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Talreja T, Tandale A, Kunkulol R, Maniyar V, Krishnakumar K, Dube R, Kokate P. Comparative evaluation of penetration of sealers in dentinal tubules using passive ultrasonic irrigation and Erbium: yttrium-aluminum-garnet laser - A confocal laser scanning microscope study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2023; 26:634-638. [PMID: 38292741 PMCID: PMC10823976 DOI: 10.4103/jcde.jcde_105_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: 07/31/2023] [Revised: 08/21/2023] [Accepted: 09/18/2023] [Indexed: 02/01/2024]
Abstract
Context Smear layer clearance and sealer penetration into dentinal tubules play a crucial role in root canal treatment. Hence, efficient irrigation is a crucial component of the root canal debridement. This in vitro study's objective was to assess the effectiveness of passive ultrasonic activation and Erbium: yttrium-aluminum-garnet (Er: YAG) laser-activated irrigation on irrigation solution penetration and sealer penetration into dentinal tubules. Aims The aim of this study was to evaluate and compare the dentinal tubule penetration of epoxy resin-based sealer and bioceramic sealer after ultrasonic agitation and Er: YAG laser activation of the irrigant. Settings and Design This was an in vitro study. Materials and Methods Extracted tooth samples (n = 42) into 06 groups (Group A-F) with 7 samples in each group. Postobturation transverse section was made and assessed under a confocal laser scanning microscope for the total dentinal tubule penetration area and recorded as the mean apical, middle, and coronal penetration. Statistical Analysis One-way analysis of variance test, followed by post hoc was used. Results The intergroup comparison showed that Group E and Group F have significantly more penetration as compared to the controls and ultrasonic irrigation, P < 0.001 and P < 0.01, respectively. Conclusions Er: YAG laser with AH plus sealer has the highest penetration in all the sections of tooth, followed by CeraSeal sealer.
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Affiliation(s)
- Twinkle Talreja
- Department of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Anita Tandale
- Department of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Rahul Kunkulol
- Professor and Head, Department of Pharmacology, Director Research, Pravara Institute of Medical Sciences (DU), Loni, Maharashtra, India
| | | | - Karishma Krishnakumar
- Department of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Ridhi Dube
- Department of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Prajakta Kokate
- Department of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
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Chaurasia B, Tewari N, Mathur VP, Nag TC, Yadav SC, Rahul M, Mishra D, Bansal K. Evaluation of two rehydration protocols for fractured tooth fragments for characteristics of penetration of resin tags using confocal laser scanning microscopy. Dent Traumatol 2023; 39:157-164. [PMID: 36409272 DOI: 10.1111/edt.12807] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/22/2022] [Accepted: 10/25/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Fragment reattachment is the recommended treatment modality in uncomplicated crown fractures. There is a paucity of literature regarding the mechanisms responsible for increased resistance to fracture after fragment rehydration in such cases. Hence, the aim of this proof-of-concept study was to decipher the microscopic changes in the penetration characteristics of resin in tooth fragments after different rehydration protocols. MATERIAL AND METHODS Sixty bovine incisors free of structural deformities were fractured as per a standard protocol and the fragments were stored in saline at 4°C. They were randomly allocated into three groups (n = 20)-Group 1: negative-control, no-rehydration, Group 2: rehydration by immersion in distilled water for 15 min, Group 3: rehydration by humidification for 15 min. They were subjected to the "experimental bonding protocol" using an eighth-generation bonding agent mixed with rhodamine-B dye. The samples were subjected to decalcification and sectioned into cubical blocks (2 × 2 × 2 mm3 ). They were embedded in paraffin wax, sectioned by an ultramicrotome and evaluated by using a confocal laser scanning microscope. The depths and width of the resin tags were assessed by image analysis software, and the number of tags was counted manually by blinded evaluators. Statistical analysis was done with Stata-14. RESULTS The depth of penetration of the resin tags was greatest in Group 2 (927.81 ± 280.38 μm) followed by Group 3 (902.03 ± 371.85 μm) and Group 1 (287.74 ± 124.80 μm). Similarly, the width of the penetrated resin tags was greatest in Group 2 (58.29 ± 21.15), followed by Group 3 (35.53 ± 22.15) and Group 1 (23.89 ± 6.88). The number of resin tags in the majority of the samples in Group 1 had less than 25 tags (65%), whereas there were more than 25 tags in Group 2 (70%) and Group 3 (75%). These differences were statistically significant (p < .05). CONCLUSION The resin penetration, as observed by the number of tags and their depth and width, was significantly affected by the rehydration of the fragments. The fragments rehydrated in the distilled water had greater penetration of resin tags than those rehydrated in a humidification chamber.
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Affiliation(s)
- Bikash Chaurasia
- Pediatric & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Nitesh Tewari
- Pediatric & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Prakash Mathur
- Pediatric & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Tapas Chandra Nag
- Electron Microscope Facility, SAIF, Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - Subhash Chandra Yadav
- Electron Microscope Facility, SAIF, Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - Morankar Rahul
- Pediatric & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Deepika Mishra
- Oral Pathology and Microbiology, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Kalpana Bansal
- Pediatric & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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Uslu G, Gündoğar M, Üngör M, Özyürek T, Erkan E, Keskin NB. Investigation of the effectiveness of sonic, ultrasonic and new laser-assisted irrigation activation methods on smear removal and tubular penetration. Lasers Med Sci 2023; 38:30. [PMID: 36595139 DOI: 10.1007/s10103-022-03697-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/19/2022] [Indexed: 01/04/2023]
Abstract
The aim of this study was to examine the effectiveness of different irrigation activation methods on smear layer removal and tubular penetration. One hundred-five distal roots of mandibular molar teeth in total; 50 for smear removal efficiency (n = 10) analysis using scanning electron microscopy (SEM), and 55 roots were used to examine tubular penetration using confocal laser scanning microscope (CLSM). Five different irrigation activation methods were used in this study; conventional needle irrigation (CNI), sonic irrigation device of EDDY, passive ultrasonic irrigation (PUI), PIPS and SWEEPS techniques, which are two different laser irrigation activation methods. The obtained data were statistically analyzed and the significance level was determined as p < 0.05. At the apical level, the cleanest canal walls were observed when laser methods PIPS and SWEEPS were used, while in the middle third, there was no difference in smear removal efficiencies between all groups except for the CNI (p > 0.05). Penetration depths and percentages increased from apically to coronally in all groups. The PUI and EDDY generally showed similar penetration depths and percentages to the CNI, except at the coronal root level (p > 0.05). In all groups, when PIPS was used, it showed greater penetration depth and percentage (p < 0.05). PIPS and SWEEPS techniques showed lowest and similar smear scores compared to PUI and EDDY in the apical area where access and effectiveness of the irrigation solution are difficult.
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Affiliation(s)
- Gülşah Uslu
- Faculty of Dentistry, Department of Endodontics, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Mustafa Gündoğar
- Faculty of Dentistry, Department of Endodontics, Medipol University, Istanbul, Turkey
| | - Mete Üngör
- Faculty of Dentistry, Department of Endodontics, Medipol University, Istanbul, Turkey
| | - Taha Özyürek
- Faculty of Dentistry, Department of Endodontics, Bahçeşehir University, Istanbul, Turkey
| | - Erhan Erkan
- Faculty of Dentistry, Department of Endodontics, Medipol University, Istanbul, Turkey
| | - Neslihan Büşra Keskin
- Faculty of Dentistry, Department of Endodontics, Yıldırım Beyazıt University, Ankara, Turkey.
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Tan L, Liu Q, Chen Y, Zhao YQ, Zhao J, Dusenge MA, Feng Y, Ye Q, Hu J, Ou-Yang ZY, Zhou YH, Guo Y, Feng YZ. Comparison of sealer penetration of sonic activation versus conventional needle irrigation: a systematic review and meta-analysis of randomized controlled trials. BMC Oral Health 2022; 22:566. [PMID: 36463149 PMCID: PMC9719620 DOI: 10.1186/s12903-022-02608-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/21/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Most existing studies comparing the efficiency of sonic irrigation (SI) and conventional needle irrigation (CNI) in increasing the penetration of sealers into dentine tubules are controversial; and this study aimed to determine whether the use of SI can lead to greater sealing ability than CNI, during the root canal treatment. METHODS The EMBASE, PubMed, and Cochrane Library databases were used to find confocal laser scanning microscopy studies evaluating percentage and maximum depth of sealer penetration following the use of SI or CNI in mature permanent teeth until October 2022. The critical estimative checklist of randomized controlled trials of the standardized Joanna Briggs Institute was adopted to independently score the quality of each study. The random-effect model for meta-analysis was used to analyse for each canal segment (apical, middle, coronal). The results are shown in the forest plots as weighted mean differences (WMDs) with 95% confidence intervals (95% CIs). RESULTS Ninety-seven articles were included in the preliminary screening, and nine of them were included in this study. Eight studies were included in the meta-analysis.The meta-analysis exhibited great increases in the coronal (WMD: 8.09, 95% CI 2.78-13.40/WMD: 165.32, 95% CI 128.85-201.80), and middle segments (WMD: 8.81, 95% CI 5.76-11.87/WMD: 132.98, 95% CI 68.71-197.25) for the percentage and maximum depth of sealer penetration, respectively. The percentage of sealer penetration in the apical thirds region was nonsignificant (WMD: 4.73, 95% CI - 2.34-11.80). However, the maximum depth of sealer penetration in the apical thirds region was significant (WMD: 121.46, 95% CI 86.55-156.38). Chi-squared analysis revealed heterogeneity scores of 0.0-70.0% and 44.0-90.0% for the percentage and maximum depth of sealer penetration, respectively. DISCUSSION This review verified that SI significantly improves tubular dentin sealer penetration in most areas of the root canal; thus, SI may lead to better filling efficiency and anti-reinfection effects than CNI during and after the root canal therapy. Nevertheless, a large heterogeneity in the current data comparing the irrigation efficiency of SI versus CNI in the apical third of the root canal was found, implying the necessity to standardize root canal irrigation procedures and obtain more accurate results in this area. TRIAL REGISTRATION INPLASY database (INPLASY202270116).
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Affiliation(s)
- Li Tan
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Qiong Liu
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Yun Chen
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Ya-Qiong Zhao
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Jie Zhao
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Marie Aimee Dusenge
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Yao Feng
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Qin Ye
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Jing Hu
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Ze-Yue Ou-Yang
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Ying-Hui Zhou
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China ,grid.452708.c0000 0004 1803 0208National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China
| | - Yue Guo
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
| | - Yun-Zhi Feng
- grid.452708.c0000 0004 1803 0208Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, 410011 Hunan China
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Elrashid AH, Alderaa KJ, Alissa HA, Almadhi WH, Bawazir HS, Alsougi SS, Alraffa SA. Perceived effectiveness about endodontic practice among private general dental practitioners in Riyadh city, Saudi Arabia. J Family Med Prim Care 2020; 9:2426-2430. [PMID: 32754514 PMCID: PMC7380752 DOI: 10.4103/jfmpc.jfmpc_129_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/13/2020] [Accepted: 03/26/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Application of newer techniques in endodontics improves the prognosis and reduces the time to operate patients; hence, the present study was conducted to determine the characteristics of endodontic practice and to compare these characteristics between General Dental Practitioners (GDPs) and endodontists with regards to their years of experience in Riyadh city, Saudi Arabia. MATERIALS AND METHOD A cross-sectional study was conducted among GDPs and endodontists working in private sector in Riyadh. Study subjects were chosen from 5 areas of Riyadh by stratified random sampling. A structured, pretested, closed-ended, and self-administered questionnaire consisting of 36 items was employed. Questionnaire identified different aspects of endodontic practice among participants. Information related to their behavior and perceived effectiveness, and demographic data were also collected. RESULTS AND DISCUSSION A total of 259 practitioners participated in the present study. The mean behavior and perceived effectiveness scores were 5.73 (71.63%) and 1.16 (58%), respectively. A total of 64 respondents (24.7%) used magnification, while 167 (64.5%) employed digital radiography/cone-beam computed tomography. Rotary instruments were employed by 170 participants (65.64%) and adjunctive activator during irrigation was utilized by 50 (19.30%) of respondents. A majority of 217 respondents (83.80%) reported that they need further training. Correlation analysis revealed that gender was significantly associated with perceived effectiveness (r = 0.136, P = 0.029). CONCLUSIONS Behavior and perceived effectiveness of practitioners is far from satisfactory and a majority of practitioners identified the need for further training. There was a statistically significant correlation between gender and perceived effectiveness.
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Affiliation(s)
- Afra Hassan Elrashid
- Department of Restorative Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Khalid Jamal Alderaa
- Dental Student, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
| | - Hamad Abdulaziz Alissa
- Dental Student, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
| | | | | | | | - Sulaiman Ali Alraffa
- Dental Student, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
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Galler KM, Grubmüller V, Schlichting R, Widbiller M, Eidt A, Schuller C, Wölflick M, Hiller KA, Buchalla W. Penetration depth of irrigants into root dentine after sonic, ultrasonic and photoacoustic activation. Int Endod J 2019; 52:1210-1217. [PMID: 30828819 DOI: 10.1111/iej.13108] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 02/28/2019] [Indexed: 01/03/2023]
Abstract
AIM To compare penetration depths of endodontic irrigants into the dentinal tubules of extracted teeth when using several activation methods. METHODOLOGY The root canals of 90 extracted human teeth were prepared to size 40, .06 taper. The straight and round-shaped root canals were distributed randomly into six groups, and final irrigation was performed with EDTA and sodium hypochlorite as follows: (I) manual dynamic activation, (II) Ultrasonic, (III) Sonic, (IV) PIPS (photon-induced photoacoustic streaming, (V) SWEEPS (shock-wave enhanced emission photoacoustic streaming) and (0) control without final irrigation or activation. Subsequently, methylene blue was inserted into the canals and activated according to the groups (I-V). Teeth were sectioned horizontally, imaged under a light microscope, and dye penetration depths were measured in six sections per tooth and 24 points on a virtual clock-face per section. Data were analysed statistically by nonparametric tests for whole teeth and separately for coronal, middle and apical thirds. RESULTS Penetration of dye into the dentinal tubules was lowest for the controls. Median penetration depths amounted to 700-900 μm for groups I-V with differences in the apical thirds between group I and the other test groups. Minimum penetration depths were significantly greater for PIPS in the apical thirds (P ≤ 0.046). CONCLUSIONS Greater penetration depths occurred in the apical thirds for ultrasonic, sonic and laser-induced activation compared to manual dynamic activation. PIPS was associated with deeper penetration of irrigants. The novel SWEEPS mode did not increase irrigant penetration.
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Affiliation(s)
- K M Galler
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - V Grubmüller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | | | - M Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - A Eidt
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - C Schuller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - M Wölflick
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - K-A Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - W Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
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