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Nabeshima CK, Caballero-Flores H, Vicente EJ, Gavini G, Machado MEDL. Antibacterial ability of different activated irrigation after root canal preparation: intratubular analyses. Braz Dent J 2024; 35:e245883. [PMID: 38775594 PMCID: PMC11086613 DOI: 10.1590/0103-6440202405883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/15/2024] [Indexed: 05/25/2024] Open
Abstract
This study assessed the intratubular antibacterial ability of different activated irrigations after chemical mechanical preparation. Seventy-two palatal root canals of upper molars were infected with Enterococcus faecalis for 4 weeks, and then initial bacterial collection from the main root canal was performed. The root canals were prepared by using a WaveOne Gold large (45/.05) and distributed into 6 groups according to the activation of the final irrigation: ultrasonic activation (UA), XP-Endo Finisher (25/.00), XP Clean (25/.02), EasyClean (25/.04) in reciprocating motion and continuous rotary motion (ECRot), and conventional irrigation. After final irrigation, another bacterial collection from the main root canal was performed, and the root was sectioned transversely in three-thirds and stained for analysis by confocal laser microscopy. Intratubular bacteria were collected through dentin powder and plated for bacterial viability analysis. Intergroup and intragroup comparisons were performed by using analysis of variance and repeated measures analysis of variance, respectively, both at 5% significance. ECRot had higher antibacterial ability than UA (p<0.05), and both were superior to the other groups (p<0.05) in both methodologies. It can be concluded that activation of final irrigation enhances the disinfection of the root canal system, and activators have different efficacies.
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Affiliation(s)
- Cleber Keiti Nabeshima
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Hector Caballero-Flores
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Elisabete José Vicente
- Department of Microbiology, Institute of Biological Science, University of São Paulo, São Paulo, SP, Brazil
| | - Giulio Gavini
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
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de Mattos de Araujo BM, Cruz ATG, Piasecki L, Webber M, Carneiro E, Westphalen VPD, da Silva Neto UX. Micro-CT evaluation of four final irrigation protocols on hard-tissue debris removal from mesial roots of mandibular molars containing isthmus. Clin Oral Investig 2022; 26:6121-6128. [PMID: 35650363 DOI: 10.1007/s00784-022-04561-3] [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: 12/20/2021] [Accepted: 05/21/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To evaluate by means of microcomputed tomography (micro-CT), the efficacy of four final irrigation protocols in the removal of hard-tissue debris (HTD) in mesial roots of mandibular molars containing isthmus. MATERIALS AND METHODS Forty standardized mesial roots of extracted mandibular molars presenting isthmus were selected. The root canals were prepared and randomly divided into 4 groups (n = 10): EA, EndoActivator (Dentsply Sirona); EC, Easy Clean (Easy Dental Equipment, Belo Horizonte, Brazil); XPF, XP-Endo Finisher (FKG Dentaire, La Chaus-de Fonds, Switzerland); and PUI, passive ultrasonic irrigation using Irrisafe tip (Satelec Acteon, Merignac, France). Each final irrigation protocol was performed in two cycles (60 s), using, respectively, 2.5% sodium hypochlorite and 17% EDTA. Micro-CT scans were obtained pre-operatory, post-preparation, and post-irrigation. The percentage of HTD reduction was calculated. Data was analyzed statistically (ANOVA and Kruskal-Wallis, significance set at 5%). RESULTS The percentage of HTD reduction was greatest for the XPF group (77.92%), followed by EA (62.92%), PUI (47.48%), and EC (32.65%). Statistical differences (p < .05) were found between XPF and EC only. A significant difference (p < .05) was found between XPF and EC in all thirds and between PUI and EC in the middle third. CONCLUSIONS XPF, EA, and PUI were similarly effective in HTD reduction. However, none of the evaluated protocols was able to completely remove all the debris. CLINICAL RELEVANCE Final irrigation protocols aim to clean the canal complexities that are not addressed by the shaping procedures. Micro-CT allowed to assess the removal of hard-tissue debris in the isthmus and canals of mandibular molars.
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Affiliation(s)
| | | | - Lucila Piasecki
- Department of Periodontics & Endodontics, University at Buffalo, Buffalo, NY, USA.
| | - Mariel Webber
- Department of Periodontics & Endodontics, University at Buffalo, Buffalo, NY, USA
| | - Everdan Carneiro
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
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Natanasabapathy V, Arul B, Srinivasan V, Santosh SS, Vasudevan A, Arockiam S, Namasivayam A, Deivanayagam K, Srinivasan MR. Removal of accumulated hard tissue debris from mesial root of mandibular molars evaluated using micro-CT - a systematic review and network meta-analysis. Evid Based Dent 2021:10.1038/s41432-021-0207-x. [PMID: 34795397 DOI: 10.1038/s41432-021-0207-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 05/21/2021] [Indexed: 11/09/2022]
Abstract
Aim The aim of this systematic review and network meta-analysis was to identify the best irrigant activation technique (IAT) for the removal of accumulated hard tissue debris (AHTD) from the mesial root of mandibular molars evaluated using micro-CT studies.Methods The research question was based on the PICO format. Four electronic databases - PubMed, Scopus, Embase and Web of Science - were searched for articles up to June 2020. Selected articles were assessed for bias using the Joanna Briggs Institute Critical appraisal tool. The network meta-analysis using a fixed-effects model and SUCRA ranking were performed. The quality of the evidence was assessed using the CINeMA framework.Results Eleven studies were included for qualitative synthesis while seven were included for quantitative synthesis. The risk of bias of all included articles was low. The results based on SUCRA values revealed the IAT shock wave-enhanced emission photoacoustic streaming (100%) resulted in the greatest reduction of the volume of AHTD from mesial roots of mandibular molars. Ranking of the other IATs was as follows: photon-induced photoacoustic streaming (87%), laser-activated irrigation (79.3%), XP EndoFinisher (71.2%), ultrasonically activated irrigation (59.6%), apical negative pressure (42.3%), EasyClean (37.4%), EDDY (26.2%), EndoActivator (24.2%), self-adjusting file (11.6%) and needle irrigation (11.3%).Conclusion None of the IATs rendered the root canals completely free of AHTD. The laser-activated irrigation groups fared better than all other interventions in reducing AHTD from the mesial roots of mandibular molars. The confidence rating ranged from low to high for indirect evidence and moderate to high for mixed evidence. Results must be interpreted with caution due to the laboratory nature of the included studies.
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Affiliation(s)
- Velmurugan Natanasabapathy
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research (MAHER), No.1, Alapakkam Main Road, Maduravoyal, Chennai, 600095, Tamil Nadu, India.
| | - Buvaneshwari Arul
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research (MAHER), No.1, Alapakkam Main Road, Maduravoyal, Chennai, 600095, Tamil Nadu, India
| | - Vignesh Srinivasan
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research (MAHER), No.1, Alapakkam Main Road, Maduravoyal, Chennai, 600095, Tamil Nadu, India
| | - Sneha Susan Santosh
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research (MAHER), No.1, Alapakkam Main Road, Maduravoyal, Chennai, 600095, Tamil Nadu, India
| | - Aishwarya Vasudevan
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research (MAHER), No.1, Alapakkam Main Road, Maduravoyal, Chennai, 600095, Tamil Nadu, India
| | - Selva Arockiam
- Department of Orthodontics, Faculty of Dentistry, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research (MAHER), No.1, Alapakkam Main Road, Maduravoyal, Chennai, 600095, Tamil Nadu, India
| | - Ambalavanan Namasivayam
- Department of Periodontology and Oral implantology, Faculty of Dentistry, Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research (MAHER), No.1, Alapakkam Main Road, Maduravoyal, Chennai, 600095, Tamil Nadu, India
| | - Kandaswamy Deivanayagam
- Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, 600116, Tamil Nadu, India
| | - M R Srinivasan
- Department of Conservative Dentistry and Endodontics, Sri Venkateswara Dental College and Hospital, Chennai, 600130, Tamil Nadu, India
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Fernandes KGC, Silva BBD, Boer NC, Mandarini DR, Moreti LCT, Kato AS, Bueno CEDS, Limoeiro AGDS, Pinheiro SL, Martin ASD, Fontana CE. The Effectiveness of Three Irrigation Systems in the Enterococcus faecalis Reduction after Instrumentation with a Reciprocating Instrument. Eur J Dent 2020; 14:539-543. [PMID: 32898871 PMCID: PMC7535969 DOI: 10.1055/s-0040-1714760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE This study aimed to analyze the effectiveness of three irrigation systems: EndoActivator, passive ultrasonic irrigation (PUI), and Easy Clean in the reduction of Enterococcus faecalis, after instrumentation with the reciprocating system, through microbiological collection and culture method. MATERIALS AND METHODS A total of 60 extracted human lower premolars were used and standardized at 16 mm in length. The teeth were accessed, contaminated with E. faecalis, and incubated for 21 days at 37°C. Initial collections (S1) were made with an absorbent paper cone to confirm the contamination; subsequently, instrumentation was performed with WaveOne Primary. The teeth were divided into four groups according to the final irrigation protocol (n = 15): group 1. EndoActivator; group 2, PUI; group 3, Easy Clean; and group 4, control group irrigated with saline solution sterile and without agitation. In the final irrigation, the agitation of the 17% ethylene amine tetra-acetic acid (EDTA) solutions was used, then 2.5% sodium hypochlorite (NaOCl); in both for this, three cycles of 20 seconds each. After the chemical-mechanical preparation and agitation of the irrigating solutions, the final collections (S2) for counting the colony-forming units (CFU/mL) occurred. RESULTS The Kruskal-Wallis test revealed that all the agitation systems reduced by 100% and the control group by 65.7%. CONCLUSION The control group presented a significantly higher amount of CFU/mL after the chemical-mechanical preparation than the other groups, which were similar to each other (p > 0.05).
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Affiliation(s)
| | | | | | | | | | - Augusto Shoji Kato
- Department of Endodontics, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil
| | | | | | - Sergio Luiz Pinheiro
- Department of Endodontics, Postgraduate Program in Health Sciences, Pontifical Catholic University of Campinas (PUC-Campinas), Postgraduate Program in Health Sciences, Campinas, São Paulo, Brazil
| | - Alexandre Sigrist De Martin
- Department of Endodontics, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil
| | - Carlos Eduardo Fontana
- Department of Endodontics, Postgraduate Program in Health Sciences, Pontifical Catholic University of Campinas (PUC-Campinas), Postgraduate Program in Health Sciences, Campinas, São Paulo, Brazil
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