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Awati AS, Dhaded NS, Mokal S, Doddwad PK. Analysis of the depth of penetration of an epoxy resin-based sealer following a final rinse of irrigants and use of activation systems: An in vitro study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:87-94. [PMID: 38389742 PMCID: PMC10880483 DOI: 10.4103/jcde.jcde_221_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 02/24/2024]
Abstract
Objective The objective of the study was to compare and evaluate the depth of penetration of an epoxy resin-based sealer following a final rinse of 17% ethylenediaminetetraacetic acid (EDTA) and 18% 1-hydroxyethylidene 1, 1-diphosphonate (HEDP), with diode laser and passive ultrasonic activation (PUI): an in vitro confocal laser scanning microscopy study. Materials and Methods Fifty-two extracted human mandibular premolar teeth with single root and single canal were selected. They were disinfected in 0.1% thymol solution, cleaned of calculus and soft tissues, and stored in 0.1% thymol solution till use. All teeth were radiographed and selected as per the inclusion and exclusion criteria. The teeth were decoronated using a diamond disk under copious water spray to acquire a standardized root length of 14 mm. Working length was established by inserting a size 10-K file into each root canal until it is visible at the apical foramen and by subtracting 1 mm from the recorded length. Instrumentation of the root canal was done till master apical file size of F3 using ProTaper universal, rotary instruments. The canals were irrigated with 2 mL of 3% sodium hypochlorite between successive files. Teeth were randomly divided into four subgroups n = 12 according to the intervention. Passive ultrasonic irrigation and diode laser were used to activate the irrigants. Final irrigation was performed with distilled water. These specimens were examined using confocal laser scanning microscope (OLYMPUS FLUOVIEW FV 3000) for dentinal tubule penetration of the sealer. Two-way ANOVA test and Tukey's multiple post hoc test were used for statistical analysis. Results Highly significant difference was seen between the groups with EDTA and HEDP, with HEDP demonstrating the highest penetration. Among the activation techniques used in this study, PUI showed the highest penetration of the sealer. The least penetration was seen with diode laser activation and EDTA. Conclusions The irrigation activation techniques significantly influence the penetration of sealer into root dentinal tubules. When penetration of sealer with different irrigation techniques and irrigants was evaluated, significant greater level of sealer penetration was attained with PUI activation of HEDP.
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Affiliation(s)
- Aishwarya Sanjay Awati
- Department of Conservative Dentistry and Endodontics, KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
| | - Neha S. Dhaded
- Department of Conservative Dentistry and Endodontics, KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
| | - Siddhesh Mokal
- Department of Conservative Dentistry and Endodontics, KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
| | - Preeti Kore Doddwad
- Department of Conservative Dentistry and Endodontics, KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India
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Kadulkar N, Kataki R, Deka A, Medhi H, Chakraborty S, Singh A. Comparative Evaluation of the Effect of Different Chelating Agents on Mineral Content and Erosion of Radicular Dentine: A FESEM-EDS Analysis. Eur Endod J 2024; 9:73-80. [PMID: 38157281 PMCID: PMC10777092 DOI: 10.14744/eej.2023.19971] [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: 06/12/2023] [Revised: 07/20/2023] [Accepted: 08/08/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE Irrigating solutions play an important role in the debridement and disinfection of the root canal space, and thus, it is crucial to comprehend their effects on the composition and surface structure of radicular dentine. This study evaluated and compared the effects of 17% ethylenediaminetetraacetic acid (EDTA), 9% 1-hydroxyethylidene-1,1-bisphosphonate (HEBP) and 0.2% chitosan on the mineral content and erosion of radicular dentine when used as a final rinse. METHODS Sixty extracted human mandibular premolar teeth were decoronated and instrumented to ProTaper size F2. After final instrumentation, the samples were randomly divided into 4 groups (n=15) according to the type of final irrigant used: Normal saline (control), 17% EDTA, 9% HEBP and 0.2% chitosan. Field emission scanning electron microscopy was used to assess the erosion of radicular dentine, and energy dispersive X- ray spectroscopy was used to quantify the radicular dentine mineral composition at the coronal, middle and apical levels of all the prepared samples after final irrigation. The one-way analysis of variance was used for intra-group and inter-group comparisons of means, the Kruskal Wallis test for intra-group and inter-group comparisons of medians and Tukey's post hoc test for pairwise comparisons. RESULTS There was no significant difference in the levels of calcium (Ca), phosphorus (P) and Ca/P ratio after final rinse with 17% EDTA, 9% HEBP and 0.2% chitosan at all three root levels (p>0.05); except at the coronal level, where 0.2% chitosan caused significantly less alteration in Ca levels and Ca/P ratio than 17% EDTA and 9% HEBP respectively (p<0.05). 17% EDTA, 9% HEBP and 0.2% chitosan caused no erosion at the middle and apical levels. Meanwhile, 17% EDTA and 9% HEBP caused moderate erosion at the coronal level. CONCLUSION Alternatives to 17% EDTA during final irrigation can be 9% HEBP and 0.2% chitosan. (EEJ-2023-06-078).
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Affiliation(s)
- Nishad Kadulkar
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, India
| | - Rubi Kataki
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, India
| | - Adrija Deka
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, India
| | - Himchumi Medhi
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, India
| | - Suchismita Chakraborty
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, India
| | - Abhishek Singh
- Centre for the Environment, Indian Institute of Technology, Guwahati, India
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Radeva EN, Mironova JV, Marinova-Takorova MB. Efficacy of Three Irrigation Methods in Removing Calcium Hydroxide from Curved Root Canals: An In Vitro Micro-CT Study. J Int Soc Prev Community Dent 2023; 13:342-348. [PMID: 37876582 PMCID: PMC10593373 DOI: 10.4103/jispcd.jispcd_80_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/20/2023] [Accepted: 07/27/2023] [Indexed: 10/26/2023] Open
Abstract
Aims and Objectives This in vitro study aimed to compare the efficacy of three different irrigation methods in removing calcium hydroxide from curved root canals and to estimate the amount of residual medicament using microcomputed tomography. Materials and Methods Thirty extracted molars with curved mesial root canals, ranging from 25° to 30°, were prepared with ProTaper Next using X2 to full working length and were filled with calcium hydroxide. Teeth also were randomly divided into four groups: group 1 (n = 8)- Erbium: Yttrium-Aluminum-Garnet (Er:YAG) laser; group 2 (n = 8)-EndoActivator; group 3 (n = 8)-EndoVac; and a control group (n = 6)-negative control with no calcium hydroxide. Microcomputed tomography was used to evaluate the residual amount of filling material. Statistical analysis was performed using IBM SPSS Statistics 26, with a significance level of 0.05. Descriptive statistics, student t test, and Chi-square test were applied for data analysis. Results The greatest amount of residual calcium hydroxide was observed in the samples with EndoVac irrigation (0.515 mm3), followed by EndoActivator (0.381 mm3) and Er:YAG laser (0.121 mm3). However, no statistically significant difference was observed between the groups. The greatest residual amount was observed in the apical third (0.419 mm3), followed by the middle (0.050 mm3) and the coronal (0.015 mm3). Conclusions No statistically significant differences were observed in the efficacy of the tested techniques for removing calcium hydroxide from curved root canals, whereas a significant difference was observed in the distribution of residual material depending on the technique used. The removal of the calcium hydroxide was more effective in the coronal and middle third of the canal. The greatest residual material was found in the apical portion of the root canal.
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Affiliation(s)
- Elka N Radeva
- Department of Conservative Dentistry, Faculty of Dental Medicine, Medical University-Sofia, Bulgaria, Bulgaria
| | - Jasmina V Mironova
- Department of Conservative Dentistry, Faculty of Dental Medicine, Medical University-Sofia, Bulgaria, Bulgaria
| | - Mirela B Marinova-Takorova
- Department of Conservative Dentistry, Faculty of Dental Medicine, Medical University-Sofia, Bulgaria, Bulgaria
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Marella K, Sampathi N, Pavani LT, Manduru C, Moosani G. An in vitro evaluation of smear layer removal with non-activated self adjusting file, xp-endo finisher and rotary canal brush: A scanning electron microscopic study. JOURNAL OF DR. NTR UNIVERSITY OF HEALTH SCIENCES 2022. [DOI: 10.4103/jdrntruhs.jdrntruhs_86_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Akçay A, Gorduysus M, Aydin B, Gorduysus MO. Evaluation of different irrigation techniques on dentin erosion and smear layer removal: A scanning electron microscopy study. J Conserv Dent 2022; 25:311-316. [PMID: 35836563 PMCID: PMC9274701 DOI: 10.4103/jcd.jcd_127_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 01/24/2022] [Accepted: 03/10/2022] [Indexed: 11/17/2022] Open
Abstract
Aim The purpose of the present study is to evaluate the effectiveness of different irrigation techniques EndoVac, RinsEndo, Canal CleanMax (CCMax), SonicMax, Passive Ultrasonic Irrigation (PUI), and Manual Needle Irrigation (MNI) on dentin erosion and smear layer removal using Scanning electron microscopy (SEM). Materials and Methods Seventy extracted single-rooted teeth were instrumented with ProTaper rotary instruments. The roots were randomly divided into six experimental groups (n = 10): EndoVac, RinsEndo, CCMax, SonicMax, PUI, and MNI. Final irrigation was performed with NaOCl followed by ethylenediaminetetraacetic acid and NaOCl. Six roots served as control and were irrigated with only NaOCl. Next, the roots were sectioned in a buccolingual direction and the halves were examined by SEM. Smear layer and erosion scores were recorded in the cervical, middle and apical third of the roots. Data analysis was performed using the Kruskal-Wallis and Mann-Whitney U-tests with a level of significance α = 0.05. Results PUI had the greatest amount of smear layer compared to other groups (P < 0.001). However, SonicMax had the greatest degree of erosion compared to RinsEndo, MNI, PUI, and EndoVac groups (P < 0.001) and CCMax group (P < 0.05). Conclusions RinsEndo and EndoVac techniques left the least amount of smear layer while causing erosion the least compared to CCMax, PUI, and MNI techniques.
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Affiliation(s)
- Alper Akçay
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Melahat Gorduysus
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey,Address for correspondence: Dr. Melahat Gorduysus, Department of Endodontics, Faculty of Dentistry, Hacettepe University, Sihhiye 06100, Ankara, Turkey. E-mail:
| | - Berdan Aydin
- Department of Endodontics, Faculty of Dentistry, Eylul University, Izmir, Turkey
| | - Mehmet Omer Gorduysus
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
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Srivastava I, Srivastava S, Grover R, Paliwal A. Comparative Evaluation of Efficacy of Different Irrigating Needles and Devices in Removal of Debris from Apical Third of Root Canal: An In-vitro SEM Study. Contemp Clin Dent 2021; 12:222-229. [PMID: 34759677 PMCID: PMC8525803 DOI: 10.4103/ccd.ccd_468_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/25/2020] [Accepted: 07/16/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Irrigants were required to eliminate the microbes and debris from the intraradicular space and must have direct contact with the entire root canal wall. Therefore, different irrigation methods have been proposed to deliver the irrigant as close as possible to the remote areas of the root canal. AIM The aim of the present study is to evaluate the cleaning efficacy of single-beveled needle, side-vented needle, endovac, and endo-irrigator plus in the removal of debris from apical third of root canal by Scanning Electron Microscope. MATERIALS AND METHODS Forty single-rooted freshly extracted human permanent mandibular premolars were collected. Root canals were cleaned and instrumented till X2 (25/06) with rotary Protaper Next at working length 1 mm short of the apex. Teeth were randomly divided into four equal groups: Group 1 (n = 10): Endovac, Group 2 (n = 10): Endo irrigator plus, Group 3 (n = 10): Side-vented needle, and Group 4 (n = 10): Single-beveled needle. Irrigation was done with 5.25% NaOCl, followed by 17% ethylenediaminetetraacetic acid. Samples were sectioned and examined under SEM at apical levels. STATISTICAL ANALYSIS Analysis of variance followed by Tukey's post hoc test was performed. RESULTS The level of debris removal efficacy is as follows: Endovac > Endo-irrigator plus > Side-vented needle ~ Single-beveled needle. CONCLUSION Endovac showed the maximum number of debris removal and has better cleaning efficacy in the apical areas of the root canal, followed by Endo irrigator plus, Side-vented needle and Single-beveled needle.
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Affiliation(s)
- Isha Srivastava
- Department of Conservative Dentistry and Endodontics, All India Institute of Medical Sciences, Gorakhpur, India
| | - Sanjeev Srivastava
- Department of Conservative Dentistry and Endodontics, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, India
| | - Rohit Grover
- Department of Conservative Dentistry and Endodontics, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, India
| | - Ajay Paliwal
- Department of Conservative Dentistry and Endodontics, Saraswati Dental College, Lucknow, Uttar Pradesh, India
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Shetty B, Sripada S, Bhandary S, Shetty D, Naik R. Efficient removal of 2,6-xylidine precipitate using different agitation protocols: An in vitro field emission scanning electron microscopic study. J Conserv Dent 2021; 24:622-627. [PMID: 35558670 PMCID: PMC9089760 DOI: 10.4103/jcd.jcd_85_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 02/26/2021] [Accepted: 05/23/2021] [Indexed: 11/04/2022] Open
Abstract
Background: Aim: Materials and Methods: Results: Conclusion:
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Jasrotia A, Bhagat K, Bhagat N, Bhagat RK. Comparison of Five Different Irrigation Techniques on Smear Layer Removal in Apical Thirds of Root Canals of Mandibular First Premolar: A Scanning Electron Microscopic Study. J Int Soc Prev Community Dent 2020; 9:630-636. [PMID: 32039084 PMCID: PMC6905312 DOI: 10.4103/jispcd.jispcd_267_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 09/19/2019] [Indexed: 11/28/2022] Open
Abstract
Aim: This study was conducted to compare smear layer removal by five different irrigation techniques—conventional needle irrigation (CI), manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), sonic irrigation (SI), and negative apical pressure (NAP). Materials and Methods: Fifty freshly extracted mandibular first premolars were cleaned and shaped by One Curve rotary files and 3% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. The samples were divided into five equal groups (n = 10), according to the final irrigation activation technique: Group I, CI; Group II, MDA; Group III, PUI; Group IV, SI; and Group V, NAP. The samples were prepared and observed under a scanning electron microscope. The photomicrographs were recorded and evaluated with a scoring system. Results: Group I and Group II had the highest scores, which showed a statistically significant difference between the other groups (P < 0.05). This was followed by PUI, NAP, and SI. Conclusion: Final irrigation activation with SI and NAP resulted in the better removal of smear layer when compared to that with other groups.
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Affiliation(s)
- Ankush Jasrotia
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Government Dental College and Hospital, Jammu, Jammu and Kashmir, India
| | - Kanchan Bhagat
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Government Dental College and Hospital, Jammu, Jammu and Kashmir, India
| | - Neeru Bhagat
- MDS in Orthodontics, Private Practioner, Jammu, India
| | - Ravinder K Bhagat
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Government Dental College and Hospital, Jammu, Jammu and Kashmir, India
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Antunes PVS, Flamini LES, Chaves JFM, Silva RG, Cruz Filho AMD. Comparative effects of final canal irrigation with chitosan and EDTA. J Appl Oral Sci 2019; 28:e20190005. [PMID: 31800870 PMCID: PMC6886396 DOI: 10.1590/1678-7757-2019-0005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/24/2019] [Indexed: 11/21/2022] Open
Abstract
Chitosan is a natural, biocompatible chelating substance with potential for dental use. This study compared the effects of final canal irrigation with chitosan and EDTA on dentin microhardness, sealer dentin tubules penetration capacity, and push-out strength.
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Affiliation(s)
- Polliana Vilaça Silva Antunes
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Odontologia Restauradora, Ribeirão Preto, SP, Brasil
| | - Luis Eduardo Souza Flamini
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Odontologia Restauradora, Ribeirão Preto, SP, Brasil
| | - Jardel Francisco Mazzi Chaves
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Odontologia Restauradora, Ribeirão Preto, SP, Brasil
| | - Ricardo Gariba Silva
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Odontologia Restauradora, Ribeirão Preto, SP, Brasil
| | - Antonio Miranda da Cruz Filho
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Odontologia Restauradora, Ribeirão Preto, SP, Brasil
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Abraham S, Vaswani SD, Najan HB, Mehta DL, Kamble AB, Chaudhari SD. Scanning electron microscopic evaluation of smear layer removal at the apical third of root canals using diode laser, endoActivator, and ultrasonics with chitosan: An in vitro study. J Conserv Dent 2019; 22:149-154. [PMID: 31142984 PMCID: PMC6519194 DOI: 10.4103/jcd.jcd_337_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aim The aim of this study was to compare the effect of diode laser, endoActivator, and passive ultrasonics for smear layer removal at the apical third from root canals with 0.2% chitosan. Materials and Methods A total of 40 mandibular premolars were decoronated to establish a working length of 12 mm and shaped with ProTaper rotary files up to size F3. In Group A, canals were irrigated with 1 ml of 0.2% chitosan. In Group B, canals were initially irrigated with 0.8 ml of 0.2% chitosan and the remaining 0.2 ml was activated with diode laser. In Group C, canals were irrigated with 1 ml of 0.2% chitosan which was activated with endoActivator. In Group D, canals were irrigated with 0.2% chitosan and activated with passive ultrasonics. All samples were finally flushed with 3 ml of distilled water. The percentage of smear layer removal was analyzed with a scanning electron microscope examination at ×1000 and ×3000. Data were analyzed using Statistical Package for the Social Sciences version 16.0 (SPSS Inc., Chicago, IL, USA) at a significance level of P < 0.05. Results The mean value for Group B when compared to Group C for the removal of smear layer was higher, but there was no statistically significant difference between the two groups (P < 0.068 and P < 0.295). Both Group B and Group C showed a statistically significant difference (P < 0.001) when compared to Group A and Group D for the removal of smear layer. Conclusion Diode laser and endoActivator with 0.2% chitosan proved better in the removal of the smear layer when compared to passive ultrasonic irrigation.
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Affiliation(s)
- Sathish Abraham
- Department of Conservative Dentistry and Endodontics, S.M.B.T. Dental College and Hospital, Sangamner, Maharashtra, India
| | - Sneha Dhruvkumar Vaswani
- Department of Conservative Dentistry and Endodontics, S.M.B.T. Dental College and Hospital, Sangamner, Maharashtra, India
| | - Harshal Balasaheb Najan
- Department of Conservative Dentistry and Endodontics, S.M.B.T. Dental College and Hospital, Sangamner, Maharashtra, India
| | - Disha Lalit Mehta
- Department of Conservative Dentistry and Endodontics, S.M.B.T. Dental College and Hospital, Sangamner, Maharashtra, India
| | - Aradhana Babu Kamble
- Department of Conservative Dentistry and Endodontics, S.M.B.T. Dental College and Hospital, Sangamner, Maharashtra, India
| | - Salil Dinesh Chaudhari
- Department of Conservative Dentistry and Endodontics, S.M.B.T. Dental College and Hospital, Sangamner, Maharashtra, India
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Comparison of bacterial removal from dentinal tubules with different irrigant agitation techniques: An in vitro study. Saudi Dent J 2019; 31:431-436. [PMID: 31695293 PMCID: PMC6823731 DOI: 10.1016/j.sdentj.2019.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/05/2019] [Accepted: 05/06/2019] [Indexed: 11/20/2022] Open
Abstract
Aim This investigation was conducted to assess the ability of various irrigant agitation devices to eradicate Enterococcus faecalis from the dentinal tubules of extracted teeth. Methodology Fifty roots of extracted human teeth were instrumented to size 30 k with a 0.04 taper. The roots were autoclaved and then injected with E. faecalis. The canals were assigned to one of four intervention groups and disinfected using (A) standard needle irrigation, (B) EndoUltra® Ultrasonic Activator, (C) the EndoActivator system, or (D) EDDY sonic activation and to two control groups that were (E) treated with saline and (F) not inoculated with any bacteria. The roots were split in half, dyed with a LIVE/DEAD Back Light Bacterial Viability Kit, and then scanned with a confocal laser scanning microscope (CLSM) to identify live/dead bacteria in the dentinal tubules. Results CLSM images revealed differences among the groups. Both the EndoUltra® Ultrasonic Activator group and the EDDY group had a combination of dead and live bacteria, while the EndoActivator group had mostly dead bacteria, in contrast to single needle irrigation which had mostly live bacteria. Activation of the irrigating solution resulted in more dead bacteria than standard needle irrigation at the coronal, middle, and apical parts of the roots. Overall, the EndoActivator system was superior to all other techniques in reducing live bacteria within the root canal. Conclusion Activation of sodium hypochlorite with sonic and ultrasonic systems dramatically reduced live bacteria contamination in the dentinal tubules of infected root canals.
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12
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Seven N, Cora S. Effectiveness of different irrigation systems in the presence of intracanal-separated file. Microsc Res Tech 2019; 82:238-243. [PMID: 30636084 DOI: 10.1002/jemt.23165] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 09/25/2018] [Accepted: 10/08/2018] [Indexed: 01/23/2023]
Abstract
The aim of this study was to evaluate conventional syringe irrigation and three different irrigant activation techniques' effectiveness for smear layer removal in the absence and presence of intracanal-separated file (SF) fragment. Mandibular anterior teeth (160 total) with single canal were used and each root canal preparation was finished with the ProTaper Universal F1. The samples were randomly divided into eight equal groups with n = 20 in each group. The Protaper Universal F3 file was used to simulate intracanal file separation in four groups. To remove the smear layer, final irrigation for each group was performed with conventional syringe irrigation (CSI), EndoActivator, Vibringe, and passive ultrasonic irrigation (PUI). The roots were divided into two longitudinal parts and evaluated with scanning electron microscopy, and two observers scored smear layers at 1, 2, and 3 mm away from the minor foramen. The data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests (p < .05). PUI significantly removed the smear layer better at all levels than other nonseparated file groups (p < .05). In the presence of intracanal SF, PUI had the most efficiency loss. Sonic techniques and CSI revealed statistically better smear layer removal efficiency than PUI at 3 mm level in the presence of SF (p < .05). The intragroup score analysis at all levels revealed that there were less smear layers at 3 mm than at 1 mm in all SF groups (p < .001). As a conclusion, sonic/ultrasonic methods did not yield better irrigant by-passing than CSI in the presence of intracanal SF.
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Affiliation(s)
- Naimenur Seven
- Department of Endodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Sabri Cora
- Department of Endodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
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13
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Virdee SS, Seymour DW, Farnell D, Bhamra G, Bhakta S. Efficacy of irrigant activation techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta-analysis. Int Endod J 2017; 51:605-621. [PMID: 29178166 DOI: 10.1111/iej.12877] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 11/16/2017] [Indexed: 12/21/2022]
Abstract
AIMS To establish whether irrigant activation techniques (IATs) result in greater intracanal smear layer and debris removal than conventional needle irrigation (CNI). METHODOLOGY Six electronic databases were searched to identify scanning electron microscopy studies evaluating smear layer and/or debris removal following the use of manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), sonic irrigation (SI) or apical negative pressure (ANP) IATs in mature permanent teeth. Meta-analyses were performed for each canal segment (coronal, middle, apical and apical 1 mm) in addition to subgroup analyses for individual IATs with respect to CNI. Outcomes were presented as standardized mean differences (SMD) alongside 95% confidence intervals (95% CI) and chi-squared analysis. RESULTS From 252 citations, 16 studies were identified. The meta-analyses demonstrated significant improvements in coronal (SMD: 1.15, 95% CI: 0.72-1.57 / SMD: 0.54, 95% CI: 0.29-0.80), middle (SMD: 1.30, 95% CI: 0.59-2.53 / SMD: 0.8, 95% CI: 0.58-1.13) and apical thirds (SMD: 1.22, 95% CI: 0.83-1.62 / SMD: 1.86, 95% CI: 0.76-2.96) for smear layer and debris removal, respectively. In the apical 1 mm IATs improved cleanliness; however, differences were insignificant (SMD: 1.15, 95% CI: -0.47-2.77). Chi-squared analysis revealed heterogeneity scores of 79.3-92.8% and 0.0-93.5% for smear layer and debris removal, respectively. CONCLUSIONS IATs improve intracanal cleanliness across a substantial portion of the canal, and therefore, their use is recommended throughout root canal preparation. However, current data is too heterogeneous to compare and identify superiority of an individual technique highlighting the need to standardize experimental protocols and develop a more representative research model to investigate the in vivo impact of IATs on clinical outcomes and periapical healing following root canal treatment.
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Affiliation(s)
- S S Virdee
- Department of Restorative Dentistry, Birmingham Dental Hospital, Birmingham, UK
| | - D W Seymour
- Department of Restorative Dentistry, York Hospital, York, UK
| | - D Farnell
- Department of Dentistry, Cardiff University School of Dentistry, Cardiff, UK
| | - G Bhamra
- Department of Restorative Dentistry, Cardiff University Dental Hospital, Cardiff, UK
| | - S Bhakta
- Department of Restorative Dentistry, Leeds Dental Institute, Leeds, UK
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Kfir A, Blau-Venezia N, Goldberger T, Abramovitz I, Wigler R. Efficacy of self-adjusting file, XP-endo finisher and passive ultrasonic irrigation on the removal of calcium hydroxide paste from an artificial standardized groove. AUST ENDOD J 2017. [PMID: 28643935 DOI: 10.1111/aej.12204] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to compare the effectiveness of self-adjusting file (SAF), XP-endo finisher (XP), passive ultrasonic irrigation (PUI) and conventional syringe and needle irrigation (SNI) in the removal of Ca(OH)2 from an artificial groove. Eighty mandibular incisors with single oval canals were prepared to size 40/0.04 and split longitudinally. A standardised groove was prepared in the apical third and filled with Ca(OH)2 . The root halves were reassembled and divided into two control groups (n = 4) and four experimental groups (n = 18) according to the removal methods used. The amount of residual Ca(OH)2 was evaluated using a four-grade scoring system. The differences among the groups were analysed using the Kruskal-Wallis test (P < 0.05). SAF, XP and PUI removed significantly more Ca(OH)2 than SNI (P < 0.001), although there were no significant differences among them (P = 0.209). None of the tested methods could completely clean Ca(OH)2 from the groove.
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Affiliation(s)
- Anda Kfir
- Department of Endodontology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nuphar Blau-Venezia
- Department of Endodontology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tomer Goldberger
- Department of Endodontology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Itzhak Abramovitz
- Department of Endodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Ronald Wigler
- Department of Endodontology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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15
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da Silva Beraldo ÂJ, Silva RV, da Gama Antunes AN, Silveira FF, Nunes E. Scanning Electron Microscopic Evaluation of Smear Layer Removal Using Isolated or Interweaving EDTA with Sodium Hypochlorite. IRANIAN ENDODONTIC JOURNAL 2017; 12:55-59. [PMID: 28179925 PMCID: PMC5282380 DOI: 10.22037/iej.2017.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: The aim of this study was to verify the effect of alternating 2.5% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA) on the smear layer removal from root canal surfaces. Methods and Materials: A total of 15 single-rooted human teeth, instrumented with ProTaper files, were randomly distributed in 3 groups. In group 1 (n=7) the canals were irrigated with 1 mL of 2.5% NaOCl between files and final irrigation was done with 1 mL of 2,5% NaOCl, followe by 1 mL of 17% EDTA, for a perio of 15 sec with new irrigtion of 1 mL of 2,5% NaOCl at each change of files. In group 3 (control group) (n=1), saline solution was used. All samples were cleaved into two sections, metalized and analyzed under scanning electron microscopy (SEM). The presence or absence of smear layer in the cervical, middle and apical thirds, with scores varying from 1 to 3, respectively were evaluated. The data were submitted to nonparametric Mann-Whitney U test. The level of significance was set at 0.05. Results: It was observed that there was a greater discrepancy between groups with respect to the apical third. In the other areas there was a greater similarity between the scores attributed to the groups. There was a statistically significant difference between the groups only in the apical third, when group 1 presented the higher median (P<0.05). Conclusion: The alternating use of EDTA during instrumentation with NaOCl was the most effective irrigation method to remove the apical smear layer. Both forms of irrigation were effective on removal of the smear layer in the coronal and middle thirds of the canals.
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Affiliation(s)
| | - Rogério Vieira Silva
- Department of Dentistry, Pontificial Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Frank Ferreira Silveira
- Department of Dentistry, Pontificial Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Eduardo Nunes
- Department of Dentistry, Pontificial Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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16
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Antibacterial Efficacy of Calcium Hypochlorite with Vibringe Sonic Irrigation System on Enterococcus faecalis: An In Vitro Study. BIOMED RESEARCH INTERNATIONAL 2016; 2016:8076131. [PMID: 27218106 PMCID: PMC4863093 DOI: 10.1155/2016/8076131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 04/10/2016] [Indexed: 11/20/2022]
Abstract
Aim. The purpose of this study was to compare the in vitro efficacy of calcium hypochlorite (Ca[OCl]2) and sodium hypochlorite (NaOCl) associated with sonic (Vibringe) irrigation system in root canals which were contaminated with Enterococcus faecalis. Material and Methods. The root canals of 84 single-rooted premolars were enlarged up to a file 40, autoclaved, inoculated with Enterococcus faecalis, and incubated for 21 days. The samples were divided into 7 groups according to the irrigation protocol: G0: no treatment; G1: distilled water; G2: 2.5% NaOCl; G3: 2.5% Ca(OCl)2; G4: distilled water with sonic activation; G5: 2.5% NaOCl with sonic activation; and G6: 2.5% Ca(OCl)2 with sonic activation. Before and after decontamination procedures microbiological samples were collected and the colony-forming units were counted and the percentages of reduction were calculated. Results. Distilled water with syringe irrigation and sonic activation groups demonstrated poor antibacterial effect on Enterococcus faecalis compared to other experimental groups (p < 0.05). There was no statistically significant difference between syringe and sonic irrigation systems with Ca(OCl)2 and NaOCl. Conclusion. The antimicrobial property of Ca(OCl)2 has been investigated and compared with that of NaOCl. Both conventional syringe irrigation and sonic irrigation were found effective at removing E. faecalis from the root canal of extracted human teeth.
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Tanomaru-Filho M, Miano LM, Chávez-Andrade GM, Torres FFE, Leonardo RDT, Guerreiro-Tanomaru JM. Cleaning of Root Canal System by Different Irrigation Methods. J Contemp Dent Pract 2015; 16:859-63. [PMID: 26718291 DOI: 10.5005/jp-journals-10024-1771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of this study was to compare the cleaning of main and lateral canals using the irrigation methods: negative pressure irrigation (EndoVac system), passive ultrasonic irrigation (PUI) and manual irrigation (MI). MATERIALS AND METHODS Resin teeth were used. After root canal preparation, four lateral canals were made at 2 and 7 mm from the apex. Root canals were filled with contrast solution and radiographed pre- and post-irrigation using digital radiographic system [radiovisiography (RVG)]. The irrigation protocols were: MI1-manual irrigation [22 G needle at 5 mm short of working length-WL]; MI2-manual irrigation (30G needle at 2 mm short of WL); PUI; EV1-EndoVac (microcannula at 1 mm short of WL); EV2-Endovac (microcannula at 3 mm short of WL). The obtained images, initial (filled with contrast solution) and final (after irrigation) were analyzed by using image tool 3.0 software. Statistical analysis was performed by analysis of variance (ANOVA) and Tukey tests (5% significance level). RESULTS EV1 and EV2, followed by PUI showed better cleaning capacity than manual irrigation (MI1 and MI2) (p < 0.05). CONCLUSION Negative pressure irrigation and PUI promoted better cleaning of main and simulated lateral canals. CLINICAL SIGNIFICANCE Conventional manual irrigation technique may promote less root canal cleaning in the apical third. For this reason, the search for other irrigation protocols is important, and EndoVac and PUI are alternatives to contribute to irrigation effectiveness.
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Affiliation(s)
- Mário Tanomaru-Filho
- Professor, Department of Restorative Dentistry, Araraquara Dental School, UNESP-Univ Estadual Paulista, , Rua Humaita 1680 Centro CEP 14801-903, Araraquara, Sao Paulo, Brazil Phone: +55-16-3301-6390, e-mail:
| | - Lucas Martinati Miano
- Department of Restorative Dentistry, Araraquara Dental School, UNESP-Univ Estadual Paulista, Araraquara, Sao Paulo, Brazil
| | | | | | - Renato de Toledo Leonardo
- Department of Restorative Dentistry, Araraquara Dental School, UNESP-Univ Estadual Paulista, Araraquara, Sao Paulo, Brazil
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