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Fahim SZ, Ghali RM, Hashem AA, Farid MM. The efficacy of 2780 nm Er,Cr;YSGG and 940 nm Diode Laser in root canal disinfection: A randomized clinical trial. Clin Oral Investig 2024; 28:175. [PMID: 38403667 PMCID: PMC10894764 DOI: 10.1007/s00784-024-05563-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/14/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES Effective disinfection of the root canals is the cornerstone of successful endodontic treatment. Diminishing the microbial load within the root canal system is crucial for healing in endodontically treated teeth. The aim of this study was to evaluate the effect of 2780 nm Er,Cr:YSGG and 940 nm diode lasers on the eradication of microorganisms from single-rooted teeth with asymptomatic apical periodontitis. MATERIALS AND METHODS Thirty participants conforming to the inclusion criteria were randomly divided into 3 groups according to the disinfection protocol used; Conventional group: 2.5% Sodium Hypochlorite (NaOCl) and 17% EDTA solution NaOCl/EDTA, Dual laser group: 2780 nm Erbium, chromium: yttrium scandium-gallium-garnet (Er,Cr:YSGG) laser and 940 nm diode laser Er,CrYSGG/Diode, and Combined group: 17% EDTA and 940 nm diode laser EDTA/Diode. Bacterial samples were collected before and after intervention. The collected data were statistically analyzed using Friedman's test and Kruskal-Wallis test (P ≤ 0.05). RESULTS The results of the study showed that both dual laser Er,CrYSGG/Diode and combined laser EDTA/Diode groups showed significantly less mean Log10 CFU/ml of aerobic and anaerobic bacterial counts than the conventional NaOCl/EDTA group. CONCLUSIONS In this study we evaluated in vivo the bactericidal efficacy of three disinfection protocols for endodontic treatment of single-rooted teeth with apical periodontitis. The results indicated that both dual laser Er,CrYSGG/Diode and combined laser EDTA/Diode groups provide superior bactericidal effect compared to the conventional NaOCl/EDTA group. CLINICAL RELEVANCE The integration of lasers into root canal disinfection protocols has demonstrated significant bacterial reduction which might promote healing and long-term success.
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Affiliation(s)
- Sara Zakaria Fahim
- Faculty of Dentistry, Department of Oral Medicine, Periodontology, Diagnosis and Radiology, Future University, Cairo, Egypt.
| | - Rami Maher Ghali
- Faculty of Dentistry, Department of Prosthodontics, Ain Shams University, Cairo, Egypt
| | - Ahmed A Hashem
- Ain Shams University, Faculty of Dentistry, Endodontic Department, Cairo, Egypt
- Cleveland Dental Institute, Cleveland, OH, USA
| | - Mary Medhat Farid
- Faculty of Dentistry, Department of Oral and Maxillofacial, Radiology, Ain Shams University, Cairo, Egypt
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Mali S, Patil A, Sharma D, Jaiswal H, Saoji HA, Sinha A, Singh R. The Influence of Nickel-Titanium (Ni-Ti) Rotary Instrument Systems on Debris and Smear Layer Formation in Endodontic Procedures: An In Vitro Scanning Electron Microscopy Study. Cureus 2024; 16:e54310. [PMID: 38496119 PMCID: PMC10944652 DOI: 10.7759/cureus.54310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/14/2024] [Indexed: 03/19/2024] Open
Abstract
Background Successful endodontic treatment relies on the effective removal of debris and the prevention of smear layer formation within the root canals. The choice of nickel-titanium (Ni-Ti) rotary instrument systems can significantly impact these outcomes. Aim This study aims to evaluate and compare the debris and smear layer formation in root canals of extracted mandibular second premolar teeth following instrumentation with the ProTaper Universal (Dentsply Sirona, Charlotte, NC) (Group II), Twisted File (Kerr Endodontics, Gilbert, AZ) (Group III), and XP Endo (FKG Dentaire, La Chaux-de-Fonds, Switzerland) (Group IV) Ni-Ti rotary instrument systems. Methods In this in vitro study, 60 extracted mandibular second premolar teeth were randomly divided into four groups, each containing 15 teeth. Group I served as the control with no instrumentation. Groups II, III, and IV were instrumented with the ProTaper Universal rotary file, the Twisted File, and the XP Endo file systems, respectively. Debris and smear layer formation were evaluated through scanning electron microscopy (SEM), and photomicrographs were scored using a standardized index. Results Group II (ProTaper) exhibited the highest mean debris and smear layer scores, with values of 3.50 and 2.70, respectively. Group IV (XP Endo) demonstrated the least debris and smear layer formation, with mean scores of 2.65 and 2.08, respectively. Statistical analysis confirmed significant differences among the groups for both debris and smear layer formation. Conclusion The results highlight the practical importance of selecting appropriate Ni-Ti rotary instrument systems to minimize debris and smear layer formation during endodontic procedures. The XP Endo file system showed promise as a favorable choice in this regard, but further clinical research is needed to validate these findings.
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Affiliation(s)
- Sheetal Mali
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Amit Patil
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Deepak Sharma
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Himmat Jaiswal
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Hrishikesh A Saoji
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Anamika Sinha
- Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Navi Mumbai, IND
| | - Ramanpal Singh
- Department of Oral Medicine and Radiology, New Horizon Dental College And Research Institute, Bilaspur, IND
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AlGhamdi AS, Alotaibi B, Alsalhi H, Aljuailan RI, Barakat A. Photo-induced photoacoustic streaming and pineapple peel extract as final irrigant on extrusion bond strength of root filling material to canal wall. Pak J Med Sci 2023; 39:983-987. [PMID: 37492341 PMCID: PMC10364286 DOI: 10.12669/pjms.39.4.7370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/06/2023] [Accepted: 03/26/2023] [Indexed: 07/27/2023] Open
Abstract
Objective Photon-induced photoacoustic streaming (PIPS) with pineapple peel extract (PPE) and ethylenediaminetetraacetic acid (EDTA) as a final endodontic irrigant on the push-out bond strength (PBS) of root filling material to conventional irrigation NaOCl with EDTA. Methods An in vitro study at Dar Al Uloom University was conducted over three months. Root canal preparation was performed. Based on final irrigation, all the specimens were divided randomly into four groups (n=10) Group 1: 2.25% NaOCl+ 17% EDTA (control), Group-2: 2.25% NaOCl+PIPS + 6.25% PPE, Group-3: 2.25% NaOCl+PIPS + 17% EDTA, Group-4: 2.25% NaOCl + 6.25% PPE. Canals were obturated and sealed with AH Plus sealer. Root sectioning was performed at 1mm thickness and PBS testing was performed using the universal testing machine. The debonded samples were analyzed for failure mode. ANOVA compared the means and standard deviations (SD) of all investigated group. Assessment of multiple comparisons was performed using Tukey's post hoc test. Results The maximum PBS was demonstrated by the coronal section of Group-2 (2.25%NaOCl +PIPS+6.25%PPE) specimens (8.21±0.81MPa). The apical section of Group-1 (2.25% NaOCl+17% EDTA) specimens demonstrated minimum bond strength (2.80±0.18 MPa). The intergroup comparison revealed that Group-3 (2.25% NaOCl +PIPS +17% EDTA) and Group-2 demonstrated comparable outcomes (p>0.05). Group-4 (2.25% NaOCl +6.25% PPE) specimens established significantly lower values than Group-3 and Group-4 (p<0.05). Conclusion Photon-induced photoacoustic streaming with pineapple peel extract and EDTA demonstrated better bond strength of root canal sealer and have the potential to be used as the final irrigant.
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Affiliation(s)
- AbdulRahman Saeed AlGhamdi
- AbdulRahman Saeed AlGhamdi, Department of Restorative and Prosthetic Dentistry, College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Badi Alotaibi
- Badi Alotaibi, Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Al-Mulayda, Qassim, Saudi Arabia
| | - Hanin Alsalhi
- Hanin Alsalhi, Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Al-Mulayda, Qassim, Saudi Arabia
| | - Roqayah Ibrahim Aljuailan
- Roqayah Ibrahim Aljuailan, Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Al-Mulayda, Qassim, Saudi Arabia
| | - Ali Barakat
- Ali Barakat, Department of Restorative and Prosthetic Dentistry, College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia
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Almadi KH, Alkahtany MF. Pretreatment of Root Dentin Using Photon-Induced Photoacoustic Streaming, Photodynamic Therapy, and Riboflavin with EDTA as a Final Irrigant to Improve Bond Integrity of Glass Fiber Post. Photobiomodul Photomed Laser Surg 2023; 41:358-363. [PMID: 37459609 DOI: 10.1089/photob.2022.0156] [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] [Indexed: 07/20/2023] Open
Abstract
Objective: To evaluate the outcome of post space disinfection using Er,Cr:YSGG laser (ECYL), riboflavin photosensitizer (RFP), and photon-induced photoacoustic streaming (PIPS) along with ethylene diamine tetra acetic acid (EDTA) as final irrigant on the bond values of glass fiber post (GFP) to the canal wall. Materials and methods: Forty human mandibular premolars were subjected to root canal treatment after decoronation till the cementoenamel junction. Post space was prepared using a Gates-Glidden drill leaving 4 mm of gutta perch at the apical third of the root section. Random allocation of samples was performed into four groups based on the post space disinfection (n = 10 each): Group 1: 1% RFP and 17% EDTA, group 2: 5.25% sodium hypochlorite (NaOCl) and 17% EDTA (control), group 3: PIPS and 17% EDTA, and group 4: ECYL and 17% EDTA. GFP was luted using Rely X Unicem. A universal testing machine and stereomicroscope were used to assess the push-out bond strength (PBS) and failure mode, respectively. Analysis of variance determined the PBS amid different experimental groups at three root levels. Multiple group comparison using means of tested groups was identified using post hoc Tukey. Results: The coronal third of group 2 (5.25% NaOCl +17% EDTA) demonstrated the highest PBS (8.83 ± 0.11 MPa). However, the lowest bond integrity (4.15 ± 0.52 MPa) was displayed in an apical third of group 1 (RFP +17% EDTA). The intergroup comparison revealed that 5.25% NaOCl +17% EDTA at all three levels demonstrated comparable outcomes of PBS with PIPS +17% EDTA and ECYL +17% EDTA specimens (p > 0.05). However, riboflavin +17% EDTA demonstrated the lowest bond strength (p < 0.05). Conclusions: Er,Cr: YSGG and PIPS in combination with 17% EDTA demonstrated comparable outcomes of bond score with those of conventional gold standard irrigation regime 5.25% NaOCl.
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Affiliation(s)
- Khalid H Almadi
- Department of Restorative Dental Science, Division of Endodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mazen F Alkahtany
- Department of Restorative Dental Science, Division of Endodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Ateş AA, Arıcan B, Çiftçioğlu E, Küçükay ES. Influence of different irrigation regimens on the dentinal tubule penetration of a bioceramic-based root canal sealer: a confocal analysis study. Lasers Med Sci 2021; 36:1771-1777. [PMID: 34148161 DOI: 10.1007/s10103-021-03356-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/07/2021] [Indexed: 11/29/2022]
Abstract
This study aims to assess the efficacy of various irrigation protocols on the dentinal tubule penetration of a bioceramic-based endodontic sealer. Sixty-four single-rooted extracted human mandibular incisors were used. After instrumentation, teeth were randomly divided into the following four groups (n = 16 each) according to the final irrigation technique: group 1, conventional endodontic needle (CEN); group 2, EndoActivator (EA); group 3, Er,Cr: YSGG laser; group 4, XP-endo Finisher (XPF). The root canals were finally irrigated with 17% EDTA and 5.25% NaOCl for 1 min (min) respectively. The teeth were then obturated with Endosequence BC Points and rhodamine B dye-labeled BC Sealer. After 2 weeks, 1-mm-thick transverse sections were cut 2 and 5 mm from the apex, and examined by confocal laser scanning microscopy at 5 × magnification. The total percentage of sealer penetration (TPSP), sealer penetration area (SPA), and maximum sealer penetration depth (MSPD) was measured. Data were analyzed by Kruskal-Wallis, Dunn's multiple comparison, and Wilcoxon tests, with significance set at P < 0.05. At 2 mm level, no significant differences were detected among the groups (P > 0.05). At the 5 mm level, the XPF group showed significantly higher values for both TPSP and SPA in comparison with the Er,Cr: YSGG laser and CEN groups (P < 0.05), but no significant difference was observed with the EA group. The choice of different final irrigation techniques can affect dentinal tubule penetration.
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Affiliation(s)
- Ayfer Atav Ateş
- Department of Endodontics, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey.
| | - Burçin Arıcan
- Department of Endodontics, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey
| | - Elif Çiftçioğlu
- Department of Endodontics, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey
| | - E Sedat Küçükay
- Department of Endodontics, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey
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Copper-Calcium Hydroxide and Permanent Electrophoretic Current for Treatment of Apical Periodontitis. MATERIALS 2021; 14:ma14030678. [PMID: 33540551 PMCID: PMC7867200 DOI: 10.3390/ma14030678] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/26/2021] [Accepted: 01/29/2021] [Indexed: 12/19/2022]
Abstract
Endodontic failure has been and continues to be a problem for endodontics-specialists. Complicated anatomy, numerous foramens, and accessory canals are an environment for microorganisms to infect the teeth. The purpose of the present work was to evaluate the regeneration of copper–calcium hydroxide (Cupral)-endodontically treated teeth diagnosed with apical periodontitis using an electrophoresis technique. In total, 132 patients, aging from 19 to 65 years old, underwent endodontic treatment mono- and multi-radicular teeth, with complicated canals from January 2019 to June 2020. The patients were divided into two groups: (i) the control group—which included 54 patients (n = 62 teeth) receiving endodontic paste (Calcipast + 1) and, as final filling, the AH-PlusTM cement—and (ii) the Cupral group, which included 78 patients (n = 80 teeth) receiving Cupral paste plus the electrophoretic current and, as final filling, the Atacamit-alkaline cement. The clinical cases were periodically observed along an 18-month follow-up period via radiography. Data were expressed as focal size of the lesions (mean ± standard error (SEM) of all the radiographic outcomes) observed in each group at each interval point. Statistical analysis was performed using the Student’s t-test that allowed us to compare the control and Cupral groups; the statistical significance was set at p < 0.05 and p < 0.01, where the latter was highly significant. Before treatments, the focal sizes were 4.8 mm and 4.95 mm for control and Cupral-treated groups, respectively. After 6 months, the mean focal sizes were 3.9 mm and 2.14 mm for the control and Cupral groups, respectively. After 12 months, in the control group, the mean focal size was measured at 2.8 mm, while, in Cupral group, the lesion size decreased down to 0.31 mm and a highly dynamic regeneration of the destructive focal-bone occurred. After 18 months, the lesions were further significantly reduced in the control group (mean values of 2.62 mm), while they were barely detectable in the Cupral group (0.2 mm). In conclusion, we provide initial evidence that the Cupral-electrophoresis methodology is effective in treating destructive periodontitis of teeth with problematic canals up to 18 months, thus allowing teeth preservation.
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Rasheed SS, Jawad HA. Smear Layer Removal from the Apical Third Using the Er,Cr:YSGG Photon-induced Photoacoustic Streaming. IRANIAN ENDODONTIC JOURNAL 2021; 16:238-243. [PMID: 36704774 PMCID: PMC9735310 DOI: 10.22037/iej.v16i4.34544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/26/2021] [Accepted: 09/09/2021] [Indexed: 01/28/2023]
Abstract
Introduction The purpose was to study the influence of Erbium,Chromium:Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser at short pulse duration on smear layer removal from apical root third. Materials and Methods Twenty-four single-rooted mandibular premolars were used. The roots length was cut to 14 mm and instrumented using the Protaper Gold system to size 40/0.06. The samples were divided into four groups (n=6) as follows: (A) conventional irrigation with 5 mL of 17% Ethylenediaminetetraacetic acid ( EDTA), (B) passive ultrasonic irrigation with 5mL of 17% EDTA, (C) Er,Cr:YSGG induced photoacoustic streaming (PIPS) with 5 mL of 17% EDTA and (D)Er,Cr: YSGG induced PIPS with 5 mL of 5.25% sodium hypochlorite (NaOCl). After final irrigation with normal saline and drying, the roots were painted with nail varnish externally, and 2%methylene blue dye was injected into the canal. The tooth split horizontally at the fourth millimetres. The picture was taken by a professional Digital SLR camera. The dye penetration was measured using analytical software (measure picture CAD-KAS Kessler Germany). Dunnett's test was used to compare control group against experimental groups. Results After the statistical test, the highest mean percentage was presented in the laser group with 17% EDTA (Group C=85.9804) followed by the laser group with 5.25% NaOCl (Group D=69.7817) and ultrasonic group (Group B=34.5453) respectively and the lowest mean percentage was in the control group (Group A=20.7969). Conclusion Based on this in vitro study, PIPS technique using Er,Cr:YSGG pulse laser (0.5 W,5 Hz, air and water off) at short pulse duration and 17% EDTA proved effectively in smear layer removal, while the PIPS proved an acceptable result when the laser is used alone assisted by NaOCl.
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Affiliation(s)
| | - Hussien Ali Jawad
- Institute of Laser for Postgraduate Studies, University of Baghdad, Baghdad, Iraq
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Çırakoğlu S, Baddal B, İslam A. The Effectiveness of Laser-Activated Irrigation on the Apical Microleakage Qualities of MTA Repair HP and NeoMTA Plus in Simulated Immature Teeth: A Comparative Study. MATERIALS 2020; 13:ma13153287. [PMID: 32718044 PMCID: PMC7436115 DOI: 10.3390/ma13153287] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/10/2020] [Accepted: 07/17/2020] [Indexed: 01/09/2023]
Abstract
There are limited data regarding the potential effect of erbium, chromium: yttrium–scandium–gallium–garnet (Er,Cr:YSGG) laser-activated irrigation (LAI) on the microleakage qualities of calcium silicate-based cements. The objective of the present study was to assess the effect of LAI on the microleakage qualities of MTA Repair HP (MTA-HP) and NeoMTA Plus (Neo) used in root-end filling and to compare the antimicrobial effectiveness of MTA- HP. Two experimental sets were conducted: antimicrobial activity (agar diffusion test/at 24, 48 h) and microleakage (glucose leakage model/at 1st, 10th, 20th days). Antimicrobial activities of MTA-HP, Neo, Biodentine, ProRoot and MTA Angelus were evaluated, and inhibition zones were observed not only against a range of Gram-positive and Gram-negative bacteria but also against yeast at 48h. For microleakage evaluation, fifty teeth were prepared to simulate the clinical situation where the root-tips (apex) are open, and randomly divided into two experimental groups (n = 20/group) according to the cement type (MTA-HP and Neo), and two control (n = 5/group) groups. Each experimental group was further divided into two subgroups (n = 10/group) with respect to LAI: MTA-HP, L-HP, Neo, L-Neo. A statistical difference was only detected between Neo and L-HP groups on day 1. Subsequently, MTA-HP exhibited superior microleakage quality compared to Neo in the short-term. Er,Cr:YSGG laser-activated irrigation could be used as a reliable technique without creating adverse effects on the sealing abilities of MTA Repair HP and NeoMTA Plus.
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Affiliation(s)
- Serenad Çırakoğlu
- Department of Pediatric Dentistry, Faculty of Dentistry Near East University, 99138 Nicosia, North Cyprus;
| | - Buket Baddal
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, 99138 Nicosia, North Cyprus;
- Desam Institute, Near East University, 99138 Nicosia, North Cyprus
| | - Aylin İslam
- Department of Pediatric Dentistry, Faculty of Dentistry Near East University, 99138 Nicosia, North Cyprus;
- Desam Institute, Near East University, 99138 Nicosia, North Cyprus
- Correspondence: ; Tel.: +90-(392)-680-20-30; Fax: +90-(392)-680-20-25
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