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Er Karaoğlu G, Aydın ZU. The effect of different irrigation activation methods on the penetration of the irrigation solution into the dentinal tubules in teeth with calcium hydroxide applied and oval-shaped canals: Confocal laser scanning microscope analysis. Microsc Res Tech 2024; 87:2194-2203. [PMID: 38716871 DOI: 10.1002/jemt.24594] [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: 09/16/2023] [Revised: 01/30/2024] [Accepted: 04/25/2024] [Indexed: 08/02/2024]
Abstract
This study aimed to evaluate the efficacy of different irrigation techniques including standard needle irrigation (SNI), passive ultrasonic irrigation (PUI), EndoActivator (EA), XP-Endo Finisher (XPF), photon-induced photoacoustic streaming (PIPS), and shock wave enhanced emission photo-acoustic streaming (SWEEPS) systems on the penetration of irrigation solutions into dentinal tubules in teeth with calcium hydroxide (CH) applied and oval-shaped canals by confocal laser scanning microscope (CLSM). Ninety mandibular incisor teeth with oval-shaped canals were included in this study. After the preparation of teeth using Resiproc Blue R25 (VDW, Munich, Germany) canals were filled with a paste based on CH. The teeth were stored in 100% humidity at a temperature of 37°C for 14 days. According to the irrigation activation systems, the teeth were divided into six groups (n = 15); SNI, PUI, EA, XPF, PIPS, and SWEEPS. In each group, 3 irrigation/activation cycles of 20 s of irrigation and 20 s of activation were performed with the relevant activation method. The root canals were filled with fluorescein sodium (Sigma, Alldrich Co., St. Louis, MO, USA) and activated with the relevant activation method for 30 s. Specimens were sectioned horizontally to 1 ± 0.1 mm at 2, 5, and 8 mm from the apex and then examined under the CLSM. Maximum penetration depth, maximum penetration area and penetration percentage were measured by using Image J software. Data were analyzed using a two-way analysis of variance (ANOVA) and posthoc Tukey tests (p = .05). No difference was found between the activation systems in terms of maximum penetration depth and maximum penetration area of irrigation solutions in the apical section (p > .05). The penetration percentage of irrigation solutions was higher in PUI and PIPS compared with EA and XPF at the apical section (p < .05). No difference was found between SNI, PUI, PIPS, and SWEEPS in terms of the penetration percentage of irrigation solutions in all sections (p > .05). The penetration percentage of irrigation solutions was higher in the middle and coronal sections compared to the apical section in EA and XPF (p < .05). Tubule penetration of irrigation solutions in SNI was similar between sections. The Tubule penetration area of irrigation solutions in PUI, EA, XPF, PIPS, and SWEEPS was lower in the apical section than in the middle and coronal sections. RESEARCH HIGHLIGHTS: The tubule penetration depth and area of the irrigation solutions were similar between the activation systems tested in the apical sections. The Tubule penetration area of irrigation solutions in middle and coronal sections was higher in PUI and PIPS than in SNI.
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Affiliation(s)
- Gamze Er Karaoğlu
- Department of Endodontics, Faculty of Dentistry, University of Izmir Katip Celebi, Izmir, Turkey
| | - Zeliha Uğur Aydın
- Department of Endodontics, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey
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Furuncuoğlu F, Uğur Aydın Z, Doğan Çankaya T, Ocak MG. Evaluation of the efficacy of different irrigation activation techniques in removing of calcium hydroxide on teeth with the simulated internal root resorption cavity: a confocal laser scanning microscope analysis. Lasers Med Sci 2024; 39:213. [PMID: 39129047 DOI: 10.1007/s10103-024-04167-z] [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: 11/17/2023] [Accepted: 07/31/2024] [Indexed: 08/13/2024]
Abstract
The aim of this study is to evaluate the effect of different irrigation activation methods on root canal sealer penetration in teeth with simulated internal root resorption (IRR) and calcium hydroxide (CH) applied using a confocal laser scanning microscope (CLSM). 60 incisors with a single root and a single canal were included in the study. IRR cavities were created in the middle third of the root canal, and CH was placed. The samples were randomly divided into 4 groups (n = 15) according to the irrigation activation method to be tested: standard needle irrigation (SNI), sonic activation (EDDY), photon-induced photoacoustic flow (PIPS), and shock wave enhanced emission photoacoustic flow (SWEEPS). After irrigation activation applications, the root canals were obturated. Sections of 1.0 ± 0.1 mm were taken from the apical, middle, and coronal regions of each sample. The penetration area (µm2) and maximum penetration depth (µm) of the root canal sealer were examined by CLSM and analyzed using ImageJ software. Statistical analysis was performed with a one-way ANOVA and post-hoc Tukey test at the P < 0.05 significance level. Among all irrigation activation methods tested, both the penetration area and maximum penetration depth of the root canal sealer were greater in the coronal region than in the apical region (p < 0.05). In the IRR region, there was no difference in terms of maximum penetration depth between PIPS and SWEEPS (p > 0.05), it was highest in SWEEPS (p < 0.05). PIPS and SWEEPS were better than other irrigation activation methods in the penetration of root canal sealer in the resorption areas of teeth with IRR.
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Affiliation(s)
- Fatma Furuncuoğlu
- Faculty of Dentistry, Department of Endodontics, Sakarya University, Sakarya, Turkey
| | - Zeliha Uğur Aydın
- Gülhane Faculty of Dentistry, Department of Endodontics, Health Sciences University, Ankara, Turkey
| | - Tülin Doğan Çankaya
- Faculty of Dentistry, Department of Endodontics, Alanya Alaaddin Keykubat University, Antalya, Turkey.
| | - Mehmet Görkem Ocak
- Faculty of Dentistry, Department of Endodontics, Bolu Abant İzzet Baysal University, Bolu, Turkey
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Jafari Semnani S, Moghadam KN, Jafari Z, Chiniforush N. Comparative effects of the conventional, ultrasonic, and laser-activated irrigation on penetration depth of three photosensitizers in the root canal system. Photodiagnosis Photodyn Ther 2024; 49:104286. [PMID: 39053791 DOI: 10.1016/j.pdpdt.2024.104286] [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: 06/26/2024] [Revised: 07/20/2024] [Accepted: 07/22/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVES This study compared the effects of conventional, ultrasonic, and laser-activated irrigation (LAI) on penetration depth of three photosensitizers (PSs) in the root canal system. MATERIALS AND METHODS In this in vitro, experimental study, 120 extracted anterior teeth were decoronated such that the remaining root length was standardized at 12 mm. After root canal instrumentation with the ProTaper rotary system and irrigation with 5.25% NaOCl, the roots were assigned to 12 groups for the application of toluidine blue (TB), curcumin, and phycocyanin PSs combined with the LAI using erbium laser with 0.4 mm and 0.6 mm tips, ultrasonic activation, and conventional irrigation. The specimens were sectioned apicocoronally, and the dye penetration depth was quantified in the coronal, middle, and apical thirds under a stereomicroscope at x20 magnification. Data were analyzed by the Kruskal-Wallis and Dunn test (alpha=0.05). RESULTS The effects of irrigation technique, PS type, and their interaction on dye penetration depth were significant at the apical, middle, and coronal thirds (P < 0.0001). TB + LAI with 0.4- and 0.6-mm laser tips showed the highest penetration depth while phycocyanin + LAI or conventional irrigation showed the lowest penetration depth at all areas. Dye penetration depth was the highest in the coronal, and the lowest in the apical third. CONCLUSION The LAI technique with erbium laser (0.4- and 0.6-mm tips) enhanced the penetration depth of TB. The tested irrigation techniques had no significant efficacy for enhancement of the penetration depth of curcumin and phycocyanin.
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Affiliation(s)
| | | | - Zahra Jafari
- Department of Endodontics, Dental school, Shahed University, Tehran, Iran
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Hepsenoglu YE, Ersahan S, Erkan E, Gundogar M, Ozcelik F. Is SWEEPS better than PUI in reducing intracanal bacteria and inflammation in cases of apical periodontitis? Lasers Med Sci 2024; 39:182. [PMID: 39012553 PMCID: PMC11252177 DOI: 10.1007/s10103-024-04117-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 06/24/2024] [Indexed: 07/17/2024]
Abstract
To evaluate the efficacy of SWEEPS mode of the Er: YAG laser(SL) and passive ultrasonic irrigation(PUI) in the eradication of microorganisms and in the inflammation detection by IL-1β. Thirty patients with chronic apical periodontitis(AP) were allocated into two groups: Group SL-SWEEPS laser activated irrigation(n = 15) and Group PUI-passive ultrasonic irrigation(n = 15). Bacteriological samples were taken before(S1) and after chemomechanical preparation(S2), and then after final irrigation activation(S3). The levels of total bacteria and Streptococci were measured by means of PCR. Blood samples were collected before and 3rd day after treatment. Enzyme-linked immunosorbent assay was used to measure the levels of IL-1β. The bacterial reduction showed no differences between groups after chemo-mechanical treatment and after irrigant activation(p = 0.590). Post-treatment IL-1β levels were lower than pretreatment levels in both groups(p < 0.001). SL or PUI application in addition to chemomechanical preparation has similar effects on total bacterial level and inflammation detected by IL-1β in patients with AP.
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Affiliation(s)
- Yelda Erdem Hepsenoglu
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey
| | - Seyda Ersahan
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey.
| | - Erhan Erkan
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey
| | - Mustafa Gundogar
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Birlik Mah. Bahçeler Cad. No: 5 Esenler, Istanbul, Turkey
| | - Fatih Ozcelik
- Department of Medical Biochemistry Department, Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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Meire M, De Moor RJG. Principle and antimicrobial efficacy of laser-activated irrigation: A narrative review. Int Endod J 2024; 57:841-860. [PMID: 38340037 DOI: 10.1111/iej.14042] [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: 11/01/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
In the last two decades, the activation of root canal irrigants with pulsed lasers as an adjunct in root canal treatment has become increasingly popular. This narrative review explains the physical basics and the working mechanism of laser-activated irrigation (LAI), explores the parameters influencing LAI efficacy, considers historical evolutions in the field and summarizes laboratory and clinical evidence with emphasis on the antimicrobial action of LAI. Cavitation is the driving force behind LAI, with growing and imploding vapour bubbles around the laser tip causing various secondary phenomena in the irrigant, leading to intense liquid dynamics throughout the underlying root canal. High-speed imaging research has shown that laser wavelength, pulse energy, pulse length and fibre tip geometry are parameters that influence this cavitation process. Nevertheless, this has not resulted in standardized settings for LAI. Consequently, there is significant variability in studies assessing LAI efficacy, complicating the synthesis of results. Laboratory studies in extracted teeth suggest that, with regard to canal disinfection, LAI is superior to conventional irrigation and there is a trend of higher antimicrobial efficacy of LAI compared to ultrasonic activation. Clinical evidence is limited to trials demonstrating similar postoperative pain levels after LAI versus no activation or ultrasonic activation. Clinical evidence concerning the effect of LAI on healing of apical periodontitis as yet is scarce.
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Affiliation(s)
- Maarten Meire
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
| | - Roeland J G De Moor
- Department of Oral Health Sciences, Section of Endodontology, Ghent University, Ghent, Belgium
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Abat VH, Bayrak GD, Gündoğar M. Assessment of apical extrusion in regenerative endodontics: a comparative study of different irrigation methods using three-dimensional immature tooth models. Odontology 2024:10.1007/s10266-024-00961-x. [PMID: 38913232 DOI: 10.1007/s10266-024-00961-x] [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: 04/13/2024] [Accepted: 06/04/2024] [Indexed: 06/25/2024]
Abstract
To investigate the apical extrusion of sodium hypochlorite in immature permanent teeth caused by conventional syringe irrigation (CSI), EDDY, XP-endo Finisher file (XP-F), and a new laser irrigation activation system [shock-wave-enhanced-emission-photo-acoustic-streaming (SWEEPS)]. Three-dimensionally printed forty-nine teeth with immature central incisor morphology were randomly assigned to seven experimental groups, based on the irrigation activation methods and insertion depths (1 mm and 2 mm short of the working length) as follows: CSI-1, CSI-2, EDDY-1, EDDY-2, XP-1, XP-2, and SWEEPS. Prior to the irrigation activation process, samples were placed in metacresol mixed agar gel in Eppendorf tubes. To evaluate NaOCI extrusion into the gel, each sample was digitally photographed, and the area of apical extrusion was analyzed using ImageJ software. To examine potential significant differences between the continuous variables, the Mann-Whitney U test and Kruskal-Wallis H test, were applied (P = .05). The SWEEPS resulted in a greater amount of apical extrusion compared to the CSI method, regardless of the insertion depth (P < 0.001). The SWEEPS resulted in greater apical extrusion scores compared to EDDY-2 (P < 0.001). The EDDY-1 resulted in greater amount of apical extrusion scores compared to EDDY-2 (P < 0.001). This study, the first to show the effect of the novel SWEEPS technology on NaOCI extrusion, found that irrigation activation can cause different levels of apical extrusion depending on the method and distance from the working length. It is crucial to consider the potential occurrence of apical extrusion when applying activation methods to immature teeth.
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Affiliation(s)
- Vahide Hazal Abat
- Department of Endodontics, Faculty of Dentistry, Uskudar University, Istanbul, Turkey.
| | - Gökçen Deniz Bayrak
- Department of Pediatric Dentistry, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Mustafa Gündoğar
- Department of Endodontics, Faculty of Dentistry, Medipol University, Istanbul, Turkey
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Myint PYA, Watanabe S, Okiji T. Comparative Effectiveness of Different Er:YAG Laser-Activated Irrigation Systems on Removing Calcium Hydroxide from Simulated Internal Root Resorption Cavities at Different Root Levels. Photobiomodul Photomed Laser Surg 2024; 42:480-487. [PMID: 38836513 DOI: 10.1089/pho.2024.0057] [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] [Indexed: 06/06/2024] Open
Abstract
Objective: To investigate the effectiveness of Er:YAG laser-activated irrigation (LAI) with a short pulse duration for removing calcium hydroxide (CH) from simulated internal root resorption (IRR) cavities at three root levels. Background: Pulse duration is an important parameter during LAI, which ensures the efficiency of irradiation and the corresponding activation process. Short pulses in the range of a few microseconds enable rapid expansion and successive implosion of irrigants, resulting in distinct fluid movement. There have been few reports on CH removal efficacy from IRR cavities of different LAI systems, including those using short pulse duration. Methods: IRR cavities (1.6 mm diameter) were created at the apical, middle, and coronal root levels in 60 mandibular premolars and filled with a radiopaque CH paste. Samples were assigned to the following irrigation groups (n = 12, each): (1) LAI(P)-F, a prototype laser device that operates with short pulse duration (Morita Manufacturing) with a flat tip; (2) LAI(EA)-F, the ErwinAdverl laser device (Morita Manufacturing) with a flat tip; (3) LAI(EA)-T, the ErwinAdverl laser device with a tapered tip; (4) PIPS-T, the Lightwalker laser device (Fotona) with a tapered tip; and (5) SI, the syringe irrigation group. The laser tips were fixed at the canal entrance. The remaining CH volume and surface area were assessed in IRR cavities using micro-computed tomography and scanning electron microscopy, respectively. Data were statistically analyzed utilizing one-way analysis of variance and Tukey's test at 5% significance level. Results: The LAI(P)-F and PIPS-T groups exhibited the highest CH removal rates at three different levels (p < 0.05). The LAI(EA)-F group had a significantly better efficacy of CH removal compared with the LAI(EA)-T group at the middle level (p < 0.05). Conclusion: The LAI(P)-F and PIPS-T groups demonstrated superior efficiency in removing CH from simulated IRR cavities.
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Affiliation(s)
- Phu Yadanar Aung Myint
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Satoshi Watanabe
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takashi Okiji
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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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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Katunarić A, Grgac SF, Gabrić D, Pavelić B, Bago I. Effect of sodium hypochlorite and ethylenediaminotetraacetic acid activated by laser and ultrasonic energy on surface morphology and chemical composition of intracanal dentin. Microsc Res Tech 2024; 87:818-831. [PMID: 38100184 DOI: 10.1002/jemt.24474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 11/03/2023] [Accepted: 12/05/2023] [Indexed: 03/02/2024]
Abstract
The aim of the study was to evaluate the structural and chemical changes in intracanal dentin after root canal irrigation with sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) using additional activation with a novel Er:YAG Shock Wave-Enhanced Emission Photoacoustic Streaming (SWEEPS), ultrasonic irrigation (UI), and Nd:YAG irradiation. Root canals of extracted human premolars were instrumented with distilled water and distributed into groups according to the irrigation protocol used: Group 1: conventional needle irrigation (CI) with 3% NaOCl; group 2: CI with 15% EDTA; and group 3: CI with NaOCl+EDTA. In group 4, root canals were irrigated with NaOCl+EDTA+NaOCl using the following techniques: CI (group 4A), SWEEPS (group 4B), UI (group 4C). In group 4D, root canals were finally irradiated with Nd:YAG laser. After the irrigation, the intracanal dentin sample was collected and analyzed using spectroscope with a Fourier transformation of infrared spectrum in Attenuated total reflection technique (FTIR-ATR) to calculate apatite/collagen ratio. Scanning electron microscopy (SEM) and energy dispersive x-ray spectrometry (EDS) were used to determine its chemical composition. FTIR-ATR showed no significant difference in the phosphate/amid I ratio between the control and the experimental groups (p > 0.05). SWEEPS and UI of NaOCl+EDTA+NaOCl caused the most pronounced decrease of Ca and P (p < 0.05) value compared to CI and control group, and canal wall erosion. SWEEPS and UI of NaOCl+EDTA+NaOCl caused the most pronounced decrease of Ca and P value and significant canal wall erosion. However, no difference in phosphate/amide ratio was reported among groups. RESEARCH HIGHLIGHTS: SWEEPS and UI of NaOCl+EDTA+NaOCl caused the most pronounced decrease of Ca and P values and significant canal wall erosion. There was no difference in phosphate/amide ratio among the irrigation protocols.
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Affiliation(s)
- Adriana Katunarić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Dragana Gabrić
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Božidar Pavelić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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Bao P, Liu H, Yang L, Zhang L, Yang L, Xiao N, Shen J, Deng J, Shen Y. In vitro efficacy of Er:YAG laser-activated irrigation versus passive ultrasonic irrigation and sonic-powered irrigation for treating multispecies biofilms in artificial grooves and dentinal tubules: an SEM and CLSM study. BMC Oral Health 2024; 24:261. [PMID: 38389109 PMCID: PMC10882935 DOI: 10.1186/s12903-024-04042-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/17/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Multispecies biofilms located in the anatomical intricacies of the root canal system remain the greatest challenge in root canal disinfection. The efficacy of Er:YAG laser-activated irrigation techniques for treating multispecies biofilms in these hard-to-reach areas has not been proved. The objective of this laboratory study was to evaluate the effectiveness of two Er:YAG laser-activated irrigation techniques, namely, photon-induced photoacoustic streaming (PIPS) and shock wave-enhanced emission photoacoustic streaming (SWEEPS), in treating multispecies biofilms within apical artificial grooves and dentinal tubules, in comparison with conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI), and sonic-powered irrigation (EDDY). Two types of multispecies root canal biofilm models were established in combination with two assessment methods using scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM) with the aim to obtain more meaningful results. METHODS Ninety extracted human single-rooted premolars were chosen for two multispecies biofilm models. Each tooth was longitudinally split into two halves. In the first model, a deep narrow groove was created in the apical segment of the canal wall. After cultivating a mixed bacterial biofilm for 4 weeks, the split halves were reassembled and subjected to five irrigation techniques: CNI, PUI, EDD, PIPS, and SWEEPS. The residual biofilms inside and outside the groove in Model 1 were analyzed using SEM. For Model 2, the specimens were split longitudinally once more to evaluate the percentage of killed bacteria in the dentinal tubules across different canal sections (apical, middle, and coronal thirds) using CLSM. One-way analysis of variance and post hoc multiple comparisons were used to assess the antibiofilm efficacy of the 5 irrigation techniques. RESULTS Robust biofilm growth was observed in all negative controls after 4 weeks. In Model 1, within each group, significantly fewer bacteria remained outside the groove than inside the groove (P < 0.05). SWEEPS, PIPS and EDDY had significantly greater biofilm removal efficacy than CNI and PUI, both from the outside and inside the groove (P < 0.05). Although SWEEPS was more effective than both PIPS and EDDY at removing biofilms inside the groove (P < 0.05), there were no significant differences among these methods outside the groove (P > 0.05). In Model 2, SWEEPS and EDDY exhibited superior bacterial killing efficacy within the dentinal tubules, followed by PIPS, PUI, and CNI (P < 0.05). CONCLUSION Er:YAG laser-activated irrigation techniques, along with EDDY, demonstrated significant antibiofilm efficacy in apical artificial grooves and dentinal tubules, areas that are typically challenging to access.
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Affiliation(s)
- Pingping Bao
- School and Hospital of Stomatology, Tianjin Medical University, Tianjin, 300070, China
- Department of Endodontics, School of Medicine, Tianjin Stomatological Hospital, Nankai University, Tianjin, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China
| | - He Liu
- Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Lan Yang
- Hangzhou Stomatological Hospital, Hangzhou, China
| | - Lulu Zhang
- Department of Endodontics, School of Medicine, Tianjin Stomatological Hospital, Nankai University, Tianjin, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China
| | - Liwei Yang
- Department of Endodontics, School of Medicine, Tianjin Stomatological Hospital, Nankai University, Tianjin, China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China
| | - Nannan Xiao
- State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China
| | - Jing Shen
- Department of Endodontics, School of Medicine, Tianjin Stomatological Hospital, Nankai University, Tianjin, China.
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, 300041, China.
| | - Jiayin Deng
- School and Hospital of Stomatology, Tianjin Medical University, Tianjin, 300070, China.
| | - Ya Shen
- Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
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Cheung MC, Peters OA, Parashos P. Global survey of endodontic practice and adoption of newer technologies. Int Endod J 2023; 56:1517-1533. [PMID: 37800848 DOI: 10.1111/iej.13982] [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: 07/14/2023] [Revised: 09/07/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
AIM To investigate current endodontic practices, adoption of technologies and continuing education attendance within specialist endodontic practice globally and to identify geographic trends. METHODOLOGY A web-based survey of endodontic association members in Australia, Britain, Canada, Italy, New Zealand and the USA on routine treatment preferences, armamentarium and education attendance was conducted. Chi-squared, independent sample t-tests, Cochran's Q test and McNemar's test were performed. RESULTS The survey was completed by 543 endodontists or endodontic post-graduate students. Almost all respondents used the dental operating microscope (DOM, 91.3%), engine-driven nickel-titanium instruments (NiTi, 97.6%), electronic apex locators (EAL, 93.0%), cone-beam computed tomography (CBCT, 91.2%) and calcium silicate-based materials (CSBMs, 93.7%). Dental dam was always used by 99.1%. Over half used irrigation adjuncts (81.8%), warm vertical compaction (74.6%) and heat-treated NiTi (60.2%). Geographic comparison between AP (Asia-Pacific, n = 78), AM (Americas, n = 402) and EM (Europe and Middle East, n = 63) was performed. AM and EM preferred single-visit treatment more (p < .001) and used higher sodium hypochlorite concentrations than AP. AM had more access to CBCT in the workplace (86.6%) than AP (65.4%, p < .001) and used CBCT for routine preoperative assessment (39.6%) more than EM (7.3%, p < .001). Almost all of EM used irrigation adjuncts (95.2%), more than AM (78.1%, p = .001). AP used steroid/antibiotic medicaments most (p < .001) and had the highest attendance at continuing education programmes. CONCLUSION Several endodontic-specific armamentaria have reached almost complete adoption within global specialist endodontic practice, whilst the continued uptake of newer technologies should be followed over time. Some practising philosophies varied significantly across different geographic regions.
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Affiliation(s)
| | - Ove Andreas Peters
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Peter Parashos
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
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Silva WO, Amoroso-Silva P, Olivares P, Alcalde MP, Alves FRF, Marceliano-Alves MF. Enhancing debris removal in curved canals: a comparative evaluation of XP-endo Finisher and Passive Ultrasonic Irrigation. Clin Oral Investig 2023; 27:7523-7529. [PMID: 37910237 DOI: 10.1007/s00784-023-05342-2] [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: 08/03/2023] [Accepted: 10/14/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVES The study aimed to compare the efficacy of XP-endo Finisher and Passive Ultrasonic Irrigation (PUI) in removing hard tissue debris from curved canals. MATERIALS AND METHODS Thirty-four mandibular molars with Vertucci's type II mesial canals were scanned in microcomputed tomography before and after preparation with HyFlex EDM, and accumulated hard tissue debris was quantified. Subsequently, the teeth were randomly divided into two groups according to the supplementary procedure: PUI with the Ultra-X insert or XP-endo Finisher. After the intervention, the specimens underwent another scanning. Two separate analyses were conducted, one for the total canal and another for the isthmus area. Unpaired and paired T-tests were used for inter- and intergroup comparisons, with a significance level set at 5%. RESULTS Both supplementary methods reduced the amount of debris compared to the initial volume. Remarkably, the XP-endo Finisher achieved a significantly higher percentage of debris removal (71% for the total canal and 74% for the isthmus areas) compared to PUI (41% for the total canal and 52% for the isthmus area) (P < 0.05). CONCLUSIONS Both supplementary approaches reduced the amount of hard tissue debris from canal preparation, still XP-endo Finisher showed a higher reduction compared to PUI (p < 0.05). CLINICAL RELEVANCE None of the supplementary methods rendered canals completely free of hard tissue debris. However, the supplementary approach with XP-endo Finisher resulted in lower levels of hard tissue debris than PUI in curved canals with isthmuses.
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Affiliation(s)
- Warley Oliveira Silva
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
- Federal University of Valley of Jequitinhonha and Mucuri (UFVJM), Diamantina, Brazil
| | - Pablo Amoroso-Silva
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Patrícia Olivares
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Murilo Priori Alcalde
- Faculty of Dentistry of Bauru, Department of Dentistry, Endodontics and Dental Materials, University of São Paulo, Bauru, SP, Brazil
| | - Flávio Rodrigues Ferreira Alves
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
- Department of Endodontics and Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Av. Abílio Augusto Távora, 2134, Nova Iguaçu, RJ, 26260-045, Brazil
| | - Marília Fagury Marceliano-Alves
- Department of Endodontics and Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Av. Abílio Augusto Távora, 2134, Nova Iguaçu, RJ, 26260-045, Brazil.
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13
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Shahi Ardakani A, Afrasiabi S, Sarraf P, Benedicenti S, Solimei L, Chiniforush N. In Vitro Assessment of SWEEPS and Antimicrobial Photodynamic Therapy Alone or in Combination for Eradicating Enterococcus faecalis Biofilm in Root Canals. Pharmaceutics 2023; 15:2628. [PMID: 38004605 PMCID: PMC10674832 DOI: 10.3390/pharmaceutics15112628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVES This study investigates the efficacy of antimicrobial photodynamic therapy (aPDT) using riboflavin and a blue diode laser (BDL), combined with shock wave-enhanced emission photoacoustic streaming (SWEEPS), against Enterococcus faecalis. MATERIALS AND METHODS A total of 48 extracted single-rooted human teeth were used. The root canals were instrumented, sealed at their apices, had the smear layer removed, and then underwent autoclave sterilization. Subsequently, each canal was inoculated with E. faecalis bacterial suspension and allowed to incubate for ten days. After confirming the presence of biofilms through scanning electron microscopy (SEM) in three teeth, the remaining teeth were randomly allocated into nine groups, each containing five teeth: control, 5.25% sodium hypochlorite (NaOCl), BDL, SWEEPS + normal saline, SWEEPS + NaOCl, riboflavin, riboflavin + SWEEPS, riboflavin + BDL, and riboflavin + BDL + SWEEPS. After the treatment, the numbers of colony-forming units (CFUs)/mL were calculated. The data were analysed using one-way ANOVA followed by Tukey's test for comparisons. RESULTS All groups, with the exception of the BDL group, exhibited a significant reduction in E. faecalis CFU/mL when compared to the control group (p < 0.001). The difference in CFU/mL value between riboflavin + BDL + SWEEPS and riboflavin + SWEEPS was significant (p = 0.029), whereas there was no significant difference between riboflavin + BDL + SWEEPS and riboflavin + BDL (p = 0.397). Moreover, there was no statistically significant difference between the riboflavin + SWEEPS group and the riboflavin + BDL group (p = 0.893). CONCLUSIONS The results demonstrated that combining the SWEEPS technique with riboflavin as a photosensitizer activated by BDL in aPDT effectively reduced the presence of E. faecalis in root canals.
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Affiliation(s)
- Ali Shahi Ardakani
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1441987566, Iran;
| | - Shima Afrasiabi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1441987566, Iran;
| | - Pegah Sarraf
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran 1441987566, Iran;
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (S.B.); (L.S.)
| | - Luca Solimei
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (S.B.); (L.S.)
| | - Nasim Chiniforush
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (S.B.); (L.S.)
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Donnermeyer D, Averkorn C, Bürklein S, Schäfer E. Cleaning Efficiency of Different Irrigation Techniques in Simulated Severely Curved Complex Root Canal Systems. J Endod 2023; 49:1548-1552. [PMID: 37586645 DOI: 10.1016/j.joen.2023.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/08/2023] [Accepted: 08/08/2023] [Indexed: 08/18/2023]
Abstract
INTRODUCTION To compare the biofilm-mimicking hydrogel removal efficiency of laser-activated irrigation (LAI) with five other irrigation techniques in simulated curved root canals with lateral canals. METHODS Three-dimensional-printed root canal models (60°-curvature, radius 5 mm; dimension 25/.06) with a total length of 20 mm and lateral canals in all directions at 2, 5, and 8 mm (diameter 0.2 mm) from the apex were filled with a colored biofilm-mimicking hydrogel. The following protocols (each 3 × 20 seconds continuous irrigation with distilled water 3 ml/20 seconds; n = 20) were carried out: conventional needle irrigation; manual agitation ([MA], gutta-percha point 25/.06); EndoActivator (=sonically-activated irrigation EndoActivator, 25/.04); EDDY (=sonically-activated irrigation EDDY [SAI-E]; 25/.04); ultrasonically-activated irrigation and LAI (Erbium-doped Yttrium Aluminum Garnet laser; P400FL tip at canal entrance; 25 pps, 50 mJ, 300 μs). Standardized photos were taken with a microscope and the removal of the hydrogel was determined as a percentage for the entire system, the main canal and the lateral canals. Statistical analysis was performed using analysis of variance and Scheffé test (P = .05). RESULTS LAI (89.3% ± 5.9%) showed the greatest hydrogel removal followed by SAI-E (65.5% ± 3.3%) and ultrasonically-activated irrigation (59.1% ± 4.7%), with significant differences between these groups (P < .05). Needle irrigation, MA, and sonically-activated irrigation EndoActivator performed equally (P > .05) and obtained the significantly lowest values (P < .05). LAI and SAI-E showed the significantly best hydrogel removal from the main canal (P < .05). At all three levels, LAI removed significantly more hydrogel from the lateral canals than all other techniques (P < .05). CONCLUSIONS LAI was superior to other techniques in both the entire system and the lateral canals in removing the hydrogel. SAI-E achieved comparable results in the main canal.
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Affiliation(s)
- David Donnermeyer
- Department of Periodontology and Operative Dentistry, University of Münster, Münster, Germany
| | - Christin Averkorn
- 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
| | - Edgar Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany.
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Plotino G, Özyürek T, Gündoğar M, Uslu G, Pedullà E, Careddu R, Franco V. Efficacy of different irrigant activation devices in removing dentin debris from an artificial isthmus connecting curved canals. AUST ENDOD J 2023; 49 Suppl 1:353-358. [PMID: 36960975 DOI: 10.1111/aej.12748] [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: 01/13/2022] [Revised: 01/27/2023] [Accepted: 03/06/2023] [Indexed: 03/25/2023]
Abstract
The aim of this study was to evaluate the debridement efficacy of sonic irrigation (EDDY; VDW, Munich, Germany and EndoActivator; Dentsply-Sirona, Ballaigues, Switzerland) and ultrasonically activated irrigation (Irrısafe; Satelec Acteon, Merignac, France) in a simulated canal isthmus connecting curved canals. Transparent resin blocks were produced containing two curved canals connected with an isthmus. The isthmus was then filled with dentin debris. Three irrigant activation cycles were performed and the amount of remaining debris was compared analysing pictures taken after each activation cycle. Data were statistically analysed using one-way ANOVA and post hoc Tukey tests at a significance level of p < 0.05. EDDY showed greater efficiency in removing dentin debris from the simulated isthmus than the other techniques tested. An increase in the activation time enhanced the efficiency of both EDDY and ultrasonically activated irrigation in debris removal.
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Affiliation(s)
- Gianluca Plotino
- Private Practice, Grande Plotino & Torsello - Studio di Odontoiatria, Rome, Italy
| | - Taha Özyürek
- Department of Endodontics, Faculty of Dentistry, Istanbul Medeniyet University, İstanbul, Turkey
| | - Mustafa Gündoğar
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, İstanbul, Turkey
| | - Gülşah Uslu
- Department of Endodontics, Faculty of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Eugenio Pedullà
- Department of General Surgery and Medical - Surgical Specialties, University of Catania, Catania, Italy
| | - Roberto Careddu
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Dublin, Ireland
| | - Vittorio Franco
- Private Practice, Studio di Odontoiatria Digitale, Rome, Italy
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Coşkun Başoğlu E, Koçak S, Özdemir O, Koçak MM, Sağlam BC. Efficacy of various activation techniques on tubule penetration of resin-based and bioceramic root canal sealers: An in vitro confocal microscopy study. AUST ENDOD J 2023; 49 Suppl 1:381-389. [PMID: 36971332 DOI: 10.1111/aej.12754] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/30/2023] [Accepted: 03/16/2023] [Indexed: 09/17/2023]
Abstract
To compare the penetration of Ah Plus and MTA Fillapex after irrigation activation with sonic, passive ultrasonic, SWEEPS and XP-Endo Finisher using confocal microscopy. Instrumented root canals of 160 mandibular premolar teeth were allocated randomly to four groups (n = 40/group) and eight subgroups according to the activation techniques and canal sealers (n = 20/subgroup). After the obturation, three sections at 1-2, 5-6 and 9-10 mm levels from the apex were examined. Penetration area and maximum penetration depth values were represented as mean and standard deviation, and results below 0.05 were considered statistically significant. For penetration area and maximum penetration depth, the statistical difference was found in terms of material, device and region (Maximum penetration depth: p = 0.006, p < 0.001, p < 0.001; Penetration area: p = 0.004, p < 0.001, p < 0.001). SWEEPS was found to be relatively higher than other groups. Sealers presented similar results when evaluated independently of the region. The use of SWEEPS for irrigation activation is promising in terms of tubule penetration.
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Affiliation(s)
| | - Sibel Koçak
- Department of Endodontics, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Olcay Özdemir
- Department of Endodontics, Faculty of Dentistry, Karabük University, Karabük, Turkey
| | - Mustafa Murat Koçak
- Department of Endodontics, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Baran Can Sağlam
- Department of Endodontics, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
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Bago I, Đurin A, Kanižaj D, Vuletić LB, Zdrilić IV, Anić I. The efficacy of a novel SWEEPS laser-activated irrigation compared to ultrasonic activation in the removal of pulp tissue from an isthmus area in the apical third of the root canal. Lasers Med Sci 2023; 38:189. [PMID: 37599293 DOI: 10.1007/s10103-023-03857-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/13/2023] [Indexed: 08/22/2023]
Abstract
This study aimed to evaluate the efficacy of Shock Wave Enhanced Emission Photoacoustic Streaming (SWEEPS) in the removal of remaining pulp tissue from the root canal isthmus area in lower molars and compare it with ultrasonically activated irrigation (UAI) and conventional needle irrigation (NI). Forty-one lower molars with isthmuses between mesial canals were included in the study. The teeth were randomly distributed into experimental groups (n = 12/each) based on the final irrigation protocol (SWEEPS, UAI, or NI) and a control group (C) (n = 5). The traditional access cavity of the mesial part of each tooth was made in all samples. The mesial root canals in the experimental groups were instrumented with a Wave One Gold Primary (25/.07) file using 3% sodium hypochlorite (NaOCl) while the distal canal served as a control for the presence of pulp tissue. No treatment was performed in the C group. Sections from the isthmus region were processed for histopathology to measure the remaining pulp tissue (RPT). The results were analyzed using analysis of variance and the Kruskal-Wallis test (α = 0.05). There were no significant differences in the relative surface area of root canals and isthmus among the groups (p > 0.05). Samples in the SWEEPS group had significantly less RPT than UAI, NI, and C (p = 0.003, 0.014, 0.003, respectively). There were no significant differences between the UAI and NI (p = 0.583). SWEEPS was the most efficient in debridement of the root canal isthmus area. UAI and NI showed similar but lower efficiency.
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Affiliation(s)
- Ivona Bago
- Department of Endodontics and Restorative Dentistry, University of Zagreb School of Dental Medicine, Gundulićeva 5, Zagreb, Croatia.
| | - Adriana Đurin
- Department of Endodontics and Restorative Dentistry, University of Zagreb School of Dental Medicine, Gundulićeva 5, Zagreb, Croatia
| | - Debora Kanižaj
- Department of Endodontics and Restorative Dentistry, University of Zagreb School of Dental Medicine, Gundulićeva 5, Zagreb, Croatia
| | | | - Ivana Vidović Zdrilić
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Ivica Anić
- Department of Endodontics and Restorative Dentistry, University of Zagreb School of Dental Medicine, Gundulićeva 5, Zagreb, Croatia
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Terlep S, Dogsa I, Pajk F, Stopar D. Biofilm Removal from In Vitro Narrow Geometries Using Single and Dual Pulse Er:YAG Laser Photoacoustic Irrigation. Microorganisms 2023; 11:2102. [PMID: 37630662 PMCID: PMC10459327 DOI: 10.3390/microorganisms11082102] [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: 07/14/2023] [Revised: 07/26/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
The disinfection and removal of biofilm from titanium dental implants remains a great challenge in oral medicine. Here we present results of novel photoacoustic irrigation laser modalities for biofilm removal in model geometries mimicking the peri-implant pocket. The efficacy of single pulse (Er:YAG-SSP) and dual pulse (Er:YAG-AutoSWEEPS) photoacoustic irrigation modalities were determined for Enterococcus faecalis biofilm decontamination from titanium surfaces in narrow cylindrical and square gap geometries. The density of bacteria as well as the number of live bacteria were determined prior and after different photoacoustic treatments. Both SSP and AutoSWEEPS photoacoustic irrigation techniques removed at least 92% of biofilm bacteria during the 10 s photoacoustic treatment. The effectiveness of cleaning was better in the narrow square gap geometry compared to the cylindrical geometry. The dual pulse Er:YAG-AutoSWEEPS photoacoustic irrigation showed better results compared to SSP modality. No chemical adjuvants were needed to boost the effectiveness of the photoacoustic irrigation in the saline solution. The results imply that photoacoustic irrigation is an efficient cleaning method for debridement and decontamination in narrow geometries and should be considered as a new therapeutic option for the treatment of peri-implant diseases.
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Affiliation(s)
- Saša Terlep
- Fotona d.o.o., Stegne 7, 1000 Ljubljana, Slovenia;
| | - Iztok Dogsa
- Department of Microbiology, Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, 1000 Ljubljana, Slovenia;
| | - Franja Pajk
- LA&HA—Laser and Health Academy, Stegne 3, 1000 Ljubljana, Slovenia;
| | - David Stopar
- Department of Microbiology, Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, 1000 Ljubljana, Slovenia;
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Rostami G, Afrasiabi S, Benedicenti S, Signore A, Chiniforush N. The Evaluation of SWEEPS Plus Antimicrobial Photodynamic Therapy with Indocyanine Green in Eliminating Enterococcus faecalis Biofilm from Infected Root Canals: An In Vitro Study. Biomedicines 2023; 11:1850. [PMID: 37509490 PMCID: PMC10376893 DOI: 10.3390/biomedicines11071850] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 06/17/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVES This study aimed to assess the efficacy of shockwave-enhanced emission photoacoustic streaming (SWEEPS) plus antimicrobial photodynamic therapy (aPDT) using indocyanine green (ICG) for the elimination of Enterococcus faecalis biofilm from infected root canals. MATERIALS AND METHODS thirty sound human single-canal teeth were chosen and standardized to have 12 mm of root length. The root canals were shaped and prepared by means of ProTaper rotary files. After sterilization of the teeth, the canals were inoculated with E. faecalis for 2 weeks. The teeth were then randomly divided into six groups (n = five) of control, ICG, ICG + 808 nm diode laser, ICG + SWEEPS, ICG + 808 nm diode laser + SWEEPS, and 5.25% sodium hypochlorite (NaOCl). Following treatment, the number of colony-forming units (CFUs)/mL were calculated for each group. Statistical analysis was carried out using one-way ANOVA. For multiple comparisons, Tukey's test was used as the post hoc test. RESULTS NaOCl alone showed the highest efficacy (p < 0.001). The ICG + 808 nm diode laser + SWEEPS group displayed significantly lower amounts of bacteria than either the ICG + 808 nm diode laser or SWEEPS (p < 0.001). There was a statistically significant difference detected between the ICG + 808 nm diode laser and ICG + SWEEPS (p = 0.035). CONCLUSIONS SWEEPS can effectively increase the photosensitizer distribution in the root canal space, and its application along with irrigants can bring about promising results.
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Affiliation(s)
- Golriz Rostami
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1441987566, Iran
| | - Shima Afrasiabi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1441987566, Iran
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Viale Benedetto XV 6, 16132 Genoa, Italy
| | - Antonio Signore
- Therapeutic Dentistry Department, Institute of Dentistry, I.M. Sechenov First Moscow State Medical University, Trubetskaya Str., 8, b. 2, 119992 Moscow, Russia
| | - Nasim Chiniforush
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Viale Benedetto XV 6, 16132 Genoa, Italy
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Rödig T, Westbomke V, Haupt F, Münster M, Baxter S. Effect of preparation size on the removal of accumulated hard-tissue debris from the mesial root canal system of mandibular molars using SWEEPS technology. Clin Oral Investig 2023; 27:2787-2796. [PMID: 36642725 PMCID: PMC10264281 DOI: 10.1007/s00784-023-04862-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 01/06/2023] [Indexed: 01/17/2023]
Abstract
OBJECTIVES This study assessed the influence of preparation size on the efficacy of shock wave-enhanced emission photoacoustic streaming (SWEEPS) and conventional irrigation (CI) on removal of accumulated hard tissue debris (AHTD) from isthmus-containing mandibular molars using micro-computed tomographic analysis. MATERIALS AND METHODS Sixty extracted mandibular molars with two mesial canals connected by an isthmus were selected. Canals were shaped with Mtwo instruments (VDW, Munich, Germany) up to sizes 25/.06, 40/.04 or 40/.06 (n = 20), and specimens were distributed into 2 final irrigation groups (n = 10): SWEEPS and CI. Roots were scanned at a resolution of 10.5 µm before and after preparation and final irrigation. Data sets were co-registered, and the percentage reduction of AHTD calculated for each specimen was statistically compared using analysis of variance with a of 5% significance level. RESULTS The preparation size did not significantly influence the percentage reduction of AHTD (p < 0.05), whereas the final irrigation technique had a significant effect on debris removal (p < 0.05). A significant reduction of AHTD was achieved after final irrigation in all groups (p < 0.05); however, SWEEPS was associated with a significantly greater percentage reduction of debris than CI (p < 0.05). None of the specimens presented a completely clean isthmus. CONCLUSIONS Removal of AHTD was not significantly affected by the preparation size. SWEEPS was associated with significantly less debris than CI. CLINICAL RELEVANCE SWEEPS performed significantly better than CI regarding the removal of AHTD from isthmus-containing mandibular molars irrespective of the preparation size.
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Affiliation(s)
- Tina Rödig
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
| | - Valerie Westbomke
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Franziska Haupt
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Marc Münster
- Endopur, Clinic for Endodontology, Frankfurt, Germany
| | - Steffi Baxter
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
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21
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Bolhari B, Meraji N, Seddighi R, Ebrahimi N, Chiniforush N. Effect of SWEEPS and PIPS techniques on dye extrusion in photodynamic therapy procedure after root canal preparation. Photodiagnosis Photodyn Ther 2023; 42:103345. [PMID: 36804946 DOI: 10.1016/j.pdpdt.2023.103345] [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: 12/07/2022] [Revised: 01/28/2023] [Accepted: 02/14/2023] [Indexed: 02/17/2023]
Abstract
AIM The aim of this study is to measure and compare the amount of apical extrusion of the methylene blue as photosensitizer using Laser-activated irrigation(LAI) techniques (SWEEPS, PIPS) and photodynamic therapy (PDT). MATERIALS AND METHODS 40 single-rooted premolar teeth were selected and their root canals were cleaned and prepared. The photosensitizer, Methylene blue (MB), was used as dye which applied inside the root canals and the access cavities. Then the teeth were randomly allocated to 4 groups. Different techniques (SWEEPS, PIPS, PDT) were used in 3 groups. One group received no activation. Data related to the concentration of the extruded methylene blue was measured using ultraviolet and visible (UV-Vis) absorption spectroscopy. Absorption peak intensity of MB in the wavelength of 668 nm was considered as the concentration index according to Beer Lambert law. Taking into account the normal distribution of this data, one-way ANOVA analysis was used to evaluate the effects of the independent variables on the amount of apical extrusion of the irrigant. RESULTS Based on the results of ANOVA analysis, there was no significant difference between the amounts of apical extrusion of MB between different groups (p = 0.628) CONCLUSION: Using SWEEPS and PIPS techniques, despite diffusion of the photosensitizer, didn't lead to any difference in the amount of apical extrusion. Therefore, these LAI techniques can be used safely for root canal irrigation.
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Affiliation(s)
- Behnam Bolhari
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Naghmeh Meraji
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Rahim Seddighi
- School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Ebrahimi
- School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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22
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Grande NM, Castagnola R, Minciacchi I, Marigo L, Plotino G. A review of the latest developments in rotary NiTi technology and root canal preparation. Aust Dent J 2023; 68 Suppl 1:S24-S38. [PMID: 37960998 DOI: 10.1111/adj.12998] [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: 10/18/2023] [Indexed: 11/15/2023]
Abstract
The introduction of nickel-titanium (NiTi) mechanical instruments dramatically changed clinical endodontics over the last few decades. Before NiTi, it was necessary to use more instruments to create an ideal root canal shape, and many approaches, sequences and techniques were developed over the years. Recently, NiTi endodontic instruments have undergone a series of changes brought about by modifications in design, surface treatments, and thermal treatments to improve their root canal preparation outcomes and reduce associated canal preparation risks during root canal treatment. Heat treatment is one of the most fundamental approaches to improving the fatigue resistance and flexibility of NiTi endodontic instruments. In addition, new kinematics have been developed to offer greater safety and efficiency. This narrative review describes the general properties and manufacturing of NiTi instruments, and the mechanical system evolution of NiTi instruments.
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Affiliation(s)
- N M Grande
- Dipartimento di Testa-Collo e organi di senso, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R Castagnola
- Dipartimento di Testa-Collo e organi di senso, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - L Marigo
- Dipartimento di Testa-Collo e organi di senso, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC Odontoiatria Generale e Ortodonzia, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo. Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
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23
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Badami V, Akarapu S, Kethineni H, Mittapalli SP, Bala KR, Fatima SF. Efficacy of Laser-Activated Irrigation Versus Ultrasonic-Activated Irrigation: A Systematic Review. Cureus 2023; 15:e36352. [PMID: 37082501 PMCID: PMC10111875 DOI: 10.7759/cureus.36352] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 03/21/2023] Open
Abstract
This study aimed to conduct a systematic review and critical analysis of the evidence pertaining to the efficacy of laser-activated irrigation (LAI) versus ultrasonic-activated irrigation (UAI) in mature permanent teeth. A comprehensive literature search was performed using PubMed and Google Scholar. Additionally, a hand search was performed to identify relevant studies related to UAI and LAI. The search covered all articles published from January 1997 to December 2021. The identified studies were screened for eligibility using the inclusion and exclusion criteria. The included articles were then subjected to data extraction and analysis. The search yielded 1,637 results. Of these, 23 articles were included in this systematic review. All included articles were assessed for the outcomes of antimicrobial efficacy, smear layer, and dentin debris removal. The majority of the articles reported the superiority of LAI over UAI. Within the confines of this systematic review, the current evidence mandates that LAI has superior efficacy over UAI in the elimination of microorganisms, dentin debris, and smear layer from the root canal system.
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24
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Jezeršek M, Molan K, Terlep S, Levičnik-Höfferle Š, Gašpirc B, Lukač M, Stopar D. The evolution of cavitation in narrow soft-solid wedge geometry mimicking periodontal and peri-implant pockets. ULTRASONICS SONOCHEMISTRY 2023; 94:106329. [PMID: 36801675 PMCID: PMC9945771 DOI: 10.1016/j.ultsonch.2023.106329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/27/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
In periodontology and implantology, laser-induced cavitation has not yet been used to treat biofilm-related problems. In this study we have checked how soft tissue affects the evolution of cavitation in a wedge model representing periodontal and peri-implant pocket geometry. One side of the wedge model was composed of PDMS mimicking soft periodontal or peri-implant biological tissue, the other side was composed of glass mimicking hard tooth root or implant surface, which allowed observations of the cavitation dynamics with an ultrafast camera. Different laser pulse modalities, PDMS stiffness, and irrigants were tested for their effect on the evolution of cavitation in the narrow wedge geometry. The PDMS stiffness varied in a range that corresponds to severely inflamed, moderately inflamed, or healthy gingival tissue as determined by a panel of dentists. The results imply that deformation of the soft boundary has a major effect on the Er:YAG laser-induced cavitation. The softer the boundary, the less effective the cavitation. We show that in a stiffer gingival tissues model, photoacoustic energy can be guided and focused at the tip of the wedge model, where it enables generation of secondary cavitation and more effective microstreaming. The secondary cavitation was absent in severely inflamed gingival model tissue, but could be induced with a dual-pulse AutoSWEEPS laser modality. This should in principle increase cleaning efficiency in the narrow geometries such as those found in the periodontal and peri-implant pockets and may lead to more predictable treatment outcomes.
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Affiliation(s)
- Matija Jezeršek
- University of Ljubljana, Faculty of Mechanical Engineering, Aškerčeva cesta 6, 1000 Ljubljana
| | - Katja Molan
- University of Ljubljana, Biotechnical Faculty, Department of Microbiology, Večna pot 111, 1000 Ljubljana, Slovenia
| | - Saša Terlep
- Fotona d.o.o., Stegne 7, 1000 Ljubljana, Slovenia
| | | | - Boris Gašpirc
- University of Ljubljana, Medical Faculty, Department of Oral Medicine and Periodontology, Vrazov trg 2, 1000 Ljubljana
| | - Matjaž Lukač
- Institut Jozef Stefan, Jamova 39, 1000 Ljubljana, Slovenia
| | - David Stopar
- University of Ljubljana, Biotechnical Faculty, Department of Microbiology, Večna pot 111, 1000 Ljubljana, Slovenia.
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25
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Huang Q, Li Z, Lyu P, Zhou X, Fan Y. Current Applications and Future Directions of Lasers in Endodontics: A Narrative Review. Bioengineering (Basel) 2023; 10:bioengineering10030296. [PMID: 36978686 PMCID: PMC10044917 DOI: 10.3390/bioengineering10030296] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 03/02/2023] Open
Abstract
The utilization of lasers has been regarded as a novel technique for the purposes of clinical use in the dental field. Recently, numerous studies have been conducted on the potential applications of laser therapy in endodontics. Moreover, due to their ablation, penetrability, and disinfection capabilities, lasers have performed well with respect to endodontic treatments, including root canal treatment, vital pulp therapy (pulp capping and pulpotomy), dentinal hypersensitivity treatment, and management of dental pain related to pulp and periradicular disease. In particular, the superiorities of laser-aided pulp therapy are emphasized through condensed clinical controlled trials, and histological studies, in this review. Moreover, the ingenious use of laser applications with respect to aiding in the acceleration of root development and the extraction of foreign matters (i.e., broken files and fiber posts) in canals has quickly become the cutting-edge trend of current research. This review offers a summary and discussion of the current literature on all the aforementioned laser applications. Moreover, the characteristics of laser devices, including erbium lasers, neodymium-doped lasers, CO2 lasers, and diode lasers, are detailed and discussed here, providing useful references for laser application in endodontics. We also focus on the different wavelengths with respect to the lasers that are applied in endodontics. High-power lasers perform well as operative instruments; in addition, low-level lasers lead to the regulation of pulp inflammation, and the promotion of pulp healing. This narrative review provides a summary of the advanced applications of lasers in conjunction with various devices in the practice of endodontics, and aims to inspire innovative perspectives on lasers in the context of the treatment of dental diseases, especially pulp diseases, in the future.
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Advances in the Role of Sodium Hypochlorite Irrigant in Chemical Preparation of Root Canal Treatment. BIOMED RESEARCH INTERNATIONAL 2023; 2023:8858283. [PMID: 36685672 PMCID: PMC9859704 DOI: 10.1155/2023/8858283] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 01/15/2023]
Abstract
Irrigation of root canal system is of great significance to the success of endodontic treatment, where sodium hypochlorite (NaOCl) is the most widely used irrigant in chemical preparation. NaOCl functions by eliminating bacterial biofilms and dissolving organic tissue, which may vary according to several factors such as the microbiology of root canal infection and the concentration of the irrigant. It has been proposed that the effectiveness of NaOCl could be enhanced via several methods, including heating the irrigant, applying in conjunction with certain reagents, or activating by agitation techniques. Despite its antibacterial and tissue-dissolving capacities, NaOCl should be used with caution to avoid detrimental effect due to its cytotoxicity and negative effect on dentin properties. In this narrative review, we discussed the factors that affect the properties of NaOCl, the methods to improve its efficacy, and the side effects that might occur in clinical practice.
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Uslu G, Gündoğar M, Üngör M, Özyürek T, Erkan E, Keskin NB. Investigation of the effectiveness of sonic, ultrasonic and new laser-assisted irrigation activation methods on smear removal and tubular penetration. Lasers Med Sci 2023; 38:30. [PMID: 36595139 DOI: 10.1007/s10103-022-03697-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/19/2022] [Indexed: 01/04/2023]
Abstract
The aim of this study was to examine the effectiveness of different irrigation activation methods on smear layer removal and tubular penetration. One hundred-five distal roots of mandibular molar teeth in total; 50 for smear removal efficiency (n = 10) analysis using scanning electron microscopy (SEM), and 55 roots were used to examine tubular penetration using confocal laser scanning microscope (CLSM). Five different irrigation activation methods were used in this study; conventional needle irrigation (CNI), sonic irrigation device of EDDY, passive ultrasonic irrigation (PUI), PIPS and SWEEPS techniques, which are two different laser irrigation activation methods. The obtained data were statistically analyzed and the significance level was determined as p < 0.05. At the apical level, the cleanest canal walls were observed when laser methods PIPS and SWEEPS were used, while in the middle third, there was no difference in smear removal efficiencies between all groups except for the CNI (p > 0.05). Penetration depths and percentages increased from apically to coronally in all groups. The PUI and EDDY generally showed similar penetration depths and percentages to the CNI, except at the coronal root level (p > 0.05). In all groups, when PIPS was used, it showed greater penetration depth and percentage (p < 0.05). PIPS and SWEEPS techniques showed lowest and similar smear scores compared to PUI and EDDY in the apical area where access and effectiveness of the irrigation solution are difficult.
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Affiliation(s)
- Gülşah Uslu
- Faculty of Dentistry, Department of Endodontics, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Mustafa Gündoğar
- Faculty of Dentistry, Department of Endodontics, Medipol University, Istanbul, Turkey
| | - Mete Üngör
- Faculty of Dentistry, Department of Endodontics, Medipol University, Istanbul, Turkey
| | - Taha Özyürek
- Faculty of Dentistry, Department of Endodontics, Bahçeşehir University, Istanbul, Turkey
| | - Erhan Erkan
- Faculty of Dentistry, Department of Endodontics, Medipol University, Istanbul, Turkey
| | - Neslihan Büşra Keskin
- Faculty of Dentistry, Department of Endodontics, Yıldırım Beyazıt University, Ankara, Turkey.
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Tong J, Liu L, Du J, Gao Y, Song D, Huang D. Effect of photon-induced photoacoustic streaming and shock-wave enhanced emission photoacoustic streaming technique on the removal of the smear layer after root canal preparation in curved root canals. J Dent Sci 2023; 18:157-164. [PMID: 36643274 PMCID: PMC9831787 DOI: 10.1016/j.jds.2022.06.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/21/2022] [Indexed: 01/18/2023] Open
Abstract
Background/purpose The efficiency of root canal irrigation has an important impact on the prognosis of root canal treatment. Photon-induced photoacoustic streaming (PIPS) and shock wave enhanced emission photoacoustic streaming (SWEEPS) are the special modality of Er: YAG laser, whether can they improve the efficiency of root canal irrigation remains to be studied. Materials and methods Fifty human teeth with curved root canals were collected and stored in the thymol solution until used in the study. After traditional endodontic cavities preparation, root canals were prepared to size #35 with a 0.04 taper. The final irrigating techniques were as follows: (I) manual dynamic activation (MDA), (II) ultrasonically activated irrigation (UAI), (III) sonically activated irrigation (SAI), (IV) PIPS, and (V) SWEEPS. Fifty teeth were randomly divided into five groups mentioned above. After root canal preparation, the roots were cleaved longitudinally. The dentine surfaces were photographed from the coronal, middle, and apical third of the root by scanning electron microscopy operated at a low vacuum. Two examiners separately graded each image according to the remained smear layer situations. Results PIPS and SWEEPS groups showed fewer smear layers remaining than the others in the middle and the apical third (P < 0.05) of the root canal. In contrast, in the coronal third, five groups showed no significant difference (P > 0.05). Conclusion PIPS and SWEEPS showed superior smear layer clearing efficiency than traditional irrigating techniques in curved root canals.
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Affiliation(s)
- Jiaru Tong
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liu Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jing Du
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuan Gao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Dongzhe Song
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Corresponding author. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Dingming Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Corresponding author. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Kapetanović Petričević G, Katić M, Brzović Rajić V, Anić I, Bago I. The Efficacy of Er:YAG Laser-Activated Shock Wave-Enhanced Emission Photoacoustic Streaming Compared to Ultrasonically Activated Irrigation and Needle Irrigation in the Removal of Bioceramic Filling Remnants from Oval Root Canals-An Ex Vivo Study. Bioengineering (Basel) 2022; 9:bioengineering9120820. [PMID: 36551026 PMCID: PMC9774814 DOI: 10.3390/bioengineering9120820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/27/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
The removal of filling material is important for successful root canal retreatment. The aim of the study was to compare the efficiency of two activated irrigation techniques, the shock wave-enhanced emission photoacoustic streaming (SWEEPS) mode of the Er:YAG laser and ultrasonically activated irrigation (UAI) and a conventional syringe-needle technique (SNI), in the removal of bioceramic sealer/gutta-percha during conventional retreatment in oval root canals. The study sample consisted of distal root canals of 42 extracted human mandibular molars, which were prepared using a ProTaper Next system up to size 40/0.06 and filled with bioceramic sealer using a single-cone obturation technique. The teeth were then re-treated with a Reciproc Blue RB40 file and 3% sodium hypochlorite solution. The prepared teeth were randomly divided into three groups (n = 14 per group) and subjected to one of the three irrigation methods. Micro-CT scans were performed at different stages to assess the amount of filling material after each retreatment phase. The results of the study showed that all the tested irrigation techniques reduced a statistically significant amount of the remnant filling material at retreatment (p < 0.05), and there were no statistically significant differences in efficacy between the three methods. All tested techniques had similar efficacy in the removal of the remaining filling remnants.
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Affiliation(s)
- Gabrijela Kapetanović Petričević
- Department of Endodontics and Restorative Dental Medicine, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marko Katić
- Department of Materials, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, 10000 Zagreb, Croatia
| | - Valentina Brzović Rajić
- Department of Dental Diseases, Dentistry Clinic, University Hospital Centre, 10000 Zagreb, Croatia
| | - Ivica Anić
- Department of Endodontics and Restorative Dental Medicine, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Ivona Bago
- Department of Endodontics and Restorative Dental Medicine, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Correspondence: ; Tel.: +385-1-4802128
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Angerame D, De Biasi M, Porrelli D, Bevilacqua L, Zanin R, Olivi M, Kaitsas V, Olivi G. Retreatability of calcium silicate-based root canal sealer using reciprocating instrumentation with different irrigation activation techniques in single-rooted canals. AUST ENDOD J 2022; 48:415-422. [PMID: 34928535 DOI: 10.1111/aej.12603] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2021] [Indexed: 12/14/2022]
Abstract
This study analysed the bioceramic sealer cleaning ability of two chemo-mechanical systems in intact and restored teeth. Thirty-two single-rooted teeth were used, and half of them restored with a pre-endodontic composite restoration (PCR). All samples were instrumented with a size 40 Reciproc Blue file and filled with BioRoot RCS. Canals were retreated using the R40 and then R50 Reciproc Blue. The samples were divided into four experimental groups (n = 8): intact teeth/passive ultrasonic irrigation (PUI) (G1), intact teeth/shock wave-enhanced emission photoacoustic streaming (SWEEPS) (G2), PCR/PUI (G3) and PCR/SWEEPS (G4). The samples were scanned by micro-CT before and after retreatment, and the volume of remaining filling material was evaluated. The minor percentage of residues were observed in G2, with a volume of 0.447 ± 0.356% of the endodontic space (P < 0.001). The Reciproc/SWEEPS technique showed the better performance in intact teeth compared with PUI technique. Pre-endodontic restoration did not significantly affect the effectiveness of sealer removal.
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Affiliation(s)
- Daniele Angerame
- University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Matteo De Biasi
- University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Davide Porrelli
- University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Lorenzo Bevilacqua
- University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Riccardo Zanin
- University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | | | | | - Giovanni Olivi
- Private Practice, Rome, Italy.,Master Course Laser Dentistry, Catholic University of Sacred Heart, Rome, Rome, Italy
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Comparative effects of SWEEPS technique and antimicrobial photodynamic therapy by using curcumin and nano-curcumin on Enterococcus faecalis biofilm in root canal treatment. Photodiagnosis Photodyn Ther 2022; 40:103130. [PMID: 36162755 DOI: 10.1016/j.pdpdt.2022.103130] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/13/2022] [Accepted: 09/19/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES This study aimed to compare the antimicrobial effects of the shock wave enhanced emission photoacoustic streaming (SWEEPS) technique and Antimicrobial photodynamic therapy (aPDT) with curcumin and nano-curcumin photosensitizers on Enterococcus faecalis (E. faecalis) biofilm in root canals of extracted teeth. MATERIALS AND METHODS This experimental study was conducted on extracted single-rooted human teeth. The teeth were decoronated at the cementoenamel junction, the root canals were instrumented with BioRace system, and their apices were sealed. Smear layer was removed, and the teeth were autoclave-sterilized. E. faecalis strains were cultured in sterile brain heart infusion (BHI) and a bacterial suspension with 0.5 McFarland standard concentration was prepared. The root canals were inoculated with the bacterial suspension and incubated at 37 °C for 4 weeks. The teeth were then divided into 12 groups (curcumin, nano-curcumin, curcumin + LED, nano-curcumin + LED, curcumin + SWEEPS, nano-curcumin + SWEEPS, curcumin + LED + SWEEPS, nano-curcumin + LED + SWEEPS, SWEEPS, positive control and negative control). The number of colony forming units (CFUs) was counted and analyzed by one-way ANOVA and Tukey's test. RESULTS A significant difference was noted in colony count among the groups (P<0.001). LED alone had the lowest and nano-curcumin + LED + SWEEPS had the highest root canal cleaning efficacy. SWEEPS along with curcumin, nano-curcumin, and LED significantly decreased the bacterial count compared with other groups (P<0.05). CONCLUSION Application of the SWEEPS technique with curcumin and nano-curcumin as photosensitizer activated by LED in aPDT improved the reduction of E. faecalis in root canals.
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32
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Aydın RN, Gençoğlu N. Histological Investigation of the Cleaning Effectiveness of Different Biomechanic Processes of Isthmus in Lower Molars. Eur J Dent 2022. [DOI: 10.1055/s-0042-1753455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract
Objectives This study aimed to evaluate the efficacy of different instruments (Hyflex, ROTATE, and hand files) and irrigation methods (EndoUltra, EndoActivator, and side-perforated syringe) in the mesial root canal of a mandibular first molar with isthmuses.
Materials and Methods Sixty-three mandibular molar teeth with isthmus were selected using cone beam computed tomography (CBCT) images. The root canals were instrumented with Hyflex, ROTATE, or hand files (21 of each) and three of each as control group and the specimens were embedded in silicone blocks. Final irrigation was performed with the perforated syringe or ultrasonic (EndoUltra) or sonic irrigation (EndoActivator). All canals were irrigated using 5.25% NaOCl solution (15 mL). Then, the roots were stained with hematoxylin–eosin, and specimens were sliced for histologic evaluation. The isthmus regions (2.7, 3, 4.7, and 5 mm from the apex) were analyzed, and the percentage of debris was calculated.
Statistical Analysis All data were statistically analyzed using one-way analysis of variance and Tukey's tests.
Results Both Hyflex and ROTATE groups showed less debris compared with the hand instrument group (P < 0.05). When irrigation methods were compared, EndoUltra showed the least, followed by EndoActivator and perforated needle irrigation having the maximum debris (p < 0.05). When sections were compared, the maximum debris was found in the apical section and the least in the coronal section (p < 0.05).
Conclusion Although none of the methods cleaned the isthmus completely, nickel–titanium (NiTi) systems and ultrasonic and sonic systems removed more debris than the side-perforated needle syringe irrigation.
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Affiliation(s)
- Rabia N. Aydın
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, İstanbul, Turkey
| | - Nimet Gençoğlu
- Department of Endodontics, Faculty of Dentistry, Marmara University, İstanbul, Turkey
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Petričević GK, Katić M, Anić I, Salarić I, Vražić D, Bago I. Efficacy of different Er:YAG laser-activated photoacoustic streaming modes compared to passive ultrasonic irrigation in the retreatment of curved root canals. Clin Oral Investig 2022; 26:6773-6781. [PMID: 35879623 DOI: 10.1007/s00784-022-04637-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 07/12/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To evaluate the efficacy of passive ultrasonic irrigation (PUI) and super short pulse (SSP) and shock wave-enhanced emission photoacoustic streaming (SWEEPS) modes of Er:YAG laser-activated irrigation (LAI) with two different laser tips, in removing filling remnants after conventional retreatment in severely curved root canals. MATERIALS AND METHODS The study sample consisted of 40 extracted molars with curved mesiobuccal root canals. The canals were instrumented with ProTaper Next and filled with an epoxy resin-based sealer and gutta-percha using continuous wave vertical compaction and warm injection back-filling. After retreatment with ProTaper Universal Retreatment system and sodium hypochlorite (NaOCl), all samples were randomly divided into four groups (n = 10) according to the final irrigation technique: PUI, LAI/SSP, SWEEPS/flat-tip, and SWEEPS/radial-tip, using 6 mL of 3% NaOCl for an activation time of 3 × 30 s. The samples were subjected to micro-CT scans after root canal filling, retreatment, and final irrigation. The filling material volume and percentage reduction were calculated. RESULTS All tested irrigation techniques were successful in the elimination of the filling remnants after the retreatment (p < 0.001). The LAI/SSP group showed a higher reduction rate than the SWEEPS/flat-tip group (p = 0.032). No significant differences were found between the other groups (p > 0.05). CONCLUSION All tested techniques improved the removal of filling material during retreatment in curved canals. LAI/SSP showed slightly better results than other techniques. CLINICAL RELEVANCE The study highlights the need for additional activated irrigation after the retreatment of curved root canals. The choice between PUI and LAI is not decisive for success.
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Affiliation(s)
- Gabrijela Kapetanović Petričević
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10 000, Zagreb, Croatia
| | - Marko Katić
- Department of Materials, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia
| | - Ivica Anić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10 000, Zagreb, Croatia
| | - Ivan Salarić
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Domagoj Vražić
- Department of Periodontology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10 000, Zagreb, Croatia.
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Moon W, Chung SH, Chang J. Sonic irrigation for removal of calcium hydroxide in the apical root canal: A micro-CT and light-coupled tracking analysis. PLoS One 2022; 17:e0268791. [PMID: 35653310 PMCID: PMC9162323 DOI: 10.1371/journal.pone.0268791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 05/08/2022] [Indexed: 11/19/2022] Open
Abstract
Objective This study aimed to evaluate the efficacy of three sonic irrigation systems for removal of calcium hydroxide dressing from the apical root canal. Materials and methods A total of 96 single-rooted teeth in three categories of root canal curvatures (straight: 0–5°, moderate: 6–20°, and severe: > 20°) were allocated to four groups: conventional needle irrigation, EndoActivator, EQ-S, and Vibringe. The root canals were instrumented using Protaper NEXT and filled with calcium hydroxide. After removal of calcium hydroxide, the remaining volume of calcium hydroxide was measured by micro-CT analysis. Data were compared among root canal curvatures and irrigation systems using the Kruskal-Wallis test and Mann-Whitney test (p < .05). The oscillating range of each irrigation system was measured using light-coupled motion tracking. Results The volumes of calcium hydroxide remaining in the canals with severe curvature were significantly higher than in those of straight curvature (p < .05). In the canals of moderate or severe curvature, EQ-S showed the highest removal percentage, followed by EndoActivator, Vibringe, and needle irrigation (p < .05). Light-coupled tracking showed the largest oscillating range in EQ-S (p < .05). Conclusions Sonically activated irrigation systems with a flexible tip can be beneficial for calcium hydroxide intracanal dressing removal in the curved apical canals.
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Affiliation(s)
- Wonjoon Moon
- Department of Dental Biomaterials Science, School of Dentistry and Dental Research Institute, Seoul National University, Jongno-gu, Seoul, Republic of Korea
| | - Shin Hye Chung
- Department of Dental Biomaterials Science, School of Dentistry and Dental Research Institute, Seoul National University, Jongno-gu, Seoul, Republic of Korea
| | - Juhea Chang
- National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital, Jongno-gu, Seoul, Republic of Korea
- * E-mail:
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Lei L, Wang F, Wang Y, Li Y, Huang X. Laser Activated Irrigation with SWEEPS Modality Reduces Concentration of Sodium Hypochlorite in Root Canal Irrigation. Photodiagnosis Photodyn Ther 2022; 39:102873. [DOI: 10.1016/j.pdpdt.2022.102873] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/09/2022] [Accepted: 04/15/2022] [Indexed: 11/30/2022]
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Boutsioukis C, Arias-Moliz MT. Present status and future directions - irrigants and irrigation methods. Int Endod J 2022; 55 Suppl 3:588-612. [PMID: 35338652 PMCID: PMC9321999 DOI: 10.1111/iej.13739] [Citation(s) in RCA: 91] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/21/2022] [Indexed: 11/30/2022]
Abstract
Irrigation is considered the primary means of cleaning and disinfection of the root canal system. The purpose of this review was to set the framework for the obstacles that irrigation needs to overcome, to critically appraise currently used irrigants and irrigation methods, to highlight knowledge gaps and methodological limitations in the available studies and to provide directions for future developments. Organization of bacteria in biofilms located in anatomic intricacies of the root canal system and the difficulty to eliminate them is the main challenge for irrigants. Sodium hypochlorite remains the primary irrigant of choice, but it needs to be supplemented by a chelator. Delivery of the irrigants using a syringe and needle and activation by an ultrasonic file are the most popular irrigation methods. There is no evidence that any adjunct irrigation method, including ultrasonic activation, can improve the long‐term outcome of root canal treatment beyond what can be achieved by instrumentation and syringe irrigation. It is necessary to redefine the research priorities in this field and investigate in greater depth the penetration of the irrigants, their effect on the biofilm and the long‐term treatment outcome. New studies must also focus on clinically relevant comparisons, avoid methodological flaws and have sufficiently large sample sizes to reach reliable conclusions. Future multidisciplinary efforts combining the knowledge from basic sciences such as Chemistry, Microbiology and Fluid Dynamics may lead to more effective antimicrobials and improved activation methods to bring them closer to the residual biofilm in the root canal system.
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Affiliation(s)
- C Boutsioukis
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M T Arias-Moliz
- Department of Microbiology, Faculty of Dentistry, University of Granada, Granada, Spain
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Tashkandi N, Alghamdi F. Effect of Chemical Debridement and Irrigant Activation on Endodontic Treatment Outcomes: An Updated Overview. Cureus 2022; 14:e21525. [PMID: 35223300 PMCID: PMC8863357 DOI: 10.7759/cureus.21525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2022] [Indexed: 12/20/2022] Open
Abstract
Chemical debridement is considered one of the most important steps during root canal treatment to target unreached areas and provide thorough disinfection of the canals. The efficiency of this step efficiency can be increased using different agitation and irrigation techniques/devices. This comprehensive review aimed to summarize the effect of various irrigant activation and agitation techniques/devices on endodontic treatment outcomes. Using mechanical active irrigation, which enables the activation or agitation of the irrigating solution, is beneficial in root canal treatment by increasing the efficiency of delivering the irrigant up to working length and ensuring isthmus cleanliness. However, considerable variation was noticed between the protocols used in each technique with a lack of well-designed randomized clinical trials to focus on the long-term outcome. Moreover, a low level of evidence was noticed regarding the effectiveness of certain activation techniques over others. Therefore, each study needs to be carefully weighed before using its results and embracing its conclusion. Future studies need to focus more on the antimicrobial effect of each technique and its effect on the healing of apical periodontitis. Also, recent advances, such as multisonic and laser activation, are promising tools that need more clinical investigations to show their efficiency.
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Alhussain BS, Alshehri AM, Alrasheed MA, Algadhi SK, Alahmad FA. Endodontics Retreatment and Successful Removal of Endodontic Sealers Using Lasers: A Systematic Review. ANNALS OF DENTAL SPECIALTY 2022. [DOI: 10.51847/ekiqcpebrz] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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39
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Al Omari T, El-Farraj H, Alzenate H, Al Charabi N, Al Khatib R, Ateş A. The usage of lasers in cleaning, shaping, and disinfection of root canal system. SAUDI ENDODONTIC JOURNAL 2022. [DOI: 10.4103/sej.sej_179_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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40
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Vatanpour M, Toursavadkouhi S, Sajjad S. Comparison of three irrigation methods: SWEEPS, Ultrasonic, and Traditional irrigation, in smear layer and debris removal abilities in the root canal, beyond the fractured instrument. Photodiagnosis Photodyn Ther 2021; 37:102707. [PMID: 34971819 DOI: 10.1016/j.pdpdt.2021.102707] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/23/2021] [Accepted: 12/27/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study compared the effectiveness of three irrigation methods in removing smear layer and debris in the presence of the fractured instrument. The three compared irrigation methods were conventional syringe irrigation, passive ultrasonic irrigation, and SWEEPS (Shock wave enhanced emission photoacoustic streaming) irrigation. METHODS AND MATERIALS Sixty-three permanent mandibular molars with moderate curvature were included in this experimental study. Mesiobuccal root canals were prepared with Race files (FKG Dentaire. Switzerland) up to #25, 4%. A #30, 6% Race file was used to simulate file fracture 3 mm short of working length. The prepared samples, randomly divided into three groups, and final irrigation was separately done in each group. Group 1 conventional syringe irrigation (CSI) as the control group, Group 2 passive ultrasonic irrigation (PUI), and Group 3 Shock wave enhanced emission photoacoustic streaming or SWEEPS Irrigation (SI). Smear layer and debris removal beyond separated file scored with scanning electron microscope(SEM) images. Data were analyzed using the nonparametric tests to compare the smear layer and debris scores. RESULT SWEEPS and passive ultrasonic irrigation significantly removed smear layer and debris, better than conventional syringe irrigation (p<0.001). The smear layer and debris removal efficiency between passive ultrasonic Irrigation and SWEEPS were not significantly different (p=0.629). CONCLUSION In the face of the irretrievably broken instrument in the root canal, passive ultrasonic irrigation and the SWEEPS method can enhance smear layer and debris removal compared to conventional syringe irrigation.
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Affiliation(s)
- Mehdi Vatanpour
- Endodontic department, Dental school, Islamic Azad university of medical sciences, Tehran, Iran
| | - Sohrab Toursavadkouhi
- Endodontic department, Dental school, Islamic Azad university of medical sciences, Tehran, Iran
| | - Shirin Sajjad
- Endodontic department, Dental school, Islamic Azad university of medical sciences, Tehran, Iran.
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Natanasabapathy V, Arul B, Srinivasan V, Santosh SS, Vasudevan A, Arockiam S, Namasivayam A, Deivanayagam K, Srinivasan MR. Removal of accumulated hard tissue debris from mesial root of mandibular molars evaluated using micro-CT - a systematic review and network meta-analysis. Evid Based Dent 2021:10.1038/s41432-021-0207-x. [PMID: 34795397 DOI: 10.1038/s41432-021-0207-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 05/21/2021] [Indexed: 11/09/2022]
Abstract
Aim The aim of this systematic review and network meta-analysis was to identify the best irrigant activation technique (IAT) for the removal of accumulated hard tissue debris (AHTD) from the mesial root of mandibular molars evaluated using micro-CT studies.Methods The research question was based on the PICO format. Four electronic databases - PubMed, Scopus, Embase and Web of Science - were searched for articles up to June 2020. Selected articles were assessed for bias using the Joanna Briggs Institute Critical appraisal tool. The network meta-analysis using a fixed-effects model and SUCRA ranking were performed. The quality of the evidence was assessed using the CINeMA framework.Results Eleven studies were included for qualitative synthesis while seven were included for quantitative synthesis. The risk of bias of all included articles was low. The results based on SUCRA values revealed the IAT shock wave-enhanced emission photoacoustic streaming (100%) resulted in the greatest reduction of the volume of AHTD from mesial roots of mandibular molars. Ranking of the other IATs was as follows: photon-induced photoacoustic streaming (87%), laser-activated irrigation (79.3%), XP EndoFinisher (71.2%), ultrasonically activated irrigation (59.6%), apical negative pressure (42.3%), EasyClean (37.4%), EDDY (26.2%), EndoActivator (24.2%), self-adjusting file (11.6%) and needle irrigation (11.3%).Conclusion None of the IATs rendered the root canals completely free of AHTD. The laser-activated irrigation groups fared better than all other interventions in reducing AHTD from the mesial roots of mandibular molars. The confidence rating ranged from low to high for indirect evidence and moderate to high for mixed evidence. Results must be interpreted with caution due to the laboratory nature of the included studies.
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Affiliation(s)
- Velmurugan Natanasabapathy
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research (MAHER), No.1, Alapakkam Main Road, Maduravoyal, Chennai, 600095, Tamil Nadu, India.
| | - Buvaneshwari Arul
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research (MAHER), No.1, Alapakkam Main Road, Maduravoyal, Chennai, 600095, Tamil Nadu, India
| | - Vignesh Srinivasan
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research (MAHER), No.1, Alapakkam Main Road, Maduravoyal, Chennai, 600095, Tamil Nadu, India
| | - Sneha Susan Santosh
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research (MAHER), No.1, Alapakkam Main Road, Maduravoyal, Chennai, 600095, Tamil Nadu, India
| | - Aishwarya Vasudevan
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research (MAHER), No.1, Alapakkam Main Road, Maduravoyal, Chennai, 600095, Tamil Nadu, India
| | - Selva Arockiam
- Department of Orthodontics, Faculty of Dentistry, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research (MAHER), No.1, Alapakkam Main Road, Maduravoyal, Chennai, 600095, Tamil Nadu, India
| | - Ambalavanan Namasivayam
- Department of Periodontology and Oral implantology, Faculty of Dentistry, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research (MAHER), No.1, Alapakkam Main Road, Maduravoyal, Chennai, 600095, Tamil Nadu, India
| | - Kandaswamy Deivanayagam
- Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600116, Tamil Nadu, India
| | - M R Srinivasan
- Department of Conservative Dentistry and Endodontics, Sri Venkateswara Dental College and Hospital, Chennai, 600130, Tamil Nadu, India
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Bago I, Batelja-Vuletić L, Tarle A, Sesar A, Anić I. Novel laser activated photoacoustic streaming for removing pulp remnants from round root canals after single file reciprocating instrumentation: Photoacoustic streaming for removing pulp. Photodiagnosis Photodyn Ther 2021; 37:102631. [PMID: 34798349 DOI: 10.1016/j.pdpdt.2021.102631] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/07/2021] [Accepted: 11/12/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study evaluated the efficacy of a new laser-assisted irrigation system, the shock wave enhanced emission photo-acoustic streaming (SWEEPS) technique in removing pulp tissue from single-rooted premolars. METHODS Freshly extracted mandibular premolars with round root canals (n=40), scanned using cone beam computed tomography, were randomly divided into control and four experimental (according to the irrigation technique used) groups (n=8/group). Groups 1, 2, and 3 were instrumented using Reciproc Blue (RB25/.06) followed by final irrigation protocol (FIP), activated by SWEEPS, ultrasonically activated irrigation (UAI), and conventional irrigation (CI), respectively. In these groups, 7 mL 3% NaOCl in total was used during instrumentation; for FIP, 3% NaOCl (60 s), ethylenediaminotetraacetic acid (60s), and 3% NaOCl (30s). In group 4, SWEEPS activation of 3% NaOCl for 6 × 30 s alone was performed. The untreated control group specimens were processed for histological evaluation of remaining pulp tissue (RPT) in each canal third. The results were analyzed using the Mann-Whitney U test (α =0.05). RESULTS Significant differences were observed between the control group and the experimental groups (p<0.05). In the middle third, the UIA and SWEEPS showed similar efficacy (p=0.171), superior to CI and SWEEPS without instrumentation (p<0.05). In the apical third, SWEEPS was the most efficient (p=0.002), and UIA and CI showed no difference (p=0.643). CONCLUSION SWEEPS was superior to UIA and CI in removing RPT in the apical region of round canals after single instrument root canal preparation; SWEEPS without instrumentation was inefficient in removing pulp tissue.
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Affiliation(s)
- Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia.
| | | | | | - Anja Sesar
- Dental Polyclinic Zagreb, Zagreb, Croatia
| | - Ivica Anić
- Dental Polyclinic Zagreb, Zagreb, Croatia
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Kirmizi D, Aksoy U, Orhan K. Efficacy of Laser-Activated Irrigation and Conventional Techniques in Calcium Hydroxide Removal from Simulated Internal Resorption Cavities: Micro-CT Study. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:674-681. [PMID: 34662526 DOI: 10.1089/photob.2021.0001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: This study aimed to evaluate the effectiveness of different irrigant-activation techniques for eliminating calcium hydroxide from an internal root canal resorption cavity by using microcomputed tomography (micro-CT). Background: Several techniques and irrigants are inadequate for the complete removal of calcium hydroxide from an internal root resorption cavity. Recently, a few studies have investigated the effectiveness of various methods, but there has been no micro-CT study that compares the effectiveness of photon-induced photoacoustic streaming (PIPS) and shock wave enhanced emission photoacoustic streaming (SWEEPS) techniques. Methods: Seventy single-canal mandibular premolar teeth were selected and divided into seven groups (n = 10) according to the techniques to be used: syringe irrigation (SI), passive ultrasonic irrigation (PUI), EndoActivator (EA), XP-Endo finisher file (XP), Er,Cr:YSGG laser-activated irrigation, PIPS, and SWEEPS. The root canals were instrumented using a rotary system and divided vertically. Internal resorption cavities were created and standardized through diamond burs. Calcium hydroxide was placed into the root canal space. All specimens were evaluated using micro-CT in two different periods. The initial and residual calcium hydroxide volumes in the simulated cavities were calculated. Data were analyzed using a Kruskal-Wallis H test. Results: SWEEPS and PIPS were significantly more effective than EA, Er,Cr:YSGG, PUI, XP, and SI (p < 0.05). There was no significant difference between the SWEEPS and PIPS groups (p > 0.05). SI and XP showed the least effective activity (p < 0.05). Conclusions: The SWEEPS and PIPS techniques were superior to the EA, Er,Cr:YSGG, PUI, XP, and SI techniques. None of the techniques used entirely removed the calcium hydroxide from the resorption cavities.
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Affiliation(s)
- Dilan Kirmizi
- Department of Endodontics, Near East University Faculty of Dentistry, Mersin, Turkey
| | - Umut Aksoy
- Department of Endodontics, Near East University Faculty of Dentistry, Mersin, Turkey
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Ankara University, Faculty of Dentistry, Ankara, Turkey.,Ankara University Medical Design Application and Research Center (MEDITAM), Ankara, Turkey
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Bago I, Plotino G, Katić M, Ferenac A, Petričević GK, Gabrić D, Anić I. Effect of a novel laser-initiated photoacoustic activation of a solvent or sodium hypochlorite in the removal of filling remnants after retreatment of curved root canals. Photodiagnosis Photodyn Ther 2021; 36:102535. [PMID: 34536606 DOI: 10.1016/j.pdpdt.2021.102535] [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: 07/31/2021] [Revised: 08/30/2021] [Accepted: 09/13/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study aimed to evaluate the effect of Er:YAG laser-initiated shockwave-enhanced emission of photoacoustic streaming (SWEEPS®) and passive ultrasonic irrigation (PUI) combining thymol-based solvent or sodium hypochlorite (NaOCl) in the removal of filling remnants from curved canals. METHODS Forty-eight curved root canals were instrumented and filled with an epoxy-resin-based sealer and gutta-percha. The canals were retreated with a Wave One Gold primary file (tip size 25; variable taper) and sodium hypochlorite (NaOCl). After the retreatment, the samples were randomly divided into four groups according to the additional irrigation protocol: PUI/NaOCl, PUI/solvent, SWEEPS®/NaOCl or SWEEPS®/solvent. The volume of filling material in root canal was measured after root canal filling, after mechanical retreatment, after final irrigation protocol and after additional irrigation protocol, using micro-CT. The results were analyzed using Kruskal-Wallis test with the post-hoc Mann-Whitney U test and Wilcoxon test (α=0.05). RESULTS In the PUI group, irrigation with the solvent or NaOCl resulted in similar filling reduction (p = 0.224). In the SWEEPS® group, irrigation with NaOCl resulted in a significantly greater filling reduction compared to the solvent (p = 0.021). The SWEEPS®/NaOCl group was more effective than the PUI/NaOCl group (p = 0.008). No significant differences were found between PUI/solvent and SWEEPS® groups (p>0.05) and PUI/NaOCl and SWEEPS®/solvent group (p>0.05). CONCLUSION Although all tested protocols improved the removal of filling remnants from curved root canal, the SWEEPS® was more successful than PUI when NaOCl was used. Both tested techniques showed similar efficacy when in combination with the solvent.
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Affiliation(s)
- Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia.
| | - Gianluca Plotino
- Private Practice, Grande Plotino & Torsello - Studio di Odontoiatria, Via Calabria 25, Rome, Italy
| | - Marko Katić
- Department of Quality - National Laboratory for Length, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Croatia
| | - Adriana Ferenac
- Student of the 5th year of the School of Dental Medicine University of Zagreb, Croatia
| | | | - Dragana Gabrić
- Department of Oral Surgery, School of Dental Medicine University of Zagreb, Croatia
| | - Ivica Anić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia
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Sarwar H, Qazi F, Ahmed S, Abidi Y, Naeem M, Shabbir J, Khurshid Z. Efficacy of Handpiece Mounted Continuous Irrigation System for the Removal of Residual Pulpal Debris During Root Canal Preparation. Eur J Dent 2021; 15:551-556. [PMID: 33975373 PMCID: PMC8382463 DOI: 10.1055/s-0041-1726160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective
The removal of residual pulpal debris (RPD) from the root canal walls, especially in necrotic teeth is important for successful endodontic outcome. The aim of this study was to evaluate the RPD removal efficacy of handpiece mounted continuous irrigation with simultaneous root canal preparation from the apical third of root canals as compared to conventional syringe irrigation (SI).
Materials and Methods
Ninety extracted teeth were randomly divided into three groups: SI; handpiece mounted continuous irrigation (CI); and both syringe and continuous irrigation (CI+SI). After root canal preparation, roots were sectioned at 1 (a), 3 (b) and 5 (c) mm from apex and prepared for Hematoxylin-Eosin staining. Sections were microscopically examined for presence of RPD.
Statistical Analysis
Intergroup difference in average percentage of RPD at different root levels was calculated by using analysis of variance test (ANOVA). Tuckey test was used for pairwise comparison.
Results
ANOVA showed significant difference between all three groups (
p
< 0.05). SI group showed a significantly higher percentage of RPD as compared with CI and CI+ SI groups at all root levels (
p
< 0.01). At root level a, CI showed a significantly higher percentage of RPD as compared with CI+SI (
p
< 0.01).
Conclusion
Handpiece mounted CI during rotary instrumentation showed a significant reduction in RPD as compared with conventional syringe irrigation. This technique was found to be an effective method for an enhanced root canal debridement.
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Affiliation(s)
- Huma Sarwar
- Department of Operative Dentistry & Endodontics, Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan.,Department of Periodontology, Dr Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Fazal Qazi
- Department of Operative Dentistry & Endodontics, Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan.,Department of Periodontology, Dr Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Shahbaz Ahmed
- Department of Operative Dentistry & Endodontics, Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan.,Department of Periodontology, Dr Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Yawar Abidi
- Department of Operative Dentistry & Endodontics, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Meshal Naeem
- Department of Operative Dentistry & Endodontics, Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan.,Department of Periodontology, Dr Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Juzer Shabbir
- Department of Operative Dentistry & Endodontics, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al Ahsa, Saudi Arabia
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Wu L, Jiang S, Ge H, Cai Z, Huang X, Zhang C. Effect of Optimized Irrigation With Photon-Induced Photoacoustic Streaming on Smear Layer Removal, Dentin Microhardness, Attachment Morphology, and Survival of the Stem Cells of Apical Papilla. Lasers Surg Med 2021; 53:1105-1112. [PMID: 33764609 DOI: 10.1002/lsm.23394] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 01/11/2021] [Accepted: 02/12/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND OBJECTIVES This study aimed to evaluate the effect of optimized irrigation with photon-induced photoacoustic streaming (PIPS) activation of different irrigants (distilled water or ethylenediaminetetraacetic acid [EDTA]) on smear layer removal, dentin microhardness, attachment morphology, and survival of stem cells of the apical papilla (SCAP) in an organotypic root canal model. STUDY DESIGN/MATERIALS AND METHODS A total of 144 standardized root segments were randomly allocated into 6 groups for irrigation: (i) NaOCl group, (ii) NaOCl + EDTA group, (iii) NaOCl + PIPS (distilled water) group, (iv) NaOCl + PIPS (EDTA) group, (v) NaOCl + EDTA + PIPS (distilled water) group, and (vi) NaOCl + EDTA + PIPS (EDTA) group. Each group was divided into four subgroups for assessment: (i) dentin cleanliness; (ii) dentin microhardness; (iii) cell attachment morphology; and (iv) viable SCAP quantification. RESULTS Compared with the control groups, the NaOCl + EDTA + PIPS (EDTA) group showed higher efficiency in smear layer removal and in increasing SCAP viability with more stretched cellular morphology. There were no statistically significant differences in either smear layer removal effect, dentin microhardness, attachment morphology, or survival of SCAP among the other groups when optimized with PIPS (distilled water or EDTA) (P > 0.05). CONCLUSIONS Our findings indicated that irrigation optimized with PIPS activation of EDTA for 40 seconds was conducive to smear layer removal without additional dentin microhardness decrease. Additionally, this irrigation created more cell-friendly dentin conditioning than other approaches, which was beneficial for the attachment and survival of SCAP. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.
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Affiliation(s)
- Lixuan Wu
- Fujian Key Laboratory of Oral Diseases, Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fujian, 350002, China.,Department of Stomatology, Stomatological Hospital of Xiamen Medical College, Fujian, 361003, China
| | - Shan Jiang
- School of Stomatology, Shenzhen University Health Science Center, Shenzhen, 518037, China
| | - Huan Ge
- Department of Stomatology, Rui Jin Hospital North, Shanghai Jiaotong University School of Medicine, Shanghai, 201800, China
| | - Zhiyu Cai
- Department of Stomatology, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Xiaojing Huang
- Fujian Key Laboratory of Oral Diseases, Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fujian, 350002, China
| | - Chengfei Zhang
- Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, 999077, China
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Mustafa M, Almnea R, Ajmal M, Alamri HM, Abdulwahed A, Divakar DD. Efficacy of root canal treatment in c-shaped canals with adjunctive photodynamic therapy using micro-CT. Photodiagnosis Photodyn Ther 2021; 34:102257. [PMID: 33737217 DOI: 10.1016/j.pdpdt.2021.102257] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/04/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
AIM To investigate the efficacy of conventional root canal treatment (cRCT) with adjunctive photodynamic therapy (aPDT) against microbial biofilms within infected c-shaped root canals. METHODS In this in vitro report, the inoculation of 20 freshly extracted human mandibular molar teeth having c-shaped root canal configuration was performed with E. faecalis and P. aeruginosa to produce three-day biofilms in prepared canal system. PDT used a combination of chlorin (ce6) and polyethylenimine (PEI) as the photosensitizer (PS). A 200 μ-fiber was employed to deliver a 660 nm diode laser light into the root canal, and this was compared and conjugated with conventional endodontic treatment utilizing antiseptic irrigation and mechanical debridement. RESULTS The utilization of aPDT (group-2) resulted in a considerable decrease in the count of E. faecalis and P. aeruginosa from 12.84 ± 2.18 CFU/mL to 5.13 ± 0.67 CFU/mL, and from 14.06 ± 3.98 CFU/mL to 4.82 ± 1.05 CFU/mL pre-and post-treatment, respectively. A statistically significant reduction in the bacterial counts of both microbes was observed after treatment among the samples of the both study groups (p < 0.05). Specimens in group-2 (8.42 ± 1.14 MPa) demonstrated the highest mean push-out bond strength, whereas the lowest was shown by samples in group-1 (7.08 ± 1.09 MPa). ANOVA showed no statistical difference between the research groups (p = 0.676). The independent t-test revealed that the mean push-out bond strength scores of the cervical segments were higher than the apical and middle segments of roots in research groups (p < 0.05). CONCLUSION In c-shaped root canals, the application of photodynamic therapy as an adjuvant to conventional root canal treatment contributes to a statistically significant decrease in the microbial count of E. faecalis and P. aeruginosa along with an improved push-out bond strength of the root canal filling material with root.
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Affiliation(s)
- Mohammed Mustafa
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, P.O. BOX: 173, Al-Kharj, 11942, Saudi Arabia.
| | - Raid Almnea
- Department of Restorative Dentistry, Endodontics Division, College of Dentistry, Najran University, P.O Box 1988, Najran, 66446, Saudi Arabia
| | - Muhammed Ajmal
- Department of Diagnostic Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia; Photonix Diagnostic Imaging, Chalappuram, Calicut, Kerala, India
| | - Hadi Mohammed Alamri
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, P.O. BOX: 173, Al-Kharj, 11942, Saudi Arabia
| | - Abdulaziz Abdulwahed
- Department of Conservative Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, P.O. BOX: 173, Al-Kharj, 11942, Saudi Arabia
| | - Darshan Devang Divakar
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, P. O. Box: 10219, Riyadh, 11433, Saudi Arabia
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Lukač M, Olivi G, Constantin M, Lukač N, Jezeršek M. Determination of Optimal Separation Times for Dual-Pulse SWEEPS Laser-Assisted Irrigation in Different Endodontic Access Cavities. Lasers Surg Med 2020; 53:998-1004. [PMID: 33259683 PMCID: PMC8451836 DOI: 10.1002/lsm.23357] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/05/2020] [Accepted: 11/07/2020] [Indexed: 12/31/2022]
Abstract
Background and Objectives The purpose of this ex vivo study is to investigate whether it is possible to pre‐determine and set the optimal separation times for the SWEEPS Er:YAG laser pulses pair during laser‐assisted irrigation of endodontic root canals based on known lateral dimensions of the endodontic access cavities of different types of teeth. Study Design/Materials and Methods As the optimal SWEEPS laser pulse pair separation for enhanced shockwave generation depends on the life‐cycle of a single‐pulse bubble, measurements of the oscillation time TB of the Er:YAG laser‐generated bubble were made in 23 different endodontic access cavities of different types of teeth progressively widened in three different steps, into larger cavities, for a total of 69 cavities of different shapes and sizes. Different fiber‐tip geometries (flat and radial), laser pulse energies (10 mJ and 20 mJ) and depth of fiber‐tip insertion (2 mm and 4 mm) were also investigated. The obtained data were then analyzed using the reported relationship between the bubble oscillation time and the diameter of a cylindrically shaped cavity. Results A good fit to the relation analogue for ideal cylindrical cavities was found by taking the characteristic diameter of the access cavity to be represented by the cavity diameter either in the mesiodistal (Dmin) or buccolingual (Dmax) direction, or alternatively by the average of the two diameters (Dave). The best fit was obtained for Dmin (R2 = 0.73) followed in order by Dave (R2 = 0.71) and Dmax (R2 = 0.63). Conclusion In spite of the endodontic cavities being non‐cylindrical and of varied shape and size, the bubble oscillation time TB and the corresponding optimal SWEEPS separation time can be well predicted using a single characteristic dimension of the access cavity. This finding enables a simple and practical method for determining optimal conditions for shock wave generation and enhanced photodynamic streaming in differently shaped and sized root canals, leading to improved treatment efficacy and safety of root canal irrigation. Lasers Surg. Med. 2020. © 2020 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals LLC
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Affiliation(s)
- Matjaž Lukač
- Department of Complex Matter, Jozef Stefan Institute, Jamova cesta 39, 1000, Ljubljana, Slovenia
| | - Giovanni Olivi
- Master Laser Dentistry, Catholic University of Sacred Hearth-Rome, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Mihnea Constantin
- Master Laser Dentistry, Catholic University of Sacred Hearth-Rome, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Nejc Lukač
- Faculty of Mechanical Engineering, University of Ljubljana, Aškerčeva 6, 1000, Ljubljana, Slovenia
| | - Matija Jezeršek
- Faculty of Mechanical Engineering, University of Ljubljana, Aškerčeva 6, 1000, Ljubljana, Slovenia
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Silva EJNL, Guerreiro MYR, Belladonna FG, Monteiro LPB, Lima CO, Brandão JMS. Response to the letter to the editor‐ Is EDTA the protagonist for the enhancement of accumulated hard tissue debris removal from root canals? Int Endod J 2020; 53:1456-1457. [DOI: 10.1111/iej.13358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- E. J. N. L. Silva
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
- Department of Endodontics State University of Rio de Janeiro Rio de Janeiro Rio de JaneiroBrazil
- Department of Endodontics Grande Rio University Duque de Caxias Rio de JaneiroBrazil
| | | | - F. G. Belladonna
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | | | - C. O Lima
- Department of Endodontics State University of Rio de Janeiro Rio de Janeiro Rio de JaneiroBrazil
| | - J. M. S. Brandão
- Department of Endodontics Federal University of Pará Belém Brazil
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Linden D, Boone M, De Bruyne M, De Moor R, Versiani MA, Meire M. Adjunctive Steps for the Removal of Hard Tissue Debris from the Anatomic Complexities of the Mesial Root Canal System of Mandibular Molars: A Micro–Computed Tomographic Study. J Endod 2020; 46:1508-1514. [DOI: 10.1016/j.joen.2020.05.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/18/2020] [Accepted: 05/21/2020] [Indexed: 11/30/2022]
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