Efficacy of new irrigating solution on smear layer removal in apical third of root canal: A scanning electron microscope study

Effectiveness of continuous chelation irrigation protocol in endodontics: a scoping review of laboratory studies

This scoping review aimed to synthesize and explore the current boundaries and limitations of laboratory research on the effectiveness of continuous chelation irrigation protocol in endodontics. This scoping review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. Literature search was conducted on Pubmed and Scopus to identify all laboratory studies evaluating smear layer and hard-tissue debris removal or, antimicrobial efficacy, or dentine erosion induced by continuous chelation. Two independent reviewers performed the all review steps and the relevant items were recorded. Seventy-seven potentially relevant studies were identified. Finally, 23 laboratory studies met the eligibility criteria for qualitative synthesis. Seven studies focused on the smear layer/debris removal outcome, 10 on antimicrobial activity, and 10 on dentine erosion. In general, the continuous chelation protocol was equally or more effective in the cleanliness of root canals and antimicrobial activity compared with traditional sequential protocol. In addition, etidronate solutions seemed to be milder chelating agents compared to those with EDTA, thus resulting in reduced or no dentine erosion and roughness modification. Yet, the methodological differences among the included studies limit the results' generalizability. The continuous chelation seems to be equally or more effective in all investigated outcomes when compared with the traditional sequential protocol. The methodological variability among the studies and shortcomings in the methods employed limit the generalizability and clinical relevance of the results. Standardized laboratory conditions combined with reliable three-dimensional investigation approaches are necessary to obtain clinically informative findings.

2D and 3D Erosion Landscape Analysis of Endodontic-Treated Teeth Using EDTA and HEDP as Chelating Agents: A High-Resolution Micro-Computed Tomographic Study

This study aimed to assess the amount of erosion during activated endodontic irrigation with either HEDP or EDTA via high-resolution micro-computed tomography. Two root canals of twenty premolars were prepared with ProTaper Next and irrigated with sodium hypochlorite. Palatal canals, which served as control groups, were sealed, while buccal canals were further irrigated with either EDTA (n = 10) or HEDP (n = 10), which served as test groups. Micro-CT was performed to measure erosion depth. For 2D and 3D measurements, non-parametric repeated ANOVA measurements and post hoc tests were performed. 2D analysis showed highly significant differences between the case groups at each position of the root (p ≤ 0.01). The cervical and apical positions showed significant differences in the EDTA group (p = 0.03). The 3D analysis also showed significant differences between both chelating agents (p < 0.01) and the case and control groups (p = 0.01). The mean erosion depths in the cervical, middle, and apical thirds of the EDTA group were 45.75, 41.79, and 32.25 µm, and for the HEDP group were 20.25, 16.40, and 15.96 µm, respectively. HEDP seems to have a significantly less erosive effect. Different irrigation protocols with harsher conditions, as might be the case during endodontic retreatment, could be assessed with micro-CT.

Comparative Evaluation of Intracanal Smear Layer Removal by Different Root Canal Irrigants: A Scanning Electron Microscope Study

Aim

The purpose of the study is to compare and evaluate the efficacy of different root canal irrigants-100, 75, 50, and 25% neem extract, 100, 75, 50, and 25% apple cider vinegar (ACV), a combination of 5.25% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA), and saline on smear layer removal using a scanning electron microscope (SEM).

Materials and methods

A total of 80 freshly extracted single-rooted teeth were collected and divided into 10 groups-group I: normal saline (negative control), group II: NaOCl with EDTA (positive control), group III: 100% neem extract, group IV: 75% neem extract, group V: 50% neem extract, group VI: 25% neem extract, group VII: 100% ACV, group VIII: 75% ACV, group IX: 50% ACV, and group X: 25% ACV. The samples were irrigated with a specific group of irrigants, then split in a longitudinal axis and processed for analysis in an SEM. Microphotographs were obtained and scored according to Torabinejad et al.

Results

Microphotographs were assessed and showed that 100% neem extract was similar to NaOCl with EDTA, followed by 75% neem extract and 100% ACV.

Conclusion

This study showed that 100% neem extract removed the smear layer, similar to the NaOCl with EDTA.

How to cite this article

Sudhakar S, Gupta N, Ghambir N, et al. Comparative Evaluation of Intracanal Smear Layer Removal by Different Root Canal Irrigants: A Scanning Electron Microscope Study. Int J Clin Pediatr Dent 2023;16(4):633-638.

Comparison of antibacterial effect of plantaricin 149 suspension and traditional root canal irrigation solutions in root canal infections in vitro

Dental pulp and periapical diseases are common conditions in stomatology, caused by various pathogenic microorganisms. Antimicrobial peptides, as new antibiotics, offer promising applications in the irrigation and disinfection medicaments for root canals.One patient with chronic periapical periodontitis was selected to extract the clinical pathogenic bacteria. Porphyromonas gingivalis (Pg) (ATCC 33,277), Streptococcus mutans (Sm) (ATCC 25,175), and Prevotella intermedius (Pi) (ATCC 25,611) were used as test strains. The effects of plantaricin (Pln) 149 on the biofilm formation and growth in infected root canals were evaluated by RT-PCR, laser confocal scanning microscopy, and bacterial diversity analysis. In addition, the cytotoxicity of Pln 149 (100 µg/mL) to human dental pulp stem cells (hDPSCs) was assessed using an MTT assay. Pln 149 exhibited significant inhibitory effects on Pg Sm and Pi (P < 0.05), with significant differences in the biofilm images of the laser confocal scanning microscope (P < 0.05). There were no significant differences in hDPSCs viability or proliferation between the Pln 149 and control groups. Considering the excellent antimicrobial effects and low cytotoxicity, we suggest that Pln 149 might be a promising option for root canal irrigation solutions.

Comparison of efficacy of ozonated water, normal saline, and povidone-iodine after surgical removal of impacted mandibular third molars: A cross-sectional study

Background:

Surgical extraction of mandibular third molars is an important and one of the most frequently performed operative procedures in dentistry. There are a variety of postoperative complications that may follow this procedure. These include pain, trismus, infection, dry socket, or alveolar osteitis. Numerous techniques have been used for reducing these morbid conditions. These range from flap designs, suture placement, use of various irrigating solutions, etc.,

Aim:

The present study aimed to compare the effectiveness of three irrigating solutions: Ozonated water, normal saline, and povidone-iodine in reducing postoperative complications following surgical removal of impacted mandibular third molars.

Materials and Methods:

A total of 100 study participants formed the sample size of this study. Study subjects were categorized into three groups: Group I (third molar surgeries using ozonated water), Group II (third molar surgeries with normal saline irrigation), and Group III (third molar surgeries using povidone-iodine irrigation). Parameters studied postoperatively were alveolar osteitis (dry socket), pain, trismus, and infection after a week interval. All data obtained were entered in Microsoft Excel 2007 worksheets and Analysis of Variance (ANOVA) as a statistical tool was employed. A P value of < 0.01 was considered statistically significant.

Results:

It was found that ozonated water provided the best statistically proven results with comparison to normal saline and povidone-iodine in reducing the incidence of alveolar osteitis or dry socket and pain. No statistically significant difference was observed in the incidence of trismus and infection rate among three studied groups.

Conclusion:

Ozonated water is the best irrigating solution when compared to normal saline and povidone-iodine in terms of reduction in pain and dry socket after a 1-week duration.