using L-rod. The plates were then assessed for colony-forming units (CFU), and the values obtained were subjected to statistical analysis. Kolmogorov-Smirnov and Shapiro-Wilk normality tests were used to check whether the variables follow a normal distribution. For within-group comparison, the Friedman test and the Kruskal-Wallis test were used. For between-group comparison, the Mann-Whitney U test was used. Results Saline had the highest CFU values, while cetylpyridinium chloride had the lowest CFU values in both contaminated and non-contaminated groups. In all the conditions, the CFU values of cetylpyridinium chloride were significantly lowest compared to the other three groups. CFU values of the calcium hydroxide group were significantly high, followed by the chlorhexidine group when compared to cetylpyridinium chloride in both contaminated and non-contaminated groups. Conclusion Within the limitations of the current study, it can be concluded that cetylpyridinium chloride was the most effective intracanal medicament against E. faecalis than calcium hydroxide and chlorhexidine at varying time intervals, even in the presence of a periapical exudate. Thus, cetylpyridinium chloride can be considered an effective intracanal medicament for root canal disinfection.
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Affiliation(s)
- Ilango Sangita
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Sankar Vishwanath
- Conservative Dentistry and Endodontics, KSR (K.S. Rangasamy) Institute of Dental Science and Research, Erode, IND
| | - Kadandale Sadasiva
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Anupama Ramachandran
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Yashini Thanikachalam
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Vengidesh Ramya
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
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Praveen Kumar V, Sadasiva K, Raj Kumar J, Ramachandran A, Parthasarathy R, Thanikachalam Y. Current Trends in Intentional Replantation Treatment Among Endodontists and Postgraduate Students in India, the United States of America, and the United Kingdom: A Cross-Sectional Study. Cureus 2023; 15:e39742. [PMID: 37398781 PMCID: PMC10310542 DOI: 10.7759/cureus.39742] [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] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Objective This study aimed to investigate the knowledge, attitude, and practices (KAP) of intentional replantation among postgraduate students and endodontists in India, the United States of America, and the United Kingdom. Materials and methods The sample size was estimated using G*Power. Based on the pilot study done before with 60 participants, a sample size of 928 was obtained. The survey consisted of 22 questions, which were finalized after content validation by two endodontic experts. It was circulated through multiple online social platforms such as Instagram, Facebook, WhatsApp, and other online dental communities/channels. The respondents were questioned about the case selection, extraction methods, antibiotic therapy, patient acceptance level, operator preference, prognostic indicator, and various other steps in the intentional replantation treatment modality. The data for this KAP survey were organized in an Excel sheet, and statistical analysis was done using the Chi-squared test. Analysis of descriptive and inferential statistics was conducted using SPSS version 20.0 (IBM Inc., Armonk, New York). A p-value of <0.05 was considered significant. Results A strong statistical difference was found in the KAP of the practitioners in different countries. The vast majority (72.7%) considered intentional replantation as an adjunct treatment modality rather than a last resort. A total of 76.5% of the respondents preferred replantation of the tooth into the socket within 15 minutes, and 86.4% of the participants regarded replantation as the most cost-effective treatment modality. Ultrasonics (76.8%) was most commonly chosen for retrograde preparation, and Biodentine (60.1%; Septodont, Saint-Maur-des-Fossés, France) as root-end filling material. Conclusion It can be concluded that a broad majority of practitioners in different countries view intentional replantation as an adjunct treatment modality rather than a last resort. Thus, intentional replantation seems to be a promising option for preserving the natural dentition of teeth with high survival rates and better outcomes.
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Affiliation(s)
| | - Kadandale Sadasiva
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Jwaalaa Raj Kumar
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Anupama Ramachandran
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
| | - Revathy Parthasarathy
- Conservative Dentistry and Endodontics, Sree Balaji Dental College and Hospital, Chennai, IND
| | - Yashini Thanikachalam
- Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND
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Seghayer I, Lee AHC, Cheung GSP, Zhang C. Effect of Passive Ultrasonic Irrigation, Er,Cr:YSGG Laser, and Photon-Induced Photoacoustic Streaming against Enterococcus faecalis Biofilms in the Apical Third of Root Canals. Bioengineering (Basel) 2023; 10:bioengineering10040490. [PMID: 37106677 PMCID: PMC10135464 DOI: 10.3390/bioengineering10040490] [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: 03/08/2023] [Revised: 04/08/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
PURPOSE This study aimed to compare the antibacterial effectiveness of passive ultrasonic irrigation (PUI), Er,Cr:YSGG laser (WTL), and photon-induced photoacoustic streaming (PIPS) using an Er:YAG laser against Enterococcus faecalis biofilms in the apical third of root canals. METHODS Root canals of 70 single-rooted human teeth were instrumented and infected with E. faecalis for 3 weeks to form biofilms. The samples were randomly divided into five groups as follows: (i) PUI + 3% NaOCl (n = 16); (ii) Er,Cr:YSGG laser (n = 16); (iii) PIPS + 3% NaOCl (n = 16); (iv) positive control group (n = 10); and (v) negative control group (n = 10). The bacterial content in the root canal was sampled using (a) the paper-point sampling method before (S1) and after (S2) treatment and (b) pulverising the apical 5 mm of the root. The number of bacteria recovered from each group was counted as colony-forming units (CFUs). The amount of reduction between the groups was compared with the Kruskal-Wallis test and post-test Dunn's multiple comparisons tests. The significance level was set at 5% (p < 0.05). RESULTS The samples from the paper-point sampling method showed that the amount of bacteria before (S1) and after treatment (S2) was significantly different between PIPS and WTL, as well as between the PUI and WTL groups. In contrast, no significant difference was found between the PIPS and PUI groups. From the pulverised samples, the results indicated no significant difference among all experimental groups in the amount of bacterial reduction in the apical 5 mm of the root. CONCLUSIONS PUI and PIPS showed a significantly greater reduction in bacterial content within the main root canal compared with the WTL. There was no difference among all experimental groups in the apical third of the root.
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Affiliation(s)
- Ibrahim Seghayer
- Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Angeline H C Lee
- Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Gary S P Cheung
- Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Chengfei Zhang
- Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Diogo P, Amparo F Faustino M, Palma PJ, Rai A, Graça P M S Neves M, Miguel Santos J. May carriers at nanoscale improve the Endodontic's future? Adv Drug Deliv Rev 2023; 195:114731. [PMID: 36787865 DOI: 10.1016/j.addr.2023.114731] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/29/2022] [Accepted: 02/08/2023] [Indexed: 02/16/2023]
Abstract
Nanocarriers (NCs) are dynamic nanovehicles used to transport bioactive derivatives like therapeutical formulations, drugs and/or dyes. The current review assists in understanding the mechanism of action of several recent developed NCs with antimicrobial purposes. Here, nine NCs varieties are portrayed with focus on nineteen approaches that are fulfil described based on outcomes obtained from in vitro antimicrobial assays. All approaches have previously been verified and we underline the biochemical challenges of all NCs, expecting that the present data may encourage the application of NCs in endodontic antimicrobial basic research. Methodological limitations and the evident base gaps made not possible to draw a definite conclusion about the best NCs for achieving efficient antimicrobial outcomes in endodontic studies. Due to the lack of pre-clinical trials and the scarce number of clinical trials in this emergent area, there is still much room for improvement on several fronts.
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Affiliation(s)
- Patrícia Diogo
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal.
| | - M Amparo F Faustino
- LAQV-REQUIMTE and Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Paulo J Palma
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Akhilesh Rai
- CNC - Center for Neuroscience and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal; Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | | | - João Miguel Santos
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine and Clinical Academic Center of Coimbra (CACC), 3000-548 Coimbra, Portugal
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Farrayeh A, Akil S, Eid A, Macaluso V, Mancino D, Haïkel Y, Kharouf N. Effectiveness of Two Endodontic Instruments in Calcium Silicate-Based Sealer Retreatment. Bioengineering (Basel) 2023; 10:bioengineering10030362. [PMID: 36978753 PMCID: PMC10045724 DOI: 10.3390/bioengineering10030362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023] Open
Abstract
The objective of the present in vitro work was to investigate the effectiveness and time required for the removal of calcium silicate-based sealer using two rotary retreatment systems. Sixty extracted, single-canal, lower premolars were used. After obturation using the single-cone technique with calcium silicate-based sealer, samples were divided into four groups according to the technique of desobturation: Group 1 (G1): D-Race; Group 2 (G2): D-Race followed by the use of XP–Endo Finisher R; Group 3 (G3): Protaper Universal Retreatment; and Group 4 (G4): Protaper Universal Retreatment followed by the use of XP–Endo Finisher R. Cone beam computed tomography (CBCT) images were used to calculate the remaining filling materials at the middle and apical thirds. Times required to perform each method were recorded. Scanning electron microscopy (SEM) and digital microscopy were used to evaluate the remaining filling materials. Data were statistically analyzed using the t-test and one way ANOVA on ranks tests. No statistically significant difference was found between G1 and G3 after CBCT observations (p > 0.05). Xp-Endo Finisher R significantly increased the ability to remove materials regardless of the initially used retreatment system (p < 0.05). Statistically significant longer time was found in G3 and G4 compared to G1 and G2, respectively (p < 0.05), to reach the full working length. No retreatment system was able to totally remove the calcium silicate-based sealer from the root canal at the middle and apical thirds (p > 0.05). Digital microscopy demonstrated that the residual materials were the remaining sealers on the canal walls. SEM showed the mineral depositions of calcium silicate materials onto the canal walls and into the dentinal tubules. However, that calcium silicate materials provide mineral deposition into the dentinal tubules might indicate that the traditional irrigants could not be sufficient to remove calcium silicate-based materials from the root canal, and other agents should be used to make retreatment considerably easier.
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Affiliation(s)
- Antoun Farrayeh
- Department of Endodontics, Faculty of Dental Medicine, Damascus University, Damascus 0100, Syria
| | - Samar Akil
- Department of Endodontics, Faculty of Dental Medicine, Damascus University, Damascus 0100, Syria
| | - Ammar Eid
- Department of Endodontics, Faculty of Dental Medicine, Damascus University, Damascus 0100, Syria
| | | | - Davide Mancino
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
- Department of Biomaterials and Bioengineering, INSERM UMR_S, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
| | - Youssef Haïkel
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
- Department of Biomaterials and Bioengineering, INSERM UMR_S, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
| | - Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Correspondence: ; Tel.: +33-(0)6-6752-2841
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LR S, Nirmala S, Reddy N, Chukka RR, Reddy SD, Kumar K N. Sterilization of New Endodontic Hand Files Stored in Dental Office Inventory: An In Vitro Study. Cureus 2023; 15:e36116. [PMID: 37065374 PMCID: PMC10099112 DOI: 10.7759/cureus.36116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 03/15/2023] Open
Abstract
Background and objective Endodontic files, as supplied by the manufacturers to the endodontists, are not pre-sterile routinely. For both new and used equipment, rotary as well as manual, autoclaving is the standard sterilization protocol used in clinical and academic practice. In dentistry, instrument sterilization aims to safeguard patients from cross-contamination through instruments. Hence, every device should be thoroughly cleaned and sterilized. In this study, we aimed to evaluate the presence of various microorganisms in sealed and unsealed stored packs in dental offices and the probable impact of pre-sterilization procedures on the survival of these microorganisms. Materials and methods Two groups of root canal files varying in their packing method, boxes (Mani stainless steel K-files, ISO 25, length 25 mm) and blister packs (UGD, ISO 25, length 25 mm), pre-sterile, opened/unopened were chosen and stored for about two weeks in the dental office and were classified into three groups based on their storage and further classified into subgroups depending on their packing modes as follows: Group-1 (unopened and stored in shelf for two weeks), Subgroup-1A (boxes), Subgroup-1B (blister packs); Group-2 (unopened and stored on the countertop for two weeks), Subgroup-2A (boxes), Subgroup-2B (blister packs); Group-3 (opened and stored on the countertop for two weeks). After two weeks of storage, a set of three new files from each pack, both boxes and blisters, were placed in the nutrient broth to assess the turbidity and later cultured to assess the presence/absence and type of any bacterial growth. All the instruments in the three groups and subgroups were placed separately in the nutrient broth and carried to the microbiology lab for bacterial cultures. The entire procedure was carried out under the laminar flow. All these files in the nutrient broth were incubated for about 72 hours and the turbidity was assessed, and then the turbid bacteria were cultured on blood agar and MacConkey agar plates for the presence/absence and the type of bacteria in each group and subgroups. Results All specimens, both opened/unopened boxes and blister packs, after about two weeks of storage, were cultured and observed for contamination. All the tested files groups showed bacterial culture growth both on blood agar and MacConkey agar plates. Group-1 (Subgroups 1A, 1B) boxes and blister packs unopened and stored on the shelf for two weeks demonstrated aerobic spore bacilli; Group-2 (Subgroups 2A, 2B) boxes and blister packs unopened and stored on the countertop for two weeks demonstrated Gram-positive bacilli; Group-3 opened boxes and blisters stored on the countertop for two weeks demonstrated Micrococci and Gram-negative bacilli. Conclusion In the present study, all the packs, blisters and boxes, demonstrated the presence of bacterial growth irrespective of their storage in the dental office. Hence, in order to prevent any new infections from the operating field, sterilization of not only the old files but also the pre-sterilization of new files should be made mandatory.
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