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Teja KV, Janani K, Srivastava KC, Shrivastava D, Natoli V, Di Blasio M, Cicciu M, Minervini G. Comparative evaluation of antimicrobial efficacy of different combinations of calcium hydroxide against Enterococcus faecalis. BMC Oral Health 2023; 23:849. [PMID: 37951871 PMCID: PMC10638705 DOI: 10.1186/s12903-023-03552-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/19/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND The study aims to compare the synergistic antibacterial efficacy of different combinations of calcium hydroxide as an intracanal medicament against E. faecalis. MATERIAL AND METHODS The current study included four hundred extracted human permanent mandibular premolar teeth. After complete chemo-mechanical preparation, the middle third of the root was sectioned using a rotary diamond disc and a total of 400 samples were obtained. The specimens were inoculated with E. faecalis for 21 days. After that, specimens were divided into five groups (n = 80) based on materials used for the disinfection of samples: Group I, calcium hydroxide alone; Group II, calcium hydroxide + 2% chlorhexidine gel; Group III, calcium hydroxide + 2% chitosan gel; Group IV, calcium hydroxide + 0.02% silver nanoparticle gel; Group V, calcium hydroxide + Bioactive glass S53P4. Dentin shavings from the apical third were obtained from the inner third of dentin were obtained using gates glidden no.1 to the apical depth, followed by no.2, 3, 4 and 5 analyzed for E. faecalis using the culture method. One-way analysis of variance (ANOVA) was used for data analysis, followed by post-hoc Tukey's test for multiple comparisons of means to check the difference in bacterial inhibition between the groups. RESULTS ANOVA results revealed a significant reduction of bacterial counts in all the groups compared (p < 0.001). Intergroup comparison showed maximum bacterial reduction (p < 0.001) with calcium hydroxide + bioactive glass S53P4 compared with other groups. CONCLUSION Synergistic effect of calcium hydroxide showed better bacterial reduction compared to calcium hydroxide alone. Among the combinations evaluated, calcium hydroxide with bioactive glass, found to be most effective compared to other groups.
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Affiliation(s)
- Kavalipurapu Venkata Teja
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College & Hospitals, Saveetha University, Chennai, Tamilnadu, India
| | - Krishnamchari Janani
- Department of Conservative Dentistry and Endodontics, SRM Dental College, Ramapuram, Chennai, Tamilnadu, India
| | - Kumar Chandan Srivastava
- Department of Oral & Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, 72345, Sakaka, Saudi Arabia.
| | - Deepti Shrivastava
- Department of Preventive Dentistry, College of Dentistry, Jouf University, 72345, Sakaka, Saudi Arabia.
- Department of Periodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, 602105, India.
| | - Valentino Natoli
- Department of Dentistry, School of Biomedical and Health Sciences, European University of Madrid, 28670, Madrid, Spain
| | - Marco Di Blasio
- Department of Medicine and Surgery, University Center of Dentistry, University of Parma, 43126, Parma, Italy.
| | - Macro Cicciu
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123, Catania, Italy
| | - Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", 80121, Naples, Italy
- Saveetha Dental College & Hospitals Saveetha Institute of Medical & Technical Sciences Saveetha University, Saavetha Dental College, Chennai, India
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Symptomatic Apical Periodontitis of the Mandibular First Molar with the Accessory Canal in the Furcation Area Mimicking Furcation Perforation. Case Rep Dent 2022; 2022:6324447. [PMID: 35601083 PMCID: PMC9119794 DOI: 10.1155/2022/6324447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 04/02/2022] [Accepted: 04/12/2022] [Indexed: 11/30/2022] Open
Abstract
Apical periodontitis frequently presents as a chronic disease. To arrive at a true diagnosis, in addition to the clinical examination, it is mandatory to undertake radiographic examinations and evaluate the clinical presentation. Knowledge of the root canal morphology is a prerequisite for effective nonsurgical endodontic treatment. The internal morphological features of the pulp chamber are variable and complex. This case report describes the treatment and outcome of symptomatic apical periodontitis of a mandibular first molar with the accessory (chamber) canal. The applied treatment fully contributed to the periapical lesion regression as shown in the four-year recall periapical radiography.
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Zubizarreta-Macho Á, Rico-Romano C, Fernández-Aceñero MJ, Mena-Álvarez J, Cabal B, Díaz LA, Torrecillas R, Moya JS, López-Píriz R. Adding Two Antimicrobial Glasses to an Endodontic Sealer to Prevent Bacterial Root Canal Reinfection: An In Vivo Pilot Study in Dogs. Antibiotics (Basel) 2021; 10:antibiotics10101183. [PMID: 34680764 PMCID: PMC8532650 DOI: 10.3390/antibiotics10101183] [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: 08/10/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022] Open
Abstract
Current endodontic procedures continue to be unsuccessful for completely removing pathogens present inside the root canal system, which can lead to recurrent infections. In this study, we aimed to assess the antimicrobial capacity and tissue response of two inorganic bactericidal additives incorporated into a paste root canal sealer on contaminated root dentin in vivo. An experimental study was performed in 30 teeth of five Beagle dogs. After inducing microbiological contamination, root canal systems were treated by randomly incorporating one of two antimicrobial additives into a commercial epoxy-amine resin sealer (AH Plus), i.e., G3T glass-ceramic (n = 10) and ZnO-enriched glass (n = 10); 10 samples were randomized as a control group. After having sacrificed the animals, microbiological, radiological, and histological analyses were performed, which were complemented with an in vitro bactericidal test and characterization by field emission scanning electron microscopy. The tested groups demonstrated a non-significant microbiological reduction in the postmortem periapical index values between the control group and the bactericidal glass-ceramic group (p = 0.885), and between the control group and the ZnO-enriched glass group (p = 0.169). The histological results showed low values of inflammatory infiltrate, and a healing pattern characterized by fibrosis in 44.4% of the G3T glass-ceramic and 60.0% of ZnO-enriched glass. Bactericidal glassy additives incorporated in this root canal sealer are safe and effective in bacterial reduction.
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Affiliation(s)
- Álvaro Zubizarreta-Macho
- Department of Endodontics, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (Á.Z.-M.); (C.R.-R.); (J.M.-Á.)
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain
| | - Cristina Rico-Romano
- Department of Endodontics, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (Á.Z.-M.); (C.R.-R.); (J.M.-Á.)
| | | | - Jesús Mena-Álvarez
- Department of Endodontics, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain; (Á.Z.-M.); (C.R.-R.); (J.M.-Á.)
| | - Belén Cabal
- Nanomaterials and Nanotechnology Research Centre (CINN), Consejo Superior de Investigaciones Científicas (CSIC), Universidad de Oviedo (UO), Principado de Asturias (PA), Avenida de la Vega 4-6, 33940 El Entrego, Spain; (L.A.D.); (R.T.); (J.S.M.)
- Correspondence: (B.C.); (R.L.-P.)
| | - Luis Antonio Díaz
- Nanomaterials and Nanotechnology Research Centre (CINN), Consejo Superior de Investigaciones Científicas (CSIC), Universidad de Oviedo (UO), Principado de Asturias (PA), Avenida de la Vega 4-6, 33940 El Entrego, Spain; (L.A.D.); (R.T.); (J.S.M.)
| | - Ramón Torrecillas
- Nanomaterials and Nanotechnology Research Centre (CINN), Consejo Superior de Investigaciones Científicas (CSIC), Universidad de Oviedo (UO), Principado de Asturias (PA), Avenida de la Vega 4-6, 33940 El Entrego, Spain; (L.A.D.); (R.T.); (J.S.M.)
| | - José Serafín Moya
- Nanomaterials and Nanotechnology Research Centre (CINN), Consejo Superior de Investigaciones Científicas (CSIC), Universidad de Oviedo (UO), Principado de Asturias (PA), Avenida de la Vega 4-6, 33940 El Entrego, Spain; (L.A.D.); (R.T.); (J.S.M.)
| | - Roberto López-Píriz
- Nanomaterials and Nanotechnology Research Centre (CINN), Consejo Superior de Investigaciones Científicas (CSIC), Universidad de Oviedo (UO), Principado de Asturias (PA), Avenida de la Vega 4-6, 33940 El Entrego, Spain; (L.A.D.); (R.T.); (J.S.M.)
- Advanced Oral Surgery Institute (ICOA), 28691 Madrid, Spain
- Correspondence: (B.C.); (R.L.-P.)
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Cheung AWT, Lee AHC, Cheung GSP. Clinical efficacy of activated irrigation in endodontics: a focused review. Restor Dent Endod 2021; 46:e10. [PMID: 33680899 PMCID: PMC7906851 DOI: 10.5395/rde.2021.46.e10] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 02/02/2023] Open
Abstract
Root canal debridement, which includes the removal of infected tissues and microbial biofilms, is considered the corner stone of root canal treatment. Chemical adjuncts play a multitude of functions in this regard, as tissue solvents, antimicrobial agents and for removing the smear layer. These adjuncts (irrigants) are usually delivered using a syringe and needle. With increasing knowledge of the complexity of root canal anatomy and tenacity of microbial biofilms, the need for strategies that potentiate the action of these irrigants within the root canal system cannot be overemphasized. Several such activated irrigation strategies exist. The aim of this review is to comprehensively discuss the different irrigant activation methods from the context of clinical studies.
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Affiliation(s)
- Amelia Wan Tin Cheung
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Angeline Hui Cheng Lee
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Gary Shun Pan Cheung
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
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Effectiveness of passive ultrasonic irrigation on periapical healing and root canal disinfection: a systematic review. Br Dent J 2019; 227:228-234. [DOI: 10.1038/s41415-019-0532-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Zubizarreta-Macho Á, Ferreiroa A, Agustín-Panadero R, Rico-Romano C, Lobo-Galindo AB, Mena-Álvarez J. Endodontic re-treatment and restorative treatment of a dens invaginatus type II through new technologies. J Clin Exp Dent 2019; 11:e570-e576. [PMID: 31346380 PMCID: PMC6645261 DOI: 10.4317/jced.55840] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 05/01/2019] [Indexed: 12/11/2022] Open
Abstract
Background The complex anatomy of dens invaginatus makes access cavity to root canal system difficult, which has an impact on the prognosis of these teeth. A novel technique, based on new technologies, is proposed to make access cavity conservative and guided with minimal dental structure lost. Material and Methods This case report shows the root canal retreatment and the endodontic surgery of a dens invaginatus type II in a left lateral upper incisor previously treated which was affected by a chronic apical abscess and an apical fracture. A Cone Beam Computed Tomography was performed to better diagnosis the dental anatomy. An intraoral scan was performed to get a digital 3D model. A computer-guided implant planning software was used to plan the access cavity and design the splint guided. Finally, the clinical crown was restored by a resin nanoceramic veneer made by a chairside system made up of an intraoral scanning unit and a grinding unit. Last, the authors carried through the endodontic surgery to extract the apical fractured fragment. Results Follow-up appointments at 6, 12 and 18 months showed a radiographic reduction of the periapical lesion and absence of clinical signs. Conclusions The splint guide allowed a guided and conservative access cavity to root canal system. It facilitates the root canal retreatment and improves the prognosis of the teeth with dental malformations. Key words:CAD-CAM, Cone-Beam Computed Tomography, dens in dente, dens invaginatus, dental pulp cavity, endodontics.
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Affiliation(s)
- Álvaro Zubizarreta-Macho
- DDS, PhD. Associate professor. Department of Endodontics. Faculty of Health Sciences. Alfonso X el Sabio University. Madrid. Spain
| | - Alberto Ferreiroa
- DDS, PhD. Associate professor. Department of Dental Prosthesis. Faculty of Dentistry. Complutense University. Madrid. Spain
| | - Rubén Agustín-Panadero
- DDS, PhD.Adjunct Professor. Department of Dental Medicine. Faculty of Medicine and Dentistry. University of Valencia. Spain
| | - Cristina Rico-Romano
- DDS, PhD. Associate professor. Department of Endodontics. Faculty of Health Sciences. Alfonso X el Sabio University. Madrid. Spain
| | - Ana-Belén Lobo-Galindo
- DDS, MS. Associate professor. Department of Endodontics. Faculty of Health Sciences. Alfonso X el Sabio University. Madrid. Spain
| | - Jesús Mena-Álvarez
- DDS, PhD. Head Director. Department of Endodontics. Faculty of Health Sciences. Alfonso X el Sabio University. Madrid. Spain
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Nagendrababu V, Jayaraman J, Suresh A, Kalyanasundaram S, Neelakantan P. Effectiveness of ultrasonically activated irrigation on root canal disinfection: a systematic review of in vitro studies. Clin Oral Investig 2018; 22:655-670. [DOI: 10.1007/s00784-018-2345-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/15/2018] [Indexed: 12/01/2022]
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Radiological Evaluation of Penetration of the Irrigant according to Three Endodontic Irrigation Techniques. Int J Dent 2016; 2016:3142742. [PMID: 27433162 PMCID: PMC4940559 DOI: 10.1155/2016/3142742] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/30/2016] [Accepted: 05/22/2016] [Indexed: 11/17/2022] Open
Abstract
Introduction. This experimental study is to compare radiographs based on the penetration depth of the irrigant following three final irrigation techniques. Material and Method. A sample of sixty teeth with single roots were prepared with stainless steel K files followed by mechanized Ni-Ti files iRace® under irrigation with 2.5% sodium hypochlorite. Radiopaque solution was utilized to measure the penetration depth of the irrigant. Three irrigation techniques were performed during this study: (i) passive irrigation, (ii) manually activated irrigation, and (iii) passive irrigation with an endodontic needle CANAL CLEAN®. Radiographs were performed to measure the length of irrigant penetration in each technique. Results. In comparison, passive irrigation with a conventional syringe showed infiltration of the irrigant by an average of 0.682 ± 0.105, whereas the manually activated irrigation technique indicated an average of 0.876 ± 0.066 infiltration. Irrigation with an endodontic syringe showed an average infiltration of 0.910 ± 0.043. The results revealed highly significant difference between the three irrigation techniques (α = 5%). Conclusion. Adding manual activation to the irrigant improved the result by 20%. This study indicates that passive irrigation with an endodontic needle has proved to be the most effective irrigation technique of the canal system.
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