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Nasrabadi N, Naseri M, Khosraviani F, Nematollahi Z. A Successful Non-surgical Management of a Type II Dens Invaginatus with Antimicrobial Photodynamic Therapy: A Case Report. IRANIAN ENDODONTIC JOURNAL 2023; 18:59-62. [PMID: 36751410 PMCID: PMC9900150 DOI: 10.22037/iej.v18i1.38789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/24/2022] [Accepted: 12/03/2022] [Indexed: 02/09/2023]
Abstract
Endodontic therapy of dens invaginatus (DI) anomalies is challenging due to difficult access, inadequate cleaning and shaping, and incomplete disinfection of its complicated root canal system. The present case report describes the treatment of tooth #10 with tooth discomfort, intermittent pus discharge, and localized swelling. Sinus tract, mobility, and probing grade 1 were observed. The tooth was tender on palpation and percussion with negative responses to pulp sensibility tests. Radiographic assessments revealed an atypical structure of pulpal anatomy, probably dens invaginatus, associated with a large periapical lesion and severe root curvature. Cone-beam computed tomography confirmed the presence of DI type II. Finally, the diagnosis of pulp necrosis with chronic apical abscess of tooth #10 was made. Combining antimicrobial photodynamic therapy as an adjunctive treatment with different irrigation techniques were effective in nonsurgical endodontic management of the complicated DI type II in a maxillary lateral incisor with a large periradicular lesion and severe root curvature. Six-month and one-year recall radiographic images revealed asymptomatic tooth and progressive osseous healing.
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Affiliation(s)
- Navid Nasrabadi
- Department of Endodontics, School of Dentistry, Birjand University of Medical Sciences, Birjand, Iran;
| | - Mandana Naseri
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
| | - Farshad Khosraviani
- University of California Los Angeles, School of Dentistry, Los Angeles, USA; ,Corresponding author: Farshad Khosraviani, 714 Tiverton Drive, Los Angeles, CA, 90024. E-mail:
| | - Zahra Nematollahi
- Dental Research Center, Research Institute of Dental Science, Shahid Beheshti University of Medical Science, Tehran, Iran, and Crani -Maxillofacial Research Center, Azad University, Dental Branch, Tehran, Iran
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Oliveira Tavares SJ, Pintor AVB, Caetano SK, dos Santos NCA, Pistoia BM, de Carvalho Camilo MR, Scelza P, Scelza MFZ. Is There a Relationship between Laser Therapy and Root Canal Cracks Formation? A Systematic Review. IRANIAN ENDODONTIC JOURNAL 2023; 18:2-14. [PMID: 36751412 PMCID: PMC9900151 DOI: 10.22037/iej.v18i1.39754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/23/2022] [Accepted: 12/26/2022] [Indexed: 02/09/2023]
Abstract
Introduction Crack formation has become an important issue for endodontists, as it can be decisive for the long-term prognosis of the endodontically treated tooth. Since the applicability of laser in endodontics has become frequent, this systematic review aimed to evaluate the association between laser therapy and the formation of cracks in the dentinal structure of the root canal. Materials and Methods A search was performed in PubMed, Scopus, Web of Science, and Virtual Health Library, as well as in the gray literature, on September 24, 2021. Studies that evaluated the formation of cracks in human root dentin due to different types of lasers were included. The risk of bias was assessed following the modified version of the Consolidated Standards of Reporting Trials (CONSORT) checklist tool. A meta-analysis was performed to evaluate (i) the total number of crack incidences; (ii) complete crack formation; (iii) incomplete crack formation; (iv) intra-dentinal crack formation between ultrasonic tips and laser use. The mean difference was calculated with a 95% confidence interval in a fixed-effect model, the heterogeneity was tested using the I2 index with level of significance of 5%. Results Of the 22 studies included in this review, 15 have shown that lasers can form cracks in root dentin, including those that performed baseline assessment of samples. The meta-analysis confirmed no difference in crack formation between ultrasonic tips and laser devices. Conclusions Laser therapy has been gaining prominence in endodontics and that irradiation can form and propagate cracks in the dentinal structure of the root canal assessed by in vitro studies. This is a critical concern for endodontists as it affects the strength and longevity of the tooth. Future research is encouraged to seek the standardization of good methodological practices and achieve establishing parameters to minimize harmful effects of laser on dentin.
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Affiliation(s)
| | - Andréa Vaz Braga Pintor
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil;
| | | | | | - Bruna Muniz Pistoia
- Faculty of Dentistry, Universidade Federal Fluminense, Niterói, RJ, Brazil;
| | | | - Pantaleo Scelza
- Geriatric Dentistry Department, Faculty of Dentistry, Universidade Federal Fluminense, Niterói, RJ, Brazil;
| | - Miriam Fatima Zaccaro Scelza
- Department of Endodontics, Laboratory of Experimental Culture Cell (LECCel), Faculty of Dentistry, Universidade Federal Fluminense, Niterói, RJ, Brazil,Corresponding author: Miriam Zaccaro Scelza, Department of Endodontics, Universidade Federal Fluminense, Niterói, RJ, Brazil. 30 Mario Santos Braga Street, Centro, Niteroi, RJ 24020-140, Brazil. E-mail:
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Ahangari Z, Asnaashari M, Akbarian Rad N, Shokri M, Azari-Marhabi S, Asnaashari N. Investigating the Antibacterial Effect of Passive Ultrasonic Irrigation, Photodynamic Therapy and Their Combination on Root Canal Disinfection. J Lasers Med Sci 2021; 12:e81. [PMID: 35155166 PMCID: PMC8837837 DOI: 10.34172/jlms.2021.81] [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: 08/01/2021] [Accepted: 10/06/2021] [Indexed: 12/27/2022]
Abstract
Introduction: Enterococcus faecalis is a gram-positive, facultative anaerobic bacterium associated with persistent endodontic infections. Conventional disinfection methods may not completely eradicate the bacteria within the root canal system. Therefore, novel modalities have been suggested to optimize root canal disinfection. The aim of this study was to evaluate and compare the antibacterial effect of photodynamic therapy (PDT), passive ultrasonic irrigation (PUI) and their combination in addition to conventional endodontic irrigation against E. faecalis biofilms in root canals. Methods: Root canals of 50 single-rooted extracted human teeth were prepared and incubated with E. faecalis for 21 days. They were then divided into 4 treatment groups and a control group as follows: (1) NaOCl-Syringe irrigation with 2.5% NaOCl, (2) PUI-Passive ultrasonic irrigation with NaOCl, (3) NaOCl+PDT-Photodynamic therapy following syringe irrigation with NaOCl, (4) PUI+PDT, (5) Control-Syringe irrigation with saline. Colony-forming units were counted and bacterial reduction was calculated for each treatment group. Results: All treatments led to significant reductions in the bacterial load compared to the control group. PUI and PUI+PDT led to the complete elimination of the bacteria from the root canals. NaOCl and NaOCl+PDT treatments reduced the bacteria by 99.9% and 99.5% respectively. NaOCl+PDT was significantly less effective in reducing the bacteria compared to other treatment groups. There were no significant differences between the NaOCl, PUI, and PUI+PDT groups. Conclusion: Passive ultrasonic irrigation with or without the combination of Photodynamic therapy completely eradicated the bacteria. The use of PDT as an adjunction to NaOCl syringe irrigation and PUI did not enhance their antibacterial effect.
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Affiliation(s)
- Zohreh Ahangari
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Asnaashari
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazila Akbarian Rad
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Shokri
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saranaz Azari-Marhabi
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Negin Asnaashari
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Alimadadi H, Asnaashari M, Naseri M, Yadegari Z. Effect of Apical Size and Taper on the Efficacy of Root Canal Disinfection With LED Photodynamic Therapy as an Adjunct to Irrigation With Sodium Hypochlorite. J Lasers Med Sci 2021; 12:e58. [PMID: 35155143 PMCID: PMC8837831 DOI: 10.34172/jlms.2021.58] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/10/2021] [Indexed: 07/26/2023]
Abstract
Introduction: This study assessed the effect of apical size and taper on the efficacy of root canal disinfection with LED photodynamic therapy (PDT) as an adjunct to irrigation with sodium hypochlorite. Methods: A total of 126 extracted human mandibular molars were divided into 4 groups. The mesiobuccal canal was prepared to size 25/4% in group 1, 25/6% in group 2, 30/4% in group 3, and 30/6% in group 4 using the iRaCe rotary system. A 21-day Enterococcus faecalis biofilm was prepared and used for inoculation of the canals. Each group was randomly divided into 3 subgroups for canal disinfection with 2.5% sodium hypochlorite, sodium hypochlorite plus LED PDT and saline (positive control). Samples from the root canals were obtained with rotary files and cultured. Microbiologic data were analyzed using the Poisson regression test. Results: The bacterial count significantly decreased following disinfection with sodium hypochlorite with/without PDT in all sizes and tapers of preparation compared with the control group (P<0.05). Increasing the apical taper or apical size and the use of PDT as an adjunct did not have a significant effect on the reduction of the bacterial count (P>0.05). However, the apical size and PDT had a significant effect on the number of residual bacteria (P<0.05), and increasing the apical size and conduction of PDT significantly decreased the number of residual bacteria. Conclusion: The apical size and taper and the use of PDT as an adjunct did not have a significant effect on the reduction of the bacterial count. However, increasing the apical size and conduction of PDT as an adjunct to sodium hypochlorite irrigation significantly decreased the number of residual bacteria in the root canal system.
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Affiliation(s)
- Hoda Alimadadi
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Asnaashari
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mandana Naseri
- Department of Endodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Yadegari
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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A View on Polymerase Chain Reaction as an Outstanding Molecular Diagnostic Technique in Periodontology. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9979948. [PMID: 34337068 PMCID: PMC8315861 DOI: 10.1155/2021/9979948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/11/2021] [Accepted: 07/13/2021] [Indexed: 12/12/2022]
Abstract
Objectives This study presents a discussion on the fundamentals of polymerase chain reaction (PCR) and its use as a diagnostic tool in periodontology. Materials and Methods A computer-aided as well as hand-made search in PubMed and Scopus indexed journals (relevant to the topic) was done by keywords of molecular technique in periodontology, PCR, applications of PCR, and PCR in periodontics. Only the papers in the English language and outlining PCR and its association with periodontology were collected and utilized to provide a succinct review. There was no limitation for publication time. Results The results of our search showed that PCR has turned into a standard in diagnosis in the field of periodontology. A variety of researches has demonstrated that its sensitive, and specific characteristics make it a quick and effective technique of recognition, identification, and quantification of microorganisms. Identification of various immunoinflammatory markers at the mRNA expression level as well as ascertaining gene-related polymorphisms can also be performed. Conclusions The mechanisms of periodontal disease can further become clarified using PCR. Clinical Relevance. PCR as a diagnostic method can play a main part in the validation of the clinical diagnosis of periodontal disease indicating the reason, pathogenesis, clinical steps, progress, and prognosis of the disease.
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de Vasconcelos Neves G, dos Santos KSA, de Souza Sales Rocha EAL, de Moura RQ, Morais Barros DG, Gominho LF, de Castro Gomes DQ. Antibacterial Effect of Photodynamic Therapy on Root Canal Disinfection Combined with Different Irrigation Protocols. IRANIAN ENDODONTIC JOURNAL 2020; 15:90-95. [PMID: 36704438 PMCID: PMC9709835 DOI: 10.22037/iej.v15i2.27801] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/18/2020] [Accepted: 03/01/2020] [Indexed: 01/28/2023]
Abstract
Introduction Photodynamic therapy (PDT) is an emerging alternative therapy to conventional endodontic treatment to optimize bacterial elimination. The aim of this study was to evaluate the in vitro antibacterial effect of PDT combined with different irrigation protocols on root canals inoculated with Enterococcus (E.) faecalis. Methods and Materials Ninety uni-radicular human premolars were prepared and contaminated with E. faecalis for 4 days. Teeth were randomly divided into six groups: positive control group (C+) consisted of conventional needle irrigation with 2.5% sodium hypochlorite (NaOCl); negative control group (C-) consisted of no treatment after contamination; PDT group as treated with 0.005% methylene blue and diode laser irradiation for 90 sec at wavelength of 660 nm, energy of 9 Joules, power of 100 mW; the fourth group consisted of NaOCl+PDT, the fifth group were treated with passive ultrasonic irrigation (PUI) with NaOCl+PDT (PUI+PDT); and the final group were treated with XP Endo Finisher with NaOCl+PDT (XP Endo+PDT). The contents of the root canals were collected with sterile absorbent paper points at two times: before and 24 h after decontamination protocols. The number of colony-forming units (CFU) was determined for each root canal. ANOVA and the Tukey test were used, with significance set at 5% (P<0.05). Results The inhibition percentage ranged from 10.72 (C-) to 100% (XP Endo+PDT), with CFU/mL counts differing among all protocols tested (P<0.05). The different protocols significantly influenced bacterial inhibition (P<0.05). However, the XP Endo+PDT protocol resulted in the highest inhibition percentage (100%), followed by NaOCl+PDT (65.85%). Conclusions PDT combined with different final irrigation protocols was more effective in inhibiting E. faecalis growth than photodynamic therapy alone. XP Endo was the best irrigation protocol to eradicate this microorganism.
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Affiliation(s)
- Gabriella de Vasconcelos Neves
- Departamento de Odontologia, Universidade Estadual da Paraíba, Rua das Baraúnas, 351, Bairro Universitário, Campina Grande, Paraíba, Brasil; ,Corresponding author: Gabriella de Vasconcelos Neves, Teresinha de Farias, 159, Catolé. Campina Grande, Paraíba, Brasil. CEP: 58429-500. Tel: +55-839 88587314, E-mail:
| | - Kátia Simone Alves dos Santos
- Departamento de Odontologia, Universidade Estadual da Paraíba, Rua das Baraúnas, 351, Bairro Universitário, Campina Grande, Paraíba, Brasil
| | | | - Rodrigo Queiroga de Moura
- Departamento de Odontologia, Universidade Estadual da Paraíba, Rua das Baraúnas, 351, Bairro Universitário, Campina Grande, Paraíba, Brasil
| | - Danyllo Guimarães Morais Barros
- Departamento de Odontologia, Universidade Estadual da Paraíba, Rua das Baraúnas, 351, Bairro Universitário, Campina Grande, Paraíba, Brasil
| | - Luciana Ferraz Gominho
- Departamento de Odontologia Restauradora / Universidade Federal da Paraíba - UFPB, João Pessoa, Brasil
| | - Daliana Queiroga de Castro Gomes
- Departamento de Odontologia, Universidade Estadual da Paraíba, Rua das Baraúnas, 351, Bairro Universitário, Campina Grande, Paraíba, Brasil
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Ghoddusi J, Moushekhian S, Arian E, Ghiasi J, Forghani M. The Effectiveness of Sonic-Activated Irrigation in Reducing Intratubular Enterococcus faecalis. IRANIAN ENDODONTIC JOURNAL 2019; 14:63-67. [PMID: 36879604 PMCID: PMC9984808 DOI: 10.22037/iej.v14i1.22436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/24/2018] [Accepted: 12/10/2018] [Indexed: 03/08/2023]
Abstract
Introduction The purpose of this in vitro study was to compare the effectiveness of sonic activation and syringe irrigation of 5.25% sodium hypochlorite in removing the Enterococcus faecalis (E. faecalis) biofilm. Methods and Materials Root canals of 54 extracted human single-rooted central incisors were prepared with ProTaper S1-S2-F1-F2 and Gates Gliden burs size 1, and 2 at the working length. After sterilization, the root canals were contaminated with E. faecalis suspension and randomly assigned to three groups: G1, conventional syringe irrigation; G2, sonic agitation of NaOCl with Endo Activator system; and G3, no subjected to the mentioned irrigation techniques (negative control). Canals were sampled after the disinfection procedure. The colony forming units (CFU) count was evaluated. Samples were also visualized under fluorescent microscope to count viable bacteria. Data were statistically analyzed using the Kruskal-Wallis and one-way ANOVA followed by Tukey's test (P<0.05). Results There was a significant reduction in the CFU count after both irrigation techniques. There was no significant difference between two techniques (P=0.874). Using bacterial viability kit, Endo Activator displayed the least viable bacteria than the other groups (P<0.001) and control group showed the greatest one (P<0.001). Conclusion In this in vitro study, the Endo Activator system was more successful in reducing intratubular viable bacteria compared with NaOCl syringe irrigation alone.
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Affiliation(s)
- Jamileh Ghoddusi
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Siavash Moushekhian
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Arian
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Maryam Forghani
- Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Ramazani M, Asnaashari M, Ahmadi R, Zarenejad N, Rafie A, Yazadani Charati J. The Effect of Final Rinse Agitation with Ultrasonic or 808 nm Diode Laser on Coronal Microleakage of Root-canal Treated Teeth. IRANIAN ENDODONTIC JOURNAL 2018; 13:108-113. [PMID: 29692845 PMCID: PMC5800451 DOI: 10.22037/iej.v13i1.17248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/21/2017] [Accepted: 12/02/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION This in vitro study aimed at comparing the effect of agitating the final irrigant solutions of root canal by ultrasonic or using 808 nm Diode laser on the apical seal of canal. METHODS AND MATERIALS A total of 90 extracted human maxillary central incisors were prepared up to size #45 and were randomly assigned to 4 experimental groups (n=20) and two control groups (n=5) respectively, as follows: I): 3 mL of 5.25% NaOCl was agitated as final irrigant solution with ultrasonic for 30 sec. The ultrasonic tip was 1 mm shorter than the working length, II): 3 mL of 5.25% NaOCl was agitated as final irrigant with 808 nm Diode laser for 30 sec. Fiber tip, placed in 1 mm shorter from working length was spirally moved coronally, III): 3 mL of 17% EDTA was agitated as final irrigant with 808 nm Diode laser for 30 sec and was applied similar to group II, IV): 3 mL of 17% EDTA was stimulated as final irrigant with ultrasonic for 30 sec and was applied similar to I. Apical seal was assessed by Dual Chamber technique using Bovine Serum Albumin protein. Kruskal-Wallis and Mann Whitney tests were used with significance level lower than 0.05% for statistical analysis. RESULTS The average leakage in the negative control, positive control, and groups I, II, III, IV were: 0.00, 13.5±5.1, 1.72±2.9, 5.12±5.6, 3.36±3.7, 2.4±4.2, respectively. Statistical analysis showed significant difference between groups (P<0.05). There was a significant difference between groups 1 and 2 in terms of protein leakage. CONCLUSION Agitating 5.25% sodium hypochlorite solution as the final irrigant with ultrasonic is more effective in apical leakage reduction compared to other groups.
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Affiliation(s)
- Mohsen Ramazani
- Department of Endodontics, Sari Dental School, Mazandaran University of Medical Sciences;
| | - Mohammad Asnaashari
- Iranian Center For Endodontic Research , Research Institute of Dental Research, Department of Endodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
| | | | - Nafiseh Zarenejad
- Restorative Dentistry, Sari Dental School, Mazandaran University of Medical Sciences, Sari, Iran;
| | - Alireza Rafie
- Department of Immunology, Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran;
| | - Jamshid Yazadani Charati
- Biostatistic Department, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
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