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Saghiri MA, Vakhnovetsky J, Abdolmaleki A, Samadi E, Samadi F, Napoli S, Conte M, Morgano SM. Mechanical properties of simulated dentin caries treated with metal cations and L-ascorbic acid 2-phosphate. Odontology 2024; 112:489-500. [PMID: 37978093 DOI: 10.1007/s10266-023-00868-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 10/16/2023] [Indexed: 11/19/2023]
Abstract
This pH cycling study aimed to investigate the effects of L-Ascorbic acid 2-phosphate (AA2P) salts of Mg, Zn, Mn, Sr, and Ba on the surface microhardness, compressive strength, diametral tensile strength (DTS), and solubility of root canal dentin. 186 cylindrical dentin specimens from 93 teeth were fortified with optimal concentrations of AA2P salts of Mg (0.18 mM), Zn (5.3 µM), Mn (2.2 × 10-8 M), Sr (1.8 µM), and Ba (1.9 µM). Saline was used as the control group. These dentin specimens underwent a 3-day cycling process simulating dentin caries formation through repeated sequences of demineralization and remineralization. Surface microhardness at 100 and 500 µm depths (n = 10/subgroup), scanning electron microscopy (n = 3/group), compressive strength (n = 10/group), DTS (n = 6/group), and solubility (n = 5/group) tests were performed to analyze the dentin specimens. Data were analyzed using Kolmogorov-Smirnov, one-way ANOVA, and Post Hoc Tukey tests (p < 0.05). The control group had significantly lower microhardness at both depths (p < 0.001), reduced DTS (p = 0.001), decreased compressive strength (p < 0.001), and higher weight loss (p < 0.001) than all other groups. The Sr group had the highest compressive strength and microhardness among all the groups. The microhardness was significantly higher for the 500 µm depth than the 100 µm depth (p < 0.001), but the difference in microhardness between depths across groups was not significant (p = 0.211). All fortifying solutions provided some protection against artificial caries lesions. Therefore, these elements might have penetrated and reinforced the demineralized dentin against acid dissolution.
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Affiliation(s)
- Mohammad Ali Saghiri
- Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ, USA.
- Department of Endodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA.
- MSB C639A, Rutgers Biomedical and Health Sciences, 185 South Orange Avenue, Newark, NJ, 07103, USA.
| | - Julia Vakhnovetsky
- Sector of Innovation in Dentistry, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, NJ, USA
- University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | | | - Elham Samadi
- Sector of Innovation in Dentistry, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, NJ, USA
- Biomaterials Laboratory, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Fatereh Samadi
- Sector of Innovation in Dentistry, Dr. Hajar Afsar Lajevardi Research Cluster (DHAL), Hackensack, NJ, USA
- Biomaterials Laboratory, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Salvatore Napoli
- Department of Oral & Maxillofacial Surgery, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Michael Conte
- Department of Restorative Dentistry, Office of Clinical Affairs, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - Steven M Morgano
- Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, NJ, USA
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2
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Aslan T, Dadi Ş, Kafdag O, Temur N, Ildiz N, Ocsoy I, Ustun Y. Rational design of EDTA-incorporated nanoflowers as novel and effective endodontic disinfection against biofilms. Odontology 2024; 112:444-452. [PMID: 37787827 DOI: 10.1007/s10266-023-00857-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/12/2023] [Indexed: 10/04/2023]
Abstract
The ethylenediaminetetradiacetic acid (EDTA) is one of the most commonly used irrigation solutions. Although EDTA has a very low antimicrobial property, it is used to remove inorganic part of smear layer in areas of root canal system. Herein, we developed EDTA-incorporated nanoflowers (EDTA NFs), for the first time, as novel and effective irrigation solution with quite high antimicrobial property to provide complete disinfection in root canal system. We both systematically elucidated the formation of the EDTA NFs with various techniques, and their catalytic and antimicrobial activities in the presence of hydrogen peroxide (H2O2) were documented through intrinsic EDTA property and peroxidase-like activities.
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Affiliation(s)
- Tugrul Aslan
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Şeyma Dadi
- Department of Nanotechnology Engineering, Abdullah Gül University, 38080, Kayseri, Turkey
| | - Ozgur Kafdag
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Nimet Temur
- Department of Analytical Chemistry, Faculty of Pharmacy, Erciyes University, Kayseri, 38039, Turkey
| | - Nilay Ildiz
- Medical Imaging Department, Bandırma Onyedi Eylul University, Vocational School of Health Services, 12 10200, Bandirma, Turkey
| | - Ismail Ocsoy
- Department of Analytical Chemistry, Faculty of Pharmacy, Erciyes University, Kayseri, 38039, Turkey
| | - Yakup Ustun
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey.
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Pai ARV. Injection of sodium hypochlorite into soft tissues of the oral cavity: A literature review with clinical preventive recommendations. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101581. [PMID: 37544507 DOI: 10.1016/j.jormas.2023.101581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/30/2023] [Indexed: 08/08/2023]
Abstract
Injection of sodium hypochlorite (NaOCl) solution instead of local anaesthetic (LA) solution is an iatrogenic error with serious consequences including medico-legal implications. Such cases have been reported despite recommended precautionary measures. The purpose of this article is to review the literature on such cases and present clinical preventive recommendations. Electronic search was conducted in PubMed/Medline, Google Scholar, Cochrane, Scopus, Lilacs, ScienceDirect, and Crossref databases for articles reporting accidental or mistaken or inadvertent injection of NaOCl instead of LA during dental or endodontic treatment. Articles reporting NaOCl accident due to extrusion or injection of NaOCl beyond root confines were excluded. A total of 11 articles were found and reviewed. Data pertaining to the patient, injected NaOCl, cause, clinical manifestations, management, hospitalization, healing and recovery, and long-term or residual effects were extracted, compiled, and analysed for interpretation and discussion. Injection of NaOCl instead of LA into the soft tissues leads to varying clinical manifestations with unpredictable extent, outcome, and recovery period. The onus lies with the clinician to prevent it. Therefore, a clinician must take all the precautionary measures and confirm the identity of LA and NaOCl solutions before delivering them. The presented clinical recommendations assist clinicians to prevent it, including its potential medico-legal consequences. However, in case of such an unfortunate event, it is crucial to immediately identify and quickly manage it to limit the tissue damage or complications.
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Affiliation(s)
- A R Vivekananda Pai
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Manipal University College Malaysia (MUCM), Jalan Batu Hampar, Bukit Baru, Melaka 75150, Malaysia.
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Ayhan M, Altunbaş D. Efficacy of Potassium Titanyl Phosphate Laser and Sodium Hypochlorite on Postoperative Pain Intensity Following Pulpotomy in Teeth with Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial. Photobiomodul Photomed Laser Surg 2023; 41:225-233. [PMID: 37092958 DOI: 10.1089/photob.2022.0152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023] Open
Abstract
Introduction: This study evaluated the postoperative pain intensity in permanent teeth with symptomatic irreversible pulpitis treated by pulpotomy using physiological saline, sodium hypochlorite (NaOCl), or the potassium titanyl phosphate (KTP) laser. Materials and methods: Ninety patients diagnosed with symptomatic irreversible pulpitis in permanent molars were randomly divided into three groups according to the pulpotomy procedures. Preoperative pain levels were recorded. Complete hemostasis was achieved with physiological saline (control group), NaOCl, or the KTP laser after initial bleeding control. Patients were asked to mark their pain level on the visual pain scale at 6, 24, 48, and 72 h and 7 and 30 days depending on the severity of pain. The permanent restoration was completed after 7 days. Data were statistically analyzed using Kruskal-Wallis, Mann-Whitney U, Friedman, and Bonferroni tests at a significance level of p < 0.05. Results: According to the present study, the statistical difference between the groups in terms of preoperative pain and percussion pain levels was insignificant (p > 0.05). There was no significant difference between groups in terms of demographic data (p > 0.05). The postoperative pain level of the KTP laser group was significantly lower at 6 h compared with the saline group (p < 0.05). There was no significant difference between groups in terms of the postoperative pain level at other time intervals (p > 0.05). The highest pain scores were observed in all groups at 6 h (p < 0.05). Conclusions: The KTP laser can be preferred primarily for reducing postoperative pain in pulpotomy treatments. The KTP laser or NaOCl-assisted pulpotomy can be an effective treatment for pain reduction in permanent teeth with symptomatic irreversible pulpitis. This report is registered at clinicaltrials.gov (ID: NCT05424796).
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Affiliation(s)
- Muhammed Ayhan
- Department of Endodontics, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Turkey
| | - Demet Altunbaş
- Department of Endodontics, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Turkey
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Miranda TC, Andrade JFM, Gelfuso GM, Cunha-Filho M, Oliveira LA, Gratieri T. Novel technologies to improve the treatment of endodontic microbial infections: Inputs from a drug delivery perspective. Int J Pharm 2023; 635:122794. [PMID: 36870400 DOI: 10.1016/j.ijpharm.2023.122794] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
Endodontic microbial infections are still a challenge for an effective treatment for being biofilm-mediated and very refractory to conventional therapies. Biomechanical preparation and chemical irrigants cannot fully eradicate biofilms due to the anatomic structure of the root canal system. Instruments employed in biomechanical preparation and irrigants solution cannot reach the narrow and deepest portion of root canals, especially the apical thirds. In addition, aside from the dentin surface, biofilms can also infiltrate dentine tubules and periapical tissues, compromising treatment success. Therefore, different technologies have been investigated to achieve a more effective outcome in the control of endodontic infections. However, these technologies continue to face great difficulties in reaching the apical region and eradicating biofilms to avoid the recurrence of infection. Here, we present an overview of the fundamentals of endodontics infections and review technologies currently available for root canal treatment. We discuss them from a drug delivery perspective, highlighting each technology's strength to envision the best use of these technologies.
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Affiliation(s)
- Thamires C Miranda
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Jayanaraian F M Andrade
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Guilherme M Gelfuso
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Marcilio Cunha-Filho
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Laudimar A Oliveira
- Department of Dentistry, Faculty of Health Sciences, University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Tais Gratieri
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil.
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SERÇE FİKİRLİ B, ALTUNKAYNAK B, KAYAOĞLU G. Kök kanal geometrisinin ve iğne tipinin apikalden irrigan taşmasına etkisi: ex vivo çalışma. ACTA ODONTOLOGICA TURCICA 2022. [DOI: 10.17214/gaziaot.945129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objective: The aim was to evaluate the effect of root canal geometry on the amount of apical extrusion of irrigant, by testing different tapers and needle types.
Materials and Method: Forty-three extracted single-rooted human mandibular premolar teeth were accessed. Experimental groups were instrumented to produce increasing amounts of taper in each successive group: Group 1 (#25/.02), Group 2 (#25/.04), Group 3 (#25/.06), and Group 4 (#25/.08) (n=43, each). Irrigation was done sequentially by using a 30-G open-ended flat needle, 30-G close-ended side-vented needle, and 27-G open-ended beveled needle. Flat and side-vented needles were each placed 3 mm short of the apex, while the beveled needle was placed as far as possible in the canal without binding. Extruded irrigant was collected in preweighed foam cubes. Statistical significance was set at p<0.05.
Results: An increase in canal taper led to a decrease in the amount of extruded irrigant for the flat needle (p<0.05; Groups 1 and 2 versus 3 and 4) and side-vented needle (p<0.05; Groups 1 and 2 versus 4), but no significant effect was found for the beveled needle. The amount of extruded irrigant was greater with the flat than with the side-vented needle at all tapers and with the beveled needle at most tapers (p<0.05). The side-vented needle was generally associated with the least amount of extrusion.
Conclusion: Given a constant needle insertion depth, the amount of apically extruded irrigant decreased as canal taper increased. The greatest and least amounts of extrusion were generally observed with the flat and side-vented needle, respectively.
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Affiliation(s)
| | | | - Güven KAYAOĞLU
- Department of Endodontics, Faculty of Dentistry, Gazi University
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Tanalp J. A critical analysis of research methods and experimental models to study apical extrusion of debris and irrigants. Int Endod J 2022; 55 Suppl 1:153-177. [DOI: 10.1111/iej.13686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 11/30/2022]
Affiliation(s)
- J Tanalp
- Yeditepe University Faculty of Dentistry Department of Endodontics Istanbul Turkey
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9
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Hülsmann M. A critical appraisal of research methods and experimental models for studies on root canal preparation. Int Endod J 2021; 55 Suppl 1:95-118. [PMID: 34800299 DOI: 10.1111/iej.13665] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/17/2021] [Indexed: 01/02/2023]
Abstract
It is the aim of this review to present a critical overview and summary on the contemporary possibilities, limitations and challenges of research related to root canal preparation. Frequently used research tools and contemporary research designs will be presented and discussed critically focussing on shortcomings and benefits with special regard to clinical relevance and scientific evidence. A plethora of experimental set-ups for assessing the shaping of root canals have been described in the endodontic literature using a considerable number of techniques and instruments. Nevertheless, it can be stated that scientific evidence demonstrating the clinical impact of many investigated topics is questionable or even missing. Instead of technical, radiographic and geometrical parameters, further research should focus on biological aspects and clinical evidence of the impact of root canal preparation on the outcome of root canal treatment.
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Affiliation(s)
- Michael Hülsmann
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
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10
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El-Din SN, Ali MM, Hassan R. Comparison of Apically Extruded Debris Associated with Different Irrigation Techniques after Removal of Intracanal Medicaments. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6094] [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
This study aimed to compare the effect of XP-endo Finisher file (XPF), passive ultrasonic irrigation (PUI) and conventional irrigation technique using side-vented needle (SVN) on the amount of apically extruded debris after the removal of calcium hydroxide Ca(OH)2 and double antibiotic paste (DAP). Materials and Methods: Sixty extracted human mandibular premolars were used. After decronation, all canals were prepared up to the ProTaper Next X4 file (Dentsply Maillefer, Ballaigues, Switzerland). After dryness, teeth were randomly assigned into 2 groups (n=30) according to the Type of intracanal medication used; Ca(OH)2 and DAP then incubated at 37 °C and 100% humidity. After one week, Samples in each group were randomly assigned to 3 subgroups (n=10) according to the method used for medicament removal: XPF, PUI and SVN. Debris extruded during the removal procedure were collected into pre-weighed Eppendorf tubes then left to dry in an incubator at 37°C for 15 days. The amount of extruded debris was assessed with an analytical balance and calculated by subtracting the initial weight from the final weight of the tube. Data were statistically analyzed using Kruskal-Wallis and Mann-Whitney U test. Results: there was no statistically significant difference regarding the amount of apically extruded debris after using the three irrigation techniques in removal of both Ca(OH)2 and DAP (P-value = 0.141, Effect size = 0.160) and (P-value = 0.237, Effect size = 0.073) respectively. Conclusions: Neither XPF nor PUI increase the risk of intracanal medicament extrusion beyond the apex.
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Hussein H, Kishen A. Engineered Chitosan-based Nanoparticles Modulate Macrophage-Periodontal Ligament Fibroblast Interactions in Biofilm-mediated Inflammation. J Endod 2021; 47:1435-1444. [PMID: 34214497 DOI: 10.1016/j.joen.2021.06.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/20/2021] [Accepted: 06/21/2021] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Crosstalk between immune cells and tissue-resident cells regulates the pathophysiology and posttreatment healing of apical periodontitis. This investigation aimed to understand the influence of residual root canal biofilm on macrophage (MQ)-periodontal ligament fibroblast (PdLF) interaction and evaluate the effect of engineered chitosan-based nanoparticles (CSnp) on MQ-PdLF interactions in residual biofilm-mediated inflammation. METHODS Six-week-old Enterococcus faecalis biofilms in root canal models were disinfected conventionally using sodium hypochlorite alone or followed by calcium hydroxide medication or CSnp dispersed in carboxymethylated chitosan (CMCS). The effect of the treated biofilms (n = 25/group) on the inflammatory response of THP-1-differentiated MQ monoculture versus coculture with PdLF was evaluated for cell viability, MQ morphometric characterization, inflammatory mediators (nitric oxide, tumor necrosis factor alpha, interleukin [IL]-1 beta, IL-1RA, IL-6, transforming growth factor beta 1 [TGF-β1], and IL-10), and the expression of transcription factors (pSTAT1/pSTAT6)/cluster of differentiation markers (CD80/206) after 24, 48, and 72 hours of interaction. PdLF transwell migration was evaluated after 8 and 24 hours. Unstimulated cells served as the negative control, whereas untreated biofilm was the positive control. RESULTS Biofilm increased nitric oxide and IL-1β but suppressed IL-10, IL-1RA, and PdLF migration with significant cytotoxic effects. CSnp/CMCS reduced nitric oxide and IL-1β (P < .01) while maintaining ≥90% cell survival up to 72 hours with evident M2-like MQ phenotypic changes in coculture. CSnp/CMCS also increased the IL-1RA/IL-1β ratio and enhanced TGF-β1 production over time (P < .05, 72 hours). In coculture, CSnp/CMCS showed the highest IL-10 level at 72 hours (P < .01), reduced the pSTAT1/pSTAT6 ratio, and enhanced PdLF migration (P < .01, 24 hours). CONCLUSIONS CSnp/CMCS medication facilitated MQ switch toward M2 (regulatory/anti-inflammatory) phenotype and PdLF migration via paracrine signaling.
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Affiliation(s)
- Hebatullah Hussein
- The Kishen Lab, Dental Research Institute, University of Toronto, Toronto, Canada; Faculty of Dentistry, University of Toronto, Toronto, Canada; Faculty of Dentistry, Endodontics Department, Ain Shams University, Cairo, Egypt
| | - Anil Kishen
- The Kishen Lab, Dental Research Institute, University of Toronto, Toronto, Canada; Faculty of Dentistry, University of Toronto, Toronto, Canada; Department of Dentistry, Mount Sinai Health System, Mount Sinai Hospital, Toronto, Ontario, Canada.
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Castelo-Baz P, Lozano FJR, Ginzo-Villamayor MJ, Vila RM, Seoane-Romero J, Martín-Cruces J, Martín-Biedma B. Efficacy of continuous apical negative ultrasonic irrigation (CANUI) in penetration of simulated lateral canals in extracted teeth. Sci Rep 2021; 11:10908. [PMID: 34035414 PMCID: PMC8149429 DOI: 10.1038/s41598-021-90430-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 03/15/2021] [Indexed: 02/08/2023] Open
Abstract
The aim of this study was to evaluate the efficacy of continuous apical negative ultrasonic irrigation into simulated lateral canals and the apical third in straight and curved root canals. Two simulated lateral canals were created 2, 4 and 6 mm from the working length in 120 single-rooted teeth (6 canals/tooth, n = 360 straight, n = 360 curved). The teeth were randomly divided into 3 experimental groups: positive pressure irrigation (PPI) (n = 20); passive ultrasonic irrigation (PUI) (n = 20); continuous apical negative ultrasonic irrigation (CANUI) (n = 20). 20% Chinese ink was added to a 5% sodium hypochlorite solution and delivered into the root canals. The results showed a significantly higher (P < 0.05) penetration of irrigant into the lateral canals and up to working length in the CANUI group for straight and curved roots. CANUI improves penetration into the lateral canals and up to the working length of the cleared teeth in straight and curved roots.
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Affiliation(s)
- Pablo Castelo-Baz
- Facultad de Odontología, University of Santiago de Compostela, Entrerríos Street, No. 15702, Santiago de Compostela, Spain.
| | | | - María J Ginzo-Villamayor
- Facultad de Odontología, University of Santiago de Compostela, Entrerríos Street, No. 15702, Santiago de Compostela, Spain
| | - Ramón Miguéns Vila
- Facultad de Odontología, University of Santiago de Compostela, Entrerríos Street, No. 15702, Santiago de Compostela, Spain
| | - Juan Seoane-Romero
- Facultad de Odontología, University of Santiago de Compostela, Entrerríos Street, No. 15702, Santiago de Compostela, Spain
| | - José Martín-Cruces
- University of Murcia, Murcia, Spain.,Universidad Internacional de Catalunya, Barcelona, Spain
| | - Benjamín Martín-Biedma
- Facultad de Odontología, University of Santiago de Compostela, Entrerríos Street, No. 15702, Santiago de Compostela, Spain
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Yilmaz Ş, Yoldas O, Dumani A, Guler G, Ilgaz S, Akbal E, Oksuz H, Celik A, Yilmaz B. Calcium hypochlorite on mouse embryonic fibroblast cells (NIH3T3) in vitro cytotoxicity and genotoxicity: MTT and comet assay. Mol Biol Rep 2020; 47:5377-5383. [PMID: 32623618 DOI: 10.1007/s11033-020-05624-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 06/26/2020] [Indexed: 10/23/2022]
Abstract
Antimicrobial irrigation solutions are widely used under clinical settings. Their effect on dental tissue is a subject of recent research, which aims for a safer irrigant for clinical use. In this regard, here our goal was to evaluate the cytotoxicity and the genotoxicity of calcium hypochlorite (Ca(OCl)2) solution, along with NaOCl, on Mouse embryonic fibroblast cells (NIH3T3). First, Cells were treated either with NaOCl or Ca(OCl)2 in a time- and dose-dependent manner for cytotoxicity by 3-(4,5-dimethylthiazolyl-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, then cell viability was calculated according to cell proliferation plots. Secondly, genotoxicity was assessed by Comet assay. Data were statistically analyzed by Tukey's test (P < .05). NaOCl and Ca(OCl)2 had similar effects on cellular viability at 3 and 6 h treatments. Cell viability of Ca(OCl)2 at concentrations of 0.0125%, 0.025%, 0.05%, or 0.125% was significantly lower than that of NaOCl at 24 h treatment (P < .05).Comparing Ca(OCl)2 and NaOCl treatments at all time points and concentrations, the damaged cell number of Ca(OCl)2 was almost fourfold higher than that of NaOCl. In conclusion, both, NaOCl and Ca(OCl)2 solutions were cytotoxic and genotoxic to NIH3T3, however, Ca(OCl)2 had a significantly higher damaged cell percentage than NaOCl at all time points and concentrations investigated.
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Affiliation(s)
- Şehnaz Yilmaz
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Oguz Yoldas
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Aysin Dumani
- Department of Endodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Gizem Guler
- Department of Biology, Faculty of Science and Letters, Mersin University, Mersin, Turkey
| | - Seda Ilgaz
- Department of Medical Biology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Eylül Akbal
- Department of Medical Biology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Hale Oksuz
- Department of Medical Biology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Ayla Celik
- Department of Biology, Faculty of Science and Letters, Mersin University, Mersin, Turkey.
| | - Bertan Yilmaz
- Department of Medical Biology, Faculty of Medicine, Cukurova University, Adana, Turkey
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Ioannidis K, Batty C, Turner C, Smith D, Deb S, Mannocci F. Ex vivo detection and quantification of apically extruded volatile compounds and disinfection by-products by SIFT-MS, during chemomechanical preparation of infected root canals. Dent Mater 2020; 36:257-269. [DOI: 10.1016/j.dental.2019.11.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/09/2019] [Accepted: 11/15/2019] [Indexed: 10/25/2022]
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Vidas J, Snjaric D, Braut A, Carija Z, Persic Bukmir R, De Moor RJG, Brekalo Prso I. Comparison of apical irrigant solution extrusion among conventional and laser-activated endodontic irrigation. Lasers Med Sci 2019; 35:205-211. [DOI: 10.1007/s10103-019-02846-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 07/11/2019] [Indexed: 12/23/2022]
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Hu S, Duan L, Wan Q, Wang J. Evaluation of needle movement effect on root canal irrigation using a computational fluid dynamics model. Biomed Eng Online 2019; 18:52. [PMID: 31060550 PMCID: PMC6501388 DOI: 10.1186/s12938-019-0679-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 04/30/2019] [Indexed: 02/05/2023] Open
Abstract
Background Irrigation is considered to be a critical part of root canal treatment. However, little is known about the effect of needle movement on the irrigation process. Therefore, this study aimed to investigate the influence of the syringe and needle movement on root canal irrigation using a three-dimensional computational fluid dynamics (CFD) numerical model. Methods The CFD codes Flow-3D was adopted to simulate the root canal irrigation process with the syringe and needle moving up and down in motions at different amplitudes and frequencies. One stationary needle was adopted to allow comparison with the needles in up-and-down motions. Six cases where the needles were moving up and down with different amplitudes and frequencies were used to investigate the relationships between the motion of needle and irrigation efficacy. Results The stationary needle gained relatively higher flow velocity and apical pressure all through the irrigation process, while the needles in constant up-and-down motions exhibited lower mean flow velocity and apical pressure. The larger the amplitude, the less mean flow velocity and apical pressure were developed. In addition, the needles moving with different frequencies were similar in the terms of irrigant replacement and apical pressure. Conclusions To avoid periapical extrusion accidents while obtaining adequate irrigant replacement, the needle should be moving up and down with a moderate amplitude during manual root canal irrigation; and the motion frequency was not highly relevant in terms of the irrigation efficiency. Electronic supplementary material The online version of this article (10.1186/s12938-019-0679-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shanshan Hu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lunliang Duan
- Department of Bridge Engineering, Southwest Jiaotong University, Chengdu, 610031, China
| | - Qianbing Wan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Jian Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China. .,Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
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Mascarenhas RJ. Management of subcutaneous facial emphysema secondary to a class V dental restoration. Clin Case Rep 2019; 7:1025-1030. [PMID: 31110739 PMCID: PMC6509900 DOI: 10.1002/ccr3.2141] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 03/16/2019] [Accepted: 03/23/2019] [Indexed: 11/11/2022] Open
Abstract
Subcutaneous facial emphysema (SFE) is a potentially serious complication of dental treatment typically associated with surgical removal of teeth using air-driven handpieces. A case of SFE is presented occurring after routine dental restoration, along with a framework to aid prevention of this complication and guide management where it occurs.
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Affiliation(s)
- Raoul Julio Mascarenhas
- School of Dentistry and Health SciencesCharles Sturt UniversityWagga WaggaNew South WalesAustralia
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Khanifam P, Pullisaar H, Risheim H. Local facial atrophy and permanent anesthesia of right upper lip following subcutaneous extrusion of chlorhexidine digluconate. ORAL AND MAXILLOFACIAL SURGERY CASES 2019. [DOI: 10.1016/j.omsc.2018.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Bjelović L, Glišić B, Živković M, Kanjevac T. Investigation of p-chloroaniline formation in the reactions between different endodontic irrigants. KRAGUJEVAC JOURNAL OF SCIENCE 2019. [DOI: 10.5937/kgjsci1941043b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Nuclear magnetic resonance spectroscopy and infrared spectroscopy analysis of precipitate formed after mixing sodium hypochlorite and QMix 2in1. PLoS One 2018; 13:e0202081. [PMID: 30110396 PMCID: PMC6093659 DOI: 10.1371/journal.pone.0202081] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 07/28/2018] [Indexed: 11/20/2022] Open
Abstract
Background Mixing sodium hypochlorite (NaOCl) with chlorhexidine (CHX) forms a brown precipitate. QMix-2in1 (QMix) was introduced as a final irrigant. Manufacturer recommends interim flushing with saline between the application of NaOCl and QMix to prevent formation of precipitation. This study assessed whether para-chloroaniline (PCA) is formed after mixing NaOCl with QMix. Methods Commercially available, 5.25% NaOCl solution, 2% CHX, QMix, 15% ethylenediaminetetraacetic acid (EDTA) and 98% PCA in powder form were used. Groups were prepared at room temperature. Group 1, 98% PCA in powder form; Group 2, 2% chlorhexidine (CHX); Group 3, QMix; Group 4, 5.25% sodium hypochlorite (NaOCl) mixed with QMix; Group 5, 5.25% NaOCl mixed with CHX; Group 6, 15% EDTA mixed with CHX. The precipitates were extracted and analysed with Proton Nuclear Magnetic Resonance (1H-NMR) and Infrared (IR) Spectroscopy, using PCA as an internal standard. Results No PCA was found in any of the irrigant-mixture groups tested. Conclusions This study used the interpretation of spectral results for the amino signals of precipitate formed after mixing QMix with 5.25% NaOCl using different nondestructive analysis methods, with PCA as an internal standard (control). We conclude that mixing QMix or 2%CHX with 5.25% NaOCl does not yield free PCA.
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Nogo-Zivanovic D, Bjelovic L, Ivanovic V, Kanjevac T, Tanaskovic I. Consideration of the Therapeutic Potential of Irrigants in Endodontic Therapy. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2018. [DOI: 10.1515/sjecr-2016-0095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Abstract
The main objective of endodontic treatment is to remove vital and necrotic remnants of pulp tissue and microorganisms and their toxic products from the root canal. During chemo-mechanical endodontic preparation, a smear layer is formed on the wall of the canals. Due to an inability to remove all tissue remnants and the smear layer from the root canal by mechanical instrumentation, it is necessary to use irrigation to ensure sufficient cleaning and disinfection of the largest part of the root canalicular system. The most commonly used irrigants are sodium hypochlorite (Na-OCl), ethylenediaminetetraacetic acid (EDTA), citric acid and chlorhexidine (CHX). Recently, the irrigants QMix and MTAD have been introduced to the market. They are a mixture of different components having antimicrobial, organolytic and mineralytic effects on canal detritus and the smear layer. This review article investigates irrigants in terms of the nature of their effect, their efficiency, optimal concentration, and method of use, and the interactions between the irrigants most commonly used in endodontic therapy are discussed, with special emphasis on QMix and MTAD.
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Affiliation(s)
- Dajana Nogo-Zivanovic
- Department for Restorative Dentistry and Endodontics, Faculty of Medicine , University of East Sarajevo , Foca , Bosnia and Herzegovina
| | - Ljiljana Bjelovic
- Department for Restorative Dentistry and Endodontics, Faculty of Medicine , University of East Sarajevo , Foca , Bosnia and Herzegovina
| | - Vladimir Ivanovic
- Department of Restorative Odontology and Endodontics, School of Dental Medicine , University of Belgrade , Belgrade , Serbia
| | - Tatjana Kanjevac
- Department of Preventive and Pediatric Dentistry, Faculty of Medical Sciences , University of Kragujevac , Kragujevac , Serbia
| | - Irena Tanaskovic
- Department of Histology and Embryology, Faculty of Medical Sciences , University of Kragujevac , Kragujevac , Serbia
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Effects of Different Glide Path Files on Apical Debris Extrusion in Curved Root Canals. J Endod 2018; 44:1191-1194. [DOI: 10.1016/j.joen.2018.04.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/13/2018] [Accepted: 04/16/2018] [Indexed: 11/20/2022]
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Konstantinidi E, Psimma Z, Chávez de Paz LE, Boutsioukis C. Apical negative pressure irrigation versus syringe irrigation: a systematic review of cleaning and disinfection of the root canal system. Int Endod J 2017; 50:1034-1054. [PMID: 27898180 DOI: 10.1111/iej.12725] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 11/24/2016] [Indexed: 01/10/2023]
Abstract
The aim of this study was to systematically review and critically analyse the published data on the treatment outcome (primary outcome) and on the cleaning and disinfection of root canals (secondary outcomes) achieved by negative pressure irrigation as compared to syringe irrigation. An electronic search was conducted in EMBASE, LILACS, PubMed, SciELO, Scopus and Web of Knowledge using both free-text keywords and controlled vocabulary. Additional studies were sought through hand searching of endodontic journals and of the relevant chapters of endodontic textbooks. No language restriction was imposed. The retrieved studies were screened by two reviewers according to predefined criteria. Included studies were critically appraised and the extracted data were arranged in tables. The electronic search and hand search retrieved 489 titles. One clinical study and 14 in vitro studies were finally included in the review; none of these studies assessed treatment outcome, four studies assessed the antimicrobial effect, seven studies evaluated the removal of pulp tissue remnants, and four studies investigated the removal of hard tissue debris or both hard tissue debris and pulp tissue remnants. Poor standardization and description of the protocols was evident. Inconclusive results were reported about the cleaning and disinfection accomplished by the two irrigation methods. Negative pressure irrigation was more effective under certain conditions when compared to suboptimal syringe irrigation; however, the variability of the protocols hindered quantitative synthesis. There is insufficient evidence to claim general superiority of any one of these methods. The level of the available evidence is low, and the conclusions should be interpreted with caution.
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Affiliation(s)
- E Konstantinidi
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Z Psimma
- Private Practice, Rotterdam, The Netherlands
| | - L E Chávez de Paz
- Division of Endodontics, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - C Boutsioukis
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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Hülsmann M, Tulus G. Non-surgical retreatment of teeth with persisting apical periodontitis following apicoectomy: decision making, treatment strategies and problems, and case reports. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/etp.12098] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Shakouie S, Salem Milani A, Eskandarnejad M, Rahimi S, Froughreyhani M, Galedar S, Ranjbar E. Antimicrobial activity of tetraacetylethylenediamine-sodium perborate versus sodium hypochlorite against Enterococcus faecalis. J Dent Res Dent Clin Dent Prospects 2016; 10:43-7. [PMID: 25973152 PMCID: PMC4417491 DOI: 10.15171/joddd.2015.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 12/26/2015] [Indexed: 11/27/2022] Open
Abstract
Background and aims. Because of compromised angulations of implants, the abutments are sometimes prepared. The purpose of this study was to investigate the effect of removing one wall of the implant abutment on the retention of cement-retained crowns. Materials and methods. Four prefabricated abutments were attached to analogues and embedded in acrylic resin blocks. The first abutment was left intact. Axial walls were partially removed from the remaining abutments to produce abutments with three walls. The screw access channel for the first and second abutments were completely filled with composite resin. For the third and fourth abutments, only partial filling was done. Wax-up models were made by CAD/CAM. Ten cast copings were fabricated for each abutment. The copings of fourth abutment had an extension into the screw access channel. Copings were cemented with Temp Bond. The castings were removed from the abutment using an Instron machine, and the peak removal force was recorded. A one-way ANOVA was used to test for a significant difference followed by the pairwise comparisons. Results. The abutments with opened screw access channel had a significantly higher retention than the two other abutments. The abutment with removed wall and no engagement into the hole by the castings exhibited the highest retention. Conclusion. Preserving the opening of screw access channel significantly increases the retention where one of the axial walls of implant abutments for cement-retained restorations is removed during preparation.
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Affiliation(s)
- Sahar Shakouie
- Assistant Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amin Salem Milani
- Assistant Professor, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahsa Eskandarnejad
- Assistant Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeed Rahimi
- Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Froughreyhani
- Associate Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeede Galedar
- Post-graduate Student, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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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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Shakouie S, Salem Milani A, Eskandarnejad M, Rahimi S, Froughreyhani M, Galedar S, Ranjbar E. Antimicrobial activity of tetraacetylethylenediamine-sodium perborate versus sodium hypochlorite against Enterococcus faecalis. J Dent Res Dent Clin Dent Prospects 2016. [PMID: 27092214 PMCID: PMC4831611 DOI: 10.15171/joddd.2016.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background. This study evaluated the antimicrobial activity of Tetraacetylethylenediamine-sodium perborate (TAED-SP) in comparison to 2.5% and 5% sodium hypochlorite (NaOCl) against Enterococcus faecalis. Methods. A standard suspension of E. faecalis was inoculated on 60 plates containing Mueller-Hinton agar culture medium. Four sterile disks of Beckman filtration paper were placed on each plate. TAED-SP, 5% and 2.5% NaOCl were placed on three disks. Sterile physiologic saline was placed on the fourth disk as negative control. After 24-hour incubation, the diameter of the inhibition zone around the disks was measured using a transparent ruler. One-way Analysis of Variance (ANOVA) was used to compare the mean zone of microbial growth in the groups. P-values less than 0.05 were considered statistically significant. Results. There was a significant difference in the diameter of the inhibition zones between groups (P < 0.05). The Tukey post hoc test showed a higher diameter of the inhibitory zone with TAED-SP than that of 2.5% NaOCl. However, there were no significant differences between the inhibitory zones of TAED-SP and 5% NaOCl. Conclusion. TAED-SP and 5% NaOCl have similar antibacterial activity against E. faecalis; however, TAED-SP has a greater antibacterial effect compared to 2.5% NaOCl.
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Affiliation(s)
- Sahar Shakouie
- Assistant Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amin Salem Milani
- Assistant Professor, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Corresponding Author;E-mail:
| | - Mahsa Eskandarnejad
- Assistant Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeed Rahimi
- Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Froughreyhani
- Associate Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeede Galedar
- Post-graduate Student, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Yost RA, Bergeron BE, Kirkpatrick TC, Roberts MD, Roberts HW, Himel VT, Sabey KA. Evaluation of 4 Different Irrigating Systems for Apical Extrusion of Sodium Hypochlorite. J Endod 2015; 41:1530-4. [PMID: 26143609 DOI: 10.1016/j.joen.2015.05.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 05/16/2015] [Accepted: 05/17/2015] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate NaOCl apical extrusion by using negative apical pressure (EndoVac), sonic agitation (EndoActivator), side-vented needle (Max-i-Probe), and photon induced photoacoustic streaming (PIPS 10 mJ and PIPS 20 mJ) laser irrigation in an in vitro gel model. METHODS Extracted mandibular and maxillary central incisors (n = 18) were prepared to size 35/.04 and 55/.04, respectively. Teeth were mounted in transparent containers with clear acrylic and suspended in a color-changing pH-sensitive gel, creating a closed system. By using a crossover design, each tooth was sequentially irrigated by using 6% NaOCl with each device following manufacturers' recommendations. Each tooth served as its own control. Pre-irrigation and post-irrigation buccal and proximal view photographs served to measure the longest distance of extrusion and were analyzed with ImageJ software. Mean results were analyzed by using Kruskal-Wallis and Dunn post hoc test (P < .05). RESULTS There were no significant differences between EndoVac, EndoActivator, and the passive extrusion groups. The EndoVac and EndoActivator groups produced significantly less extrusion than PIPS irrigation. Max-i-Probe extrusion results were more variable than those of EndoActivator but had no significant difference. Across all irrigation systems, there were no significant differences with respect to apical preparation size. CONCLUSIONS Under the in vitro conditions of this study, no difference was found between the 10 mJ and 20 mJ PIPS laser groups. EndoVac demonstrated significantly less potential for apical extrusion than PIPS and Max-i-Probe, whereas apical preparation size did not significantly affect extrusion of irrigant. The potential for apical extrusion of endodontic irrigants should be a consideration when selecting a system for final irrigation.
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Affiliation(s)
- Ross A Yost
- Keesler Medical Center, Keesler Air Force Base, Mississippi
| | | | | | - Mark D Roberts
- Keesler Medical Center, Keesler Air Force Base, Mississippi
| | | | - Van T Himel
- Louisiana State University, New Orleans, Louisiana
| | - Kent A Sabey
- Louisiana State University, New Orleans, Louisiana
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Kirchhoff AL, Fariniuk LF, Mello I. Apical extrusion of debris in flat-oval root canals after using different instrumentation systems. J Endod 2014; 41:237-41. [PMID: 25447504 DOI: 10.1016/j.joen.2014.09.023] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 09/23/2014] [Accepted: 09/27/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the amount of apically extruded debris in flat-oval root canal systems during cleaning and shaping with different instrumentation systems. METHODS Seventy-two mandibular incisors were randomly assigned to 4 groups (n = 18) according to the instrumentation system to be used: the ProTaper Next rotary system (PTN; Dentsply Tulsa Dental, Tulsa, OK), the WaveOne reciprocating system (WO, Dentsply Tulsa Dental), the Twisted File Adaptive (TFA; SybronEndo, Orange, CA) rotary/reciprocating system, and the Self-Adjusting File (SAF) system (ReDent-Nova, Ra'anana, Israel). Debris extruded during the instrumentation was collected and dried in preweighed Eppendorf tubes. Three consecutive weights were obtained for each tube, and the average was calculated. The data were analyzed using the t test and analysis of variance (Games-Howell test). RESULTS The SAF produced significantly more debris compared with the other systems (P < .05). No significant difference was noted amongst the PTN, WO, and TFA (P > .05). CONCLUSIONS Regardless of the instrumentation system used, apical extrusion of debris was exhibited at some level, regardless of the instrumentation system used. The SAF was associated with the highest amount of debris extrusion compared with PTN, WO, and TFA.
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Affiliation(s)
- Alison Luís Kirchhoff
- Department of Endodontics, Faculty of Dentistry, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Luiz Fernando Fariniuk
- Department of Endodontics, Faculty of Dentistry, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Isabel Mello
- Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Restorative Dentistry, Faculty of Dentistry, University of Manitoba, Winnipeg, Manitboa, Canada.
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Spectrophotometric Determination of Irrigant Extrusion Using Passive Ultrasonic Irrigation, EndoActivator, or Syringe Irrigation. J Endod 2014; 40:1622-6. [DOI: 10.1016/j.joen.2014.03.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 03/15/2014] [Accepted: 03/18/2014] [Indexed: 12/20/2022]
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Kandian S, Chander S, Bishop K. Management of sodium hypochlorite extrusion beyond the root apex during root canal treatment: a case report. Prim Dent J 2014; 3:72-75. [PMID: 25198335 DOI: 10.1308/205016814812135805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Sodium hypochlorite (NaOCl) is most commonly used as an irrigating solution in endodontic practice. This paper describes an incident of sodium hypochlorite extrusion past the apex (SHEPA) of the UR3. Management of the condition resulted in hospitalisation of the patient, and intravenous antibiotic and steroid therapy. This case report details the measures that can be employed to reduce the risk of SHEPA and management of its potentially serious complications. The reader should understand the various measures that can be adopted to reduce extrusion of endodontic irrigants beyond the root apex and management following SHEPA.
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Chou K, George R, Walsh LJ. Effectiveness of different intracanal irrigation techniques in removing intracanal paste medicaments. AUST ENDOD J 2013; 40:21-5. [PMID: 24330380 DOI: 10.1111/aej.12055] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study aimed to compare the effectiveness of different intracanal irrigation techniques in removing intracanal medicaments prior to obturation. A total of 168 single roots were prepared with ProTaper® rotary files and medicament pastes applied (Ledermix®, Odontopaste®, Doxypaste and Pulpdent®), left in for 2 weeks, then removed using filing followed by one of four methods: irrigation with an open-ended notched irrigation needle (Appli-Vac) either at the working length or 5 mm from the canal orifice, or the Max-I-probe or EndoActivator® at the working length. Following the removal of medicaments, the roots were split into two and the internal surfaces photographed, for digital image analysis of the overall percentage of residual medicament. With the exception of canals irrigated 5 mm apical to the root canal orifice, all four irrigation techniques achieved an average of 95% for removal of Ledermix®, Odontopaste® and Doxypaste. Calcium hydroxide paste was the most difficult medicament to remove, with no difference between irrigation techniques. Up to 27% of the Pulpdent® material remained after irrigation. No irrigation technique could completely remove all traces of medicaments. The position of the irrigational needle and the type of medicament used are key factors, which influence the effectiveness of irrigation in removing medicaments.
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Affiliation(s)
- Kenny Chou
- School of Dentistry and Oral Health, Griffith University, Southport, Queensland, Australia
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Hülsmann M. Effects of mechanical instrumentation and chemical irrigation on the root canal dentin and surrounding tissues. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/etp.12047] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Anatomy of sodium hypochlorite accidents involving facial ecchymosis - a review. J Dent 2013; 41:935-48. [PMID: 23994710 DOI: 10.1016/j.jdent.2013.08.012] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Revised: 08/12/2013] [Accepted: 08/17/2013] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Root canal treatment forms an essential part of general dental practice. Sodium hypochlorite (NaOCl) is the most commonly used irrigant in endodontics due to its ability to dissolve organic soft tissues in the root canal system and its action as a potent antimicrobial agent. Although NaOCl accidents created by extrusion of the irrigant through root apices are relatively rare and are seldom life-threatening, they do create substantial morbidity when they occur. METHODS To date, NaOCl accidents have only been published as isolated case reports. Although previous studies have attempted to summarise the symptoms involved in these case reports, there was no endeavour to analyse the distribution of soft tissue distribution in those reports. In this review, the anatomy of a classical NaOCl accident that involves facial swelling and ecchymosis is discussed. RESULTS By summarising the facial manifestations presented in previous case reports, a novel hypothesis that involves intravenous infusion of extruded NaOCl into the facial vein via non-collapsible venous sinusoids within the cancellous bone is presented. CONCLUSIONS Understanding the mechanism involved in precipitating a classic NaOCl accident will enable the profession to make the best decision regarding the choice of irrigant delivery techniques in root canal débridement, and for manufacturers to design and improve their irrigation systems to achieve maximum safety and efficient cleanliness of the root canal system.
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35
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Shen Y, Gao Y, Lin J, Ma J, Wang Z, Haapasalo M. Methods and models to study irrigation. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/etp.12029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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36
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37
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Ahmed HMA. Anatomical challenges, electronic working length determination and current developments in root canal preparation of primary molar teeth. Int Endod J 2013; 46:1011-22. [DOI: 10.1111/iej.12134] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Accepted: 04/22/2013] [Indexed: 02/01/2023]
Affiliation(s)
- H. M. A. Ahmed
- Department of Restorative Dentistry School of Dental Sciences Universiti Sains Malaysia Kelantan Malaysia
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38
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Khan S, Niu LN, Eid AA, Looney SW, Didato A, Roberts S, Pashley DH, Tay FR. Periapical Pressures Developed by Nonbinding Irrigation Needles at Various Irrigation Delivery Rates. J Endod 2013; 39:529-33. [DOI: 10.1016/j.joen.2013.01.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 01/02/2013] [Accepted: 01/02/2013] [Indexed: 12/24/2022]
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39
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Psimma Z, Boutsioukis C, Kastrinakis E, Vasiliadis L. Effect of Needle Insertion Depth and Root Canal Curvature on Irrigant Extrusion Ex Vivo. J Endod 2013; 39:521-4. [DOI: 10.1016/j.joen.2012.12.018] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 12/12/2012] [Accepted: 12/12/2012] [Indexed: 10/27/2022]
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40
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Boutsioukis C, Psimma Z, van der Sluis LWM. Factors affecting irrigant extrusion during root canal irrigation: a systematic review. Int Endod J 2013; 46:599-618. [DOI: 10.1111/iej.12038] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 11/08/2012] [Indexed: 11/29/2022]
Affiliation(s)
- C. Boutsioukis
- Physics of Fluids Group; Faculty of Science and Technology, and MESA+ Institute for Nanotechnology; University of Twente; Enschede; the Netherlands
| | - Z. Psimma
- Department of Endodontology; Dental School; Aristotle University of Thessaloniki; Thessaloniki; Greece
| | - L. W. M. van der Sluis
- Department of Conservative Dentistry and Endodontics; Paul Sabatier University; Toulouse; France
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41
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Malentacca A, Uccioli U, Zangari D, Lajolo C, Fabiani C. Efficacy and Safety of Various Active Irrigation Devices When Used with Either Positive or Negative Pressure: An In Vitro Study. J Endod 2012; 38:1622-6. [DOI: 10.1016/j.joen.2012.09.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 09/03/2012] [Accepted: 09/10/2012] [Indexed: 10/27/2022]
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42
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Apically Extruded Debris with Reciprocating Single-File and Full-sequence Rotary Instrumentation Systems. J Endod 2012; 38:850-2. [PMID: 22595125 DOI: 10.1016/j.joen.2012.02.017] [Citation(s) in RCA: 227] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 02/14/2012] [Accepted: 02/15/2012] [Indexed: 11/22/2022]
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43
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Altundasar E, Nagas E, Uyanik O, Serper A. Debris and irrigant extrusion potential of 2 rotary systems and irrigation needles. ACTA ACUST UNITED AC 2011; 112:e31-5. [DOI: 10.1016/j.tripleo.2011.03.044] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Revised: 03/20/2011] [Accepted: 03/28/2011] [Indexed: 10/17/2022]
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44
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HÜLSMANN MICHAEL, DREBENSTEDT STEFFI, HOLSCHER CHRISTIAN. Shaping and filling root canals during root canal re-treatment. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1601-1546.2011.00264.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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45
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Simbula G, Dettori C, Camboni T, Cotti E. Comparison of Tetraacetylethylendiamine + Sodium Perborate and Sodium Hypochlorite Cytotoxicity on L929 Fibroblasts. J Endod 2010; 36:1516-20. [DOI: 10.1016/j.joen.2010.05.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2010] [Revised: 05/07/2010] [Accepted: 05/19/2010] [Indexed: 10/19/2022]
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46
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Boutsioukis C, Verhaagen B, Versluis M, Kastrinakis E, Wesselink PR, van der Sluis LW. Evaluation of Irrigant Flow in the Root Canal Using Different Needle Types by an Unsteady Computational Fluid Dynamics Model. J Endod 2010; 36:875-9. [DOI: 10.1016/j.joen.2009.12.026] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Revised: 12/24/2009] [Accepted: 12/28/2009] [Indexed: 10/19/2022]
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47
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The Self-adjusting File (SAF). Part 3: Removal of Debris and Smear Layer—A Scanning Electron Microscope Study. J Endod 2010; 36:697-702. [DOI: 10.1016/j.joen.2009.12.037] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2009] [Revised: 12/03/2009] [Accepted: 12/29/2009] [Indexed: 11/20/2022]
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