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Kathiria NV, Attur K, Bagda KM, Venkataraghavan KP, Patel K, Mustafa MB, Attur SK. Postendodontic Pain Using Single File System with Different Irrigation Protocols in Single-visit Root Canal Treatment: A Randomized Control Trial. J Contemp Dent Pract 2024; 25:180-185. [PMID: 38514417 DOI: 10.5005/jp-journals-10024-3572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
AIM To evaluate the intensity of postendodontic pain (PEP) using final irrigation with side-vented needle (SV), EndoActivator (EA), and Ultra X (UX) in single-visit endodontics (SVE) with F-One rotary files. MATERIALS AND METHODS A total 150 patients indicated for endodontic treatment were selected. Single-visit endodontics treatment was performed under local anesthesia. For the final irrigation protocol, they were divided into three groups: group I (SV), group II (EA), and group III (UX). The severity of PEP was assessed using visual analogue scale (VAS) score after 6, 12, 24, and 48 hours. Analgesics taken by patients, for pain, were also recorded. Finally, the data were tabulated and statistically analyzed using SPSS 20.0 software at a level of significance being 0.05. RESULTS Postendodontic pain was less in group III (UX) and group II (EA) compared with group I (SV) at 6 and 12 hours, which is statistically significant (p < 0.05). There was no statistically significant difference found after 24 hours and 48 hours. CONCLUSION The intensity of PEP was minimum in patients treated with EndoActivator and ultrasonic along with single rotary file systems. The incidence of analgesic intake was similar in all three groups. How to cite this article: Kathiria NV, Attur K, Bagda KM, et al. Postendodontic Pain Using Single File System with Different Irrigation Protocols in Single-visit Root Canal Treatment: A Randomized Control Trial. J Contemp Dent Pract 2024;25(2):180-185.
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Affiliation(s)
- Nishtha V Kathiria
- Department of Conservative Dentistry and Endodontics, Narsinhbhai Patel Dental College & Hospital, Visnagar, Gujarat, India, Phone: +91 9712994610, e-mail:
| | - Kailash Attur
- Department of Conservative Dentistry and Endodontics, Narsinhbhai Patel Dental College & Hospital, Visnagar, Gujarat, India
| | - Kamal M Bagda
- Department of Conservative Dentistry and Endodontics, Goenka Research Institute of Dental Science, Gandhinagar, Gujarat, India
| | | | - Kiran Patel
- Oral and Maxillofacial Surgery, Shreyas Dental Clinic, Ahmedabad, Gujarat, India
| | - Mohammed B Mustafa
- Department of Conservative Dentistry and Endodontics, Narsinhbhai Patel Dental College & Hospital, Visnagar, Gujarat, India
| | - Shylaja K Attur
- Department of Conservative Dentistry and Endodontics, Narsinhbhai Patel Dental College & Hospital, Visnagar, Gujarat, India
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Hepsenoglu YE, Ersahan S. Is XP-endo Finisher a better treatment option for its efficacy against intracanal bacteria for post-treatment apical periodontitis cases than EndoActivator? AUST ENDOD J 2023; 49 Suppl 1:399-412. [PMID: 37026533 DOI: 10.1111/aej.12756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/01/2023] [Accepted: 03/21/2023] [Indexed: 04/08/2023]
Abstract
To investigate the efficacy of the supplementary use of a rotary agitation method [XP-endo Finisher (XPF)] and sonically-activated irrigation [EndoActivator (EA)], using droplet digital PCR (ddPCR) on reducing the bacterial load in previously root canal treated teeth with apical periodontitis. Twenty patients with post-treatment apical periodontitis were allocated into two groups according to the irrigation activation method used: XPF and EA group. Total bacterial loads, as well as the amount of Enterococcus faecalis (E. faecalis) were determined before (S1) and after (S2) chemomechanical preparation, and after final irrigation activation (S3) by means of ddPCR. The bacterial copy numbers were compared between groups using the Friedman test (Nonparametric Repeated Measures ANOVA). When the groups were examined in terms of gender, age, number of root canals, periapical index score, sterility control total bacteria (SCTB), S1- and S2-total bacteria copy number, it was found that there was no statistical difference between the XPF group and the EA group (p > 0.05). Subsequent activation (S3) resulted in a significant microbial reduction in both XPF and EA groups, both of which reduced significantly more bacteria than chemomechanical instrumentation (S2) (p < 0.0001). On the contrary, S3-total bacteria copy number of the EA group was lower than the XPF group (p < 0.0147). There was no statistical difference between the XPF group and the EA group in terms of E. faecalis copy number (p > 0.05). Although both the XPF and the EA optimised the antibacterial efficiency of chemomechanical preparation in previously root canal-treated teeth with apical periodontitis, a lower total bacterial copy number was achieved with the EA application than the XPF application.
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Affiliation(s)
- Yelda Erdem Hepsenoglu
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| | - Seyda Ersahan
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey
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Kashikar RR, Hindlekar A, Jadhav GR, Mittal P, Mukherjee P. Comparative evaluation of four different root canal irrigation techniques for apical extrusion of sodium hypochlorite - An in vitro study. J Conserv Dent Endod 2023; 26:424-428. [PMID: 37705540 PMCID: PMC10497079 DOI: 10.4103/jcd.jcd_210_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/08/2023] [Accepted: 05/31/2023] [Indexed: 09/15/2023]
Abstract
Objective This study compared the potential for apical extrusion of sodium hypochlorite (NaOCl) when using needle irrigation (NI), passive ultrasonic irrigation (PUI), passive subsonic irrigation (PSI), and negative pressure system (NP). Materials and Methods One hundred freshly extracted human permanent anterior teeth with complete root formation were embedded rigidly in agarose gel-containing cresol purple. Teeth were randomly allocated to six groups: G1-NI; G2-PUI; G3-PSI; G4-NP; G5-positive control; and G6-negative control. The chemomechanical preparation was completed and 12 ml of 3% NaOCl was delivered for 180 s in all groups. Dye diffusion was standardized by doing gel photography after the NaOCl final irrigation the Chi-square test and Kruskal-Wallis one-way analysis of variance test were used for the data analysis. Results G1 had statistically significant apical extrusion compared to G2 (P = 0.001), G3 (P = 0.001), and G4 (P = 0.001) groups. G4 showed the least amount of apical extrusion. Conclusions pH-sensitive gel model is useful in evaluating NaOCl extrusion. NP produced least NaOCl extrusion as compared to the other three systems. Due consideration should be given to the potential for apical extrusion of the irrigant before the selection of an irrigation system.
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Affiliation(s)
- Rasika Rajendra Kashikar
- Department of Conservative Dentistry and Endodontics, Sinhgad Dental College and Hospital, Pune, India
| | - Ajit Hindlekar
- Department of Conservative Dentistry and Endodontics, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | | | - Priya Mittal
- Department of Conservative Dentistry and Endodontics, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India
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Radeva EN, Mironova JV, Marinova-Takorova MB. Efficacy of Three Irrigation Methods in Removing Calcium Hydroxide from Curved Root Canals: An In Vitro Micro-CT Study. J Int Soc Prev Community Dent 2023; 13:342-348. [PMID: 37876582 PMCID: PMC10593373 DOI: 10.4103/jispcd.jispcd_80_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/20/2023] [Accepted: 07/27/2023] [Indexed: 10/26/2023] Open
Abstract
Aims and Objectives This in vitro study aimed to compare the efficacy of three different irrigation methods in removing calcium hydroxide from curved root canals and to estimate the amount of residual medicament using microcomputed tomography. Materials and Methods Thirty extracted molars with curved mesial root canals, ranging from 25° to 30°, were prepared with ProTaper Next using X2 to full working length and were filled with calcium hydroxide. Teeth also were randomly divided into four groups: group 1 (n = 8)- Erbium: Yttrium-Aluminum-Garnet (Er:YAG) laser; group 2 (n = 8)-EndoActivator; group 3 (n = 8)-EndoVac; and a control group (n = 6)-negative control with no calcium hydroxide. Microcomputed tomography was used to evaluate the residual amount of filling material. Statistical analysis was performed using IBM SPSS Statistics 26, with a significance level of 0.05. Descriptive statistics, student t test, and Chi-square test were applied for data analysis. Results The greatest amount of residual calcium hydroxide was observed in the samples with EndoVac irrigation (0.515 mm3), followed by EndoActivator (0.381 mm3) and Er:YAG laser (0.121 mm3). However, no statistically significant difference was observed between the groups. The greatest residual amount was observed in the apical third (0.419 mm3), followed by the middle (0.050 mm3) and the coronal (0.015 mm3). Conclusions No statistically significant differences were observed in the efficacy of the tested techniques for removing calcium hydroxide from curved root canals, whereas a significant difference was observed in the distribution of residual material depending on the technique used. The removal of the calcium hydroxide was more effective in the coronal and middle third of the canal. The greatest residual material was found in the apical portion of the root canal.
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Affiliation(s)
- Elka N Radeva
- Department of Conservative Dentistry, Faculty of Dental Medicine, Medical University-Sofia, Bulgaria, Bulgaria
| | - Jasmina V Mironova
- Department of Conservative Dentistry, Faculty of Dental Medicine, Medical University-Sofia, Bulgaria, Bulgaria
| | - Mirela B Marinova-Takorova
- Department of Conservative Dentistry, Faculty of Dental Medicine, Medical University-Sofia, Bulgaria, Bulgaria
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Tandon J, Yadav RK, Tikku AP, Shakya VK, Singh SK. Comparative evaluation of different irrigating and irrigant activation system in removal of gutta-percha/sealer during retreatment: An in vitro Micro-CT study. J Oral Biol Craniofac Res 2022; 12:444-448. [PMID: 35664952 PMCID: PMC9160468 DOI: 10.1016/j.jobcr.2022.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 05/05/2022] [Accepted: 05/11/2022] [Indexed: 11/22/2022] Open
Abstract
Background The aim of the study was to compare the efficacy of different irrigation and irrigant activation system used as an adjuvant to retreatment rotary files in removal of gutta-percha and sealer from endodontic retreatment using Micro-CT. Method 64 extracted permanent maxillary central incisor teeth with single canal, were collected and decoronated to standard length of 16 mm. Instrumentation was done using rotary files and obturation was performed using GuttaCore and AH plus sealer. After setting of sealer, initial removal of filling material was performed using ProTaper universal retreatment files (D1, D2, D3). All 64 sample were randomised into four groups (n = 16) Group1: Endodontic syringe irrigation, Group 2: Passive Ultasonic Irrigation (PUI), Group 3: EndoActivator, and Group 4: EndoVac. Micro-CT scanning was performed after obturation, initial removal of filling material by retreatment file and after using experimental protocols of each group, and volume of remaining filling material was calculated using Dolphin software. Statistical analysis performed with one-way ANOVA followed by Tukey's post hoc. Results A significant reduction in the volume of residual obturation material were found between each group. PUI was superior to the sonic (EndoActivator), negative pressure irrigation technique (EndoVac) and positive pressure irrigation at the coronal, middle third and apical third of the root canal. However, none of the supplementary techniques were able to completely remove the residual obturation material. Conclusion PUI and EndoActivator were found better in remaining filling material removal, demonstrating clinically useful as supplementary technique in removing remaining obturation material during endodontic retreatment.
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Affiliation(s)
- Jyoti Tandon
- Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, India
| | - Rakesh Kumar Yadav
- Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, India
| | - Aseem Prakash Tikku
- Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, India
| | - Vijay Kumar Shakya
- Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, India
| | - Satyendra Kumar Singh
- Stem Cell and Cell Culture Unit, Centre For Advanced Research (CFAR), King George's Medical University, U.P, Lucknow, India
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Mandhotra P, Rai K, Grewal GS, Singh K, Galhotra V, Gagan N. A Comparative Assessment of Three Different Irrigating Systems in Root Canal Treatment: An In vitro Study. J Pharm Bioallied Sci 2021; 13:S429-S431. [PMID: 34447126 PMCID: PMC8375850 DOI: 10.4103/jpbs.jpbs_587_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 09/26/2020] [Accepted: 09/27/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Exact diagnosis, efficient cleaning, shaping as well as disinfection of the root canals lead to successful root canal treatment. The present study compared three different irrigating systems in root canal treatment. Methodology: Sixty recently extracted permanent mandibular molars were classified into four groups: Group I, II, III, and IV with 15 teeth each. Group I comprised Endo-Irrigator Plus system. Group II comprised EndoActivator, Group III utilized passive ultrasonic irrigation (PUI), and Group IV was control, in which no activation of the irrigant was done. Stereomicroscope (X20) magnification was used for checking isthmus cleanliness. The scoring criteria were divided into score 1–5 depending on the amount of debris in root canal walls. Results: The mean ± standard deviation debris removal score in Group I was 2.6 ± 0.80, in Group II was 3.8 ± 0.72, in Group III was 3.9 ± 1.06, and in Group IV was 4.2 ± 0.82. The difference was significant (P < 0.05). Conclusion: Authors found that Endo-Irrigator Plus exhibited better cleaning efficacy followed by EndoActivator and PUI.
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Affiliation(s)
- Prabhat Mandhotra
- Department of Conservative Dentistry and Endodontic, Himachal Dental College, Mandi, Himachal Pradesh, India
| | - Kulwant Rai
- Department of Conservative Dentistry and Endodontics, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
| | - Gurkirat Singh Grewal
- Department of Conservative Dentistry and Endodontics, Shaheed Kartar Singh Sarabha Dental College and Hospital, Ludhiana, Punjab, India
| | - Kanwarpreet Singh
- Department of Conservative Dentistry, Yamuna Institute of Dental Sciences and Research, Yamunanagar, Haryana, India
| | - Vineet Galhotra
- Department of Dentistry, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Neel Gagan
- Department of Pedodontics and Preventive Dentistry, Maharaja Gangasingh Dental College and Research Centre, Sri Gangangar, Rajasthan, India
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Nangia D, Nawal RR, Talwar S. Evaluation of apical extrusion and cone-beam computed tomography assessment of irrigant penetration in oval-shaped canals, using XP Endo Finisher and EndoActivator. J Conserv Dent 2021; 23:185-189. [PMID: 33384493 PMCID: PMC7720767 DOI: 10.4103/jcd.jcd_390_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 07/13/2020] [Accepted: 08/10/2020] [Indexed: 12/05/2022] Open
Abstract
Background: Thorough cleaning of the pulp space is a challenging task. The mechanical instrumentation alone is usually not sufficient to completely debride the canals, and therefore, it requires the chemical action of irrigants also to disinfect the difficult to reach areas. Aim: The purpose of this study was to determine apical extrusion and assess irrigant penetration through cone-beam computed tomography (CBCT) for EndoActivator (EA) and XP Endo Finisher (XP). Materials and Methods: Sixty single-rooted mandibular premolars with oval-shaped canals were equally divided into three groups after instrumentation, based on the final irrigation: Group-1 syringe needle (30G Max-I-probe), Group-2 EA, and Group-3 XP. After the final irrigation, the weight of the extruded sodium hypochlorite was calculated. The prepared canals were then irrigated with a radiopaque contrast medium, which was activated according to the group of the sample (Group-1, 2, or 3). The volume of irrigant filled in the canal, especially in the apical third was determined through special tools in CBCT imaging. Statistics: One-way ANOVA test was used to compare the different groups. Results and Conclusion: Significantly more apical extrusion was seen in XP (P < 0.001). Both XP and EA have shown complete penetration of irrigant in the canal (100%).
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Affiliation(s)
- Divya Nangia
- Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Ruchika Roongta Nawal
- Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Sangeeta Talwar
- Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
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Gümüş H, Delikan E. The effect of sonic activation of irrigant on postoperative pain after root canal treatment in primary molar teeth: a randomized, clinical study. Clin Oral Investig 2021; 25:363-70. [PMID: 33184717 DOI: 10.1007/s00784-020-03687-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 11/06/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Postoperative pain following root canal treatment is a concern for pediatric patients and pediatric dentists. The purpose of this study was to evaluate the effect of using sonic activation (SA) on postoperative pain levels after root canal therapy of primary molars. METHODS A total of 110 patients aged 5-9 years with symptomatic irreversible pulpitis involving primary molars were included in the study and were randomly divided into two groups according to agitation methods: SA and no sonic activation (NSA). Root canal treatments were completed, and the teeth were restored permanently. Postoperative pain levels were evaluated using the five-face scale at 8, 24, 48, and 72 h and 1 week after treatment. Pain levels and frequency of analgesic intake were recorded and analyzed. RESULTS Postoperative pain values were lower in the SA group than in the NSA group at 8, 24, and 48 h after treatment (p < 0.05). No significant difference was observed between the groups in terms of postoperative pain values at 72 h and 1 week after treatment (p > 0.05). CONCLUSIONS It was determined that the use of SA reduces postoperative pain level significantly after root canal treatment in primary molar teeth. CLINICAL RELEVANCE The use of SA can be recommended to clinicians since it is effective in the successful management of postoperative pain of root canal treatment in primary molar teeth. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT04197531.
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Donnermeyer D, Schäfer E, Bürklein S. Real-time intracanal temperature measurement comparing mechanically and laser-activated irrigation to syringe irrigation. AUST ENDOD J 2020; 47:59-66. [PMID: 33159489 DOI: 10.1111/aej.12461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/06/2020] [Accepted: 10/21/2020] [Indexed: 11/28/2022]
Abstract
Antibacterial activity and tissue dilution of sodium hypochlorite (NaOCl) are improved by moderately heating the irrigant. Temperature can be risen by preheating or intracanal activation. To assess intracanal temperature development of NaOCl during irrigation activation and syringe activation (SI) in a closed system at 37°C, Type-K thermocouples were inserted close to the root canal of one human single-rooted maxillary canine at the apex and 5 and 10 mm from the apical foramen via drilled holes. The root was positioned in a plastic vial filled with alginate simulating surrounding biological structures. Experiments were performed in a closed environment at 37°C (n = 14): EA: EndoActivator (Dentsply Sirona), EDDY: EDDY (VDW), PUI: passive ultrasonic irrigation, PIPS: Photon-induced photoacoustic streaming (Fotona), S60: SI of 60°C-NaOCl, S45: SI of 45°C-NaOCl, and S20: SI of 20°C-NaOCl. S45, PUI and EDDY lead to minor intracanal temperature increases. EA and PIPS did not influence the intracanal temperature. SI with 60°C-NaOCl resulted in higher intracanal temperatures than activation systems. Temperature dissipation into simulated tissues buffered intracanal temperature changes.
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Affiliation(s)
- David Donnermeyer
- Department of Periodontology and Operative Dentistry, Westphalian Wilhelms-University, Münster, Germany
| | - Edgar Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, Münster, Germany
| | - Sebastian Bürklein
- Central Interdisciplinary Ambulance in the School of Dentistry, Münster, Germany
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Volponi A, Pelegrine RA, Kato AS, Stringheta CP, Lopes RT, Silva ASDS, Bueno CEDS. Micro-computed Tomographic Assessment of Supplementary Cleaning Techniques for Removing Bioceramic Sealer and Gutta-percha in Oval Canals. J Endod 2020; 46:1901-1906. [PMID: 32961214 DOI: 10.1016/j.joen.2020.09.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/25/2020] [Accepted: 09/14/2020] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The aim of this study was to conduct a micro-computed tomographic assessment of the effectiveness of 3 supplementary cleaning techniques in reducing the residual volume of gutta-percha and a bioceramic sealer after performing endodontic retreatment procedures in teeth with oval canals. METHODS Thirty-six mandibular premolars were instrumented with the ProTaper Next system (instruments X1-X3; Dentsply Maillefer, Ballaigues, Switzerland) and filled with gutta-percha and Bio-C Sealer (Angelus, Londrina, PR, Brazil) using the single-cone technique. The teeth were reinstrumented with the Reciproc R40 instrument (VDW, Munich, Germany) and divided into 3 groups according to the supplementary cleaning technique used (n = 12): ultrasonic-assisted irrigation (UAI), EndoActivator (Dentsply Tulsa Dental Specialties, Tulsa, OK) irrigation (EAI), or the XP-endo Finisher R system (XPR; FKG Dentaire, La Chaux-de-Fonds, Switzerland). Micro-computed tomographic imaging was used to quantify the residual volume of filling material. One-way analysis of variance complemented by the Tukey test was used to perform the statistical analysis (P < .05). RESULTS Significant reductions were obtained in the residual filling material after supplementary cleaning (P < .05). XPR (47.5%) led to significantly greater (P < .05) filling material removal than UAI (16.6%) or EAI (22.6%). The removal values of the 2 latter systems were not significantly different. CONCLUSIONS XPR was more effective than UAI and EAI in removing filling material in mandibular premolars with oval canals. None of the tested supplementary cleaning techniques completely removed the residual filling material.
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Affiliation(s)
- Andrea Volponi
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Rina Andréa Pelegrine
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Augusto Shoji Kato
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Carolina Pessoa Stringheta
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Endodontia, Campinas, São Paulo, Brazil
| | - Ricardo Tadeu Lopes
- Laboratory of Nuclear Instrumentation, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aline Saddock de Sá Silva
- Laboratory of Nuclear Instrumentation, Alberto Luiz Coimbra Institute for Graduate Studies and Research in Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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Gündoğar M, Sezgin GP, Kaplan SS, Özyürek H, Uslu G, Özyürek T. Postoperative pain after different irrigation activation techniques: a randomized, clinical trial. Odontology 2021; 109:385-92. [PMID: 32915346 DOI: 10.1007/s10266-020-00553-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/03/2020] [Indexed: 11/27/2022]
Abstract
The aim of this study was to assess the effectiveness of irrigation activation techniques on postoperative pain (PP) in mandibular premolar teeth with irreversible pulpitis after single-visit endodontic treatment. A total of 160 patients with symptomatic irreversible pulpitis were included in this prospective randomized clinical study. Four different activation methods were used in mandibular premolar teeth. In group 1, teeth were irrigated with side-port endodontic needles (NI) without any agitation; in groups 2 and 3, sonic activation was performed using EDDY and EndoActivator (EA), respectively; and in group 4, passive ultrasonic irrigation (PUI) was used. Patients' analgesic intake-as well as pain intensity during and after treatment-were recorded at 8, 24, 48 h and 7 days. The data relating to age, sex and analgesic intake was evaluated using the Chi-square test and the preoperative pain and PP intensity at different time intervals was evaluated with the Kruskal-Wallis test at a 5% significance level. Highest PP was recorded at 8 h, pain intensity decreased in all groups by the time. Pain in the NI group was found higher than that of EDDY group at 24 h (P < 0.05). EA and PUI had caused mild pain and had similar pain scores at 24 h. (P > 0.05). No statistically difference was found among the groups with regard to analgesic intake (P > 0.05). Although there were slight differences in PP levels between the groups at 24 h, pain levels decreased in all groups after 24 h. Activation of the irrigation solution did not make any difference in terms of PP after 24 h.
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Kumar S, Desai K, Palekar A, Biradar B, Chatterjee A, Kumari K. Comparison of the Efficacy of CanalBrush, EndoActivator, and Passive Ultrasonic Irrigation on the Removal of Triple Antibiotic Paste from Root Canal Walls: An In Vitro Study. J Int Soc Prev Community Dent 2020; 10:424-430. [PMID: 33042883 PMCID: PMC7523939 DOI: 10.4103/jispcd.jispcd_13_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/12/2020] [Indexed: 11/17/2022] Open
Abstract
Aim: The aim of this study was to compare the efficacy of CanalBrush (CB), EndoActivator (EA), and Passive Ultrasonic Irrigation (PUI) on the removal of triple antibiotic paste (TAP) from root canal walls. Materials and Methods: Thirty-six extracted human single-rooted teeth were prepared using ProTaper Universal rotary files (DentsplyMaillefer, Ballaigues, Switzerland) up to size F5. The root canals were filled with TAP, and after 21 days, roots were randomly assigned to three groups (n = 10) according to irrigation regimens used: CB, EA, and PUI. In three teeth, TAP was not removed (positive controls), and the other three teeth were not filled with TAP (negative controls). The roots were sectioned, and the amount of TAP remaining was evaluated at the mesial halves of each tooth at ×30 magnification under a stereomicroscope using a 4-grade scoring system. Data were evaluated using the Kruskal–Wallis and Mann–Whitney U tests. Results: There were significant differences among the experimental groups according to the different parts of the root canals (P < 0.05). At the apical and middle third, EA and PUI groups removed more TAP than CB group; however, there was a statistically significant difference only between CB and PUI groups (<0.01 at apical third and <0.05 at middle third). At the coronal third, there was no statistically significant difference between all the three groups (P > 0.05). Conclusion: PUI led to superior results compared to CB in the middle and apical thirds. There was no significant difference between EA and PUI techniques.
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Affiliation(s)
- Santosh Kumar
- Department of Conservative Dentistry and Endodontics, Patna Dental College & Hospital, Patna, Bihar, India
| | - Kavisha Desai
- Department of Conservative Dentistry and Endodontics, Rural Dental College, Pravara Institute of Medical Sciences (PIMS), Loni, Maharashtra, India
| | - Aparna Palekar
- Department of Conservative Dentistry and Endodontics, Rural Dental College, Pravara Institute of Medical Sciences (PIMS), Loni, Maharashtra, India
| | - Baswaraj Biradar
- Department of Conservative Dentistry and Endodontics, Rural Dental College, Pravara Institute of Medical Sciences (PIMS), Loni, Maharashtra, India
| | - Ananjan Chatterjee
- Department of Oral Pathology, Buddha Institute of Dental Sciences & Hospital, Patna, Bihar, India
| | - Khushboo Kumari
- Department of Oral Pathology, Buddha Institute of Dental Sciences & Hospital, Patna, Bihar, India
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Ferreira I, Babo PS, Braga AC, Gomes ME, Pina-Vaz I. Effect of Sonic Agitation of a Binary Mixture of Solvents on Filling Remnants Removal as an Alternative to Apical Enlargement-A Micro-CT Study. J Clin Med 2020; 9:E2465. [PMID: 32752148 PMCID: PMC7464987 DOI: 10.3390/jcm9082465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This work aimed to evaluate the efficacy of sonic agitation of a binary mixture of solvents (methyl ethyl ketone/tetrachloroethylene) on filling remnants removal and compare the effects of solvent agitation with the enlargement to the next instrument size. METHODS Twenty-four mandibular incisors were prepared with ProTaper Next (X1, X2) and obturated with the single-cone technique and AH Plus sealer. The teeth were retreated with ProTaper Universal Retreatment and ProTaper Next and divided into two groups (n = 12) according to the final instrument (X3 or X4). All canals were submitted to a supplementary procedure consisting of a mixture of solvents-methyl ethyl ketone/tetrachloroethylene, agitated with EndoActivator. The volume of filling remnants was assessed through micro-computed tomography in the apical 5 mm. Statistical analysis was performed with a significance level of 5%. RESULTS The supplementary procedure of agitation of the solvent mixture was beneficial in both groups (p < 0.05). There were no statistically significant differences between canals re-prepared until X4 and canals re-prepared until X3 plus solvent (p > 0.05). CONCLUSIONS An additional step with a two-solvent solution potentiated by EndoActivator showed to be very effective for the removal of gutta-percha and resinous sealer remnants from apical root canals of mandibular incisors, avoiding further enlargement.
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Affiliation(s)
- Inês Ferreira
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- CINTESIS, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
| | - Pedro S. Babo
- 3B’s Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017 Guimarães, Portugal; (P.S.B.); (M.E.G.)
- ICVS/3B’s – PT Government Associate Laboratory, 4805-017 Braga/Guimarães, Portugal
| | - Ana Cristina Braga
- Department of Production and Systems, ALGORITMI Center, University of Minho, Campus de Gualtar 4710-057 Braga, Portugal;
| | - Manuela E. Gomes
- 3B’s Research Group, I3Bs-Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805-017 Guimarães, Portugal; (P.S.B.); (M.E.G.)
- ICVS/3B’s – PT Government Associate Laboratory, 4805-017 Braga/Guimarães, Portugal
| | - Irene Pina-Vaz
- CINTESIS, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
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Susila A, Minu J. Activated Irrigation vs. Conventional non-activated Irrigation in Endodontics - A Systematic Review. Eur Endod J 2019; 4:96-110. [PMID: 32161895 DOI: 10.14744/eej.2019.80774] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 09/17/2019] [Indexed: 11/20/2022] Open
Abstract
Objective: Irrigant activation has been claimed to be beneficial in in vitro and clinical studies. This systematic review aims to investigate the clinical efficiency of mechanically activated irrigants and conventional irrigation. Methods: A literature search (PROSPERO registration number: CRD42018112595) was undertaken in PubMed, Cochrane and hand search. The inclusion criteria were clinical trials, in vivo/ex vivo on adult permanent teeth involving an active irrigation device and a control group of conventional irrigation. The exclusion criteria were studies done in vitro, animals and foreign language. Adult patients requiring endodontic treatment of permanent dentition and irrigant activation during the treatment were chosen as the participants and intervention respectively. Results: After removal of duplicates, 89 articles were obtained, and 72 were excluded as they did not meet the selection criteria. 6 devices (EndoVac, EndoActivator, Ultrasonic, MDA (manual dynamic agitation), CUI (Continuous Ultrasonic Irrigation) and PUI (Passive Ultrasonic Irrigation)) and 6 variables of interest (Post-operative pain, periapical healing, antibacterial efficacy, canal and/or isthmus cleanliness, debridement efficacy and delivery up to working length) were evaluated in the 17 included articles. The risk of bias and quality of the selected articles were moderate. Results showed that mechanical active irrigation reduces post-operative pain. It improved debridement, canal/isthmus cleanliness. It also improved delivery of irrigant up to working length. Bacterial count was more with active irrigation, though not significant. There is no effect on long-term periapical healing. Conclusion: It may be concluded that mechanical active irrigation devices are beneficial in reducing post-operative pain and improving canal and isthmus cleanliness during Endodontics.
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Jasrotia A, Bhagat K, Bhagat N, Bhagat RK. Comparison of Five Different Irrigation Techniques on Smear Layer Removal in Apical Thirds of Root Canals of Mandibular First Premolar: A Scanning Electron Microscopic Study. J Int Soc Prev Community Dent 2020; 9:630-636. [PMID: 32039084 PMCID: PMC6905312 DOI: 10.4103/jispcd.jispcd_267_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 09/19/2019] [Indexed: 11/28/2022] Open
Abstract
Aim: This study was conducted to compare smear layer removal by five different irrigation techniques—conventional needle irrigation (CI), manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), sonic irrigation (SI), and negative apical pressure (NAP). Materials and Methods: Fifty freshly extracted mandibular first premolars were cleaned and shaped by One Curve rotary files and 3% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. The samples were divided into five equal groups (n = 10), according to the final irrigation activation technique: Group I, CI; Group II, MDA; Group III, PUI; Group IV, SI; and Group V, NAP. The samples were prepared and observed under a scanning electron microscope. The photomicrographs were recorded and evaluated with a scoring system. Results: Group I and Group II had the highest scores, which showed a statistically significant difference between the other groups (P < 0.05). This was followed by PUI, NAP, and SI. Conclusion: Final irrigation activation with SI and NAP resulted in the better removal of smear layer when compared to that with other groups.
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Affiliation(s)
- Ankush Jasrotia
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Government Dental College and Hospital, Jammu, Jammu and Kashmir, India
| | - Kanchan Bhagat
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Government Dental College and Hospital, Jammu, Jammu and Kashmir, India
| | - Neeru Bhagat
- MDS in Orthodontics, Private Practioner, Jammu, India
| | - Ravinder K Bhagat
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Government Dental College and Hospital, Jammu, Jammu and Kashmir, India
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Pedullà E, Genovese C, Messina R, La Rosa GRM, Corsentino G, Rapisarda S, Arias-Moliz MT, Tempera G, Grandini S. Antimicrobial efficacy of cordless sonic or ultrasonic devices on Enterococcus faecalis-infected root canals. ACTA ACUST UNITED AC 2019; 10:e12434. [PMID: 31294531 DOI: 10.1111/jicd.12434] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 05/04/2019] [Accepted: 05/25/2019] [Indexed: 11/28/2022]
Abstract
AIM The aim of the present study was to evaluate the immediate and residual antimicrobial activity of cordless sonic or ultrasonic devices on Enterococcus faecalis (E faecalis)-infected teeth. METHODS A total of 140 single-rooted extracted teeth with E faecalis were grouped as follows (N = 15): conventional syringe irrigation with 3% sodium hypochlorite activated by ultrasonic device (group 1) or cordless ultrasonic device (group 2), EndoActivator (group 3) or without activation (group 4), conventional syringe irrigation with sterile bi-distilled water and ultrasonic device (group 5), EndoUltra (group 6), EndoActivator (group 7), or without activation (group 8). The remaining 20 teeth were used for positive and negative controls. Colony-forming units (CFU) and turbidity were recorded from bacteriological samples taken before and after irrigation and after 24 hours of re-incubation. Data were statistically analyzed using Student's t test, Mann-Whitney test, Kruskal-Wallis test, and Dunn's multiple comparison tests (P < .05). RESULTS Groups 1 and 2 showed higher antimicrobial efficacy than groups 3 and 4 (P < .05). No bacteria reduction was found in groups 5-8 (P > .05). After 24 hours, regrowth of bacteria was not significantly different for all groups (P > .05). CONCLUSIONS Ultrasound produced lower CFU and turbidity after treatment and after re-incubation of 24 hours than sonic or no activation.
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Affiliation(s)
- Eugenio Pedullà
- Department of General Surgery and Medical - Surgical Specialties, University of Catania, Italy
| | - Carlo Genovese
- Department of Biomedical Sciences, University of Catania, Italy
| | - Riccardo Messina
- Department of General Surgery and Medical - Surgical Specialties, University of Catania, Italy
| | - Giusy R M La Rosa
- Department of General Surgery and Medical - Surgical Specialties, University of Catania, Italy
| | - Giacomo Corsentino
- Department of Endodontics and Restorative Dentistry, University of Siena, Siena, Italy
| | - Silvia Rapisarda
- Department of General Surgery and Medical - Surgical Specialties, University of Catania, Italy
| | - Maria T Arias-Moliz
- Departamento de Microbiología de la Universidad de Granada, Universidad de Granada, Granada, Spain
| | - Gianna Tempera
- Department of Biomedical Sciences, University of Catania, Italy
| | - Simone Grandini
- Department of Endodontics and Restorative Dentistry, University of Siena, Siena, Italy
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Al-Obaida MI, Moukaddem R, Allahem Z, AbdulWahed A, AlOnaizan FA, Al-Madi EM. Comparison of bacterial removal from dentinal tubules with different irrigant agitation techniques: An in vitro study. Saudi Dent J 2019; 31:431-6. [PMID: 31695293 DOI: 10.1016/j.sdentj.2019.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/05/2019] [Accepted: 05/06/2019] [Indexed: 11/20/2022] Open
Abstract
Aim This investigation was conducted to assess the ability of various irrigant agitation devices to eradicate Enterococcus faecalis from the dentinal tubules of extracted teeth. Methodology Fifty roots of extracted human teeth were instrumented to size 30 k with a 0.04 taper. The roots were autoclaved and then injected with E. faecalis. The canals were assigned to one of four intervention groups and disinfected using (A) standard needle irrigation, (B) EndoUltra® Ultrasonic Activator, (C) the EndoActivator system, or (D) EDDY sonic activation and to two control groups that were (E) treated with saline and (F) not inoculated with any bacteria. The roots were split in half, dyed with a LIVE/DEAD Back Light Bacterial Viability Kit, and then scanned with a confocal laser scanning microscope (CLSM) to identify live/dead bacteria in the dentinal tubules. Results CLSM images revealed differences among the groups. Both the EndoUltra® Ultrasonic Activator group and the EDDY group had a combination of dead and live bacteria, while the EndoActivator group had mostly dead bacteria, in contrast to single needle irrigation which had mostly live bacteria. Activation of the irrigating solution resulted in more dead bacteria than standard needle irrigation at the coronal, middle, and apical parts of the roots. Overall, the EndoActivator system was superior to all other techniques in reducing live bacteria within the root canal. Conclusion Activation of sodium hypochlorite with sonic and ultrasonic systems dramatically reduced live bacteria contamination in the dentinal tubules of infected root canals.
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Haupt F, Meinel M, Gunawardana A, Hülsmann M. Effectiveness of different activated irrigation techniques on debris and smear layer removal from curved root canals: a SEM evaluation. AUST ENDOD J 2019; 46:40-46. [PMID: 30907051 DOI: 10.1111/aej.12342] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2019] [Indexed: 02/01/2023]
Abstract
This study evaluates the effectiveness of different activated irrigation techniques on removal of debris and smear layer from curved root canals. Ninety mandibular molars with a root canal curvature between 20 and 40 degrees were assigned to 4 groups (n = 20): syringe irrigation (SI), passive ultrasonic activation (PUI), sonic activation with EDDY (ED) or EndoActivator (EA) and a control group. Mesiobuccal root canals were prepared to size 40, 0.04 and irrigated with NaOCl (3%) according to the respective technique. Roots were split longitudinally and subjected to scanning electron microscopic analysis. Presence of debris and smear layer was evaluated using 5-grade scoring systems with 200× and 1000× magnification, respectively. Data were analysed with nonparametric analysis for ordinal longitudinal data (α = 5%). Activation of the irrigant significantly improved smear layer removal (P < 0.05). Regarding debris, only activation with EA and ED was significantly more effective than SI (P < 0.05). No activation technique was able to eliminate debris and smear layer completely from curved root canals.
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Affiliation(s)
- Franziska Haupt
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Michael Meinel
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Asanka Gunawardana
- Department of Mathematical Sciences, University of Texas at Dallas, Richardson, TX, USA
| | - Michael Hülsmann
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
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Yılmaz K, Tüfenkçi P, Adıgüzel M. The effects of QMix and EndoActivator on postoperative pain in mandibular molars with nonvital pulps: a randomized clinical trial. Clin Oral Investig 2019; 23:4173-80. [PMID: 30815731 DOI: 10.1007/s00784-019-02856-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 02/13/2019] [Indexed: 12/27/2022]
Abstract
AIM The purpose of this study was to compare the effects of different irrigation solutions when used EndoActivator on postoperative pain. METHODOLOGY A total of 104 subjects with nonvital pulps were selected and randomly assigned to four experimental groups; (G) 1 (n = 26) 2.5% NaOCl + conventional endodontic syringe, (G) 2 (n = 26) 2.5% NaOCl + EndoActivator, (G) 3 (n = 26) 2.5% NaOCl + QMix + conventional endodontic syringe, (G) 4 (n = 26) 2.5% NaOCl + QMix + EndoActivator. All the patients were prescribed ibuprofen 400 mg to be taken every 8 h in case of pain. The patients were asked to rate the severity of the postoperative pain on a visual analog scale (VAS) for 8th, 24th, 48th, and 72nd hours after the visit. The data were analyzed using Kruskal-Wallis, Mann-Whitney U, and Chi-Square tests. RESULTS G4 resulted in lesser postoperative pain levels on 8th, 24th, 48th, and 72nd hours than the G2, G3, and G1 did. There was no significant difference between G4 and G2 and between G3 and G1 in terms of the postoperative pain levels at any time interval (P > 0.05). CONCLUSION It was determined that the postoperative values of the groups, in which EA was used, were statistically significantly lower than in the other groups. The combined use of QMix and EA provided the most significant decrease in the postoperative pain values. CLINICAL RELEVANCE Successful management of postoperative pain is an important issue for the clinician. The combined use of Qmix and EA can be recommended to the clinicians.
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Akbulut MB, Unverdi Eldeniz A. In vitro antimicrobial activity of different electrochemically-activated solutions on enterococcus faecalis. Eur Oral Res 2019; 53:44-50. [PMID: 31309192 PMCID: PMC6612761 DOI: 10.26650/eor.20194564125648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 06/11/2018] [Accepted: 07/14/2018] [Indexed: 01/04/2023] Open
Abstract
Purpose The aim of this in vitro study was to assess and compare the antimicrobial efficacy of different electrochemically-activated solutions (ECA) and contemporary irrigants, in root canals infected with Enterococcus faecalis, used with or without EndoActivator (EA). Materials and methods A hundred single-rooted human teeth were prepared. Ninety of the root segments were infected with E. faecalis for four weeks, and divided into eight test groups (n = 10) (four with and four without EA sonication) and a positive control (n = 10). The irrigants tested were electrochemically-activated solutions produced by the Medilox® (ECA-MX) and Envirolyte® devices (ECA-EN), 2% CHX and 2.5% NaOCl. The root specimens were irrigated with 5 mL of the test solution, with additional sonic agitation applied to the EA groups. The dentine samples that were obtained from the walls were cultured, and the antibacterial efficacy was evaluated by counting the colony-forming units. Results The ECA-EN, 2.5% NaOCl and 2% CHX were more effective than the ECA-MX (p<0.05) with the addition of EA sonication, showing no statistical difference in the elimination of E. faecalis. Conclusion The ECA-EN shows potential as an endodontic irrigant, while EA usage gives no benefit in reducing bacteria from root canals.
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Affiliation(s)
- Makbule Bilge Akbulut
- Department of Endodontics, Faculty of Dentistry, Necmettin Erbakan University Turkey
| | - Ayca Unverdi Eldeniz
- Department of Endodontics, Faculty of Dentistry, Necmettin Erbakan University Turkey
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Chawla A, Kumar V. Evaluating the efficacy of different techniques and irrigation solutions for removal of calcium hydroxide from the root canal system: A scanning electron microscope study. J Conserv Dent 2018; 21:394-400. [PMID: 30122820 PMCID: PMC6080173 DOI: 10.4103/jcd.jcd_246_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aim: The aim of this scanning electron microscope study was to compare the efficacy of two techniques (EndoVac and EndoActivator) and two irrigating solutions (5.25% NaOCl in combination with 17% ethylenediaminetetraacetic acid vs. Savlon™) for removal of calcium hydroxide (CH) from the root canal walls. Settings and Design: The study was carried out in the specialty of conservative dentistry and endodontics. Materials and Methods: Forty single-canal human teeth were used. The specimens were de-coronated to obtain a standardized root length of 15 mm using a diamond disk. The canals were instrumented till F3 ProTaper and CH intracanal medicament placed in the root canal. One week later, teeth were randomly divided into one control group and six experimental groups according to different irrigation protocols with different techniques. Statistical Analysis: Kruskal–Wallis test was conducted to analyze the effect of different treatment measures with respect to three regions of tooth. Results: The results indicated that there was no statistically significant difference between the two irrigation solutions and two techniques. Conclusion: To achieve the best adaptation of filling material after root canal treatment, it is crucial to remove intracanal medication from the root canal walls. However, none of the irrigation regimens and different techniques were able to completely remove the CH from the root canal wall.
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Affiliation(s)
- Amrita Chawla
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Kumar
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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Bharti R, Tikku AP, Chandra A, Shakya VK, Yadav S. Depth and percentage of resin-based sealer penetration inside the dentinal tubules using EndoVac, EndoActivator, Navi tip FX irrigation system: A confocal laser scanning microscope study. J Conserv Dent 2018; 21:216-220. [PMID: 29674828 PMCID: PMC5890416 DOI: 10.4103/jcd.jcd_222_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Aim: This in vitro study was conducted to evaluate the effect of EndoVac, EndoActivator, and Navy Tip FX irrigation system on lateral depth and percentage of sealer penetration into the dentinal tubules using confocal laser scanning microscope. Materials and Methods: Forty recently extracted single-rooted mandibular premolars were taken and root canal treatment was performed using three different irrigation system, that is, EndoVac, EndoActivator, and Navi tip FX. The samples were divided into 4 groups according to the irrigation system used: Control or conventional needle (Group I), Navi Tip FX (Group II), EndoActivator (Group III), and EndoVac (Group IV). All teeth were obturated using AH Plus sealer labeled with fluorescent rhodamine B dye. The teeth were sectioned at coronal (5 mm), middle (3 mm), and apical 3rd (1 mm) from the apex. Total percentage and maximum depth of sealer penetration were measured using confocal laser scanning microscopy. The data were evaluated statistically using Kruskal–Wallis test with a 95% confidence level (P = 0.01). Results: EndoVac resulted in more sealer penetration then EndoActivator and Navi Tip FX irrigation system. Endoactivator resulted in more sealer penetration in comparison to Navi Tip FX. Conclusion: Percentage and depth of sealer penetration were more at apical and middle 3rd with Endovac system followed by Endoactivator and Navi tip FX system.
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Affiliation(s)
- Ramesh Bharti
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Aseem Prakash Tikku
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anil Chandra
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Vijay Kumar Shakya
- Department of Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Simith Yadav
- Department of Conservative Dentistry and Endodontics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Genc Sen O, Kaya M. Comparative Safety of Needle, EndoActivator, and Laser-Activated Irrigation in Overinstrumented Root Canals. Photomed Laser Surg 2017; 36:198-202. [PMID: 29265956 DOI: 10.1089/pho.2017.4380] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To evaluate the safety of sodium hypochlorite (NaOCl) irrigation using three different techniques during the final rinse in overinstrumented root canals. BACKGROUND DATA The effect of irrigant activation on irrigant extrusion from overinstrumented root canals is still unclear. METHODS A total of 30 single-rooted teeth were decoronated. The working lengths were determined and the roots were divided into two groups of 15 teeth each: group 1, instrumentation 0.5 mm short of the apical foramen and group 2, instrumentation 0.5 mm beyond the apical foramen (overinstrumented). Needle irrigation (NI), sonic irrigation with EndoActivator (EAI), and laser-activated irrigation (LAI) were used for the final rinse in each group; each root underwent the three irrigation procedures in a randomized crossover manner. A modified container-foam model was used to collect apically extruded NaOCl. The weight of the extruded NaOCl was calculated by subtracting the initial weights of the containers from their final weights. All data were statistically analyzed. RESULTS The amount of NaOCl extrusion was similar with all three irrigation systems in group 1. In group 2, the amount of extruded NaOCl was significantly greater with EAI than with NI and LAI. EAI and LAI caused significantly greater extrusion in group 2 than in group 1. CONCLUSIONS EAI, NI, and LAI are equally safe for irrigating canals with intact apices. However, the risk of irrigant extrusion can increase in overinstrumented canals, with EAI associated with a greater risk compared with NI and LAI.
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Affiliation(s)
- Ozgur Genc Sen
- Department of Endodontics, Faculty of Dentistry, Yuzuncu Yil University , Van, Turkey
| | - Melih Kaya
- Department of Endodontics, Faculty of Dentistry, Yuzuncu Yil University , Van, Turkey
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Agarwal A, Deore RB, Rudagi K, Nanda Z, Baig MO, Fareez MA. Evaluation of Apical Vapor Lock Formation and comparative Evaluation of its Elimination using Three different Techniques: An in vitro Study. J Contemp Dent Pract 2017; 18:790-794. [PMID: 28874643 DOI: 10.5005/jp-journals-10024-2128] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of this study was (i) to evaluate the formation of air bubbles in the apical region of root canal (apical vapor lock) during syringe irrigation, using cone beam computed tomography (CBCT) and (ii) comparative evaluation of the elimination of an established vapor lock by EndoActivator, ultrasonics, and manual dynamic agitation (MDA), using CBCT. MATERIALS AND METHODS A total of 60 extracted human single-rooted teeth were equally divided into three groups of 20 teeth each. The samples were decoronated 17 mm from the apex, cleaned, and shaped to size F4 Protaper using 3% sodium hypochlorite. Samples were irrigated with 3% sodium hypochlorite + cesium chloride radiopaque dye, and preoperative CBCT images were obtained. After formation of apical vapor lock in the scanned teeth, EndoActivator (group I), passive ultrasonic irrigation (group II), and MDA with K-file (group III) were performed and the teeth were again placed in CBCT scanner and results analyzed using the chi-square test. RESULTS The apical vapor lock was formed in all the samples. Out of the 20 teeth in each group, the apical vapor lock was eliminated in 18 samples of EndoActivator group (90%), 16 samples of ultrasonic group (80%), while it was eliminated in 10 samples by MDA (50%). CONCLUSION It is concluded that (1) apical vapor lock is consistently formed during endodontic irrigation in closed canal systems and (2) sonic activation performs better than the ultrasonics and MDA in eliminating the apical vapor lock, with statistically significant difference between all the three groups (p < 0.05). CLINICAL SIGNIFICANCE The results suggest that the apical vapor lock (dead water zone) is consistently formed during routine endodontic irrigation which impedes irrigant penetration till the working length, thereby leading to inefficient debridement. Hence, to eliminate this vapor lock, techniques, such as sonics or ultrasonics should be used along with the irrigant after shaping and cleaning of the root canal.
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Affiliation(s)
- Anand Agarwal
- Department of Conservative Dentistry and Endodontics A.C.P.M. Dental College, Dhule, Maharashtra, India
| | - Rahul B Deore
- Department of Conservative Dentistry and Endodontics A.C.P.M. Dental College, Dhule, Maharashtra, India
| | - Kavitarani Rudagi
- Department of Conservative Dentistry and Endodontics A.C.P.M. Dental College, Dhule, Maharashtra, India, Phone: +919673390777, e-mail:
| | - Zinnie Nanda
- Department of Conservative Dentistry and Endodontics A.C.P.M. Dental College, Dhule, Maharashtra, India
| | - Mirza Osman Baig
- Department of Conservative Dentistry and Endodontics, HKE Society's SN Dental College, Gulbarga, Bengaluru, Karnataka India
| | - Md Adil Fareez
- Department of Conservative Dentistry and Endodontics, HKE Society's SN Dental College, Gulbarga, Bengaluru, Karnataka India
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Mancini M, Cerroni L, Iorio L, Dall'Asta L, Cianconi L. FESEM evaluation of smear layer removal using different irrigant activation methods (EndoActivator, EndoVac, PUI and LAI). An in vitro study. Clin Oral Investig 2017; 22:993-999. [PMID: 28721527 DOI: 10.1007/s00784-017-2179-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 07/10/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study was to compare the efficacy of EndoActivator, EndoVac, PUI, and LAI methods in removing the smear layer from root canals. MATERIALS AND METHODS Eighty single-rooted mandibular premolars were decoronated to a standardized length of 15 mm. Specimens were shaped to ProTaper F4 (Dentsply Maillefer) and irrigated with 5.25% NaOCl at 37 °C. Teeth were divided into six groups (two control groups [n = 10] and four test groups [n = 15]) according to the final irrigation activation/delivering technique (sonic irrigation [EndoActivator], passive ultrasonic irrigation [PUI], negative apical pressure [EndoVac], and laser activated irrigation [LAI]). Root canals were then split longitudinally and observed with field emission scanning electron microscopy to evaluate the presence of smear layer at 1, 3, 5, and 8 mm from the apex. Scores were analyzed by Kruskal-Wallis and Mann-Whitney U tests. RESULTS The EndoActivator was significantly more efficient than PUI, LAI, and control groups in removing the smear layer at 3, 5, and 8 mm from the apex. The EndoVac System removed statistically significantly more smear layer than all groups at 1 mm from the apex. At 5 mm from the apex, EndoActivator and EndoVac removed more smear layer than LAI and control groups. At 5 and 8 mm from the apex, PUI and EndoVac did not differ statistically, but both performed statistically better than the control groups. CONCLUSION In our study, none of the activation/delivery systems completely removed the smear layer from the root canal walls; nevertheless, EV and EA showed, respectively, statistically significant better results at 1, 3, 5, and 8 mm and 3, 5, and 8 mm from the apex.
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Affiliation(s)
- Manuele Mancini
- Department of Translational Medicine and Clinical Science, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy.
| | - Loredana Cerroni
- Department of Translational Medicine and Clinical Science, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy
| | - Lorenzo Iorio
- Department of Translational Medicine and Clinical Science, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy
| | - Lorenzo Dall'Asta
- Department of Translational Medicine and Clinical Science, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy
| | - Luigi Cianconi
- Department of Translational Medicine and Clinical Science, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy
- Restorative Dentistry and Endodontics, University of Rome "Tor Vergata", Rome, Italy
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Pabel AK, Hülsmann M. Comparison of different techniques for removal of calcium hydroxide from straight root canals: an in vitro study. Odontology 2017; 105:453-9. [PMID: 28299554 DOI: 10.1007/s10266-017-0293-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 12/29/2016] [Indexed: 10/20/2022]
Abstract
To compare four different techniques for removal of calcium hydroxide from straight root canals. The present study used the design suggested by Lee et al. (Int Endod J 37:607-612, 32) and van der Sluis et al. (Int Endod J 40:52-57, 17). One-hundred and ten extracted human teeth with straight root canals were prepared to ISO-size 50 and split longitudinally. Two lateral grooves were prepared, filled with calcium hydroxide and the root halves reassembled in a muffle. Calcium hydroxide was removed using one of five techniques: (1) passive ultrasonic irrigation, (2) hydrodynamic irrigation using RinsEndo®, (3) sonic irrigation using the EndoActivator®, (4) motor-driven plastic brush (CanalBrush™), and (5) manual irrigation with a syringe as the control group. Distilled water was used as irrigant. Cleanliness of the grooves was scored under a microscope with 40× magnification. For intraindividual reproducibility and interrater agreement, Cohens Kappa was calculated. Results of scoring were analyzed using a non-parametric test. Post hoc pairwise comparisons were used for irrigation techniques (α = 0.05). Passive ultrasonic irrigation performed significantly better than all other groups in the apical groove. Significant differences were found between RinsEndo and CanalBrush (P = 0.01855) and CanalBrush and syringe irrigation (P = 0.00021). In the coronal groove, passive ultrasonic irrigation performed significantly superior and hand irrigation performed significantly worse than all other groups. A statistically significant interaction was shown between irrigation technique and localization of the groove (P = 0.01358). The coronal grooves showed more remaining calcium hydroxide than the apical grooves. Complete removal of calcium hydroxide from the root canal could not be achieved with any of the techniques investigated. The highest degree of cleanliness resulted from the use of passive ultrasonic irrigation.
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Guneser MB, Dincer AN, Arslan D. Comparison of Conventional Syringe, CanalBrush, EndoActivator, Photon-Induced Photoacoustic Streaming, and Manual Instrumentation in Removing Orange-Brown Precipitate: An In Vitro Study. Photomed Laser Surg 2017; 35:311-316. [PMID: 28186862 DOI: 10.1089/pho.2016.4248] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this in vitro study was to compare the various techniques for removing precipitate formed after irrigation with sodium hypochlorite (NaOCl) and chlorhexidine (CHX). BACKGROUND DATA It is still unclear whether different irrigant activation systems can effectively remove precipitate that is firmly attached to the root canal walls. METHODS Eighty-two extracted single-rooted human teeth were instrumented by using the ProTaper rotary system. The roots were irrigated with 5% NaOCl and then 2% CHX to form orange-brown precipitate on the root canal walls. The teeth were sectioned longitudinally, and the amount of precipitate on the canal walls was measured under a stereomicroscope at 15 × magnification before the root halves were reassembled. Then, conventional syringe irrigation (CSI), CanalBrush (CB), EndoActivator (EA) system, photon-induced photoacoustic streaming (PIPS), and manual instrumentation (MI) techniques were used to remove the precipitate, during which 5 mL of distilled water was used for 1 min. The amount of precipitate remaining on the canal walls was measured, and the percentage of precipitate removed was calculated. Data were analyzed by using the Kruskal-Wallis and Mann-Whitney U tests (p = 0.05). RESULTS All experimental groups contained residual precipitate. The precipitate was more effectively removed in the MI group than in the other groups (p < 0.05). The CB and EA groups showed better removal than the CSI and PIPS groups (p < 0.05), and there were no significant differences in removal between these latter two groups (p > 0.05). CONCLUSIONS None of the techniques used was able to completely remove the orange-brown precipitate from the root canal surfaces.
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Affiliation(s)
- Mehmet Burak Guneser
- Department of Endodontics, Faculty of Dentistry, Bezmialem Vakif University , Istanbul, Turkey
| | - Asiye Nur Dincer
- Department of Endodontics, Faculty of Dentistry, Bezmialem Vakif University , Istanbul, Turkey
| | - Dilara Arslan
- Department of Endodontics, Faculty of Dentistry, Bezmialem Vakif University , Istanbul, Turkey
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Kumar P, de Ataide IDN, Fernandes M, Lambor R. A cone-beam computed tomography assessment of the efficacy of different irrigation devices for removal of silicone oil-based calcium hydroxide from root canal system. J Conserv Dent 2017; 20:68-71. [PMID: 28855749 PMCID: PMC5564246 DOI: 10.4103/0972-0707.212245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Most often used intracanal medicament is calcium hydroxide (Ca(OH)2). Removal of Ca(OH)2 before obturation is mandatory. Different irrigation solutions and devices were tested in the previous study for this purpose. AIM The aim of this study was to evaluate the comparative efficacy of different irrigation techniques in removing intracanal medicament using cone-beam computed tomography (CBCT). MATERIALS AND METHODS Cleaning and shaping was carried out in 42 freshly extracted single-rooted mandibular first premolars using Protaper Rotary Files. Intracanal medicament (silicone oil-based Ca(OH)2 paste) was placed and left for 2 weeks in the root canal. Medicament was then removed by five different irrigation techniques: EndoActivator, EndoVac, ultrasonic irrigation with Endo-U-File, F-file, and Max-i-Probe needle. Changes in volume percentage were measured using CBCT and results were statistically analyzed using Levene's statistics and ANOVA. RESULTS Remnants of Ca(OH)2 were found in all experimental groups. No significant difference was detected among the groups. F-file showed maximum removal efficacy of approximately 48%. CONCLUSION (1) There is no statistically significant difference between any irrigation technique for removal of oil-based Ca(OH)2. (2) F-file demonstrated better results among all the other systems.
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Affiliation(s)
- Pradeep Kumar
- Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Ida de Noronha de Ataide
- Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Marina Fernandes
- Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Rajan Lambor
- Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital, Bambolim, Goa, India
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Özyürek T, Demiryürek EÖ. Comparison of the Effectiveness of Different Techniques for Supportive Removal of Root Canal Filling Material. Eur Endod J 2016; 1:1-6. [PMID: 32566900 PMCID: PMC7299057 DOI: 10.5152/eej.2016.16002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/12/2016] [Accepted: 11/04/2016] [Indexed: 11/22/2022] Open
Abstract
Objective: To compare the cleanliness of oval cross-sectioned root canals after using different supportive techniques for removal of root canal filling material as part of retreatment process. Methods: One hundred mandibular canine teeth with flat oval cross-sectioned canals were instrumented up to #40.06 and obturated using the warm vertical compaction technique. Removal of the gutta-percha and sealer was performed using the D-RaCe nickel-titanium retreatment instruments. The roots were randomly divided into four groups of 25 teeth, and the activation processes were applied: XP-endo Finisher (XP), EndoActivator (EA) and IrrıSafe (IS). Conventional needle irrigation (CI) was used as the control group. The teeth were sectioned, and digital images were captured. The photographs were analysed using AutoCAD software regarding the area of residual root filling. Kruskal–Wallis and post hoc Dunn’s tests were performed for statistical analysis. Results: There was significantly less gutta-percha and sealer remnant in the XP group than in the other groups (P<0.05). The CI group contained significantly more gutta-percha and sealer remnant than the other groups (P<0.05). The apical third of the CI group had significantly more residual gutta-percha and sealer when compared to that of the other groups (P<0.05). Conclusion: Within the limitations of this study, the amount of gutta-percha and sealer in the XP group was lower than that in the EA, IS, and CI groups.
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Affiliation(s)
- Taha Özyürek
- Department of Endodontics, Ondokuz Mayis University, Faculty of Dentistry, Samsun, Turkey
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Khalap ND, Kokate S, Hegde V. Ultrasonic versus sonic activation of the final irrigant in root canals instrumented with rotary/reciprocating files: An in-vitro scanning electron microscopy analysis. J Conserv Dent 2016; 19:368-72. [PMID: 27563189 PMCID: PMC4979287 DOI: 10.4103/0972-0707.186451] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Aim: To compare the smear layer and debris removal in root canals instrumented with two different kinematic motions after ultrasonic and sonic irrigation activation. Materials and Methods: Eighty freshly extracted teeth were selected for the study and randomly divided the samples into two groups (n = 40) for instrumentation with either rotary ProTaper NEXT (PTN) or reciprocating WaveOne (WO) file systems. These (n = 40) were further divided into two groups (n = 20) where the final irrigant was activated using either Ultrasonics (Passive Ultrasonic Irrigation; PUI) or Sonics (EndoActivator; EA). Group 1: PTN + EA; Group 2: PTN + PUI; Group 3: WO + EA; and Group 4: WO + PUI. During instrumentation, a total of 4 ml of 5.25% NaOCl was used for irrigation. The final irrigation protocol included NaOCl and Smear Clear Solution. The samples were processed by scanning electron microscopic examination for debris and smear layer scoring, and statistical analysis was done. Results: The mean debris and smear layer score was less in the group instrumented by PTN with sonic activation of the irrigant. Conclusion: A combination of PTN instrumentation with sonic irrigation activation by EA is more effective in debris and smear layer removal in the groups tested.
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Affiliation(s)
- Neha Deepak Khalap
- Department of Conservative Dentistry and Endodontics, YMT Dental College and Hospital, Kharghar, Navi Mumbai, Maharashtra, India
| | - Sharad Kokate
- Department of Conservative Dentistry and Endodontics, YMT Dental College and Hospital, Kharghar, Navi Mumbai, Maharashtra, India
| | - Vibha Hegde
- Department of Conservative Dentistry and Endodontics, YMT Dental College and Hospital, Kharghar, Navi Mumbai, Maharashtra, India
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Elnaghy AM, Mandorah A, Elsaka SE. Effectiveness of XP-endo Finisher, EndoActivator, and File agitation on debris and smear layer removal in curved root canals: a comparative study. Odontology 2016; 105:178-183. [PMID: 27206916 DOI: 10.1007/s10266-016-0251-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 04/27/2016] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to assess the efficacy of the XP-endo Finisher (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) file on debris and smear layer removal in curved root canals in comparison to different irrigation regimens. Seventy-five freshly extracted human mandibular molar teeth with mesial root curved more than 20° were used in this study. The mesial root canals were mechanically prepared using the BT-Race rotary system (FKG Dentaire) and divided into five groups (n = 15) according to the following irrigation techniques: positive control, non-agitated, File agitation, XP-endo Finisher, and EndoActivator (Dentsply Tulsa Dental Specialities, Tulsa, OK, USA). Root canals were split longitudinally and evaluated by scanning electron microscopy. Five-grade scoring system was used to assess the presence of debris and smear layer at the coronal, middle, and apical regions. The XP-endo Finisher and EndoActivator groups revealed significantly lower debris and smear layer scores than the other groups at the coronal, middle, and apical regions (P < 0.05). There was no significant difference between XP-endo Finisher and EndoActivator groups (P > 0.05). The apical region had higher debris and smear layer scores compared with the coronal regions in all groups (P < 0.05), except for the positive control group; there was no significant difference between the three regions of the root canal (P > 0.05). Irrigation of curved root canals using XP-endo Finisher and EndoActivator methods appears to be more effective on debris and smear layer removal than the other tested groups.
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Affiliation(s)
- Amr M Elnaghy
- Department of Endodontics, Faculty of Dentistry, Mansoura University, Mansoura, 35516, Egypt.
| | - Ayman Mandorah
- Dental Department, King Faisal Hospital, Makkah, Saudi Arabia
| | - Shaymaa E Elsaka
- Department of Dental Biomaterials, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Azim AA, Aksel H, Zhuang T, Mashtare T, Babu JP, Huang GTJ. Efficacy of 4 Irrigation Protocols in Killing Bacteria Colonized in Dentinal Tubules Examined by a Novel Confocal Laser Scanning Microscope Analysis. J Endod 2016; 42:928-34. [PMID: 27130334 DOI: 10.1016/j.joen.2016.03.009] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 03/10/2016] [Accepted: 03/11/2016] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The aim of this study was to determine the efficiency of 4 irrigation systems in eliminating bacteria in root canals, particularly in dentinal tubules. METHODS Roots of human teeth were prepared to 25/04, autoclaved, and inoculated with Enterococcus faecalis for 3 weeks. Canals were then disinfected by (1) standard needle irrigation, (2) sonically agitating with EndoActivator, (3) XP Endo finisher, or (4) erbium:yttrium aluminum garnet laser (PIPS) (15 roots/group). The bacterial reduction in the canal was determined by MTT assays. For measuring live versus dead bacteria in the dentinal tubules (4 teeth/group), teeth were split open and stained with LIVE/DEAD BackLight. Coronal, middle, and apical thirds of the canal dentin were scanned by using a confocal laser scanning microscope (CLSM) to determine the ratio of dead/total bacteria in the dentinal tubules at various depths. RESULTS All 4 irrigation protocols significantly eliminated bacteria in the canal, ranging from 89.6% to 98.2% reduction (P < .001). XP Endo had the greatest bacterial reduction compared with other 3 techniques (P < .05). CLSM analysis showed that XP Endo had the highest level of dead bacteria in the coronal, middle, and apical segments at 50-μm depth. On the other hand, PIPS had the greatest bacterial killing efficiency at the 150-μm depth in all 3 root segments. CONCLUSIONS XP Endo appears to be more efficient than other 3 techniques in disinfecting the main canal space and up to 50 μm deep into the dentinal tubules. PIPS appears to be most effective in killing the bacteria deep in the dentinal tubules.
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Affiliation(s)
- Adham A Azim
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Hacer Aksel
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Tingting Zhuang
- Department of Biostatistics, University at Buffalo School of Public Health and Health Professions, Buffalo, New York
| | - Terry Mashtare
- Department of Biostatistics, University at Buffalo School of Public Health and Health Professions, Buffalo, New York
| | - Jegdish P Babu
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee
| | - George T-J Huang
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee.
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Yost RA, Bergeron BE, Kirkpatrick TC, Roberts MD, Roberts HW, Himel VT, Sabey KA. Evaluation of 4 Different Irrigating Systems for Apical Extrusion of Sodium Hypochlorite. J Endod 2015; 41:1530-4. [PMID: 26143609 DOI: 10.1016/j.joen.2015.05.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 05/16/2015] [Accepted: 05/17/2015] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate NaOCl apical extrusion by using negative apical pressure (EndoVac), sonic agitation (EndoActivator), side-vented needle (Max-i-Probe), and photon induced photoacoustic streaming (PIPS 10 mJ and PIPS 20 mJ) laser irrigation in an in vitro gel model. METHODS Extracted mandibular and maxillary central incisors (n = 18) were prepared to size 35/.04 and 55/.04, respectively. Teeth were mounted in transparent containers with clear acrylic and suspended in a color-changing pH-sensitive gel, creating a closed system. By using a crossover design, each tooth was sequentially irrigated by using 6% NaOCl with each device following manufacturers' recommendations. Each tooth served as its own control. Pre-irrigation and post-irrigation buccal and proximal view photographs served to measure the longest distance of extrusion and were analyzed with ImageJ software. Mean results were analyzed by using Kruskal-Wallis and Dunn post hoc test (P < .05). RESULTS There were no significant differences between EndoVac, EndoActivator, and the passive extrusion groups. The EndoVac and EndoActivator groups produced significantly less extrusion than PIPS irrigation. Max-i-Probe extrusion results were more variable than those of EndoActivator but had no significant difference. Across all irrigation systems, there were no significant differences with respect to apical preparation size. CONCLUSIONS Under the in vitro conditions of this study, no difference was found between the 10 mJ and 20 mJ PIPS laser groups. EndoVac demonstrated significantly less potential for apical extrusion than PIPS and Max-i-Probe, whereas apical preparation size did not significantly affect extrusion of irrigant. The potential for apical extrusion of endodontic irrigants should be a consideration when selecting a system for final irrigation.
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Affiliation(s)
- Ross A Yost
- Keesler Medical Center, Keesler Air Force Base, Mississippi
| | | | | | - Mark D Roberts
- Keesler Medical Center, Keesler Air Force Base, Mississippi
| | | | - Van T Himel
- Louisiana State University, New Orleans, Louisiana
| | - Kent A Sabey
- Louisiana State University, New Orleans, Louisiana
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Akman M, Akbulut MB, Aydınbelge HA, Belli S. Comparison of different irrigation activation regimens and conventional irrigation techniques for the removal of modified triple antibiotic paste from root canals. J Endod 2015; 41:720-4. [PMID: 25747378 DOI: 10.1016/j.joen.2015.01.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 12/23/2014] [Accepted: 01/02/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The aim of this study was to compare the efficacy of irrigation activation regimens and conventional syringe irrigation technique in the removal of modified triple antibiotic paste (mTAP) from root canal walls. METHODS Fifty-six extracted human mandibular premolars were prepared using ProTaper rotary files (Dentsply Maillefer, Ballaigues, Switzerland) up to size F4. The root canals were filled with mTAP medicament, and after 21 days, the roots were randomly assigned to 5 groups (n = 10) according to the irrigation regimens used: conventional syringe irrigation (CI), Self-Adjusting File (SAF; ReDent-Nova, Ra'anana, Israel), EndoVac (Discus Dental, Culver City, CA), EndoActivator (Dentsply, Tulsa, OK), and passive ultrasonic irrigation (PUI). In 3 teeth, mTAP was not removed (positive controls), and another 3 teeth were not filled with mTAP (negative controls). The roots were sectioned, and the amount of remaining medicament at each root half (n = 20) was evaluated at 30× magnification using a 4-grade scoring system. Data were evaluated using the Kruskal-Wallis and Mann-Whitney U tests. RESULTS There were statistically significant differences among all experimental groups; of which, the CI group was the significantly least efficient in removing mTAP from the root canal (P < .05). At the apical and middle third, the PUI, SAF, EndoVac, and EndoActivator groups removed significantly more mTAP medicament than the CI group (P < .05); however, there were no significant differences between these groups (P > .05). The SAF and PUI showed significantly better performances in removing mTAP from the coronal third (P < .05). CONCLUSIONS The use of irrigation activation regimens significantly improves the removal of mTAP from root canals when compared with CI.
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Affiliation(s)
- Melek Akman
- Department of Endodontics, Faculty of Dentistry, University of Necmettin Erbakan, Konya, Turkey.
| | - Makbule Bilge Akbulut
- Department of Endodontics, Faculty of Dentistry, University of Necmettin Erbakan, Konya, Turkey
| | - Hale Arı Aydınbelge
- Department of Endodontics, Faculty of Dentistry, University of Selcuk, Konya, Turkey
| | - Sema Belli
- Department of Endodontics, Faculty of Dentistry, University of Selcuk, Konya, Turkey
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Çapar İD, Aydinbelge HA. Effectiveness of various irrigation activation protocols and the self-adjusting file system on smear layer and debris removal. Scanning 2014; 36:640-647. [PMID: 25285423 DOI: 10.1002/sca.21171] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 08/27/2014] [Accepted: 09/10/2014] [Indexed: 06/03/2023]
Abstract
The purpose of the present study is to evaluate smear layer generation and residual debris after using self-adjusting file (SAF) or rotary instrumentation and to compare the debris and smear layer removal efficacy of the SAF cleaning/shaping irrigation system against final agitation techniques. One hundred and eight maxillary lateral incisor teeth were randomly divided into nine experimental groups (n = 12), and root canals were prepared using ProTaper Universal rotary files, with the exception of the SAF instrumentation group. During instrumentation, root canals were irrigated with a total of 16 mL of 5% NaOCl. For final irrigation, rotary-instrumented groups were irrigated with 10 mL of 17% EDTA and 10 mL of 5% NaOCl using different irrigation agitation regimens (syringe irrigation with needles, NaviTip FX, manual dynamic irrigation, CanalBrush, EndoActivator, EndoVac, passive ultrasonic irrigation (PUI), and SAF irrigation). In the SAF instrumentation group, root canals were instrumented for 4 min at a rate of 4 mL/min with 5% NaOCl and received a final flush with same as syringe irrigation with needles. The surface of the root dentin was observed using a scanning electron microscope. The SAF instrumentation group generated less smear layer and yielded cleaner canals compared to rotary instrumentation. The EndoActivator, EndoVac, PUI, and SAF irrigation groups increased the efficacy of irrigating solutions on the smear layer and debris removal. The SAF instrumentation yielded cleaner canal walls when compared to rotary instrumentation. None of the techniques completely removed the smear layer from the root canal walls.
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Affiliation(s)
- İsmail Davut Çapar
- Department of Endodontics, Faculty of Dentistry, İzmir Katip Çelebi University, İzmir, Turkey
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Ramamoorthi S, Nivedhitha MS, Divyanand MJ. Comparative evaluation of postoperative pain after using endodontic needle and EndoActivator during root canal irrigation: A randomised controlled trial. AUST ENDOD J 2014; 41:78-87. [PMID: 25195661 DOI: 10.1111/aej.12076] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The purpose of this study was to evaluate and compare the postoperative level of pain after activation of irrigants using EndoActivator with conventional needle irrigation during root canal therapy. In this prospective randomised clinical trial, 72 symptomatic irreversible pulpitis patients were selected. Based on block randomisation after routine root canal preparation, patients were assigned to two groups. In group EN, procedures were performed with endodontic irrigating needle (n = 36) while group EA received activation using EndoActivator (n = 36) in the final irrigation protocol. All the participants were called through phone at 8, 24 and 48 h to analyse pain score using visual analogue scale. Those patients who developed pain were prescribed ibuprofen 200 mg. Pain score and frequency of tablet intake were recorded and statistically analysed. Results showed that group EA resulted in significantly less postoperative pain and analgesics intake than group EN. In conclusion, within the limitations of this study, the activation of irrigants using EndoActivator can be considered an effective method for reducing postoperative pain.
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Affiliation(s)
- Surendar Ramamoorthi
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha University, Chennai, Tamilnadu, India
| | - Malli Sureshbabu Nivedhitha
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha University, Chennai, Tamilnadu, India
| | - Madras Jeyaprakash Divyanand
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha University, Chennai, Tamilnadu, India
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Arslan H, Akcay M, Capar ID, Ertas H, Ok E, Uysal B. Efficacy of needle irrigation, EndoActivator, and photon-initiated photoacoustic streaming technique on removal of double and triple antibiotic pastes. J Endod 2014; 40:1439-42. [PMID: 25146028 DOI: 10.1016/j.joen.2014.02.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 02/03/2014] [Accepted: 02/10/2014] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Photon-induced photoacoustic streaming (PIPS) is a novel technique used for the removal of material on root canal walls, such as bacteria and the smear layer. This study evaluated the efficacy of needle irrigation, the EndoActivator System (Dentsply Tulsa Dental Specialties, Tulsa, OK), and PIPS on the removal of antibiotic pastes from an artificial groove created in a root canal. METHODS Root canal preparation was performed up to size #40 on 84 extracted single-rooted teeth using ProTaper rotary instruments (Dentsply Maillefer, Ballaigues, Switzerland). The specimens were then split longitudinally, and 2 standardized grooves were prepared in the coronal and apical part of each segment. Double (DAP) and triple antibiotic pastes (TAP) were placed in the grooves for 4 weeks, and the root halves were reassembled. Needle irrigation, the EndoActivator System, and PIPS were used for the removal of DAP and TAP. The root segments were disassembled, and the amount of remaining antibiotic pastes was evaluated under a stereomicroscope at 20× magnification using a 4-grade scoring system. The data were evaluated statistically using Mann-Whitney U tests with a 95% confidence level (P = .05). RESULTS PIPS removed significantly more antibiotic pastes than the EndoActivator and needle irrigation (P < .001). The EndoActivator was superior to needle irrigation in removing antibiotic pastes (P < .001). There were no statistically significant differences between DAP and TAP and between coronal and apical thirds in their removing from artificially created grooves (P > .05). CONCLUSIONS PIPS was more effective in removing both DAP and TAP from artificial grooves in root canals than the EndoActivator System and needle irrigation. The EndoActivator was also more effective than needle irrigation. It is difficult to completely remove antibiotic pastes from root canals.
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Affiliation(s)
- Hakan Arslan
- Department of Endodontics, Faculty of Dentistry, Ataturk University, Erzurum.
| | - Merve Akcay
- Department of Pedodontics, Faculty of Dentistry, Katip Çelebi University, İzmir, Turkey
| | - Ismail Davut Capar
- Department of Endodontics, Faculty of Dentistry, Katip Çelebi University, İzmir, Turkey
| | - Hüseyin Ertas
- Department of Endodontics, Faculty of Dentistry, Katip Çelebi University, İzmir, Turkey
| | - Evren Ok
- Department of Endodontics, Faculty of Dentistry, Şifa University, İzmir, Turkey
| | - Banu Uysal
- Department of Endodontics, Faculty of Dentistry, Katip Çelebi University, İzmir, Turkey
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