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Hachem CE, Nehme W, Kaloustian MK, Ghosn N, Daou M, Zogheib C, Karam M, Mhanna R, Macaluso V, Kharouf N, Chedid JCA. The Effectiveness of Different Irrigation Techniques on Debris and Smear Layer Removal in Primary Mandibular Second Molars: An In Vitro Study. J Contemp Dent Pract 2022; 23:1173-1179. [PMID: 37073943 DOI: 10.5005/jp-journals-10024-3440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
AIMS The aim of the present in vitro study was to compare the effectiveness of passive ultrasonic irrigation (PUI), sonic irrigation, and mechanic dynamic activation on the removal of debris and smear layer from primary mandibular second molars during pulpectomy. MATERIALS AND METHODS Mesial roots of 48 primary mandibular second molars were prepared with an R-motion 21 mm file (30/0.04) (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland), irrigated with 1% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA), and divided into four groups (n = 24 canals) according to the final irrigation activation technique: control group without activation, PUI with Ultra-X (Eighteeth, Changzhou, China), mechanical activation with XP-endo Finisher (FKG), and sonic irrigation with EQ-S (Meta Biomed, Chungcheongbuk-do, Korea). The roots were split longitudinally and analyzed using scanning electron microscopy (SEM). The presence of debris and smear layer was assessed using a 5-grade scoring scale with 200× and 1000× magnification, respectively. The Kruskal-Wallis and Friedman tests were used for data analysis. RESULTS The activation of the irrigant significantly improved debris and smear layer removal (p < 0.001). There was no significant difference between Ultra-X, XP-endo Finisher, and EQ-S (p > 0.05). No activation technique was able to completely eliminate debris and smear layer from the root canals of primary mandibular second molars. CONCLUSIONS During pediatric pulpectomy, the irrigation protocol must include activation of the irrigation solutions using either ultrasonic, sonic, or mechanical activation techniques to enhance the removal of debris and smear layer for a better prognosis. CLINICAL SIGNIFICANCE During root canal treatment on primary teeth, the clinician must incorporate an activation technique in the irrigation protocol to enhance the removal of debris and smear layer and increase the success of the treatment.
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Affiliation(s)
- Claire El Hachem
- Department of Pediatric and Community Dentistry, Saint Joseph University, Beirut, Lebanon, Phone: +0096170107702, e-mail:
| | - Walid Nehme
- Department of Endodontics, Saint Joseph University, Beirut, Lebanon; Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, United States of America, Orcid: https://orcid.org/0000-0002-1589-1454
| | - Marc Krikor Kaloustian
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University, Beirut, Lebanon, Orcid: https://orcid.org/0000-0002-0811-6935
| | - Nabil Ghosn
- Faculty of Dental Medicine, Craniofacial Research Laboratory, Saint Joseph University, Beirut, Lebanon, Orcid: https://orcid.org/0000-0003-1524-5310
| | - Maha Daou
- Faculty of Dental Medicine, Saint Joseph University, Beirut, Lebanon; McGill University, Montreal, Canada, Orcid: https://orcid.org/0000-0001-6882-9227
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dental Medicine, Saint Joseph University, Beirut, Lebanon, Orcid: https://orcid.org/0000-0003-0857-6998
| | - Mia Karam
- Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon, Orcid: https://orcid.org/0000-0002-9783-3334
| | - Rami Mhanna
- Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon, Orcid: https://orcid.org/0000-0003-0345-625X
| | - Valentina Macaluso
- ESTA, School of Business & Technology, Belfort, France, Orcid: https://orcid.org/0000-0002-6503-9841
| | - Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S1121, Strasbourg University, Strasbourg, France; Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, Strasbourg, France, Orcid: https://orcid.org/0000-0001-6768-138X
| | - Jean Claude Abou Chedid
- Department of Pediatric and Community Dentistry, Faculty of Dental Medicine, Saint Joseph University, Beirut, Lebanon, Orcid: https://orcid.org/0000-0001-5161-8693
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Bassam S, El-Ahmar R, Salloum S, Ayoub S. Endodontic postoperative flare-up: An update. Saudi Dent J 2021; 33:386-394. [PMID: 34803278 PMCID: PMC8589595 DOI: 10.1016/j.sdentj.2021.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/13/2021] [Accepted: 05/20/2021] [Indexed: 02/03/2023] Open
Abstract
Endodontic treatment corresponds to a combined chemical and mechanical approach, followed by a three dimensional hermetic obturation, that eliminate the pulpal and periradiculare disease and boost healing and repair of periradiculare tissue. Despite the advances in the endodontic field, the inter-appointment flare up remains a true nightmare that encounters every dentist. This complication commences a few hours or days after root canal procedures and it is characterized by the development of pain and/or swelling, requiring an unscheduled appointment for emergency treatment. Different studies showed that flare-ups represent a multifactorial phenomenon including mechanical, chemical and microbial factors. In addition, a correlation was found between flare-up and age, gender, tooth type, presence of preoperative pain, tooth condition before treatment, irrigation techniques, number of visits as well as intracanal medication. Moreover, some medicine intake was proved to be efficient in controlling this postoperative pain. However, a clear procedure to avoid its occurrence is yet to be established. In this review, we summarize knowledge about the etiology of flare-up and its related factors. This could be effective in helping dentists to adapt some strategies to prevent it.
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Affiliation(s)
- Sanaa Bassam
- Department of Endodontics, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Rima El-Ahmar
- Department of Restorative and Esthetic Dentistry, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Sara Salloum
- Department of Endodontics, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Sara Ayoub
- Department of Prosthodontics, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
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