1
|
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.
Collapse
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
| |
Collapse
|
2
|
Park KH, Ordinola-Zapata R, Noblett WC, Lima BP, Staley C. The effect of ultrasonic and multisonic irrigation on root canal microbial communities: An ex vivo study. Int Endod J 2024; 57:895-906. [PMID: 37983635 DOI: 10.1111/iej.13996] [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: 12/07/2022] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/22/2023]
Abstract
AIM To analyse the effect of ultrasonic irrigant activation (UIA) and the GentleWave (GW) multisonic irrigation (GW) with minimal instrumentation on the root canal microbial diversity in an ex vivo model that used extracted molars with a history of pulp necrosis. METHODOLOGY Twenty-three mandibular molars were prepared ex vivo for collection of superficial (surface control), pre-treatment and post-treatment samples 24 h after extraction. Samples were divided into two groups: UIA using 6% NaOCl (n = 11) and GW group (n = 12). All samples were processed using quantitative real-time polymerase chain reaction (qPCR) and 16S rRNA next-generation sequencing to measure microbial diversity before and after the antimicrobial treatment. For qPCR, a t-test (α = .05) was used to compare the log10 reduction. The Chao1 and Shannon indices evaluated alpha diversity. Differences in community composition (beta diversity) were evaluated by analysis of similarity (ANOSIM). Kruskal-Wallis test with Bonferroni corrections was performed to evaluate the differences in abundances genera in the samples. RESULTS Quantitative real-time polymerase chain reaction revealed an estimated 1.6 and 2.6 log10 reduction for UIA and GW groups respectively (p = .048). An average of 5 ± 4 and 3 ± 5 operational taxonomic units (OTUs) were found in surface's samples in the UIA and GW group respectively. These values were significantly lower (p < .001) compared to the number of preoperative OTUs in those groups (155 ± 79 and 187 ± 121). In assessing beta diversity, there were no significant differences found in pre-treatment samples (R = .090, p = .070 ANOSIM with Bonferroni corrections). Also, no significant differences in community composition were observed in post-treatment samples (R = -.05, p = .829). After treatment, there was a significant reduction of Eubacterium using conventional treatment with UIA and a significant reduction of Prevotella using minimal instrumentation with GW irrigation (p = .007 and p = .002 respectively). CONCLUSION Quantitative PCR analysis revealed a significant reduction in microbial load for GW group. Overall, diversity changes were similar between UIA and GW irrigation in this ex vivo model that used extracted teeth with a history of pulp necrosis. OTUs obtained from the surface sample were negligible and did not affect the statistical outcome of the study.
Collapse
Affiliation(s)
- Ki Hong Park
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ronald Ordinola-Zapata
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - W Craig Noblett
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Bruno P Lima
- Division of Basic Sciences, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Christopher Staley
- Division of Basic & Translational Research, Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
3
|
Chen J, Zhang H, Zhao T, Yu Y, Song J, Zhao Y, Alshawwa H, Zou X, Zhang Z. Oxygen Self-Supplied Nanoplatform for Enhanced Photodynamic Therapy against Enterococcus Faecalis within Root Canals. Adv Healthc Mater 2024; 13:e2302926. [PMID: 38273674 DOI: 10.1002/adhm.202302926] [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: 09/01/2023] [Revised: 01/10/2024] [Indexed: 01/27/2024]
Abstract
The successful treatment of persistent and recurrent endodontic infections hinges upon the eradication of residual microorganisms within the root canal system, which urgently needs novel drugs to deliver potent yet gentle antimicrobial effects. Antibacterial photodynamic therapy (aPDT) is a promising tool for root canal infection management. Nevertheless, the hypoxic microenvironment within the root canal system significantly limits the efficacy of this treatment. Herein, a nanohybrid drug, Ce6/CaO2/ZIF-8@polyethylenimine (PEI), is developed using a bottom-up strategy to self-supply oxygen for enhanced aPDT. PEI provides a positively charged surface, which enables precise targeting of bacteria. CaO2 reacts with H2O to generate O2, which alleviates the hypoxia in the root canal and serves as a substrate for Ce6 under 660 nm laser irradiation, leading to the successful eradication of planktonic Enterococcus faecalis (E. faecalis) and biofilm in vitro and, moreover, the effective elimination of mature E. faecalis biofilm in situ within the root canal system. This smart design offers a viable alternative for mitigating hypoxia within the root canal system to overcome the restricted efficacy of photosensitizers, providing an exciting prospect for the clinical management of persistent endodontic infection.
Collapse
Affiliation(s)
- Jiawen Chen
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Hong Zhang
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Tiancong Zhao
- College of Chemistry and Materials, Department of Chemistry and Laboratory of Advanced Materials, Shanghai Key Laboratory of Molecular Catalysis and Innovative Materials, State Key Laboratory of Molecular Engineering of Polymers, Collaborative Innovation Center of Chemistry for Energy Materials (2011-iChEM), Fudan University, Shanghai, 200433, P. R. China
| | - Yiyan Yu
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Jiazhuo Song
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Yuanhang Zhao
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Hamed Alshawwa
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Xinying Zou
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| | - Zhimin Zhang
- Department of Endodontics, Jilin Provincial Key Laboratory of Oral Biomedical Engineering, School and Hospital of Stomatology, Jilin University, Changchun, 130021, P. R. China
| |
Collapse
|
4
|
Mohamed AA, Fayyad DM, El-Telbany M, Mohamed DAA. Antibacterial biofilm efficacy of calcium hydroxide loaded on Gum Arabic nanocarrier: an in-vitro study. BMC Oral Health 2024; 24:215. [PMID: 38341565 PMCID: PMC10859034 DOI: 10.1186/s12903-024-03941-3] [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: 07/10/2023] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND An innovative intracanal medication formulation was introduced in the current study to improve the calcium hydroxide (Ca(OH)2) therapeutic capability against resistant Enterococcus faecalis (E. faecalis) biofilm. This in-vitro study aimed to prepare, characterize, and evaluate the antibacterial efficiency of Ca(OH)2 loaded on Gum Arabic (GA) nanocarrier (Ca(OH)2-GA NPs) and to compare this efficiency with conventional Ca(OH)2, Ca(OH)2 nanoparticles (NPs), GA, and GA NPs. MATERIALS AND METHODS The prepared nanoparticle formulations for the tested medications were characterized using Transmission Electron Microscope (TEM) and Fourier-Transform Infrared Spectroscopy (FTIR). 141 human mandibular premolars were selected, and their root canals were prepared. Twenty-one roots were then sectioned into 42 tooth slices. All prepared root canals (n = 120) and teeth slices (n = 42) were divided into six groups according to the intracanal medication used. E. faecalis was inoculated in the samples for 21 days to form biofilms, and then the corresponding medications were applied for 7 days. After medication application, the residual E. faecalis bacteria were assessed using CFU, Q-PCR, and SEM. Additionally, the effect of Ca(OH)2-GA NPs on E. faecalis biofilm genes (agg, ace, and efaA) was investigated using RT-PCR. Data were statistically analyzed at a 0.05 level of significance. RESULTS The synthesis of NPs was confirmed using TEM. The results of the FTIR proved that the Ca(OH)2 was successfully encapsulated in the GA NPs. Ca(OH)2-GA NPs caused a significant reduction in the E. faecalis biofilm gene expression when compared to the control (p < 0.001). There were significant differences in the E. faecalis CFU mean count and CT mean values between the tested groups (p < 0.001) except between the Ca(OH)2 and GA CFU mean count. Ca(OH)2-GA NPs showed the least statistical E. faecalis mean count among other groups. SEM observation showed that E. faecalis biofilm was diminished in all treatment groups, especially in the Ca(OH)2-GA NPS group when compared to the control group. CONCLUSIONS Ca(OH)2 and GA nanoparticles demonstrate superior anti-E. faecalis activity when compared to their conventional counterparts. Ca(OH)2-GA NPs showed the best antibacterial efficacy in treating E. faecalis biofilm. The tested NP formulations could be considered as promising intracanal medications.
Collapse
Affiliation(s)
- Alshafey Alsayed Mohamed
- Department of Endodontics, Faculty of Dentistry, Suez Canal University, 4.5 Ring Road, Ismailia, 41522, Egypt
| | - Dalia Mukhtar Fayyad
- Department of Endodontics, Faculty of Dentistry, Suez Canal University, 4.5 Ring Road, Ismailia, 41522, Egypt
| | - Mohamed El-Telbany
- Microbiology and Botany Department, Faculty of Science, Zagazig University, Zagazig, 44519, Egypt
- Department of Bioscience and Biotechnology, Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu University, 744 Motooka, Nishi-Ku, Fukuoka, 819-0395, Japan
| | - Dalia Abd-Allah Mohamed
- Department of Endodontics, Faculty of Dentistry, Suez Canal University, 4.5 Ring Road, Ismailia, 41522, Egypt.
- Department of Endodontics, Faculty of Dentistry, Sinai University, Kantara, Ismailia, Egypt.
| |
Collapse
|
5
|
Wenzler JS, Falk W, Frankenberger R, Braun A. Temporary Root Canal Obturation with a Calcium Hydroxide-Based Dressing: A Randomized Controlled Clinical Trial. Antibiotics (Basel) 2023; 12:1663. [PMID: 38136697 PMCID: PMC10740497 DOI: 10.3390/antibiotics12121663] [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: 10/18/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Successful bacterial inactivation or elimination is essential for successful outcomes in endodontics. This study investigated the efficacy of a calcium hydroxide paste (Ca(OH)2) as a temporary medical dressing for 1 week after chemomechanical root canal treatment (CMRCT). Microbiological samples from 26 patients were collected after endodontic emergency treatment as follows: (1) removal of the provisional filling material; (2) CMRCT; (3) irrigation with sodium hypochlorite I (3%); (4) medicinal insertion of Ca(OH)2; and (5) irrigation with sodium hypochlorite II (3%). A microbiological examination was carried out after the specimens had been taken from the root canals via saline and sterile paper points. CMRCT resulted in a significant reduction in total bacterial load (TBL) in the root canal (p < 0.05). Additional irrigation (3) resulted in a further significant reduction in TBL (p < 0.05). In contrast, Ca(OH)2 medication did not prevent the bacterial load from returning to the previous level immediately after CMRCT, but did not increase above that level either (p < 0.05). However, the increase in TBL was significant (p < 0.05) in comparison with the disinfection groups (I/II). Administration of Ca(OH)2 for 1 week shows that in combination with an additional disinfection procedure, an increase in TBL must be expected, but not above the level of conditions after CMRCT.
Collapse
Affiliation(s)
- Johannes-Simon Wenzler
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany;
- Department of Operative Dentistry, Endodontics and Pediatric Dentistry, Campus Marburg, University Medical Center Giessen and Marburg, Georg-Voigt-Strasse 3, 35039 Marburg, Germany
| | - Wolfgang Falk
- Center for Oro-Dental Microbiology, Hamburger Chausse 25, 24220 Flintbek, Germany
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics and Pediatric Dentistry, Campus Marburg, University Medical Center Giessen and Marburg, Georg-Voigt-Strasse 3, 35039 Marburg, Germany
| | - Andreas Braun
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany;
- Department of Operative Dentistry, Endodontics and Pediatric Dentistry, Campus Marburg, University Medical Center Giessen and Marburg, Georg-Voigt-Strasse 3, 35039 Marburg, Germany
| |
Collapse
|
6
|
Liu L, Wu D, Tu H, Cao M, Li M, Peng L, Yang J. Applications of Hydrogels in Drug Delivery for Oral and Maxillofacial Diseases. Gels 2023; 9:gels9020146. [PMID: 36826316 PMCID: PMC9956178 DOI: 10.3390/gels9020146] [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: 12/19/2022] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 02/12/2023] Open
Abstract
Oral and maxillofacial diseases have an important impact on local function, facial appearance, and general health. As a multifunctional platform, hydrogels are widely used in the biomedical field due to their excellent physicochemical properties. In recent years, a large number of studies have been conducted to adapt hydrogels to the complex oral and maxillofacial environment by modulating their pore size, swelling, degradability, stimulus-response properties, etc. Meanwhile, many studies have attempted to use hydrogels as drug delivery carriers to load drugs, cytokines, and stem cells for antibacterial, anticancer, and tissue regeneration applications in oral and maxillofacial regions. This paper reviews the application and research progress of hydrogel-based drug delivery systems in the treatment of oral and maxillofacial diseases such as caries, endodontic diseases, periodontal diseases, maxillofacial bone diseases, mucosal diseases, oral cancer, etc. The characteristics and applications of hydrogels and drug-delivery systems employed for the treatment of different diseases are discussed in order to provide a reference for further research on hydrogel drug-delivery systems in the future.
Collapse
Affiliation(s)
- Lijia Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Dan Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Heng Tu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Mengjiao Cao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Mengxin Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Li Peng
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu 610065, China
| | - Jing Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence:
| |
Collapse
|
7
|
Ruiz-Linares M, Monroy-Rojas JF, Solana C, Baca P, Aguado B, Soriano-Lerma A, Arias-Moliz MT, Ferrer-Luque CM. Antimicrobial potential of new diclofenac hydrogels for disinfection in regenerative endodontics: An in vitro and ex vivo study. Int Endod J 2023; 56:103-117. [PMID: 36169591 DOI: 10.1111/iej.13840] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 09/07/2022] [Accepted: 09/22/2022] [Indexed: 12/13/2022]
Abstract
AIM There is a need to explore new alternatives for root canal disinfection in regenerative endodontics, since the current strategies are far from ideal. Currently, the potential use of diclofenac (DC) is being investigated for controlling root canal infections. The objective was to evaluate the antimicrobial efficacy of novel DC-based hydrogels (DCHs) against polymicrobial biofilms grown in radicular dentine and root canals and to compare results with triantibiotic (TAH) and diantibiotic (DAH) hydrogels, and calcium hydroxide (Ca[OH]2 ). METHODOLOGY The in vitro antimicrobial activity of intracanal medicaments was evaluated against 3-week-old polymicrobial root canal biofilms grown on human radicular dentine. Dentine samples were obtained and randomly divided into the study groups (n = 4/group): (1) 1 mg/ml TAH; (2) 1 mg/ml DAH; (3) 5% diclofenac (DCH); (4) 2.5% DCH; (5) 1.25% DCH; (6) 1 mg/ml DAH + 5% DCH; (7) Ca(OH)2 paste; (8) positive control. The microbial viability, in terms of percentage of intact cell membranes, was assessed after 7 days by confocal scanning laser microscopy (CSLM). The ex vivo efficacy of intracanal medications was evaluated in root canals infected with a polymicrobial suspension. Intracanal microbiological samples at baseline (S1) and 7 days post-treatment (S2) were taken; microbial quantification and cell viability were assessed by quantitative polymerase chain reaction (qPCR) and flow cytometry (FC). The mean Log10 of bacterial DNA copies in root canal samples before (S1) and the Log10 reduction of DNA copies S1-S2 in qPCR were recorded. The absolute value of total cells stained, and the percentage reduction of intact membrane cells after treatment (S1-S2), were analysed by FC. Global comparison was done using the Kruskal-Wallis test, whilst the Mann-Whitney U test was used for pair-by-pair comparison. RESULTS Confocal scanning laser microscopy analysis indicated that the greatest effectiveness was obtained with 5% DCH, showing significant differences with respect to the other groups (p < .001). In root canals, the highest Log10 DNA reduction S1-S2 was obtained with 5% DCH and TAH, with no differences between them. The results of FC showed that only 5% DCH proved significantly superior to the other treatments. CONCLUSIONS Sodium DC hydrogels demonstrate antimicrobial efficacy against endodontic biofilms.
Collapse
Affiliation(s)
- Matilde Ruiz-Linares
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Javier F Monroy-Rojas
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - Carmen Solana
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Pilar Baca
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Beatriz Aguado
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain
| | - Ana Soriano-Lerma
- Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, Spain.,GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
| | - María Teresa Arias-Moliz
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,Department of Microbiology, School of Dentistry, University of Granada, Granada, Spain
| | - Carmen María Ferrer-Luque
- Department of Stomatology, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| |
Collapse
|
8
|
Mahfouz Omer SM, Mohamed DA, Ali Abdel Latif RM. Comparative Evaluation of the Antibacterial Effect of Allium Sativum, Calcium hydroxide and Their Combination as Intracanal Medicaments in Infected Mature Anterior Teeth A Randomized Clinical Trial. Int Endod J 2022; 55:1010-1025. [DOI: 10.1111/iej.13801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 06/14/2022] [Accepted: 07/14/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Shaimaa Mohamed Mahfouz Omer
- Department of Pediatric Dentistry, Preventive Dentistry and Dental Public Health, Faculty of Dentistry Suez Canal University Egypt
| | | | - Reham Mohamed Ali Abdel Latif
- Department of Pediatric Dentistry, Preventive Dentistry and Dental Public Health, Faculty of Dentistry Suez Canal University Egypt
- Department of Restorative Dental Science, Vision Colleges Jeddah Saudi Arabia
| |
Collapse
|