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Cordova AT, Alcalde MP, Klymus ME, Bonjardim LR, Vivan RR, Duarte MAH. Impact of different agitation methods on smear layer cleaning of mesial canals with accentuated curvature. Restor Dent Endod 2024; 49:e12. [PMID: 38841384 PMCID: PMC11148408 DOI: 10.5395/rde.2024.49.e12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/12/2023] [Accepted: 01/04/2024] [Indexed: 06/07/2024] Open
Abstract
Objectives This study evaluated the impact of different methods of irrigant agitation on smear layer removal in the apical third of curved mesial canals of 3 dimensionally (D) printed mandibular molars. Materials and Methods Sixty 3D-printed mandibular second molars were used, presenting a 70° curvature and a Vertucci type II configuration in the mesial root. A round cavity was cut 2 mm from the apex using a trephine of 2 mm in diameter, 60 bovine dentin disks were made, and a smear layer was formed. The dentin disks had the adaptation checked in the apical third of the teeth with wax. The dentin disks were evaluated in environmental scanning electron microscope before and after the following irrigant agitation methods: G1(PIK Ultrasonic Tip), G2 (Passive Ultrasonic Irrigation with Irrisonic- PUI), G3 (Easy Clean), G4 (HBW Ultrasonic Tip), G5 (Ultramint X Ultrasonic tip), and G6 (conventional irrigation-CI) (n = 10). All groups were irrigated with 2.5% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. Results All dentin disks were 100% covered by the smear layer before treatment, and all groups significantly reduced the percentage of the smear layer after treatment. After the irrigation protocols, the Ultra-X group showed the lowest coverage percentage, statistically differing from the conventional, PIK, and HBW groups (p < 0.05). There was no significant difference among Ultramint X, PUI-Irrisonic, and Easy Clean (p > 0.05). None of the agitation methods could remove the smear layer altogether. Conclusions Ultramint X resulted in the most significant number of completely clean specimens.
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Affiliation(s)
- Abel Teves Cordova
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo – USP, Bauru, SP, Brazil
| | - Murilo Priori Alcalde
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo – USP, Bauru, SP, Brazil
| | - Michel Espinosa Klymus
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo – USP, Bauru, SP, Brazil
| | - Leonardo Rigoldi Bonjardim
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo – USP, Bauru, SP, Brazil
| | - Rodrigo Ricci Vivan
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo – USP, Bauru, SP, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo – USP, Bauru, SP, Brazil
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Zou X, Zheng X, Liang Y, Zhang C, Fan B, Liang J, Ling J, Bian Z, Yu Q, Hou B, Chen Z, Wei X, Qiu L, Chen W, He W, Xu X, Meng L, Zhang C, Chen L, Deng S, Lei Y, Xie X, Wang X, Yu J, Zhao J, Shen S, Zhou X, Yue L. Expert consensus on irrigation and intracanal medication in root canal therapy. Int J Oral Sci 2024; 16:23. [PMID: 38429299 PMCID: PMC10907616 DOI: 10.1038/s41368-024-00280-5] [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: 11/05/2023] [Revised: 12/22/2023] [Accepted: 01/03/2024] [Indexed: 03/03/2024] Open
Abstract
Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment. However, irrigant selection or irrigation procedures are far from clear. The vapor lock effect in the apical region has yet to be solved, impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes. Additionally, ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified. Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes. Indeed, clinicians have been aware of these concerns for years. Based on the current evidence of studies, this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions. The evolution of different kinetic irrigation methods, their effects, limitations, the paradigm shift, current indications, and effective operational procedures regarding intracanal medication are also discussed. This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication, thus facilitating a better understanding of infection control, standardizing clinical practice, and ultimately improving the success of endodontic therapy.
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Affiliation(s)
- Xiaoying Zou
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
- Center of Stomatology, Peking University Hospital, Beijing, China
| | - Xin Zheng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuhong Liang
- Department of Emergency, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Chengfei Zhang
- Restorative Dental Sciences, Endodontics, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Bing Fan
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jingping Liang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Clinical Research Center for Oral Diseases; National Center for Stomatology; Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Junqi Ling
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology , Guangzhou, China
| | - Zhuan Bian
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qing Yu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xián, China
| | - Benxiang Hou
- Center for Microscope Enhanced Dentistry, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Zhi Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xi Wei
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology , Guangzhou, China
| | - Lihong Qiu
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Wenxia Chen
- College & Hospital of Stomatology, Guangxi Medical University, Nanning, China
| | - Wenxi He
- Department of Stomatology, Air Force Medical Center, The Air Force Medical University, Beijing, China
| | - Xin Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liuyan Meng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Chen Zhang
- Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Liming Chen
- Department of Endodontics, Guiyang Stomatological Hospital, Guiyang, China
| | - Shuli Deng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Yayan Lei
- Department of Endodontics, the Affiliated Stomatological Hospital of Kunming Medical University, Kunming, China
| | - Xiaoli Xie
- Department of Endodontology, Hunan Xiangya Stomatological Hospital, Central South University, Changsha, China
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Jinhua Yu
- Institute of Stomatology, Nanjing Medical University & Department of Endodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Jin Zhao
- Department of Endodontics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Song Shen
- Center of Stomatology, Peking University Hospital, Beijing, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Lin Yue
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.
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Iandolo A, Pisano M, Buonavoglia A, Giordano F, Amato A, Abdellatif D. Traditional and Recent Root Canal Irrigation Methods and Their Effectiveness: A Review. Clin Pract 2023; 13:1059-1072. [PMID: 37736930 PMCID: PMC10514886 DOI: 10.3390/clinpract13050094] [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: 08/15/2023] [Revised: 08/25/2023] [Accepted: 08/25/2023] [Indexed: 09/23/2023] Open
Abstract
According to contemporary dental standards, the primary goal of endodontic therapy is the chemo-mechanical cleaning of the complex root canal system. Watering root canals with approved solutions and activating them are essential parts of this operation. This review outlines various irrigant activation methods for root canal therapy. Specifically, a comparison among the methods of manual dynamic activation, sonics (subsonic, sonic, and ultrasonic), internal heating, and lasers, was conducted. The results in this work were gathered using Scopus, Web of Science, Google Scholar, and PubMed databases by searching the following keywords: sodium hypochlorite, cleaning, activation, and irrigation methods. The present work concluded that the use of irrigant activation has a greater benefit than its absence. Regardless, it is impossible to point to a single effective activation method.
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Affiliation(s)
- Alfredo Iandolo
- Department of Medicine and Surgery, School of Dentistry, University of Salerno, 84081 Salerno, Italy; (M.P.); (F.G.); (A.A.)
| | - Massimo Pisano
- Department of Medicine and Surgery, School of Dentistry, University of Salerno, 84081 Salerno, Italy; (M.P.); (F.G.); (A.A.)
| | - Alessio Buonavoglia
- Department of Biomedical and Neuromotor Sciences, School of Dentistry, University of Bologna, 40125 Bologna, Italy;
| | - Francesco Giordano
- Department of Medicine and Surgery, School of Dentistry, University of Salerno, 84081 Salerno, Italy; (M.P.); (F.G.); (A.A.)
| | - Alessandra Amato
- Department of Medicine and Surgery, School of Dentistry, University of Salerno, 84081 Salerno, Italy; (M.P.); (F.G.); (A.A.)
| | - Dina Abdellatif
- Department of Endodontics, Faculty of Dentistry, University of Alexandria, Alexandria 21531, Egypt;
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Azizi Mazreah S, Shirvani A, Azizi Mazreah H, Dianat O. Evaluation of irrigant extrusion following the use of different root canal irrigation techniques: A systematic review and meta-analysis. AUST ENDOD J 2023; 49:396-417. [PMID: 35988128 DOI: 10.1111/aej.12678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/27/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022]
Abstract
This systematic review investigates whether different irrigation techniques have different effects on irrigant extrusion from mature tooth apices. Articles published between January 2000 and January 2022 were searched in six electronic databases (MEDLINE, Embase, Google Scholar, Web of Science, Scopus and Cochrane) using appropriate keywords. Overall, 2265 articles were screened by their titles and abstracts. Fifty-six full-text articles were selected based on the inclusion criteria. Of them, 17 in vitro studies were included in the systematic review and meta-analysis. The meta-analysis was conducted using the random-effects inverse variance method. The results showed that the negative pressure technique caused a lesser amount (p = 0.00) and frequency (p = 0.00) of extrusion than the open-ended needle irrigation. Sonic and ultrasonic activation caused less amount of extrusion than both open-ended (p = 0.00 or p = 0.01) and closed-ended needle (p = 0.00) irrigation.
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Affiliation(s)
| | - Armin Shirvani
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Omid Dianat
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Maryland, USA
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Arumugam C, Ashok R, Ramesh SR, Kalaiselvam R, Soundararajan K, Rajendran MR. External Root Surface Temperature Control with 1,1,1,2-Tetrafluoroethane Intracanal Cryotherapy during Thermoplastic Obturation: An In Vitro Study. J Contemp Dent Pract 2023; 24:419-423. [PMID: 37622617 DOI: 10.5005/jp-journals-10024-3528] [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: 08/26/2023]
Abstract
AIM The aim of this in vitro study was to determine the effectiveness of 1,1,1,2-tetrafluoroethane (TFE) intracanal cryotherapy for external root surface temperature control during thermoplastic obturation. MATERIALS AND METHODS Thirty extracted adult single-rooted mandibular incisors were selected for this study. Endodontic shaping was performed until size X3 Protaper Next Rotary endodontic file. The teeth were divided into three groups: Group I-Control group wherein conventional irrigation was done using physiologic saline stored at room temperature, Group II-Irrigational Cryotherapy group using physiologic saline at 2.5°C, and Group III-Intracanal TFE cryotherapy group with intracanal refrigerant TFE application. Temperatures were recorded in the apical 3 mm before and after completion of each intervention and post thermoplastic obturation using a noncontact digital laser infrared thermometer. RESULTS Intracanal cryotherapy with TFE resulted in a mean decrease of 9.27°C compared with conventional irrigation that exhibited in a mean decrease of 2.13°C. Also, in intracanal cryotherapy group with TFE application, compared with the baseline (24.50°C), no significant differences were observed post obturation (24.61°C) with high-temperature-injectable gutta percha technique indicating good control of temperature rise on the external root surface. CONCLUSION Intracanal cryotherapy with refrigerant TFE was highly effective in controlling temperature rise on the external root surface during injectable thermoplastic obturation technique. CLINICAL SIGNIFICANCE Minimizing deleterious effects due to high temperatures generated during the thermoplastic obturation is critical. Clinically feasible measures to reduce the transmission of heat generated during thermoplastic obturation have been searched since long. In this regard, intracanal cryotherapy with TFE can be effectively used to control the rise of temperature on the external root surface when employing thermoplastic obturation technique.
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Affiliation(s)
- Chakravarthy Arumugam
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India
| | - Rupa Ashok
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India, Phone: +91 9940072721, e-mail:
| | - Seshan Rakkesh Ramesh
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India
| | - Rajeswari Kalaiselvam
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India
| | - Karthick Soundararajan
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India
| | - Mathan Rajan Rajendran
- Department of Conservative Dentistry and Endodontics, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India
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Chinta PR, Kalla N, Dhavala PC, Satyavathi DPS, Rolla SA, Uppalapati P. Comparative Evaluation of Different Irrigant Agitating Devices for Debris Removal from the Mesial Roots of Mandibular Molars: An In Vitro Study. J Contemp Dent Pract 2023; 24:449-453. [PMID: 37622621 DOI: 10.5005/jp-journals-10024-3533] [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: 08/26/2023]
Abstract
AIM To evaluate the efficiency of debris removal from the mesial root canals and isthmus of mesial roots of mandibular molars after final irrigant agitation with XP-endo Shaper, EndoVac (EV), plastic finishing file, and conventional needle irrigation. METHODS AND MATERIALS Forty extracted human mandibular first molar teeth with the isthmus between the mesial roots were selected, access cavities were prepared and distal roots were decoronated. All the mesial root specimens were mounted in acrylic, sectioned at the coronal, middle, and apical thirds, along with the resin block, and examined for debris in the canals and isthmus before the start of the procedure using a stereomicroscope and were mounted back in a custom-made jig. After determination of the working length, they were allocated to the following four different irrigant activation groups (n = 10): Group I-XP-endo Finisher; group II-EndoVac; group III-plastic finishing file; and group IV-standard needle irrigation. After biomechanical preparation (BMP) till F3, final agitation was done for debris removal with the respective agitating devices, and all the samples were examined under a stereomicroscope for the amount of debris in the canal after final agitation. RESULTS Of all the irrigation devices used, the XP-endo Finisher and EV showed more debris removal when compared to other groups (p < 0.05). The plastic finishing file in continuous rotation was more efficient in cleaning debris compared with conventional needle irrigation (p < 0.05). CONCLUSION The XP-endo Finisher and EV showed a significant difference in cleaning efficacy than the plastic finishing files. So, these can be used as adjunctive for agitating the final irrigant. CLINICAL SIGNIFICANCE The irrigant agitation devices promote the penetration of irrigants into the intricate root canal anatomy and increase their antibacterial and tissue-dissolving effectiveness thereby improving the success rate and treatment outcome.
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Affiliation(s)
- Priyanka Reddy Chinta
- Department of Conservative Dentistry and Endodontics, GSL Dental College & Hospital, Rajanagaram, Andhra Pradesh, India, Phone: +91 9493672455, e-mail: , Orcid: https://orcid.org/0000-0002-7463-9443
| | - Nagalakshmi Kalla
- Department of Conservative Dentistry and Endodontics, GSL Dental College & Hospital, Rajanagaram, Andhra Pradesh, India
| | - Padma Chaitanya Dhavala
- Master of Dental Surgery in Department of Conservative Dentistry and Endodontics, Drs Sudha & Nageswara rao Siddhartha institute of dental sciences, Gannavaram, Andhra Pradesh, India
| | - Damarla Poorna Samudra Satyavathi
- Master of Dental Surgery in Department of Conservative Dentistry and Endodontics, Drs Sudha & Nageswara rao Siddhartha institute of dental sciences, Gannavaram, Andhra Pradesh, India
| | - Sanjay Adarsh Rolla
- Department of Conservative Dentistry and Endodontics, GSL Dental College & Hospital, Rajanagaram, Andhra Pradesh, India
| | - Pragnya Uppalapati
- Department of Conservative Dentistry and Endodontics, GSL Dental College & Hospital, Rajanagaram, Andhra Pradesh, India
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Hassan HY, Hadhoud FM, Mandorah A. Retreatment of XP-endo Shaper and R-Endo files in curved root canals. BMC Oral Health 2023; 23:38. [PMID: 36694152 PMCID: PMC9872356 DOI: 10.1186/s12903-023-02735-3] [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: 07/17/2022] [Accepted: 01/11/2023] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES To compare the retreatment efficiency of XP-endo Shaper and R-Endo files in curved root canals using ImageJ software. METHODS Forty extracted mandibular first molars with curved mesial canals (25°-35°) were chosen. Access cavities, preparation and obturation of root canals were performed. Roots were randomly distributed into two groups corresponding to the retreatment files used. Group 1 retreated with XP-endo Shaper file, and group 2 retreated with R-Endo files. Each root was sectioned and photographed. ImageJ software was used to estimate the percentage of residual filling material that existed on the three root canal segments. Mann-Whitney U and the Kruskal-Wallis tests were used to compare the percentages of residual filling material between the teeth segments (P < .05). RESULTS The R-Endo group showed a significantly higher median percentage of residual filling material than the XP-endo Shaper group. In both groups, the coronal segments had the highest median of the residual filling material, followed by the middle and apical segments. CONCLUSION XP-endo Shaper is significantly more effective than R-Endo in removing root canal filling materials in the coronal, middle, and apical segments.
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Affiliation(s)
- Hayam Y. Hassan
- grid.33003.330000 0000 9889 5690Endodontic Department, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
| | - Fahd M. Hadhoud
- grid.411303.40000 0001 2155 6022Endodontic Department, Faculty of Dental Medicine Assiut Branch, Al-Azhar University, Assiut, Egypt ,grid.412895.30000 0004 0419 5255Restorative and Dental Materials Department, Faculty of Dentistry, Taif University, P.O Box 11099, Taif, 21944 Saudi Arabia
| | - Ayman Mandorah
- grid.412895.30000 0004 0419 5255Restorative and Dental Materials Department, Faculty of Dentistry, Taif University, P.O Box 11099, Taif, 21944 Saudi Arabia
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8
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Fidan ME, Erdemir A. Effect of different irrigation activation techniques on irrigation penetration into the simulated lateral canals. Odontology 2023; 111:132-141. [PMID: 35834067 DOI: 10.1007/s10266-022-00729-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 07/05/2022] [Indexed: 01/06/2023]
Abstract
This study, in which a hundred human teeth with single straight canal were used, focused on the evaluation of contrast solution penetration ability into the simulated lateral canals activated by XP-endo Finisher (XPF), EDDY, Nd:YAG, and Er:YAG laser systems with three different observation methods. The root canals were prepared up to X4 at working length using the ProTaper Next system. The teeth were decalcified and simulated lateral canals were created with #8 K-file at 2, 4, and 6 mm levels. Then the teeth were cleared using methyl salicylate and divided into 5 equal groups according to irrigation activation techniques (CSI, XPF, EDDY, Nd:YAG, and Er:YAG laser). After the contrast solution was activated, images of the simulated lateral canals were obtained by a dental microscope, digital radiography, and CBCT. The contrast solution penetration scores at the 2, 4, and 6 mm levels according to irrigation activation techniques and observation methods were analyzed statistically using Kruskal-Wallis non-parametric analysis of variance Bonferroni test post hoc comparisons. With the other 2 parameters are ignored, the highest and lowest contrast solution penetration were observed at 6 and 2 mm simulated lateral canal levels (p < 0.05), in Er:YAG irrigation activation and CSI technique (p < 0.05), and in direct visual and digital radiographic observation method (p < 0.05), respectively. Within the limits of this study, it was determined that the contrast solution penetration into the simulated lateral canals decreased from the coronal to the apical and achieved with the most effective Er:YAG laser activation technique. In addition, direct visual observation was found to be the best method for the assessment of contrast solution penetration.
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Affiliation(s)
- Mehmet Eren Fidan
- Department of Endodontics, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey.
| | - Ali Erdemir
- Department of Endodontics, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey
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9
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Sobrino M, Foschi F, Estévez R, Loroño G, Conde Villar A, Pérez-Alfayate R. Effects of continuous chelation on the instrumentation of curved canals with a martensitic NiTi file system: an ex vivo micro-CT evaluation. Odontology 2023; 111:123-131. [PMID: 35798914 DOI: 10.1007/s10266-022-00727-3] [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: 04/05/2022] [Accepted: 06/23/2022] [Indexed: 01/06/2023]
Abstract
This study aimed to evaluate the influence of continuous chelation on apical transportation and centrality in shaped curved canals prepared with a martensitic file system and evaluated by micro-CT. Twenty-four lower molar canals with a curvature of 25º-40º were scanned pre-operatively with micro-CT and divided into 2 groups according to two different irrigation regimens (n = 12). Group 1 was irrigated with NaOCl, group 2 with Dual Rinse. All canals were prepared with VDW.ROTATE system. The samples were scanned post-operatively and evaluated at 1, 3 and 5 mm from the apex to determine apical transportation and canal centrality using VG Studio software. Statistical analysis was performed with SPSS software using the non-parametric Mann-Whitney test. No statistically significant differences were found between the two groups for both apical transportation and canal centrality at any of the levels studied (p < 05). The use of continuous chelation during the instrumentation of the canals with martensitic alloy files does not produce greater transportation and does not generate changes in centralization compared to NaOCl-only irrigation. Combined chelation and disinfection while shaping with martensitic NiTi can simplify the irrigation regimen without inducing iatrogenic aberrations.
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Affiliation(s)
- M Sobrino
- Department of Dentistry, Postgraduate Program in Endodontics, Universidad Europea de Madrid, Madrid, Spain
| | - F Foschi
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guy's Hospital, Tower Wing, Floor 22, London, SE1 9RT, UK. .,Peninsula Dental School, University of Plymouth, The John Bull Building, Plymouth Science Park, Plymouth, PL6 8BU, Devon, UK.
| | - R Estévez
- Department of Dentistry, Postgraduate Program in Endodontics, Universidad Europea de Madrid, Madrid, Spain
| | - G Loroño
- Department of Dentistry, Postgraduate Program in Endodontics, Universidad Europea de Madrid, Madrid, Spain
| | - A Conde Villar
- Department of Dentistry, Postgraduate Program in Endodontics, Universidad Europea de Madrid, Madrid, Spain
| | - R Pérez-Alfayate
- Department of Dentistry, Postgraduate Program in Endodontics, Universidad Europea de Madrid, Madrid, Spain
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10
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Soliman A, Rabie M, Hassan HY. Smear Layer Removal by 1% Phytic Acid after Root Canal Preparation with Three Different Rotary Systems. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: This study compared the removal of the smear layer using 1% phytic acid or 17% ethylenediaminetetraacetic acid (EDTA) after root canal instrumentation with SmartTrack X3, Endo*star E, and ProTaper Gold rotary systems using an environmental scanning electron microscope (ESEM).
METHODS: Sixty single-rooted unidentified extracted human maxillary anterior teeth were selected. The length of all the roots used was adjusted to 16 mm from the apex. Modified access cavities were done. Roots were equally and randomly allocated to three main groups (n = 20) corresponding to the rotary systems: group A1, SmartTrack X3; group A2, Endo*star E3; and group A3, ProTaper Gold. Each group was divided into two equal subgroups (n = 10), corresponding to the chelating agents applied as a final rinse: subgroup B1, 1% phytic acid, and subgroup B2, 17% EDTA. Roots were split in a buccolingual direction into two equal halves and examined under ESEM in the presence or absence of a smear layer at the cervical, middle, and apical segments.
RESULTS: 1% Phytic acid and 17% EDTA recorded no statistically significant for removing the smear layer. For all subgroups, there was a significant difference in smear layer removal and more open dentinal tubules in the cervical segment versus the apical segment.
CONCLUSION: In smear layer removal from root canals, 1% phytic acid was effective as 17% EDTA in smear layer removal form root canals after SmartTrack X3, Endo*star E3, or ProTaper Gold rotary systems instrumentation.
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11
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Provoost C, Rocca GT, Thibault A, Machtou P, Bouilllaguet S. Influence of Needle Design and Irrigant Flow Rate on the Removal of Enterococcus faecalis Biofilms In Vitro. Dent J (Basel) 2022; 10:dj10040059. [PMID: 35448053 PMCID: PMC9030241 DOI: 10.3390/dj10040059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/24/2022] [Accepted: 03/30/2022] [Indexed: 01/27/2023] Open
Abstract
This study aimed to evaluate the influence of needle design and irrigant flow rate on the removal of Enterococcus faecalis mature biofilms during sodium hypochlorite irrigation. Forty-eight single-rooted human teeth were instrumented (ProTaper F3), autoclaved and inoculated with Enterococcus faecalis to establish a two-week-old biofilm. E. faecalis biofilms were treated with Sodium hypochlorite that was injected in the root canals using three types of needles (NaviTip, ProRinse, IrriFlex). For the IrriFlex needle, one, two, or four bars of pressure was applied to the irrigating solution to increase flow rates. Bacteria were labeled with the LIVE/DEAD BacLight Bacterial Viability kit, and viability was assessed by flow cytometry (FCM). Results were statistically analyzed using one-way ANOVA and Tukey multiple comparison intervals (α = 0.05). Bacterial viability was significantly reduced after sodium hypochlorite passive irrigation but the number of viable bacteria retrieved from root canal specimens irrigated with the Pro-Rinse needle was significantly higher compared to NaviTip and IrriFlex needles (p < 0.05). When the irrigant flow rate was increased, the viability of bacterial biofilms was significantly reduced compared to passive irrigation using the IrriFlex needle (p < 0.05). Applying higher flow rates during irrigation using the IrriFlex needle did not further reduce bacterial viability.
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12
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Boutsioukis C, Arias-Moliz MT, Chávez de Paz LE. A critical analysis of research methods and experimental models to study irrigants and irrigation systems. Int Endod J 2022; 55 Suppl 2:295-329. [PMID: 35171506 PMCID: PMC9314845 DOI: 10.1111/iej.13710] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 11/28/2022]
Abstract
Irrigation plays an essential role in root canal treatment. The purpose of this narrative review was to critically appraise the experimental methods and models used to study irrigants and irrigation systems and to provide directions for future research. Studies on the antimicrobial effect of irrigants should use mature multispecies biofilms grown on dentine or inside root canals and should combine at least two complementary evaluation methods. Dissolution of pulp tissue remnants should be examined in the presence of dentine and, preferably, inside human root canals. Micro-omputed tomography is currently the method of choice for the assessment of accumulated dentine debris and their removal. A combination of experiments in transparent root canals and numerical modeling is needed to address irrigant penetration. Finally, models to evaluate irrigant extrusion through the apical foramen should simulate the periapical tissues and provide quantitative data on the amount of extruded irrigant. Mimicking the in vivo conditions as close as possible and standardization of the specimens and experimental protocols are universal requirements irrespective of the surrogate endpoint studied. Obsolete and unrealistic models must be abandoned in favour of more appropriate and valid ones that have more direct application and translation to clinical Endodontics.
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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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13
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Kanmaz F, Altunbaş D. Evaluation of the effect of calcium hydroxide paste on sealer penetration into dentinal tubules by confocal laser scanning microscopy. AUST ENDOD J 2021; 48:82-90. [PMID: 34775668 DOI: 10.1111/aej.12588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 09/02/2021] [Accepted: 11/02/2021] [Indexed: 11/26/2022]
Abstract
The study evaluated sealer penetration after calcium hydroxide (Ca(OH)2 ) removal from the root canals. Sixty single-rooted mandibular premolars were divided into six groups. Ca(OH)2 paste placed into the root canals except for the control group (CG) was removed using the following irrigation techniques: conventional needle irrigation (CNI), EndoActivator (EA), EndoVac (EV), passive ultrasonic irrigation (PUI) and photon-induced photoacoustic streaming (PIPS) technique. After canal filling, the penetration depth, penetration area and penetration percentage of the sealer were determined using confocal microscopy. The CG and EA had a greater penetration depth than CNI in the middle section. The CG exhibited a higher dentinal tubule penetration area than CNI, EV and PUI in the middle section. EA was significantly more effective than PUI in the coronal section for the percentage of sealer penetration. EA and PIPS removed Ca(OH)2 from root canals effectively because they presented similar penetration to the CG in all sections.
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Affiliation(s)
- Fatma Kanmaz
- Department of Endodontics, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Turkey.,Adana Fatma Kemal Timuçin Oral and Dental Health Hospital, Republic of Turkey Ministry of Health, Adana, Turkey
| | - Demet Altunbaş
- Department of Endodontics, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Turkey
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14
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Zeng C, Everett J, Sidow S, Bergeron BE, Tian F, Ma J, Tay FR. In vitro evaluation of efficacy of two endodontic sonic-powered irrigant agitation systems in killing single-species intracanal biofilms. J Dent 2021; 115:103859. [PMID: 34706267 DOI: 10.1016/j.jdent.2021.103859] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To evaluate the efficacy of two sonic-powered irrigation systems, EDDY and EndoActivator, in killing intracanal biofilms. METHODS Eighty-three instrumented, autoclaved single-rooted human premolars were inoculated with Enterococcus faecalis (ATCC-29212) for 21 days to generate mature, single-species biofilms. The teeth were devided into four groups: irrigation with saline (N = 11); irrigation with 2% NaOCl without agitation (N = 24); irrigation with 2% NaOCl with agitation by the EndoActivaor (N = 24); irrigation with 2% NaOCl with agitation by the EDDY (N = 24). Colony-forming unit (CFU) counts and XTT assay were used to evaluate bacterial load. Additional teeth were split into root-halves for fluorescence staining to examine the percentages of live/dead bacteria in the dentinal tubules present in different canal locations (coronal, mid-root and apical portions). RESULTS Agitation of 2% NaOCl by EDDY or EndoActivator reduced bacteria load more proficiently than the use of 2%NaOCl without agitation (p < 0.05). No significant difference was detected between the two sonic-powered irrigant agitation systems (p > 0.05). Confocal laser scanning microscopy indicated that both devices had better intratubular bacteria killing efficacy than the use of 2% NaOCl only in all parts of the canal space (p < 0.05), with no significant difference detected between EDDY and EndoActivator (p > 0.05). Elimination of intracanal and intratubular bacteria were less efficient in the apical portion of the canal space for all experimental groups. CONCLUSION The two sonic-powered irrigant activation systems demonstrated comparable intracanal bacteria reduction efficacy when 2% NaOCl was used for disinfecting E. faecalis biofilms in single-rooted teeth. CLINICAL SIGNIFICANCE With the use of 2% NaOCl as irrigant, the EDDY and EndoActivator sonic-powered irrigant agitation systems have improved and equivalent intracanal bacteria reduction efficacy but are incapable of completely killing all bacteria that resided within the dentinal tubules of root canals.
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Affiliation(s)
- Chang Zeng
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Joseph Everett
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Stephanie Sidow
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Brian E Bergeron
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Fucong Tian
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Jingzhi Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Franklin R Tay
- The Dental College of Georgia, Augusta University, Augusta, GA, USA.
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15
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Augusto CM, Cunha Neto MA, Pinto KP, Barbosa AFA, Silva EJNL, Dos Santos APP, Sassone LM. Influence of the use of chelating agents as final irrigant on the push-out bond strength of epoxy resin-based root canal sealers: A systematic review. AUST ENDOD J 2021; 48:347-363. [PMID: 34498341 DOI: 10.1111/aej.12563] [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] [Accepted: 08/26/2021] [Indexed: 01/03/2023]
Abstract
This systematic review (PROSPERO - CRD42020150722) was performed to answer the following question: Does the use of chelating agents affect the dislodgment resistance of epoxy resin-based root canal sealers? A search was conducted in PubMed, EMBASE, Scopus, LILACS and Web of Science, hand searching of two endodontic journals and grey literature until September 2020. Extracted data included: teeth used, sample size, root canal preparation, irrigant, chelating solution, neutralisation solution, type of resin-based sealer and obturation approach, storage method and duration, root third and slice thickness, plunger dimension and loading direction and the push-out testing parameters and values. The search retrieved a total of 2.389 studies. After analysis, 12 studies fulfilled the eligibility criteria and were included. Most of the final irrigation protocols with chelating agents had a positive impact and promoted an improvement in the dislodgment resistance of epoxy resin-based sealers to the root dentin.
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Affiliation(s)
- Carla M Augusto
- Department of Endodontics, School of Dentistry, University of the State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Miguel A Cunha Neto
- Department of Endodontics, School of Dentistry, University of the State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Karem P Pinto
- Department of Endodontics, School of Dentistry, University of the State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Ana Flavia A Barbosa
- Department of Endodontics, School of Dentistry, University of the State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Emmanuel J N L Silva
- Department of Endodontics, School of Dentistry, University of the State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.,Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | - Ana Paula P Dos Santos
- Department of Community and Preventive Dentistry, School of Dentistry, University of the State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Luciana M Sassone
- Department of Endodontics, School of Dentistry, University of the State of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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16
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Afhkami F, Ahmadi P, Chiniforush N, Sooratgar A. Effect of different activations of silver nanoparticle irrigants on the elimination of Enterococcus faecalis. Clin Oral Investig 2021; 25:6893-6899. [PMID: 34476616 DOI: 10.1007/s00784-021-03979-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 05/04/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study aimed to compare the efficacy of silver nanoparticles (AgNPs) irrigating solution alone and following activation with photon-induced photoacoustic streaming (PIPS), photodynamic therapy (PDT) with indocyanine green (ICG), passive ultrasonic irrigation (PUI), and manual dynamic activation (MDA) method for elimination of Enterococcus faecalis (E. faecalis) from the root canal system. MATERIALS AND METHODS A total of 59 extracted human single-rooted teeth were collected and prepared. E. faecalis was inoculated into the root canals and incubated for 4 weeks. The teeth were then randomly divided into five experimental groups (n = 10): the AN group, irrigation with AgNPs alone; the AN/ICG/DL group, irrigation with AgNPs and ICG, then activation with diode laser; the AN/PIPS group, irrigation with AgNPs and activation with 0.3 W Er: YAG laser; the AN/MDA group, irrigation with AgNPs and activation with tapered gutta-percha; and the AN/PUI group, irrigation with AgNPs and activation with ultrasonic. Also, two control groups of irrigation with 2.5% sodium hypochlorite (n = 5) and no intervention (n = 4) were also used. Samples were collected from the dentinal chips before and after the intervention, and the percentage of reduction in colony count was calculated. RESULTS A significant reduction in E. faecalis colony count was noted in all groups (P < 0.05). Maximum reduction in colony count was noted in AN/PIPS and AN/PUI groups by 91.03 and 91.29%, respectively. Minimum reduction was noted in the AN group alone. CONCLUSION Activation with PUI and PIPS enhanced the efficacy of AgNPs irrigating solution for elimination of E. faecalis from the root canal system. CLINICAL RELEVANCE AgNPs activated by ultrasound or PIPS can be used as an adjunct for disinfection of the root canal system in endodontic treatment.
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Affiliation(s)
- Farzaneh Afhkami
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, End of North Kargar Street, Tehran, 1439955991, Iran
| | - Paniz Ahmadi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Science, Tehran, 1441987566, Iran
| | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Science, Tehran, 1441987566, Iran
| | - Aidin Sooratgar
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, End of North Kargar Street, Tehran, 1439955991, Iran.
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17
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Attavar SH, Hegde MN. Effect of Irrigants and Irrigating Devices on Disinfection of Root Canal System: A Systematic Review. JOURNAL OF ADVANCED ORAL RESEARCH 2021. [DOI: 10.1177/23202068211015878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: The effective delivery of irrigants into the inaccessible areas of the root canal system is the prerequisite for a proper disinfection of the root canal system. Numerous activation devices that can provide effective delivery of the irrigant and aid in the success of the root canal treatment are available. The activation of irrigants has claimed to be effective in in vitro and clinical trials. Hence, the present systematic review aims to analyze the effect of irrigants and irrigating devices in disinfecting the root canal system. Materials and Methods: A literature search was undertaken in PubMed, Cochrane, Web of Science, and Scopus databases. The inclusion criteria included clinical trials, both in vivo and ex vivo. The exclusion criteria included animal studies, textbooks, review articles, and case reports. The patients who required endodontic treatment along with the activation of irrigants were chosen as participants for the review. Result: The search strategy screened around 132 articles, out of which only 10 were selected for the present systematic review. The risk of bias was calculated based on the following scores: 3, high; 2, moderate; and 1, low. In the present systematic review, four articles were categorized into low-risk bias, three articles were classified as moderate risk, and three articles belonged to the high-risk category. Conclusion: The present systematic review concluded that the use of a mechanical activation device along with the irrigant will help in better removal of the smear layer and debris from the root canal system, improving the cleanliness and helping achieve more successful endodontic treatment.
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Affiliation(s)
- Shruthi H. Attavar
- Department of Conservative Dentistry and Endodontics, A B Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University), Deralakatte, Mangalore, Karnataka, India
| | - Mithra N. Hegde
- Department of Conservative Dentistry and Endodontics, A B Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University), Deralakatte, Mangalore, Karnataka, India
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18
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Dos Santos MC, da Silveira Teixeira C, da Fonseca Roberti Garcia L, Henriques B, Tay FR, Bortoluzzi EA. Heated distilled water with or without continuous ultrasonic irrigation improves final irrigation efficacy and reduces dentine erosion. J Dent 2020; 103:103507. [PMID: 33098929 DOI: 10.1016/j.jdent.2020.103507] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The present study evaluated the effects of using heated distilled water (HDW), with or without continuous ultrasonic irrigation (CUI), on smear layer removal and deterioration of root dentine microstructure. MATERIALS AND METHODS After chemomechanical preparation, 60 human teeth were longitudinally cleaved into two halves for smear layer quantification at the cervical-third, middle-third and apical root-third of the canal space. After reassembly, the root canals were irrigated with 17 % EDTA, followed by one of the six final irrigation protocols (n = 10) - G1: conventional irrigation (CI)+NaOCl at 25 °C; G2: NaOCl at 25 °C + CUI; G3: CI with DW at 25 °C; G4: DW at 25 °C + CUI; G5: CI + HDW at 65 °C; G6: HDW at 65 °C + CUI. Tooth-halves were processed and examined by scanning electron microscopy. The percentage of opened dentinal tubules in the irrigated areas of the canal space was expressed as a percentage of the total surface area. Dentine erosion was classified by numeric scores. Smear layer removal was analysed with ANOVA and Student-Newman-Keuls tests; dentine erosion was analysed with Cohran-Mantel-Haenstel statistic (α = 0.05). RESULTS The cervical-third had a higher percentage of open dentinal tubules for all groups (p < 0.05). In G2, the middle-third had a lower percentage of open tubules, which was significantly different from the other groups (p < 0.05). Groups that utilised NaOCl as the final irrigant had more extensive erosion when CUI was used. CONCLUSION Heated distilled water, with or without CUI, was as efficient as 1 % NaOCl in the final cleaning of the instrumented canal space. The use of HDW produces less extensive dentine erosion. CLINICAL SIGNIFICANCE Heated distilled water removes smear layers with less deleterious effects on dentine microstructure and may be considered a final irrigant after mechanical preparation and EDTA chelation.
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Affiliation(s)
| | | | | | - Bruno Henriques
- Department of Dentistry, Endodontics Division, Health Sciences Center, Federal University, Brazil; Ceramic and Composite Materials Research Group (CERMAT), Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil; CMEMS-UMinho, University of Minho, Campus de Azurém, Guimarães, Portugal of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Franklin R Tay
- Department of Endodontics, The Dental College of Georgia, Augusta, GA, USA.
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19
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Voegeli G, Bella ED, Mekki M, Machtou P, Bouillaguet S. Effect of a Modified Irrigation Protocol on the Cleanliness of Moderately Curved Canals. Eur J Dent 2020; 15:90-95. [PMID: 33003241 PMCID: PMC7902106 DOI: 10.1055/s-0040-1715985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objectives
This study tested the hypothesis that modifying the sequence of sodium hypochlorite (NaOCl)/ethylene diamine tetra-acetic acid (EDTA) irrigation during root canal shaping would improve apical cleanliness in moderately curved canals.
Materials and Methods
Forty-five root canals were prepared using Protaper Gold with three irrigation protocols. Standard irrigation (SI) used 0.5 mL 3% NaOCl between each instrument, followed by 5 mL 17% EDTA manually agitated for 30 seconds. Reverse irrigation (RI) used 0.5 mL of 17% EDTA between each instrument, then 5 mL of 3% NaOCl, manually agitated for 30 seconds. Reverse irrigation plus (RI+) was similar to RI, except NaOCl (5 mL), used as a final rinse, was allowed to interact for 3 minutes with dentin before manual agitation (30 seconds).
Root canal cleanliness was evaluated under the scanning electron microscope (SEM) (Hulsmann score); the chemical composition of dentin after irrigation was analyzed by energy dispersive X-ray (EDX). Statistical Analysis
Results were compared using Kruskal–Wallis ANOVA by ranks and Wilcoxon matched paired posthoc tests. A Chi-square test assessed whether the best cleanliness would demonstrate a significant association with one irrigation protocol; odds ratio calculation was performed using score “1” versus score “2 or more” (2+) (
p
< 0.05).
Results
In the apical region, cleanliness was better in RI+ than SI and both significantly better than RI. Odd ratios indicate that the cleanliness in RI+ was significantly better than RI and SI groups (
p
< 0.000 and 0.003, respectively). Independently of the irrigation protocol, EDX analyses showed no chemical alteration of root dentin.
Conclusions
Using 17% EDTA during shaping, followed by 3% NaOCl rinse for 3 minutes, improved apical cleanliness without inducing erosion of dentin.
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Affiliation(s)
- Garance Voegeli
- University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Enrico Di Bella
- Department of Economics and Business Studies, Faculty of Economics, University of Genoa, Genoa, Italy
| | - Mustapha Mekki
- Biomaterials Unit, Section of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | | | - Serge Bouillaguet
- University Clinics of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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20
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Activated Irrigation vs. Conventional non-activated Irrigation in Endodontics - A Systematic Review. Eur Endod J 2020; 4:96-110. [PMID: 32161895 PMCID: PMC7006592 DOI: 10.14744/eej.2019.80774] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 09/17/2019] [Indexed: 11/20/2022] Open
Abstract
Objective: Irrigant activation has been claimed to be beneficial in in vitro and clinical studies. This systematic review aims to investigate the clinical efficiency of mechanically activated irrigants and conventional irrigation. Methods: A literature search (PROSPERO registration number: CRD42018112595) was undertaken in PubMed, Cochrane and hand search. The inclusion criteria were clinical trials, in vivo/ex vivo on adult permanent teeth involving an active irrigation device and a control group of conventional irrigation. The exclusion criteria were studies done in vitro, animals and foreign language. Adult patients requiring endodontic treatment of permanent dentition and irrigant activation during the treatment were chosen as the participants and intervention respectively. Results: After removal of duplicates, 89 articles were obtained, and 72 were excluded as they did not meet the selection criteria. 6 devices (EndoVac, EndoActivator, Ultrasonic, MDA (manual dynamic agitation), CUI (Continuous Ultrasonic Irrigation) and PUI (Passive Ultrasonic Irrigation)) and 6 variables of interest (Post-operative pain, periapical healing, antibacterial efficacy, canal and/or isthmus cleanliness, debridement efficacy and delivery up to working length) were evaluated in the 17 included articles. The risk of bias and quality of the selected articles were moderate. Results showed that mechanical active irrigation reduces post-operative pain. It improved debridement, canal/isthmus cleanliness. It also improved delivery of irrigant up to working length. Bacterial count was more with active irrigation, though not significant. There is no effect on long-term periapical healing. Conclusion: It may be concluded that mechanical active irrigation devices are beneficial in reducing post-operative pain and improving canal and isthmus cleanliness during Endodontics.
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21
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Abduljalil M, Kalender A. Efficacy of Er,Cr:YSGG Laser with Different Output Powers on Removing Smear Layer After Retreatment of Two Different Obturation Techniques. Photobiomodul Photomed Laser Surg 2020; 38:84-90. [DOI: 10.1089/photob.2019.4642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mohamad Abduljalil
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin, Turkey
| | - Atakan Kalender
- Department of Endodontics, Faculty of Dentistry, Near East University, Mersin, Turkey
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22
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Ye WH, Yeghiasarian L, Cutler CW, Bergeron BE, Sidow S, Xu HHK, Niu LN, Ma JZ, Tay FR. Comparison of the use of d-enantiomeric and l-enantiomeric antimicrobial peptides incorporated in a calcium-chelating irrigant against Enterococcus faecalis root canal wall biofilms. J Dent 2019; 91:103231. [PMID: 31712128 DOI: 10.1016/j.jdent.2019.103231] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To compare the anti-biofilm efficacy of two antimicrobial peptides (AMPs), 1018 and DJK-5, in disrupting canal wall biofilms in the isthmus, canal and dentinal tubules of single-rooted maxillary premolars. METHODS Enterococcus faecalis single-species biofilms were formed in-situ in the root canal system of the premolars (n = 91). Confocal laser scanning microscopy, bacterial sampling, colony-forming unit counting, XTT assay, lactate dehydrogenase assay and phenol-sulphuric acid method were used to identify the anti-biofilm efficacy of both AMPs and their influence on bacterial metabolic activity. RESULTS Both AMPs disrupted in-situ E. faecalis biofilms and altered their metabolic activity. At 20 μg/mL, the d-enantiomeric AMP DJK-5 killed 55.5 %, 57.3 % and 55.8 % of biofilm bacteria in the isthmus, canal and dentinal tubules, respectively, in 1 min. In contrast, the l-enantiomeric AMP 1018 only eradicated 25.6 %, 25.5 % and 27.5 % of biofilm bacteria in the isthmus, canal and dentinal tubules, respectively, within the same time. Anti-biofilm efficacy of the root canal irrigants tested were in the order: 6 % NaOCl > 20 μg/mL DJK-5 > 10 μg/mL DJK-5 > 20 μg/mL 1018 > 10 μg/mL 1018 > 0.9 % NaCl. CONCLUSIONS The present results are confirmatory of previous studies, in that d-enantiomeric AMPs exhibit more potent antibacterial properties than l-enantiomeric AMPs against E. faecalis biofilms within the canal space. Nevertheless, the potency of both AMPs are concentration-dependent. Incorporation of these agents into EDTA, a non-antibacterial calcium-chelating irrigant for removal of the inorganic component of the canal space debris, does not reduce the efficacy of either AMP. CLINICAL SIGNIFICANCE The present study provides the proof of concept that incorporation of an antimicrobial peptide into a calcium-chelating root canal irrigant enhances the disinfection of intratubular single-species biofilms during smear layer and smear plug removal.
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Affiliation(s)
- Wei-Hu Ye
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | | | - Brian E Bergeron
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Stephanie Sidow
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Hockin H K Xu
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Li-Na Niu
- The Dental College of Georgia, Augusta University, Augusta, GA, USA; State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China; The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China.
| | - Jing-Zhi Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Franklin R Tay
- The Dental College of Georgia, Augusta University, Augusta, GA, USA.
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Keine KC, Kuga MC, Tormin FBC, Venção AC, Duarte MAH, Chávez-Andrade GM, Faria G. Effect of peracetic acid used as single irrigant on the smear layer, adhesion, and penetrability of AH Plus. Braz Oral Res 2019; 33:e057. [PMID: 31365704 DOI: 10.1590/1807-3107bor-2019.vol33.0057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 05/14/2019] [Indexed: 12/16/2022] Open
Abstract
The aim of this study was to evaluate the effect of peracetic acid (PAA) as a single irrigant on the smear layer, on the intraradicular dentinal bond strength, and on the penetrability of an epoxy-based resin sealer into the dentinal tubules. A total of 120 roots were distributed into 4 groups according to the irrigant used in root canal preparation: 1% PAA (PAA); 2.5% NaOCl followed by final irrigation with 17% EDTA and 2.5% NaOCl (NaOCl-EDTA-NaOCl); 2.5% NaOCl (NaOCl); and saline solution (SS). The smear layer was evaluated using scanning electron microscopy. The bond strength of an epoxy-based resin sealer (AH Plus) to root dentin was evaluated by the push-out test and penetrability of the sealer into dentinal tubules was observed by confocal laser microscopy. The results were analyzed by the Kruskal-Wallis and the Dunn post-test (α = 0.05). The use of 1% PAA as single root canal irrigant provided smear layer removal and improved the penetrability and bond strength of AH Plus to root dentin in a manner similar to that of the NaOCl-EDTA-NaOCl group (p > 0.05). The NaOCl and SS groups had higher values of smear layer and lower values of sealer penetrability and dentin bond strength than the PAA and NaOCl-EDTA-NaOCl groups (p < 0.05). Thus, 1% PAA has the potential to be used as a single irrigant in root canals.
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Affiliation(s)
- Katia Cristina Keine
- Department of Restorative Dentistry, UNESP - São Paulo State University, School of Dentistry, Araraquara, SP, Brazil
| | - Milton Carlos Kuga
- Department of Restorative Dentistry, UNESP - São Paulo State University, School of Dentistry, Araraquara, SP, Brazil
| | - Fernanda Borges Cunha Tormin
- Department of Restorative Dentistry, UNESP - São Paulo State University, School of Dentistry, Araraquara, SP, Brazil
| | - Ana Carolina Venção
- Department of Restorative Dentistry, UNESP - São Paulo State University, School of Dentistry, Araraquara, SP, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Restorative Dentistry, Dental Materials and Endodontics, University of São Paulo, School of Dentistry, Bauru, São Paulo
| | | | - Gisele Faria
- Department of Restorative Dentistry, UNESP - São Paulo State University, School of Dentistry, Araraquara, SP, Brazil
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Seven N, Cora S. Effectiveness of different irrigation systems in the presence of intracanal-separated file. Microsc Res Tech 2019; 82:238-243. [PMID: 30636084 DOI: 10.1002/jemt.23165] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 09/25/2018] [Accepted: 10/08/2018] [Indexed: 01/23/2023]
Abstract
The aim of this study was to evaluate conventional syringe irrigation and three different irrigant activation techniques' effectiveness for smear layer removal in the absence and presence of intracanal-separated file (SF) fragment. Mandibular anterior teeth (160 total) with single canal were used and each root canal preparation was finished with the ProTaper Universal F1. The samples were randomly divided into eight equal groups with n = 20 in each group. The Protaper Universal F3 file was used to simulate intracanal file separation in four groups. To remove the smear layer, final irrigation for each group was performed with conventional syringe irrigation (CSI), EndoActivator, Vibringe, and passive ultrasonic irrigation (PUI). The roots were divided into two longitudinal parts and evaluated with scanning electron microscopy, and two observers scored smear layers at 1, 2, and 3 mm away from the minor foramen. The data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests (p < .05). PUI significantly removed the smear layer better at all levels than other nonseparated file groups (p < .05). In the presence of intracanal SF, PUI had the most efficiency loss. Sonic techniques and CSI revealed statistically better smear layer removal efficiency than PUI at 3 mm level in the presence of SF (p < .05). The intragroup score analysis at all levels revealed that there were less smear layers at 3 mm than at 1 mm in all SF groups (p < .001). As a conclusion, sonic/ultrasonic methods did not yield better irrigant by-passing than CSI in the presence of intracanal SF.
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Affiliation(s)
- Naimenur Seven
- Department of Endodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Sabri Cora
- Department of Endodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
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Varela P, Souza E, de Deus G, Duran-Sindreu F, Mercadé M. Effectiveness of complementary irrigation routines in debriding pulp tissue from root canals instrumented with a single reciprocating file. Int Endod J 2018; 52:475-483. [PMID: 30317653 DOI: 10.1111/iej.13028] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 10/09/2018] [Indexed: 11/30/2022]
Affiliation(s)
- P. Varela
- Department of Endodontics; Universitat Internacional de Catalunya; Barcelona Spain
| | - E. Souza
- Department of Dentistry II; Federal University of Maranhão; São Luis Brazil
| | - G. de Deus
- Department of Endodontics; Grande Rio University; Duque de Caxias Brazil
| | - F. Duran-Sindreu
- Department of Endodontics; Universitat Internacional de Catalunya; Barcelona Spain
| | - M. Mercadé
- Department of Dentistry; Universitat de Barcelona; Barcelona Spain
- IDIBELL Institute; Barcelona Spain
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Debris Removal from the Mesial Root Canal System of Mandibular Molars with Laser-activated Irrigation. J Endod 2018; 44:1697-1701. [PMID: 30241679 DOI: 10.1016/j.joen.2018.06.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/12/2018] [Accepted: 06/14/2018] [Indexed: 11/22/2022]
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Coaguila-Llerena H, Stefanini da Silva V, Tanomaru-Filho M, Guerreiro Tanomaru JM, Faria G. Cleaning capacity of octenidine as root canal irrigant: A scanning electron microscopy study. Microsc Res Tech 2018; 81:523-527. [DOI: 10.1002/jemt.23007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 01/31/2018] [Accepted: 02/06/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Hernán Coaguila-Llerena
- Araraquara School of Dentistry, Department of Restorative Dentistry; UNESP - São Paulo State University; Araraquara SP Brazil
| | - Virgínia Stefanini da Silva
- Araraquara School of Dentistry, Department of Restorative Dentistry; UNESP - São Paulo State University; Araraquara SP Brazil
| | - Mario Tanomaru-Filho
- Araraquara School of Dentistry, Department of Restorative Dentistry; UNESP - São Paulo State University; Araraquara SP Brazil
| | | | - Gisele Faria
- Araraquara School of Dentistry, Department of Restorative Dentistry; UNESP - São Paulo State University; Araraquara SP Brazil
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Pucinelli CM, Silva LABD, Cohenca N, Romualdo PC, Silva RABD, Consolaro A, Queiroz AMD, Nelson P. Apical Negative Pressure irrigation presents tissue compatibility in immature teeth. J Appl Oral Sci 2018; 25:612-619. [PMID: 29211282 PMCID: PMC5701531 DOI: 10.1590/1678-7757-2016-0599] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 06/02/2017] [Indexed: 11/22/2022] Open
Abstract
Aim: To compare the apical negative pressure irrigation (ANP) with conventional irrigation in the teeth of immature dogs with apical periodontitis. Methods: Fifty-two immature pre-molar root canals were randomly assigned into 4 groups: ANP (n=15); conventional irrigation (n=17); healthy teeth (control) (n = 10); and teeth with untreated apical periodontitis (control) (n=10). After induction of apical periodontitis, teeth were instrumented using EndoVac® (apical negative pressure irrigation) or conventional irrigation. The animals were euthanized after 90 days. The sections were stained by HE and analyzed under conventional and fluorescence microscopy. TRAP histoenzymology was also performed. Statistical analyses were performed with the significance level set at 5%. Results: There was difference in the histopathological parameters between ANP and conventional groups (p<0.05). The ANP group showed a predominance of low magnitude inflammatory infiltrate, a smaller periodontal ligament, and lower mineralized tissue resorption. There were no differences in the periapical lesion extensions between the ANP and conventional groups (p>0.05). However, a lower number of osteoclasts was observed in the ANP group (p<0.05). Conclusion: The EndoVac® irrigation system presented better biological results and more advanced repair process in immature teeth with apical periodontitis than the conventional irrigation system, confirming the hypothesis.
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Affiliation(s)
- Carolina Maschietto Pucinelli
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, SP, Brasil
| | - Léa Assed Bezerra da Silva
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, SP, Brasil
| | - Nestor Cohenca
- University of Washington & Seattle Children's, Department of Endodontics, Seattle, USA
| | - Priscilla Coutinho Romualdo
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, SP, Brasil
| | - Raquel Assed Bezerra da Silva
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, SP, Brasil
| | - Alberto Consolaro
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Cirurgia, Estomatologia, Patologia e Radiologia, Bauru, SP, Brasil
| | - Alexandra Mussolino de Queiroz
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, SP, Brasil
| | - Paulo Nelson
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, SP, Brasil
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Virdee SS, Seymour DW, Farnell D, Bhamra G, Bhakta S. Efficacy of irrigant activation techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta-analysis. Int Endod J 2017; 51:605-621. [PMID: 29178166 DOI: 10.1111/iej.12877] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 11/16/2017] [Indexed: 12/21/2022]
Abstract
AIMS To establish whether irrigant activation techniques (IATs) result in greater intracanal smear layer and debris removal than conventional needle irrigation (CNI). METHODOLOGY Six electronic databases were searched to identify scanning electron microscopy studies evaluating smear layer and/or debris removal following the use of manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), sonic irrigation (SI) or apical negative pressure (ANP) IATs in mature permanent teeth. Meta-analyses were performed for each canal segment (coronal, middle, apical and apical 1 mm) in addition to subgroup analyses for individual IATs with respect to CNI. Outcomes were presented as standardized mean differences (SMD) alongside 95% confidence intervals (95% CI) and chi-squared analysis. RESULTS From 252 citations, 16 studies were identified. The meta-analyses demonstrated significant improvements in coronal (SMD: 1.15, 95% CI: 0.72-1.57 / SMD: 0.54, 95% CI: 0.29-0.80), middle (SMD: 1.30, 95% CI: 0.59-2.53 / SMD: 0.8, 95% CI: 0.58-1.13) and apical thirds (SMD: 1.22, 95% CI: 0.83-1.62 / SMD: 1.86, 95% CI: 0.76-2.96) for smear layer and debris removal, respectively. In the apical 1 mm IATs improved cleanliness; however, differences were insignificant (SMD: 1.15, 95% CI: -0.47-2.77). Chi-squared analysis revealed heterogeneity scores of 79.3-92.8% and 0.0-93.5% for smear layer and debris removal, respectively. CONCLUSIONS IATs improve intracanal cleanliness across a substantial portion of the canal, and therefore, their use is recommended throughout root canal preparation. However, current data is too heterogeneous to compare and identify superiority of an individual technique highlighting the need to standardize experimental protocols and develop a more representative research model to investigate the in vivo impact of IATs on clinical outcomes and periapical healing following root canal treatment.
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Affiliation(s)
- S S Virdee
- Department of Restorative Dentistry, Birmingham Dental Hospital, Birmingham, UK
| | - D W Seymour
- Department of Restorative Dentistry, York Hospital, York, UK
| | - D Farnell
- Department of Dentistry, Cardiff University School of Dentistry, Cardiff, UK
| | - G Bhamra
- Department of Restorative Dentistry, Cardiff University Dental Hospital, Cardiff, UK
| | - S Bhakta
- Department of Restorative Dentistry, Leeds Dental Institute, Leeds, UK
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Suman S, Verma P, Prakash-Tikku A, Bains R, Kumar-Shakya V. A Comparative Evaluation of Smear Layer Removal Using Apical Negative Pressure (EndoVac), Sonic Irrigation (EndoActivator) and Er:YAG laser -An In vitro SEM Study. J Clin Exp Dent 2017; 9:e981-e987. [PMID: 28936288 PMCID: PMC5601115 DOI: 10.4317/jced.53881] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 07/02/2017] [Indexed: 11/05/2022] Open
Abstract
Background This study aimed to compare the smear layer removing efficacy of the EndoActivator, EndoVac and Er:YAG laser in extracted mandibular premolars, at the apical, middle and coronal third of root canal, through scanning electron microscopy. Material and Methods 40 extracted mandibular premolars were decoronated to a standardized length of 12 mm. Specimens were shaped to ProTaper F4 size and irrigated with 5.25% sodium hypochlorite at 370C between instrumentation. Teeth were divided into four groups (n=10), one control (needle irrigation) and three experimental, according to the irrigant activation technique used i.e. sonic irrigation (EndoActivator), apical negative pressure (EndoVac) or laser (Er:YAG). The final irrigants used were 10ml,17% ethylenediaminetetraacetic acid (EDTA) and 10ml, 5.25% sodium hypochlorite. Root canals were then split longitudinally and observed under a scanning electron microscope. The presence of smear layer at the apical, middle and coronal third of root canal was evaluated. Scores were analyzed by Kruskal-Wallis and Mann-Whitney U tests. Intraexaminer and interexaminer reliability were determined by Kappa test. Results The EndoVac system was significantly more effective in removing debris from the apical third than all other groups. EndoActivator performed better than laser at the apical third. All three experimental groups (EndoVac, EndoActivator, and laser) were better than needle irrigation at the middle and apical third. At the coronal third, no significant difference was seen between the four groups. Conclusions None of the activation systems completely removes the smear layer from the dentine walls; nevertheless, EndoVac is significantly better in removing debris from the apical third of canal. Key words:EndoVac, EndoActivator, Er:YAG laser, smear layer, scanning electron microscopy.
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Affiliation(s)
- Sanghamitra Suman
- Post Graduate Student, Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Promila Verma
- Professor, Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Aseem Prakash-Tikku
- Professor, Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rhythm Bains
- Associate Professor, Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Vijay Kumar-Shakya
- Assistant Professor, Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
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Comparison of the Antimicrobial Efficacy of the EndoVac System and Conventional Needle Irrigation in Primary Molar Root Canals. J Clin Pediatr Dent 2017. [PMID: 28650788 DOI: 10.17796/1053-4628-41.4.284] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The purpose of this study was to compare the antimicrobial efficacy of the EndoVac system and conventional needle irrigation to eliminate E faecalis in primary molar root canals. STUDY DESIGN 60 extracted human primary second molar roots were instrumented up to an apical size .04/35 and randomly divided into two groups; Group 1: conventional needle (n=30) and Group 2: EndoVac (n=30), and four subgroups (two experimental subgroups; (a) 2.5% sodium hypochlorite (NaOCl) + ethylenediaminetetraacetic acid (EDTA) (n=20), (b) ozonated water (OW) + EDTA (n=20), and control groups (c) 5.25% NaOCl (n=10) and (d) saline (n=10). All roots were sterilized and then inoculated with E.faecalis. Before and after final irrigation procedures, root canals were sampled and the grown colony forming units (CFUs) were counted. Data were analyzed by Kruskall-Wallis and Mann-Whitney U tests using a 0.05 significance level. RESULTS The EndoVac reduced more bacteria than the conventional needle did but it was not statistically significant (p>0.05). NaOCl alone or followed by EDTA totally eliminated bacteria. OW + EDTA showed higher reduction of bacteria but could not totally eliminate bacterias. CONCLUSIONS In the context of bacterial elimination, the EndoVac was not significantly better than the conventional needle. Although, there were fewer CFU/mg when using EndoVac, there was not any statistically significant superiority to conventional needle irrigation. An OW+EDTA regimen showed antibacterial effect in the primary molar root canals but it was significantly less effective than NaOCl+EDTA.
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Koçak S, Bağcı N, Çiçek E, Türker SA, Can Sağlam B, Koçak MM. Influence of passive ultrasonic irrigation on the efficiency of various irrigation solutions in removing smear layer: a scanning electron microscope study. Microsc Res Tech 2017; 80:537-542. [PMID: 28112855 DOI: 10.1002/jemt.22829] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/02/2016] [Accepted: 12/09/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Sibel Koçak
- Department of Endodontics; Bülent Ecevit University Faculty of Dentistry; Zonguldak Turkey
| | - Nur Bağcı
- Department of Endodontics; Bülent Ecevit University Faculty of Dentistry; Zonguldak Turkey
| | - Ersan Çiçek
- Department of Endodontics; Bülent Ecevit University Faculty of Dentistry; Zonguldak Turkey
| | - Sevinç Aktemur Türker
- Department of Endodontics; Bülent Ecevit University Faculty of Dentistry; Zonguldak Turkey
| | - Baran Can Sağlam
- Department of Endodontics; Bülent Ecevit University Faculty of Dentistry; Zonguldak Turkey
| | - Mustafa Murat Koçak
- Department of Endodontics; Bülent Ecevit University Faculty of Dentistry; Zonguldak Turkey
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Ekici MA, Helvacıoğlu Kıvanç B, Ekici A, Uzun Ö. Farklı endodontik irrigasyon aktivasyon teknikleri kullanılarak yapay oluklardan debriz uzaklaştırılması: ex vivo. ACTA ODONTOLOGICA TURCICA 2017. [DOI: 10.17214/gaziaot.273922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Latham J, Fong H, Jewett A, Johnson JD, Paranjpe A. Disinfection Efficacy of Current Regenerative Endodontic Protocols in Simulated Necrotic Immature Permanent Teeth. J Endod 2016; 42:1218-25. [DOI: 10.1016/j.joen.2016.05.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 05/10/2016] [Accepted: 05/10/2016] [Indexed: 10/21/2022]
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Keles A, Kamalak A, Keskin C, Akçay M, Uzun İ. The efficacy of laser, ultrasound and self-adjustable file in removing smear layer debris from oval root canals following retreatment: A scanning electron microscopy study. AUST ENDOD J 2016; 42:104-111. [DOI: 10.1111/aej.12145] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Ali Keles
- Department of Endodontics; Faculty of Dentistry; Ondokuz Mayıs University; Samsun Turkey
| | - Aliye Kamalak
- Department of Endodontics; Faculty of Dentistry; İnönü University; Malatya Turkey
| | - Cangül Keskin
- Department of Endodontics; Faculty of Dentistry; Ondokuz Mayıs University; Samsun Turkey
| | - Merve Akçay
- Department of Pedodontics; Faculty of Dentistry; Katip Çelebi University; İzmir Turkey
| | - İsmail Uzun
- Department of Endodontics; Faculty of Dentistry; Ondokuz Mayıs University; Samsun Turkey
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Darcey J, Jawad S, Taylor C, Roudsari RV, Hunter M. Modern endodontic principles part 4: irrigation. ACTA ACUST UNITED AC 2016; 43:20-2, 25-6, 28-30 passim. [DOI: 10.12968/denu.2016.43.1.20] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- James Darcey
- Consultant and Honorary Lecturer in Restorative Dentistry, University Dental Hospital of Manchester
| | - Sarra Jawad
- Specialty Registrar/Honorary Clinical Lecturer in Restorative Dentistry, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester M15 6FH
| | - Carly Taylor
- Clinical Lecturer/Honorary Specialty Registrar in Restorative Dentistry, Dental School, University of Manchester
| | - Reza Vahid Roudsari
- Clinical Lecturer/Honorary Specialty Registrar in Restorative Dentistry, Dental School, University of Manchester
| | - Mark Hunter
- Registered Endodontic Specialist, simplyendo, Altrincham, Postgraduate Clinical Teaching Fellow, Dental School, University of Manchester, Oxford Road, Manchester M13 9PL, UK
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Seelan RG, Kumar A, Jonathan R, Maheswari U, Raja J, Chelliah P. Comparative evaluation of effect of different irrigation solutions against Enterococcus faecalis: A polymerase chain reaction-based study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2015; 7:S576-9. [PMID: 26538921 PMCID: PMC4606663 DOI: 10.4103/0975-7406.163546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Enterococcus faecalis is the most isolated or detected species from oral infections including marginal periodontitis, infected root canals, periradicular abscesses and also detected in cases of failed endodontic therapy. To prevent endodontic treatment failure irrigation is mandatory for the effective removal of smear layer, pulp tissue, and microorganisms. Cultivation and other traditional identification methods have been demonstrated to have several limitations when it comes to microbiological identification. Polymerase chain reaction was selected because it has an added advantage over traditional microbiological methods.
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Affiliation(s)
- R Gnana Seelan
- Department of Conservative Dentistry and Endodontics, Rajas Dental College, Tirunelveli, Tamil Nadu, India
| | - Arvind Kumar
- Department of Conservative Dentistry and Endodontics, Rajas Dental College, Tirunelveli, Tamil Nadu, India
| | - R Jonathan
- Department of Conservative Dentistry and Endodontics, Rajas Dental College, Tirunelveli, Tamil Nadu, India
| | - Uma Maheswari
- Department of Conservative Dentistry and Endodontics, Rajas Dental College, Tirunelveli, Tamil Nadu, India
| | - Jacob Raja
- Department of Periodontics, Rajas Dental College, Tirunelveli, Tamil Nadu, India
| | - P Chelliah
- Department of Paedodontics and Preventive Dentistry, Sri Mookambika Institute Of Dental Sciences, Kulasekharam, Kanyakumari, Tamil Nadu, India
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Weissman J, Johnson JD, Anderson M, Hollender L, Huson T, Paranjpe A, Patel S, Cohenca N. Association between the Presence of Apical Periodontitis and Clinical Symptoms in Endodontic Patients Using Cone-beam Computed Tomography and Periapical Radiographs. J Endod 2015; 41:1824-9. [DOI: 10.1016/j.joen.2015.06.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 06/08/2015] [Accepted: 06/14/2015] [Indexed: 10/23/2022]
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Vera J, Ochoa-Rivera J, Vazquez-Carcaño M, Romero M, Arias A, Sleiman P. Effect of Intracanal Cryotherapy on Reducing Root Surface Temperature. J Endod 2015; 41:1884-7. [PMID: 26433855 DOI: 10.1016/j.joen.2015.08.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 08/12/2015] [Accepted: 08/16/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The positive effect of cryotherapy has been widely described in medicine. The aim of the present study was to validate a new methodology to reduce and maintain external root surface temperature for at least 4 minutes. METHODS Twenty extracted single-rooted teeth were instrumented to size 35/.06 and subjected to 2 different irrigation interventions with a repeated-measures design using 5% sodium hypochlorite first (control) and 2.5°C cold saline solution later (experimental). In both, 20 mL of the irrigant solution was delivered for a total time of 5 minutes with a microcannula attached to the EndoVac system (Kerr Endo, Orange County, CA) inserted to the working length. The initial and lowest temperatures were recorded in the apical 4 mm with a digital thermometer for both irrigants. Data were analyzed with the repeated measure analysis of variance (Greenhouse-Geisser correction) and Bonferroni post hoc tests. Differences in maintaining a -10°C temperature reduction over 4 minutes were assessed with the Fisher exact test. RESULTS Although significant differences were found between the initial and lowest temperatures in both the control and experimental irrigation procedures (P < .001), the experimental intervention reduced it almost 10 times that of the control. When maintaining a -10°C temperature reduction over 4 minutes, the teeth in the experimental group also sustained significantly better results (P = 3.047 × 10(-10)). CONCLUSIONS Using cold saline solution as the final irrigant reduced the external root surface temperature more than 10°C and maintained it for 4 minutes, which may be enough to produce a local anti-inflammatory effect in the periradicular tissues.
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Affiliation(s)
- Jorge Vera
- Department of Postgraduate Endodontics, University of Tlaxcala, Tlaxcala, Mexico; Private Practice, Puebla, Mexico.
| | - Jorge Ochoa-Rivera
- Department of Postgraduate Endodontics, University of Tlaxcala, Tlaxcala, Mexico; Private Practice, Jalapa, Mexico
| | - Marino Vazquez-Carcaño
- Department of Postgraduate Endodontics, University of Tlaxcala, Tlaxcala, Mexico; Private Practice, Tlaxcala, Mexico
| | - Monica Romero
- Private Practice, Puebla, Mexico; Department of Endodontics, Benemerita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Ana Arias
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California
| | - Philippe Sleiman
- Department of Endodontics, University of North Carolina School of Dentistry, Chapel Hill, North Carolina; Lebanese University Dental School, Beirut, Lebanon
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MENDONÇA DHDS, COLUCCI V, RACHED-JUNIOR FJA, MIRANDA CES, SILVA-SOUSA YTC, SILVA SRCD. Effects of various irrigation/aspiration protocols on cleaning of flattened root canals. Braz Oral Res 2015; 29:S1806-83242015000100277. [DOI: 10.1590/1807-3107bor-2015.vol29.0082] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 03/10/2015] [Indexed: 11/22/2022] Open
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Jamleh A, Fukumoto Y, Takatomo Y, Kobayashi C, Suda H, Adorno CG. A comparison between two negative pressure irrigation techniques in simulated immature tooth: an ex vivo study. Clin Oral Investig 2015; 20:125-31. [DOI: 10.1007/s00784-015-1489-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 05/04/2015] [Indexed: 01/09/2023]
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Alves DRS, Cunha RS, da Silveira Bueno CE, de Alencar AHG, de Araújo Estrela CR, dos Santos TO, Estrela C. Antibacterial Potential of 2.5% Sodium Hypochlorite in Distinct Irrigation Protocols on Enterococcus faecalis Biofilm. J Contemp Dent Pract 2015; 16:340-346. [PMID: 26162251 DOI: 10.5005/jp-journals-10024-1687] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of irrigation methods on antibacterial potential of 2.5% NaOCl on Enterococcus faecalis biofilm. MATERIALS AND METHODS Enterococcus faecalis biofilms were prepared during 60 days on 48 human root canals and randomized into control and experimental groups using positive and negative pressure irrigation. Bacterial growth was analyzed using turbidity of culture medium followed by UV spectrophotometry, and scanning electron microscopy (SEM) analyses were performed. Mean and standard deviations were used for evaluate the mean optical densities associated to the number of bacteria present culture, and Scheirer-Ray-Hare (an extension of the Kruskal-Wallis test) and Tamhane test to analyze the SEM images in the groups and thirds. Significance was set at 5%. RESULTS Enterococcus faecalis was still present after root canal cleaning regardless of irrigation methods or bacterial identification methods. CONCLUSION Positive and negative pressure irrigation protocols using 2.5% NaOCl show a similar capacity to reduce E. faecalis in infected root canals.
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Affiliation(s)
- Denise Ramos Silveira Alves
- Professor, Department of Stomatologic Sciences, Federal University of Goiás, Praça Universitária s/n, Sector Universitário CEP: 74605-220, Goiânia, State of Goiás, Brazil, e-mail:
| | | | | | | | | | | | - Carlos Estrela
- Department of Stomatologic Sciences, Federal University of Goiás, Goiânia, State of Goiás, Brazil
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Rossi-Fedele G, Guastalli AR. Effect of an alcohol-based caries detector on the surface tension of sodium hypochlorite preparations. Braz Dent J 2015; 26:66-8. [PMID: 25672387 DOI: 10.1590/0103-6440201300172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 12/11/2014] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to evaluate the effect of an alcohol-based caries detector (Kurakay) on the surface tension of a conventional sodium hypochlorite (NaOCl) preparation, and a product containing a surface-active agent (Chlor-XTRA). The surface tensions of the following solutions were tested: NaOCl, a mixture of NaOCl and Kurakay 9:1 w/w, Chlor-XTRA, a mixture of Chlor-XTRA and Kurakay 9:1 w/w. Ten measurements per test solution were made at 20°C, using an optical method called the "Pendant drop method", with a commercially available apparatus. The addition of Kurakay reduced the surface tension for NaOCl (p<0.05) whilst no significant difference was detected for Chlor-XTRA (p>0.05). Statistically significant differences between the NaOCl and Chlor-XTRA groups were found (p<0.05). The addition of an alcohol-based caries detector resulted in a reduction of the original surface tension values for NaOCl only. Taking into account the fact that mixtures of NaOCl and Kurakay have been used to assess the penetration of root canal irrigants in vitro, the related changes in surface tension are a possible source of bias.
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Affiliation(s)
| | - Andrea R Guastalli
- Chemical Engineering Department, University of Barcelona, Barcelona, Spain
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Akyuz Ekim SN, Erdemir A. Comparison of different irrigation activation techniques on smear layer removal: An in vitro study. Microsc Res Tech 2015; 78:230-9. [DOI: 10.1002/jemt.22466] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 11/19/2014] [Accepted: 12/16/2014] [Indexed: 11/07/2022]
Affiliation(s)
| | - Ali Erdemir
- Faculty of Dentistry; Department of Endodontics; Kirikkale University; Kirikkale Turkey
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van der Sluis L, Boutsioukis C, Jiang LM, Macedo R, Verhaagen B, Versluis M. Root Canal Irrigation. SPRINGER SERIES ON BIOFILMS 2015. [DOI: 10.1007/978-3-662-47415-0_9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Castagnola R, Lajolo C, Minciacchi I, Cretella G, Foti R, Marigo L, Gambarini G, Angerame D, Somma F. Efficacy of three different irrigation techniques in the removal of smear layer and organic debris from root canal wall: a scanning electron microscope study. GIORNALE ITALIANO DI ENDODONZIA 2014. [DOI: 10.1016/j.gien.2014.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Çapar İD, Aydinbelge HA. Effectiveness of various irrigation activation protocols and the self-adjusting file system on smear layer and debris removal. SCANNING 2014; 36:640-647. [PMID: 25285423 DOI: 10.1002/sca.21171] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 08/27/2014] [Accepted: 09/10/2014] [Indexed: 06/03/2023]
Abstract
The purpose of the present study is to evaluate smear layer generation and residual debris after using self-adjusting file (SAF) or rotary instrumentation and to compare the debris and smear layer removal efficacy of the SAF cleaning/shaping irrigation system against final agitation techniques. One hundred and eight maxillary lateral incisor teeth were randomly divided into nine experimental groups (n = 12), and root canals were prepared using ProTaper Universal rotary files, with the exception of the SAF instrumentation group. During instrumentation, root canals were irrigated with a total of 16 mL of 5% NaOCl. For final irrigation, rotary-instrumented groups were irrigated with 10 mL of 17% EDTA and 10 mL of 5% NaOCl using different irrigation agitation regimens (syringe irrigation with needles, NaviTip FX, manual dynamic irrigation, CanalBrush, EndoActivator, EndoVac, passive ultrasonic irrigation (PUI), and SAF irrigation). In the SAF instrumentation group, root canals were instrumented for 4 min at a rate of 4 mL/min with 5% NaOCl and received a final flush with same as syringe irrigation with needles. The surface of the root dentin was observed using a scanning electron microscope. The SAF instrumentation group generated less smear layer and yielded cleaner canals compared to rotary instrumentation. The EndoActivator, EndoVac, PUI, and SAF irrigation groups increased the efficacy of irrigating solutions on the smear layer and debris removal. The SAF instrumentation yielded cleaner canal walls when compared to rotary instrumentation. None of the techniques completely removed the smear layer from the root canal walls.
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Affiliation(s)
- İsmail Davut Çapar
- Department of Endodontics, Faculty of Dentistry, İzmir Katip Çelebi University, İzmir, Turkey
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Tissue response to root canal irrigation systems in dogs’ teeth with apical periodontitis. Clin Oral Investig 2014; 19:1147-56. [DOI: 10.1007/s00784-014-1340-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Accepted: 10/14/2014] [Indexed: 11/26/2022]
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49
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Thomas AR, Velmurugan N, Smita S, Jothilatha S. Comparative Evaluation of Canal Isthmus Debridement Efficacy of Modified EndoVac Technique with Different Irrigation Systems. J Endod 2014; 40:1676-80. [DOI: 10.1016/j.joen.2014.05.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 05/05/2014] [Accepted: 05/12/2014] [Indexed: 11/26/2022]
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50
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Berkhoff JA, Chen PB, Teixeira FB, Diogenes A. Evaluation of Triple Antibiotic Paste Removal by Different Irrigation Procedures. J Endod 2014; 40:1172-7. [DOI: 10.1016/j.joen.2013.12.027] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 11/08/2013] [Accepted: 12/29/2013] [Indexed: 11/28/2022]
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