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Lopes ABS, R Lima A, D Bronzato J, Herrera DR, Francisco PA, Carvalho MCC, Abuna G, Sinhoreti M, Gomes BPFA. Influence of different presentation forms of chlorhexidine on contaminated root canals during agitation. AUST ENDOD J 2024. [PMID: 38803063 DOI: 10.1111/aej.12862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 04/11/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
This in vitro study aimed to verify the influence of chlorhexidine (CHX) (gel and solution) in association with different activation protocols on disinfection of root canals contaminated with Enterococcus faecalis. In total, 120 lower premolar roots were selected, contaminated and divided into 12 groups according to irrigation technique and substance. Samples were collected before and after each irrigation technique and analysed for colony-forming units (CFU). Three dentin discs were obtained for quantification of viable intratubular cells by using confocal laser scanning microscopy (CLSM). CFU results showed that sonic and ultrasonic were more effective than conventional irrigation. Ultrasonic activation was more effective than sonic for CHX gel (p < 0.05). CLSM showed that either activation was better than conventional in all groups and root canal thirds (p < 0.05). It was concluded that ultrasonic/sonic activation was more effective than conventional techniques and CHX enhanced intratubular dentin decontamination across all irrigation methods.
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Affiliation(s)
- Ana B S Lopes
- Department of Restorative Dentistry -Endodontics Division, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
| | - Augusto R Lima
- Department of Restorative Dentistry -Endodontics Division, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
| | - Juliana D Bronzato
- Department of Restorative Dentistry -Endodontics Division, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
| | - Daniel R Herrera
- Department of Restorative Dentistry -Endodontics Division, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
- Department of Endodontics, Federal Fuminense University, Rio de Janeiro, Brazil
| | - Priscila A Francisco
- Department of Restorative Dentistry -Endodontics Division, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
| | - Maria C C Carvalho
- Department of Restorative Dentistry -Endodontics Division, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
| | - Gabriel Abuna
- Department of Restorative Dentistry - Dental Materials Division, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
| | - Mario Sinhoreti
- Department of Restorative Dentistry - Dental Materials Division, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
| | - Brenda P F A Gomes
- Department of Restorative Dentistry -Endodontics Division, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
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Liu C, Li Q, Yue L, Zou X. Evaluation of sonic, ultrasonic, and laser irrigation activation systems to eliminate bacteria from the dentinal tubules of the root canal system. J Appl Oral Sci 2022; 30:e20220199. [DOI: 10.1590/1678-7757-2022-0199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 10/18/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
- Chunhui Liu
- Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, China
| | - Qiang Li
- Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, China
| | - Lin Yue
- Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, China
| | - Xiaoying Zou
- Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, China
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Tavares KIMC, Pinto JC, Santos-Junior AO, Esteves Torres FF, Guerreiro-Tanomaru JM, Tanomaru-Filho M. Combination of a new ultrasonic tip with rotary systems for the preparation of flattened root canals. Restor Dent Endod 2021; 46:e56. [PMID: 34909420 PMCID: PMC8636074 DOI: 10.5395/rde.2021.46.e56] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 09/09/2020] [Accepted: 09/17/2020] [Indexed: 12/24/2022] Open
Abstract
Objectives This study evaluated 2 nickel-titanium rotary systems and a complementary protocol with an ultrasonic tip and a small-diameter instrument in flattened root canals. Materials and Methods Thirty-two human maxillary second premolars with flattened canals (buccolingual diameter ≥4 times larger than the mesiodistal diameter) at 9 mm from the radiographic apex were selected. The root canals were prepared by ProDesign Logic (PDL) 30/0.01 and 30/0.05 or Hyflex EDM (HEDM) 10/0.05 and 25/0.08 (n = 16), followed by application of the Flatsonic ultrasonic tip in the cervical and middle thirds and a PDL 25/0.03 file in the apical third (FPDL). The teeth were scanned using micro-computed tomography before and after the procedures. The percentage of volume increase, debris, and uninstrumented surface area were analyzed using the Kruskal-Wallis, Dunn, Wilcoxon, analysis of variance/Tukey, and paired and unpaired t-tests (α = 0.05). Results No significant difference was found in the volume increase and uninstrumented surface area between PDL and HEDM (p > 0.05). PDL had a higher percentage of debris than HEDM in the middle and apical thirds (p < 0.05). The FPDL protocol resulted in less debris and uninstrumented surface area for PDL and HEDM (p < 0.05). This protocol, with HEDM, reduced debris in the middle and apical thirds and uninstrumented surface area in the apical third (p < 0.05). Conclusions High percentages of debris and uninstrumented surface area were observed after preparation of flattened root canals. The HEDM, Flatsonic tip, and 25/0.03 instrument protocol enhanced cleaning in flattened root canals.
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Affiliation(s)
| | - Jáder Camilo Pinto
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| | - Airton Oliveira Santos-Junior
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
| | | | | | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, SP, Brazil
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Pedrinha VF, Cardenas Cuellar MR, Velásquez-Espedilla EG, Duarte MAH, Andrade FBD, Rodrigues PDA. Impact of irrigation protocols with some chelators and mechanical agitation on intratubular decontamination. Braz Oral Res 2021; 35:e127. [PMID: 34878082 DOI: 10.1590/1807-3107bor-2021.vol35.0127] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 05/05/2021] [Indexed: 11/21/2022] Open
Abstract
This study evaluated main canal and intratubular decontamination using different irrigation solutions followed by adjunctive agitation steps for infected root canals. Sixty-eight lower incisors were contaminated with Enterococcus faecalis and allocated to groups according to canal treatment (n = 10): G1, NaOCl followed by ethylenediaminetetraacetic acid (EDTA); G2, a mixture of NaOCl with hydroxyethylidene bisphosphonate (HEBP); and G3, NaOCl followed by EDTA-T (EDTA with sodium lauryl ether sulfate). All three groups of teeth were agitated with passive ultrasonic irrigation (PUI) using saline solution, whereby G4, G5, and G6 were prepared as above, and agitation was performed using an XP-Endo Finisher instrument. Microbiological samples were collected from the root canals with paper points at three times: before and after chemomechanical preparation and after agitation. The colony-forming units (CFU)/mL count was determined, and bacterial intratubular viability was analyzed via confocal laser scanning microscopy using Live/Dead staining. Statistical analysis was performed using a Kruskal-Wallis test followed by Dunn tests. A Friedman test was applied for colony-counting data (α = 0.05). CFU/mL counting indicated equally effective decontamination in the experimental groups (p > 0.05). According to microscopy images, the use of irrigation solutions followed by agitation with the XP-Endo Finisher yielded better results. Moreover, NaOCl+EDTA-T followed by XP-Endo Finisher resulted in significantly lower viability than in the PUI-activated groups (p < 0.05). The cervical and medium thirds of the specimens presented similar results. Overall, NaOCl+EDTA-T exhibited the best intratubular antibacterial activity, mainly for canals that were subsequently agitated using XP-Endo Finisher.
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Affiliation(s)
- Victor Feliz Pedrinha
- Universidade Federal do Pará - UFPA, Graduate Program in Dentistry, Laboratory of Dental Materials, Belém, PA, Brazil
| | - Maricel Rosario Cardenas Cuellar
- Universidade de São Paulo - USP, Bauru Dental School, Department of Operative Dentistry, Dental Materials and Endodontics, Bauru, SP, Brazil
| | - Evelyn Giuliana Velásquez-Espedilla
- Universidade de São Paulo - USP, Bauru Dental School, Department of Operative Dentistry, Dental Materials and Endodontics, Bauru, SP, Brazil
| | - Marco Antonio Hungaro Duarte
- Universidade de São Paulo - USP, Bauru Dental School, Department of Operative Dentistry, Dental Materials and Endodontics, Bauru, SP, Brazil
| | - Flaviana Bombarda de Andrade
- Universidade de São Paulo - USP, Bauru Dental School, Department of Operative Dentistry, Dental Materials and Endodontics, Bauru, SP, Brazil
| | - Patrícia de Almeida Rodrigues
- Universidade Federal do Pará - UFPA, Graduate Program in Dentistry, Laboratory of Dental Materials, Belém, PA, Brazil
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Küçükkaya Eren S, Uzunoğlu-Özyürek E, Karahan S. Influence of reciprocating and rotary instrumentation on microbial reduction: a systematic review and meta-analysis of in vitro studies. Restor Dent Endod 2021; 46:e19. [PMID: 34123755 PMCID: PMC8170383 DOI: 10.5395/rde.2021.46.e19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/22/2020] [Accepted: 08/10/2020] [Indexed: 12/19/2022] Open
Abstract
Objectives The purpose of this study was to conduct a systematic review and meta-analysis of in vitro studies regarding the effectiveness of reciprocating and rotary instrumentation on microbial reduction in root canals. Materials and Methods PubMed, Scopus, Web of Science, the Cochrane Library, and the gray literature were searched through December 2019. Studies comparing the influence of reciprocating and rotary instrumentation on the removal of microorganisms from root canals that quantified the antimicrobial effect were included. Data extraction was completed using a systematic form for data collection. The risk of bias of the studies was evaluated. Standardized mean differences (SMDs) and confidence intervals (CIs) were calculated using a random effects meta-analysis. Results Seventeen in vitro studies were included in this systematic review, of which 7 provided adequate data for inclusion in the meta-analysis. Both reciprocating and rotary systems were similarly effective in reducing the microbial load in infected root canals (SMD [95% CI], 0.0481 [-0.271, 0.367]). Three studies showed a low risk of bias, whereas most of the studies (82%) presented a medium risk. Conclusions Although both techniques decrease the microbial content (with reductions of 23.32%-88.47% and 23.33%-89.86% for reciprocating and rotary instrumentation, respectively), they are not able to provide complete disinfection of root canals.
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Affiliation(s)
- Selen Küçükkaya Eren
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Emel Uzunoğlu-Özyürek
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sevilay Karahan
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Cuellar MRC, Velásquez-Espedilla EG, Pedrinha VF, Vivan RR, Duarte MAH, Andrade FBD. Can kinematics, file diameter, and PUI influence the intracanal decontamination and apical bacterial extrusion? Braz Oral Res 2020; 35:e003. [PMID: 33206776 DOI: 10.1590/1807-3107bor-2021.vol35.0003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 08/19/2020] [Indexed: 11/22/2022] Open
Abstract
The present study investigated the intracanal decontamination and apical extrusion of bacteria and debris from root canals instrumented with rotary and reciprocating systems (ProDesign Logic or ProDesign R), with different file diameters and using conventional syringe irrigation (CSI) or passive ultrasonic irrigation (PUI). Eighty extracted mandibular premolars were contaminated with Enterococcus faecalis and randomly assigned to eight experimental groups according to the root canal instrumentation and irrigation technique employed (n = 10): G1: Prodesign Logic 25.06; G2: Prodesign R 25.06; G3 and G4 were instrumented with the same single-file systems, respectively, using 35.05 diameters and CSI. G5, G6, G7, and G8 were instrumented like the previous groups, but with PUI. Apically extruded debris during instrumentation was collected into pre-weighed microtubes. The weight of the empty microtube was subtracted from the final weight to establish the amount of extruded debris. Bacteria from root canals and extruded debris were collected for a microbiological evaluation of colony forming units (CFU/mL). For statistical analyses, the Mann-Whitney and Kruskal-Wallis followed by the Dunn's tests were used (α = 0.05). All instruments caused extrusion of debris. For irrigation techniques, PUI promoted greater debris and bacterial extrusion (p < 0.05). The CFU/mL count indicated that the instrumentation of the experimental groups were equally effective in the decontamination of the root canal (p > 0.05). The systems tested (regarding file diameter and kinematics) were associated with similar amounts of apically extruded debris and root canal decontamination. PUI was associated with greater debris and bacterial extrusion.
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Affiliation(s)
- Maricel Rosario Cardenas Cuellar
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
| | - Evelyn Giuliana Velásquez-Espedilla
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
| | - Victor Feliz Pedrinha
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
| | - Rodrigo Ricci Vivan
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
| | - Marco Antonio Hungaro Duarte
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
| | - Flaviana Bombarda de Andrade
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
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Barbosa AFA, Silva EJNL, Coelho BP, Ferreira CMA, Lima CO, Sassone LM. The influence of endodontic access cavity design on the efficacy of canal instrumentation, microbial reduction, root canal filling and fracture resistance in mandibular molars. Int Endod J 2020; 53:1666-1679. [DOI: 10.1111/iej.13383] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 12/17/2022]
Affiliation(s)
- A. F. A. Barbosa
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
| | - E. J. N. L. Silva
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
- Department of Endodontics School of Dentistry Grande Rio University (UNIGRANRIO) Rio de Janeiro Brazil
| | - B. P. Coelho
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
| | - C. M. A. Ferreira
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
| | - C. O. Lima
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
| | - L. M. Sassone
- Department of Endodontics School of Dentistry State University of Rio de Janeiro (UERJ) Rio de JaneiroBrazil
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Santos-Junior AO, Tanomaru-Filho M, Pinto JC, Tavares KIMC, Pivoto-João MMB, Guerreiro-Tanomaru JM. New Ultrasonic Tip Decreases Uninstrumented Surface and Debris in Flattened Canals: A Micro-computed Tomographic Study. J Endod 2020; 46:1712-1718. [PMID: 32682793 DOI: 10.1016/j.joen.2020.07.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 07/05/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The preparation of flattened root canals using reciprocating or rotary nickel-titanium instruments associated with the Flatsonic ultrasonic tip (Helse Ultrasonic, Santa Rosa de Viterbo, SP, Brazil) was evaluated by micro-computed tomographic imaging. METHODS Twenty-four flattened distal canals of mandibular molars with a buccolingual diameter 4 or more times larger than the mesiodistal diameter were selected. The root canals were randomly divided into 2 experimental groups for preparation: a Reciproc Blue (RB; VDW GmbH, Munich, Germany) 40/.06 file in reciprocating motion or ProDesign Logic (PDL; Easy Equipamentos Odontológicos, Belo Horizonte, MG, Brazil) 40/.01 and 40/.05 files in rotary motion (n = 12). A complementary preparation was performed with the Flatsonic ultrasonic tip for both preparations. Micro-computed tomographic scanning at a resolution of 8.74 μm was performed before and after preparation with the nickel-titanium instruments and after the use of the Flatsonic tip. The percentages of increase in volume, debris, and uninstrumented surface were analyzed. The data obtained were submitted to the paired and unpaired t test, analysis of variance, and the Tukey test (α = 5%). RESULTS The percentage increase in volume, debris, and uninstrumented surface was similar between RB and PDL in the entire root canal (P > .05). The PDL promoted a lower percentage of debris in the cervical third and a lower percentage of increase in volume in the apical third in comparison with RB (P < .05). The Flatsonic decreased debris and uninstrumented surface after PDL preparation in all thirds (P < .05). After preparation with RB, the Flatsonic decreases the debris in the cervical third and the uninstrumented surface in the cervical and middle thirds (P < .05). CONCLUSIONS The preparation of flattened root canals using RB or PDL produced a high percentage of debris and uninstrumented surface. The Flatsonic ultrasonic tip significantly improved the cleaning of flattened root canals.
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Affiliation(s)
| | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil.
| | - Jader Camilo Pinto
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, São Paulo, Brazil
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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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