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Rice DD, Grandhi A, Roque-Torres GD, Oyoyo U, Bakland LK. The Effect of Calcium Hydroxide Pastes on Isolated Vital Nerve Fibers. J Endod 2024; 50:355-361. [PMID: 38190938 DOI: 10.1016/j.joen.2023.11.011] [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] [Received: 08/11/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 01/10/2024]
Abstract
INTRODUCTION Calcium hydroxide pastes (CHPs), commonly used for disinfecting root canals during endodontic treatment, are generally considered safe. However, accidental extrusions result in minimal injuries and little to no discomfort, except when extruded pastes come into contact with nerve bundles, such as the inferior alveolar nerve. Currently, there is a lack of information about the possible role of specific paste vehicles on the extent of nerve injury. The purpose of this study was to compare the role that paste vehicles, such as water or methylcellulose, may play when nerve fibers are exposed to CHP. METHODS Isolated sciatic nerves of Sprague-Dawley rats were exposed to either water-based or methylcellulose-based CHP for varying durations of time (30, 60, or 90 minutes). Histopathological changes, including axonal edema, myelin alterations, and loss of cellular outlines, were assessed, and the degrees of changes were compared using chi-square intraclass correlation coefficient tests. RESULTS Both groups exposed to the pastes demonstrated varying degrees of histopathologic changes, including axonal edema, myelin changes, and loss of cellular outlines, at different exposure times. The water-based calcium hydroxide paste induced these changes more rapidly than the methylcellulose-based paste. Similar patterns were observed in the scanning electron microscopic findings. Exposure time emerged as an important difference in the effects of the 2 pastes. In each of these tests, all observations of water-based paste exposure were rated as moderate to severe, whereas the observed cellular changes (axonal, myelin, and intact cellular outline) were rated as mild to moderate after exposure to methylcellulose-based paste for the same exposure durations. The chi-square tests indicated a statistically significant association between the material and each of the outcomes (axonal changes: χ²15 = 81.0, P < .001; myelin changes: χ²15 = 81.0, P < .001; intact cellular outline, χ²15 = 81.0, P < .001). The intraclass correlation coefficient value was 0.93. CONCLUSIONS The study demonstrates that axonal and myelin damage increase with longer exposure times, with water-based CHP causing more damage than methylcellulose-based CHP at each time point.
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Affiliation(s)
- Dwight D Rice
- Division of General Dentistry, Center for Dental Research, School of Dentistry, Loma Linda University, Loma Linda, California
| | - Anupama Grandhi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Loma Linda University, Loma Linda, California
| | - Gina Delia Roque-Torres
- Center for Dental Research, School of Dentistry, Loma Linda University, Loma Linda, California
| | - Udochukwu Oyoyo
- Department of Dental Education Services, School of Dentistry, Loma Linda University, Loma Linda, California
| | - Leif K Bakland
- Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, California.
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Abdelnaby P, Ibrahim M, ElBackly R. In vitro evaluation of filling material removal and apical debris extrusion after retreatment using Reciproc blue, Hyflex EDM and ProTaper retreatment files. BMC Oral Health 2023; 23:902. [PMID: 37990209 PMCID: PMC10664678 DOI: 10.1186/s12903-023-03579-7] [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: 03/29/2023] [Accepted: 10/25/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVES To evaluate the amount of remaining filing material and apical debris extrusion after retreatment using Reciproc Blue, Hyflex EDM and ProTaper Retreatment Files. MATERIALS AND METHODS Thirty-six extracted permanent mandibular first molars with moderately curved mesial roots were selected. Mesiobuccal canals were prepared using the ProTaper Next system up to size X2 and filled using gutta-percha and Adseal sealer via cold lateral compaction. Teeth were randomly divided into three equal groups (n = 12): Group 1: Reciproc Blue (RB)(VDW, Germany), Group 2: Hyflex EDM (HEDM)(Coltene/Whaledent, Switzerland), Group 3: ProTaper Universal Retreatment file system + ProTaper Next file system (PTUR + PTN)( Dentsply Maillefer, Switzerland). Eppendorf tubes were used to collect the apically extruded debris. Cone-beam computed tomographic scans were taken prior to and after retreatment and the volume of remaining filling material was assessed at the coronal, middle and apical levels. Statistical analysis was performed using the Kruskal-Wallis test, Friedman's test and Wilcoxon Sign Rank test. Significance level was set at p value 0.05. RESULTS There were no statistically significant differences among the three groups in the reduction of the volume of the filling material or in the amount of apically extruded debris. CONCLUSION All the tested filing systems showed similar efficacy in removing the filling material, however, none of them could achieve its complete removal. Apical extrusion of debris occurred with all the systems used with no significant difference between the three groups.
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Affiliation(s)
- Passent Abdelnaby
- Conservative Dentistry Department, MS Student, Endodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed Ibrahim
- Conservative Dentistry Department, Endodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Rania ElBackly
- Conservative Dentistry Department, Endodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
- Tissue Engineering Laboratories, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
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Jasrasaria N, Tikku AP, Bharti R. Analysis of porosity, sealer dissolution and apical extrusion of endodontic sealers: A micro computed tomography study. J Oral Biol Craniofac Res 2023; 13:495-499. [PMID: 37293581 PMCID: PMC10244689 DOI: 10.1016/j.jobcr.2023.05.013] [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: 08/10/2022] [Revised: 04/03/2023] [Accepted: 05/27/2023] [Indexed: 06/10/2023] Open
Abstract
Aim The aim of the study was to determine the porosity, dissolution and apical extrusion of AH Plus, MTA Fillapex and EndoSequence BC sealer after immersion in phosphate buffered saline (PBS) using microcomputed tomography (micro-CT). Methodology Forty-eight single-rooted teeth were selected. Gutta percha and one of the aforementioned root canal sealers was used for obturation using continuous wave technique. The specimens were scanned after obturation and after seven days of immersion in PBS, by using micro-computed tomography. Porosity, sealer dissolution and apical extrusion were calculated. Statistical analysis was done by using paired t-test, post hoc tukey test and Fischer exact test. Results Significantly higher percentage of porosity and dissolution of sealer in the apical 4 mm was found for MTA Fillapex and EndoSequence BC sealer than for AH Plus. The incidence of apical extrusion was significantly more in MTA Fillapex (56.25%), followed by EndoSequence BC (31.25%) and AH Plus (0%). Conclusions None of the three root canal sealers exhibited perfect three-dimensional obturation. The sealers manifested porosity, dissolution and apical extrusion to varying degrees both after obturation and after storage in PBS for 7 days.
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Affiliation(s)
- Neha Jasrasaria
- Department of Conservative Dentistry and Endodontics, King George Medical University, Lucknow, India
| | - Aseem P. Tikku
- Department of Conservative Dentistry and Endodontics, King George Medical University, Lucknow, India
| | - Ramesh Bharti
- Department of Conservative Dentistry and Endodontics, King George Medical University, Lucknow, India
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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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Bolhari B, Meraji N, Seddighi R, Ebrahimi N, Chiniforush N. Effect of SWEEPS and PIPS techniques on dye extrusion in photodynamic therapy procedure after root canal preparation. Photodiagnosis Photodyn Ther 2023; 42:103345. [PMID: 36804946 DOI: 10.1016/j.pdpdt.2023.103345] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Received: 12/07/2022] [Revised: 01/28/2023] [Accepted: 02/14/2023] [Indexed: 02/17/2023]
Abstract
AIM The aim of this study is to measure and compare the amount of apical extrusion of the methylene blue as photosensitizer using Laser-activated irrigation(LAI) techniques (SWEEPS, PIPS) and photodynamic therapy (PDT). MATERIALS AND METHODS 40 single-rooted premolar teeth were selected and their root canals were cleaned and prepared. The photosensitizer, Methylene blue (MB), was used as dye which applied inside the root canals and the access cavities. Then the teeth were randomly allocated to 4 groups. Different techniques (SWEEPS, PIPS, PDT) were used in 3 groups. One group received no activation. Data related to the concentration of the extruded methylene blue was measured using ultraviolet and visible (UV-Vis) absorption spectroscopy. Absorption peak intensity of MB in the wavelength of 668 nm was considered as the concentration index according to Beer Lambert law. Taking into account the normal distribution of this data, one-way ANOVA analysis was used to evaluate the effects of the independent variables on the amount of apical extrusion of the irrigant. RESULTS Based on the results of ANOVA analysis, there was no significant difference between the amounts of apical extrusion of MB between different groups (p = 0.628) CONCLUSION: Using SWEEPS and PIPS techniques, despite diffusion of the photosensitizer, didn't lead to any difference in the amount of apical extrusion. Therefore, these LAI techniques can be used safely for root canal irrigation.
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Affiliation(s)
- Behnam Bolhari
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Naghmeh Meraji
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Rahim Seddighi
- School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Ebrahimi
- School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Ada KS, Shetty S, Jayalakshmi KB, Nadig PL, Manje Gowda PG, Selvan AK. Influence of different irrigant activation methods on apical debris extrusion and bacterial elimination from infected root canals. J Conserv Dent 2023; 26:31-35. [PMID: 36908725 PMCID: PMC10003277 DOI: 10.4103/jcd.jcd_378_22] [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: 06/28/2022] [Revised: 07/28/2022] [Accepted: 08/19/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction The study aimed to determine the apical debris extrusion and microbial elimination from infected root canals after using different irrigant activation methods. Materials and Methods Forty freshly extracted human mandibular premolars were selected and randomly assigned to four groups (n = 10). The teeth were mechanically prepared, sterilized, and inoculated with Enterococcus faecalis for 1 week. Irrigation was done with 3% sodium hypochlorite following conventional syringe irrigation-Group 1, manual dynamic agitation (MDA)-Group 2, passive ultrasonic irrigation (PUI)-UltraX -Group 3, and sonic irrigation (SI)-EndoActivator -Group 4, and the extruded debris were collected using Myers and Montgomery model. The microbial samples were taken from the canals using sterile paper points, cultured and recorded as colonies. The amount of extruded debris was measured by subtracting the final weight of the Eppendorf tube with debris from the initial weight of the tube. Results I. Group 3 showed the least apical debris extrusion (P < 0.05), followed by Groups 2 and 1 and the highest with Group 4. II. Group 3 showed the least colony-forming units (CFUs)/ml, followed by Group 4, and finally, Group 2 showed lesser mean CFUs/ml compared to Group 1 (P < 0.05). Conclusion All the irrigation activation methods were associated with apical debris extrusion, with the PUI system extruding the least amount of debris compared to the other groups. Irrigation activation techniques were beneficial in reducing the microbial load from the infected canals with the PUI system showing a complete elimination of the microbes, followed by SI and MDA.
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Affiliation(s)
- K. Sadia Ada
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - Shibani Shetty
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - K. B. Jayalakshmi
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - Prasanna Latha Nadig
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - P. G Manje Gowda
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
| | - Arul K. Selvan
- Department of Conservative Dentistry and Endodontics, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India
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Karasu AE, Goker Kamalı S, Turkaydın D. Comparison of apical extrusion of sodium hypochlorite in immature teeth after needle irrigation, ultrasonic irrigation, EDDY, Er:YAG, and diode lasers. Lasers Med Sci 2022; 38:8. [PMID: 36539627 DOI: 10.1007/s10103-022-03683-0] [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] [Received: 05/19/2022] [Accepted: 11/09/2022] [Indexed: 12/24/2022]
Abstract
This study aimed to assess the apical extrusion of sodium hypochlorite in immature teeth caused by needle irrigation, ultrasonic irrigation, EDDY, Er:YAG, and diode lasers. Seventy-five human maxillary anterior teeth were selected. After the apical 3 mm of the roots was resected, the canal lumen was enlarged with #2 to #5 Gates-Glidden burs. The teeth were fixed to the lid of a flat-sided clear plastic container, and the plastic containers were filled with 0.2% agarose gel containing 1 mL of 0.1% m-cresol purple. Then, the specimens were allocated into five groups according to the irrigation activation techniques: needle irrigation, ultrasonic irrigation, EDDY, Er:YAG laser, and diode laser. The apical extrusion of sodium hypochlorite caused the color change in the gel. The containers were digitally photographed, and the percentage of pixels of irrigant extrusion (the color change) in each photograph was calculated. The diode laser group showed a significantly lower percentage of pixels than needle irrigation, EDDY, and Er:YAG laser (p < 0.05). The irrigant extrusion value of the ultrasonic irrigation group was significantly lower than that of the EDDY and Er:YAG laser groups (p < 0.05). There was no significant difference between the other groups (p > 0.05). All the groups caused irrigant extrusion in the immature teeth. The diode laser and ultrasonic irrigation caused less sodium hypochlorite extrusion than EDDY and Er:YAG laser. The needle irrigation showed more irrigant extrusion than the only diode laser group.
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Affiliation(s)
- Alparslan Eren Karasu
- Department of Endodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Selin Goker Kamalı
- Department of Endodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey.
| | - Dilek Turkaydın
- Department of Endodontics, Faculty of Dentistry, Marmara University, Istanbul, Turkey
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Deniz-Sungur D, Onur MA, Akbay E, Tan G, Daglı-Comert F, Sayın TC. Effects of calcium silicate cements on neuronal conductivity. Restor Dent Endod 2022; 47:e18. [PMID: 35692227 PMCID: PMC9160757 DOI: 10.5395/rde.2022.47.e18] [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: 11/27/2020] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives This study evaluated alterations in neuronal conductivity related to calcium silicate cements (CSCs) by investigating compound action potentials (cAPs) in rat sciatic nerves. Materials and Methods Sciatic nerves were placed in a Tyrode bath and cAPs were recorded before, during, and after the application of test materials for 60-minute control, application, and recovery measurements, respectively. Freshly prepared ProRoot MTA, MTA Angelus, Biodentine, Endosequence RRM-Putty, BioAggregate, and RetroMTA were directly applied onto the nerves. Biopac LabPro version 3.7 was used to record and analyze cAPs. The data were statistically analyzed. Results None of the CSCs totally blocked cAPs. RetroMTA, Biodentine, and MTA Angelus caused no significant alteration in cAPs (p > 0.05). Significantly lower cAPs were observed in recovery measurements for BioAggregate than in the control condition (p < 0.05). ProRoot MTA significantly but transiently reduced cAPs in the application period compared to the control period (p < 0.05). Endosequence RRM-Putty significantly reduced cAPs. Conclusions Various CSCs may alter cAPs to some extent, but none of the CSCs irreversibly blocked them. The usage of fast-setting CSCs during apexification or regeneration of immature teeth seems safer than slow-setting CSCs due to their more favorable neuronal effects.
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Affiliation(s)
- Derya Deniz-Sungur
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Mehmet Ali Onur
- Department of Biology, Faculty of Science, Hacettepe University, Ankara, Turkey
| | - Esin Akbay
- Department of Biology, Faculty of Science, Hacettepe University, Ankara, Turkey
| | - Gamze Tan
- Department of Biology, Faculty of Science and Letters, Aksaray University, Aksaray, Turkey
| | - Fügen Daglı-Comert
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.,Adult Restorative Dentistry and Endodontics, Oman Dental College, Muscat, Oman
| | - Taner Cem Sayın
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.,Private Practice, Fort Lauderdale, FL, USA
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Sowjanya T, Parvathaneni KP, Raju TBVG, Varma NM, Dondapati GD, Podili S. Comparative evaluation of apically extruded debris using three different thermomechanically heat treated file systems with two different motions: An in vitro study. J Conserv Dent 2022; 25:269-273. [PMID: 35836559 PMCID: PMC9274688 DOI: 10.4103/jcd.jcd_631_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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/27/2022] [Accepted: 01/27/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction and Aim Postoperative inflammation and endodontic failure occur due to apical extrusion of debris. The purpose of this in vitro study was to assess the amount of apically extruded debris during the root canal preparation using rotary and reciprocating nickel-titanium instrumentation systems. Materials and Methods The mesiobuccal canals of seventy five mature, human mandibular molars were randomly divided into three groups (n = 25 teeth/group). Each group was instrumented using one of the three different instrumentation systems: Hyflex EDM (HEDM) rotary file, Flexicon X7 rotary, and Flexicon X1 reciprocating files. The canals were irrigated using distilled water. The debris extruded apically was collected in preweighed Eppendorf tubes and assessed with an electronic balance and compared. Statistical Analysis Data were statistically analyzed by one-way analysis of variance and the intergroup comparison with single factor ANOVA. Results The Flexicon X1 reciprocating system showed the maximum amount of apical extrusion of debris among all the groups. The least amount of debris was observed in Flexicon X7 rotary instrument (P > 0.05). Conclusion Flexicon X7 rotary extruded significantly lesser amount of debris than Flexicon X1 reciprocating and HEDM rotary file systems.
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Affiliation(s)
- Thangi Sowjanya
- Department of Conservative Dentistry and Endodontics, Sree Sai Dental College and Research Institute, Srikakulam, Andhra Pradesh, India,Address for correspondence: Dr. Thangi Sowjanya, Department of Conservatve Dentistry and Endodontics, Sree Sai Dental College and Research Institute, Srikakulam - 532 001, Andhra Pradesh, India. E-mail:
| | - Krishna Prasad Parvathaneni
- Department of Conservative Dentistry and Endodontics, Sree Sai Dental College and Research Institute, Srikakulam, Andhra Pradesh, India
| | - TBVG Raju
- Department of Conservative Dentistry and Endodontics, Sree Sai Dental College and Research Institute, Srikakulam, Andhra Pradesh, India
| | - N. Mahendra Varma
- Department of Conservative Dentistry and Endodontics, Sree Sai Dental College and Research Institute, Srikakulam, Andhra Pradesh, India
| | - Gowtham Dev Dondapati
- Department of Conservative Dentistry and Endodontics, Sree Sai Dental College and Research Institute, Srikakulam, Andhra Pradesh, India
| | - Srivalli Podili
- Department of Conservative Dentistry and Endodontics, Sree Sai Dental College and Research Institute, Srikakulam, Andhra Pradesh, India
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Duszyc K, Noordstra I, Yap AS, Gomez GA. Live Imaging of Apoptotic Extrusion and Quantification of Apical Extrusion in Epithelial Cells. Bio Protoc 2021; 11:e4232. [PMID: 34909453 DOI: 10.21769/bioprotoc.4232] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/20/2021] [Accepted: 08/29/2021] [Indexed: 11/02/2022] Open
Abstract
Apoptotic cell death eliminates unhealthy cells and maintains homeostatic cell numbers within tissues. Epithelia, which serve as fundamental tissue barriers for the body, depend on a physical expulsion of dying cells (apoptotic cell extrusion) to remain sealed and intact. Apoptotic cell extrusion has been widely studied over recent years, with researchers using various approaches to induce apoptotic cell death. Unfortunately, the majority of chemical-based approaches for cell death induction rely on sporadically occurring apoptosis and extrusion, making imagining lengthy, often unsuccessful, and difficult to capture in high-quality images because of the frequent frame sampling needed to visualise the key molecular processes that drive extrusion. Here, we present a protocol that describes steps needed for laser-mediated induction of apoptosis in a cell of choice, followed by imaging of apoptotic extrusion in confluent monolayers of epithelial cells. Moreover, we provide the description of a new approach involving the mixing of labelled and unlabelled cells. In particular, this protocol characterises how cells surrounding apoptotic cells behave, with high spatial and temporal resolution. This can be achieved without the optical interference that apoptotic cells cause as they are physically expelled from the monolayer and move out of focus for imaging. Finally, the protocol is accompanied by detailed procedures describing cell preparation for apoptotic extrusion experiments, as well as post-acquisition analysis required to evaluate rates of successful extrusion.
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Affiliation(s)
- Kinga Duszyc
- Divisions of Cell and Developmental Biology, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Brisbane, Queensland, 4072, Australia
| | - Ivar Noordstra
- Divisions of Cell and Developmental Biology, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Brisbane, Queensland, 4072, Australia
| | - Alpha S Yap
- Divisions of Cell and Developmental Biology, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Brisbane, Queensland, 4072, Australia
| | - Guillermo A Gomez
- Divisions of Cell and Developmental Biology, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Brisbane, Queensland, 4072, Australia
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Sinha S, Singh K, Singh A, Priya S, Kumar A, Kawle S. Quantitative Evaluation of Apically Extruded Debris in Root Canals prepared by Single-file Reciprocating and Single File Rotary Instrumentation Systems: A Comparative In vitro Study. J Pharm Bioallied Sci 2021; 13:S1398-S1401. [PMID: 35017997 PMCID: PMC8686909 DOI: 10.4103/jpbs.jpbs_225_21] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/11/2021] [Accepted: 05/09/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Prevention of the debris from extruding to the periapical region is an important aspect to be taken care of as its extrusion can result in pain, periapical inflammation, and delayed healing owing to the presence of highly infective components in the debris. AIM The present trial was aimed to compare and assess the amount of debris extruded apically using the single-file reciprocating system - WaveOne GOLD and single file rotary system - OneShape in root canal preparations in vitro. MATERIALS AND METHODS Thirty mandibular premolars were divided into two groups (15 samples each) prepared with a single-file reciprocating system - WaveOne GOLD and single-file rotary system - OneShape. Debris extruded was collected and then stored in an incubator. The final weight was calculated after obtaining the mean of three consecutive weights obtained for each tooth. The data were compared using the ANOVA and Turkey's post hoc analysis. RESULTS Debris extrusions were recorded in both groups and analysis revealed statistical differences in weight before and after the instrumentation procedures in both groups. When compared, reciprocating single file - WaveOne GOLD extruded more debris than rotary single file system - OneShape with a P < 0.001. CONCLUSIONS The rotary instrumentation systems extrude lesser debris apically than the reciprocating instrumentation system. The difference found was statistically significant.
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Affiliation(s)
- Sonal Sinha
- Department of Conservative Dentistry and Endodontics, Dr. B. R. Ambedkar Institute of Dental Sciences and Hospital, Bihar, India,Address for correspondence: Dr. Sonal Sinha, Department of Conservative Dentistry and Endodontics, Dr. B. R. Ambedkar Institute of Dental Sciences and Hospital, Patna - 801 503, Bihar, India. E-mail:
| | - Konark Singh
- Department of Conservative Dentistry and Endodontics, Patna Dental College and Hospital, Bihar, India
| | - Anju Singh
- Department of Dentistry, Nalanda Medical College and Hospital, Patna, Bihar, India
| | - Swati Priya
- Department of Conservative Dentistry and Endodontics, Dr. B. R. Ambedkar Institute of Dental Sciences and Hospital, Bihar, India
| | | | - Sahil Kawle
- Department of Conservative Dentistry and Endodontics, Dr. G D Pol Foundation's, YMT Dental College and Hospital, Mumbai, Maharashtra, India
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Nabavizadeh M, Shokouhi MM, Kheirandish M, Sahebi S, Sadatshojaee N, Abbaszadegan A. A Comparison of the Apical Extrusion of Debris during the Preparation of Root Canal with Medin, RaCe, and ProTaper Rotary Systems. J Dent (Shiraz) 2021; 22:193-197. [PMID: 34514067 PMCID: PMC8417540 DOI: 10.30476/dentjods.2020.84776.1100] [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] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 07/20/2020] [Accepted: 09/12/2020] [Indexed: 11/19/2022]
Abstract
Statement of the Problem: The extrusion of intracanal debris is one of the challenging problems related to almost all root canal preparation systems, which may cause flare-ups and impairment in the healing process. Purpose: This study was conducted to evaluate the amount of apically-extruded debris during root canal preparation using Medin (MEDIN Co., Czech Republic) rotary system compared with
two common rotary systems, including ProTaper (Dentsply Maillefer., Switzerland) and RaCe (FKG Dentaire, Switzerland). Materials and Method: In this in vitro study, Sixty mandibular premolars with single canal were randomly assigned to three groups (n=20). The root canals were prepared with Medin, ProTaper,
and RaCe rotary instruments based on their manufacturers’ instructions. The debris were collected into pre-weighted Eppendorf tubes. The weight of the extruded debris was
calculated by subtracting the pretreatment weight of the vials. Data were analyzed using the Kruskal-Wallis test at a 5% significance level. Results: Medin instrument caused significantly less debris extrusion in comparison with ProTaper and RaCe (p< 0.05). The differences between the ProTaper and RaCe rotary
systems were not statistically significant (p= 0.752). Conclusion: Within the limitations of this in vitro study, Medin rotary system produced less apical extrusion than ProTaper and RaCe.
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Affiliation(s)
- Mohammadreza Nabavizadeh
- Oral and Dental Disease Research Center, Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Mehdi Shokouhi
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojgan Kheirandish
- Dental Student, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Safoora Sahebi
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nooshin Sadatshojaee
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Abbaszadegan
- Dept. of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Sunaga S, Kofuji S, Nishina H. YAP drives cell competition by activating choline metabolism. Biochem Biophys Res Commun 2021; 572:178-184. [PMID: 34375927 DOI: 10.1016/j.bbrc.2021.07.101] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 07/28/2021] [Accepted: 07/31/2021] [Indexed: 01/02/2023]
Abstract
Cell competition is a phenomenon that eliminates unfit cells from cell society, a function vital for maintaining cellular and organismal homeostasis. We previously showed that Madin-Darby canine kidney (MDCK) epithelial cells expressing the active form of the transcriptional coactivator Yes-associated protein (YAP) are apically extruded when surrounded by normal MDCK cells. Although we demonstrated that the arachidonic acid (AA) cascade is involved in YAP-dependent apical extrusion, the metabolic events leading to this outcome remained unclear. Here, we present the results of metabolomic analysis that identified phosphatidylcholine (PC) biosynthesis as the most significant player in this process. Removal of the PC biosynthetic components choline and methionine from culture medium inhibited YAP-dependent apical extrusion. Inhibition of either choline uptake or metabolic cycles involving choline or methionine also decreased YAP-dependent apical extrusion. At the molecular level, active YAP induced expression of the genes encoding glycerophosphocholine phosphodiesterase 1 (GPCPD1) and lecithin-cholesterol acyltransferase (LCAT), which are involved in choline metabolism. Our results indicate that YAP-dependent cell competition depends on YAP-mediated activation of the choline metabolic cycle.
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Affiliation(s)
- Sachi Sunaga
- Department of Developmental and Regenerative Biology, Medical Research Institute, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Satoshi Kofuji
- Department of Developmental and Regenerative Biology, Medical Research Institute, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
| | - Hiroshi Nishina
- Department of Developmental and Regenerative Biology, Medical Research Institute, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
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Yılmaz Çırakoglu N, Özbay Y. Apically extruded debris associated with ProTaper Next, ProTaper Gold and TruNatomy systems: An in vitro study. J Dent Res Dent Clin Dent Prospects 2021; 15:30-34. [PMID: 33927838 PMCID: PMC8058151 DOI: 10.34172/joddd.2021.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 06/11/2020] [Accepted: 11/01/2020] [Indexed: 11/09/2022] Open
Abstract
Background. This research aimed to investigate and compare the amount of apically extruded debris after root canal preparation using ProTaper Next, ProTaper Gold, and TruNatomy systems. Methods. Forty-five extracted mandibular premolar teeth with single canals with similar lengths were used. The root canals were prepared using ProTaper Next (Dentsply Maillefer, Ballaigues, Switzerland), ProTaper Gold (Dentsply Maillefer, Ballaigues, Switzerland), or TruNatomy (Dentsply Maillefer, Ballaigues, Switzerland) files. Apically extruded debris during preparation was gathered into preweighed Eppendorf tubes. Then the Eppendorf tubes were incubated at 70°C for five days. The Eppendorf tubes were weighed again to determine their final weight plus the extruded debris. Results. The TRN system resulted in significantly less debris extrusion than the PTN system (P <0.05). There was no significant difference between the PTN and PTG groups and between the PTG and TRN groups (P >0.05). Conclusion. All the instrumentation systems caused apical extrusion of debris. However, the TRN system resulted in significantly less debris extrusion than the other systems.
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Affiliation(s)
| | - Yağız Özbay
- Department of Endodontics, Faculty of Dentistry, Karabük University, Karabük, Turkey
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Singh AK, Chavan SC, Shah A, Parida R, Kansar N, Poojary S. Assessment of Apical Extrusion of Debris during Root Canal Preparation with Different Ni-Ti File Systems: An In Vitro Study. J Contemp Dent Pract 2021; 22:349-352. [PMID: 34267001] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
AIM AND OBJECTIVE The aim of this study was to evaluate the apical extrusion of debris during root canal preparation with the use of different Nickel-Titanium (Ni-Ti) file systems. MATERIALS AND METHODS Totally 60 single-rooted human mandibular premolar teeth with fully formed roots were chosen for the study. The coronal access cavity and all other preparations were done with the use of an access cavity kit and then 60 samples were randomly separated into three investigational groups (n = 20); group I: self-adjusting file, group II: WaveOne Gold, and group III: Mtwo rotary system. After instrumentation, the teeth were taken out from the tube and the root surface-adherent debris was collected by washing off the apical area of the tooth with distilled water (1 ml) into a centrifuge tube. The centrifuge tube was kept for 5 days in an incubator at 70°C to permit evaporation of the moisture prior to weighing the dry debris with the aid of an electrical analytical balance. RESULTS The highest quantity of debris extruded was by the Mtwo rotary system (0.0394 ± 0.880) followed by WaveOne Gold (0.0247 ± 1.030) and self-adjusting file (0.0198 ± 0.102). A statistically significant difference (p < 0.001) was found between the various file systems. CONCLUSION After considering the drawbacks of this study, apical debris extrusion could be found with all three groups. However, the self-adjusting file demonstrated a significantly reduced quantity of apical debris extrusion compared to the Mtwo rotary system and WaveOne Gold. CLINICAL SIGNIFICANCE The chief step during the procedure of root canal treatment is the preparation of the infected root canals biomechanically. This preparation may lead to forcing the apical debris into the periapical space through the apical foramen, resulting in host-initiated immunological response which leads to postoperative discomfort and pain. This consequently leads to selection of a specific rotary system for endodontic treatment.
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Affiliation(s)
- Abhinav K Singh
- Department of Conservative Dentistry and Endodontics, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India, Phone: +91 9576969374, e-mail:
| | - Suvarna Chandrakant Chavan
- Department of Conservative Dentistry and Endodontics, Subbaiah Institute of Dental Sciences, Shivamogga, Karnataka, India
| | - Anvi Shah
- Department of Pedodontics and Preventive Dentistry, Ahmedabad Dental College and Hospital, Ahmedabad, Gujarat, India
| | | | - Nisarga Kansar
- Department of Pedodontics and Preventive Dentistry, Subbaiah Institute of Dental Sciences, Shivamogga, Karnataka, India
| | - Sheela Poojary
- Department of Oral Pathology and Microbiology, Educare Institute of Dental Sciences, Malappuram, Kerala, India
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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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Sahni G, Garg N, Chhabra A, Negi S, Gupta S, Chhabra V. Assessment of various endodontic instrumentation systems on the amount of apically extruded bacteria - An in vitro study. J Conserv Dent 2020; 23:270-274. [PMID: 33551598 PMCID: PMC7861082 DOI: 10.4103/jcd.jcd_298_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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/19/2020] [Accepted: 08/23/2020] [Indexed: 11/27/2022] Open
Abstract
Aim: The objective of this in vitro study was to assess the effect of different endodontic instrumentation systems on the amount of apically extruded bacteria. Materials and Methods: One hundred and twenty freshly extracted human mandibular premolars with single canal were collected. Endodontic access cavities were prepared and then contaminated with an Enterococcus faecalis suspension (ATCC 29212). After incubation at 37°C for 24 h, the root canals were instrumented with K flare files, F360 Single file system, K3XF files, Heroshaper files, Protaper Next files, and Hyflex EDM Single file system. During instrumentation, apically extruded bacteria were collected in the vials containing 0.9% NaCl. Samples were taken from the vials and incubated in brain–heart infusion agar medium for 24 h. Statistical Analysis: The number of colony-forming units was determined, and data were statistically analyzed using one-way analysis of variance and post hoc Tukey test. Conclusions: Both rotary and hand instrumentation systems extruded intracanal bacteria through the apical foramen, Group 1 (Hand K Flare files) showed maximum, whereas, Group 5 (Protaper Next) and Group 6 (Hyflex EDM) showed the least extrusion.
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Affiliation(s)
- Garima Sahni
- Department of Conservative Dentistry and Endodontics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India
| | - Nisha Garg
- Department of Conservative Dentistry and Endodontics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India
| | - Ajay Chhabra
- Department of Conservative Dentistry and Endodontics, Rayat Bahra Dental College and Hospital, Mohali, Punjab, India
| | - Shabnam Negi
- Department of Conservative Dentistry and Endodontics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India
| | - Sandeep Gupta
- Department of Conservative Dentistry and Endodontics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India
| | - Vandana Chhabra
- Department of Oral and Maxillofacial Surgery, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Chandigarh, India
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Tüfenkçi P, Yılmaz K, Adigüzel M. Effects of the endodontic access cavity on apical debris extrusion during root canal preparation using different single-file systems. Restor Dent Endod 2020; 45:e33. [PMID: 32839714 PMCID: PMC7431936 DOI: 10.5395/rde.2020.45.e33] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 10/01/2019] [Revised: 12/23/2019] [Accepted: 01/08/2020] [Indexed: 11/11/2022] Open
Abstract
Objectives This study was conducted to evaluate the effects of traditional and contracted endodontic cavity (TEC and CEC) preparation with the use of Reciproc Blue (RPC B) and One Curve (OC) single-file systems on the amount of apical debris extrusion in mandibular first molar root canals. Materials and Methods Eighty extracted mandibular first molar teeth were randomly assigned to 4 groups (n = 20) according to the endodontic access cavity shape and the single file system used for root canal preparation (reciprocating motion with the RCP B and rotary motion with the OC): TEC-RPC B, TEC-OC, CEC-RPC B, and CEC-OC. The apically extruded debris during preparation was collected in Eppendorf tubes. The amount of extruded debris was quantified by subtracting the weight of the empty tubes from the weight of the Eppendorf tubes containing the debris. Data were analyzed using 1-way analysis of variance with the Tukey post hoc test. The level of significance was set at p < 0.05. Results The CEC-RPC B group showed more apical debris extrusion than the TEC-OC and CEC-OC groups (p < 0.05). There were no statistically significant differences in the amount of apical debris extrusion among the TEC-OC, CEC-OC, and TEC-RPC B groups. Conclusions RPC B caused more apical debris extrusion in the CEC groups than did the OC single-file system. Therefore, it is suggested that the RPC B file should be used carefully in teeth with a CEC.
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Affiliation(s)
- Pelin Tüfenkçi
- Department of Endodontics, Faculty of Dentistry, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Koray Yılmaz
- Department of Endodontics, Faculty of Dentistry, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Mehmet Adigüzel
- Department of Endodontics, Faculty of Dentistry, Hatay Mustafa Kemal University, Hatay, Turkey
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19
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Vankayala B, Anantula K, Saladi H, Gudugunta L, Basavarajaiah JM, Yadav SS. Comparative evaluation of apical bacterial extrusion following root canal instrumentation using different endodontic file systems: An in vitro study. J Conserv Dent 2020; 22:559-563. [PMID: 33088065 PMCID: PMC7542070 DOI: 10.4103/jcd.jcd_221_19] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 04/04/2020] [Accepted: 07/04/2020] [Indexed: 11/17/2022] Open
Abstract
Aim: This study aims to evaluate the amount of apical extrusion of bacteria during root canal instrumentation using K3XF, Protaper Gold, Edge taper platinum, and Hyflex CM Rotary systems. Materials and Methods: Sixty freshly extracted maxillary incisors teeth collected in saline. Access cavity prepared and canals were made free of bacterial and pulp. The teeth were mounted on the bacteria collecting apparatus. Root canals were contaminated with the Fusobacterium Nucleatum (ATCC25586) and dried at 37°C for 24 h. In Group 1 (Control group): No instrumentation was done and biomechanical preparation done in all other groups with Group 2: Hand K-files, Group 3: Protaper gold, Group 4: K3XF, Group 5: Edge taper platinum, and Group 6: Hyflex CM rotary file systems. Then, the extrude was collected, and it is incubated in Mueller-Hinton agar for 24 h and the number of colony forming units were counted and statistical comparison was done using Kruskal–Wallis test and Mann–Whitney U test. Results: Hand K-files extruded more bacteria when compared to other four rotary systems, K3XF file system extruded least number of bacteria. Conclusion: All instrumentation techniques extruded intracanal bacteria apically. However, engine-driven nickel-titanium instruments extruded less bacteria than the manual technique. The K3XF rotary file system comparatively extruded less bacteria than other rotary file systems.
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Affiliation(s)
- Bhavana Vankayala
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Hyderabad, Telangana, India
| | - Kavitha Anantula
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Hyderabad, Telangana, India
| | - Harikrishna Saladi
- Department of Conservative Dentistry and Endodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Leneena Gudugunta
- Department of Conservative Dentistry and Endodontics, AIMST University, Bedong, Kedah, Malaysia
| | | | - Sarjeev Singh Yadav
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Hyderabad, Telangana, India
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Asif A, Jeevanandan G, Govindaraju L, Vignesh R, G Subramanian EM. Comparative Evaluation of Extrusion of Apical Debris in Primary Anterior Teeth using Two Different Rotary Systems and Hand Files: An In Vitro Study. Contemp Clin Dent 2020; 10:512-516. [PMID: 32308330 PMCID: PMC7150551 DOI: 10.4103/ccd.ccd_884_18] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background The success of endodontic treatment depends on the chemomechanical preparation of the tooth. However, the debris produced during canal preparation may extrude through the apical foramen causing postoperative complications. Aim The aim of this study is to compare the apical debris extrusion during root canal preparation in primary anterior teeth using hand files, rotary ProTaper files, and rotary Kedo-S files. Materials and Methods Forty-five freshly extracted primary canine with mature apices and a single canal were randomly divided into three groups for instrumentation as follows (n = 15): Group 1: hand files; Group 2: rotary ProTaper files; and Group 3: rotary Kedo-S files. Myers and Montgomery experimental model was used for this study. Apically extruded debris collected in a preweighed Eppendorf tubes was placed in the incubator at 70°C for 5 days. The weight of the debris collected was determined by subtracting the pre- and post-instrumentation weight of the Eppendorf tubes. The data collected were analyzed using the analysis of variance and Tukey's post-hoc tests. Results Hand files produced more apical debris extrusion than ProTaper and Kedo-S files (P < 0.05) while Kedo-S produced the least (P < 0.05). Conclusion All instrumentation systems cause apical debris extrusion. Kedo-S produced less apical debris extrusion when compared to the hand files and ProTaper files.
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Affiliation(s)
- Ahsana Asif
- Department of Pedodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Ganesh Jeevanandan
- Department of Pedodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Lavanya Govindaraju
- Department of Pedodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - R Vignesh
- Department of Pedodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - E M G Subramanian
- Department of Pedodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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Solda C, Padoim K, Rigo L, Silva Sousa YTC, Hartmann MSM. Assessment of Apical Extrusion using Rotary and Reciprocating Systems during Root Canal Retreatment. J Contemp Dent Pract 2020; 21:238-241. [PMID: 32434967] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
AIM The objective of this study was to assess apical extrusion after filling material removal using two systems, one rotary and one reciprocating. MATERIALS AND METHODS A total of 34 extracted mandibular premolars with single roots were selected and, posteriorly, prepared and filled. Following material aging for 60 days, teeth were divided into two groups, according to the method used to remove root filling material: group I, ProTaper® Universal Retreatment instruments plus refining with the Hero 642® sequence and group II, WaveOne® instruments. The teeth were fixed in an apparatus designed to collect the extruded material during removal procedure. Data on the amount of debris extruded (mg/weight) were analyzed using the Student's t test with a significance level of 5%. RESULTS No significant differences were found between the groups with regard to the amount of material extruded during root canal retreatment. CONCLUSION The present findings suggest that the extrusion of debris during apical root canal retreatment does not depend on the instrument design or the protocol employed. CLINICAL SIGNIFICANCE Regardless of root canal clearance techniques, debris extrusion eventually occurs during endodontic retreatment and may be related to postoperative pain.
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Affiliation(s)
- Caroline Solda
- Department of Odontologia, IMED, Passo Fundo, Brazil, Phone: +55 54999573639, e-mail:
| | - Karine Padoim
- Department of Odontologia, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Lilian Rigo
- Department of Odontology, Faculdade IMED, Passo Fundo, Rio Grande do Sul, Brazil
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Abstract
Objectives The aim of this study was to evaluate the quantity of apically extruded debris after canal shaping with three single-file systems. Materials and Methods Sixty mesiobuccal canals of mandibular molars were divided into three experimental groups according to the used file systems-WaveOne Gold, RECIPROC Blue, and HyFlex EDM One file. Debris extruded during canal shaping were collected in preweighed vials. Each canal was irrigated with 5 mL of distilled water via a 30 G side-vented needle. The amount of the debris extruded from each canal was calculated by subtracting the preinstrumentation from postinstrumentation measurement. The preparation times were recorded. Data were analyzed using analysis of variance (ANOVA) and posthoc Tukey tests with α = 0.05. Results WaveOne Gold extruded the least amount of debris. Results between WaveOne Gold and HyFlex EDM were significantly different. No significant differences in canal shaping time were detected among the three groups (P > 0.05). Conclusion WaveOne Gold showed the best results regarding apical debris extrusion. Difference between WaveOne Gold and HyFlex EDM suggests that file design and motion kinematics affect the quantity of debris extrusion.
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Affiliation(s)
- M M Elashiry
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt; Department of Periodontics, Dental College of Georgia, Augusta University, Georgia, USA
| | - S E Saber
- Department of Endodontics, Faculty of Dentistry, Ain Shams University; Department of Endodontics, Faculty of Dentistry, British University in Egypt, Cairo, Egypt
| | - S H Elashry
- Department of Endodontics, Faculty of Dentistry, Ain Shams University; Department of Endodontics, Faculty of Dentistry, Misr International University, Cairo, Egypt
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Canakci BC, Sungur R, Er O. Comparison of warm vertical compaction and cold lateral condensation of α, β gutta-percha and resilon on apically extruded debris during retreatment. Niger J Clin Pract 2019; 22:926-931. [PMID: 31293256 DOI: 10.4103/njcp.njcp_663_18] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background This study was performed to evaluate the amount of apically extruded debris removed from a root canal filled with cold lateral condensation (CLC), and warm vertical compaction (WVC) techniques, using b or a phase gutta-percha with AH-Plus (Dentsply DeTrey, Konstanz, Germany) or Resilon (Resilon Research LLC, Madison, WI) with RealSeal SE (SybronEndo, Amersfoort, The Netherlands). Materials and Methods About 100 human incisor teeth were prepared with a #25.06 NiTi rotary system and divided into five groups according to the filling material used: Group 1: CLC (gutta-percha, AH-Plus); Group 2: WVC (b phase gutta-percha, AH-Plus); Group 3: WVC (a phase gutta-percha, AH-Plus); Group 4: CLC (Resilon, RealSeal SE); and Group 5: WVC (Resilon, RealSeal SE). Extruded debris during the retreatment procedure was collected in preweighed Eppendorf tubes. The times required for retreatment were recorded. Results The amount of debris extrusion was significantly greater with WVC than CLC in the gutta-percha and Resilon groups (P < 0.001). Using a phase gutta-percha resulted in significantly more debris extrusion than b phase gutta-percha (P < 0.001). In the WVC groups, Resilon caused significantly more debris extrusion than gutta-percha (P < 0.05). Retreatment was faster for CLC than WVC (P < 0.05). Conclusions In the retreatment procedure, the amount of apically extruded debris and retreatment duration were dependent on the type of obturation material and technique used.
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Affiliation(s)
- B C Canakci
- Department of Endodontics, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - R Sungur
- Department of Endodontics, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - O Er
- Department of Endodontics, Faculty of Dentistry, Trakya University, Edirne, Turkey
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Abstract
Several lines of evidence indicate that cell competition can occur in mammals. In particular, at the initial stage of carcinogenesis, normal epithelial cells are able to recognize the neighboring transformed cells and actively eliminate them from epithelial tissues. This implies that normal epithelia have anti-tumor activity that does not involve immune cells, which is termed epithelial defense against cancer (EDAC). In this review article, we summarize recent advances on the underlying molecular machinery of EDAC. In addition, we also describe the molecular mechanisms by which transformed cells escape from EDAC to promote carcinogenesis.
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Affiliation(s)
- Nobuyuki Tanimura
- Division of Molecular Oncology, Institute for Genetic Medicine, Graduate School of Chemical Sciences and Engineering, Hokkaido University, Sapporo, 060-0815, Japan
| | - Yasuyuki Fujita
- Division of Molecular Oncology, Institute for Genetic Medicine, Graduate School of Chemical Sciences and Engineering, Hokkaido University, Sapporo, 060-0815, Japan.
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Cai X, Wang XY, Santarcangelo F, Schoeffel GJ, Bergeron BE, Tay FR, Niu LN. Effect of simulated intraosseous sinusoidal pressure on NaOCl extrusion. J Dent 2018; 78:46-50. [PMID: 30077808 DOI: 10.1016/j.jdent.2018.08.001] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 07/28/2018] [Accepted: 08/01/2018] [Indexed: 01/29/2023] Open
Abstract
INTRODUCTION The present study examined the effects of irrigant flow rate and simulated intraosseous sinusoidal pressure on the rate of NaOCl extrusion from the apical terminus of a faux root canal. METHODS An extrusion setup was designed to enable irrigant extrusion to be opposed by 30 mm Hg simulated intraosseous pressure. The faux canal apex was opposed by atmospheric + 30 mm Hg pressure (experimental) or atmospheric pressure only (control group). Using five irrigant delivery rates (15.6 8.0, 4.0, 3.4 or 3.0 mL/min), the extrusion rates of 2% NaOCl from the faux apex were measured in both groups (n = 16). Data were analysed with two-factor ANOVA and pairwise comparisons at α = 0.05. Correlation between NaOCl delivery rates and extrusion rates in both groups were analysed with the Pearson product-moment procedure. RESULT Irrespective of the presence or absence of simulated sinusoidal pressure, NaOCl extrusion rates were positively-correlated with irrigant flow rates. For the factor "irrigant flow rates", significant differences in NaOCl extrusion rates were identified among all flow rates (p < 0.05), except for the pairwise comparison between 4.0 and 3.4 mL/min in the control. For all irrigant flow rates, NaOCl extrusion rate was significantly lower in the presence of 30 mm Hg simulated sinusoidal pressure than that obtained in the absence of opposing pressure (p < 0.05). CONCLUSION In the presence of 30 mm Hg simulated intraosseous pressure, NaOCl delivered via a side-vented needle inserted to 1 mm short of working length may be prevented from extrusion when its flow rate is ≤ 3.0 mL/min. CLINICAL SIGNIFICANCE When opposed by intraosseous sinusoidal pressure, NaOCl delivered via a side-vented needle inserted to 1 mm short of working length may be prevented from extrusion when its flow rate is ≤ 3.0 mL/min.
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Affiliation(s)
- Xue Cai
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiao-Yan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | | | - G John Schoeffel
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Brian E Bergeron
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Franklin R Tay
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, Georgia, USA; Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China.
| | - Li-Na Niu
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, Georgia, USA; Department of Prosthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China.
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Shetty VP, Naik BD, Pachlag AK, Yeli MM. Comparative evaluation of the amount of debris extruded apically using conventional syringe, passive ultrasonic irrigation and EndoIrrigator Plus system: An in vitro study. J Conserv Dent 2018; 20:411-414. [PMID: 29430092 PMCID: PMC5799986 DOI: 10.4103/jcd.jcd_200_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 11/24/2022] Open
Abstract
Aim: The aim of this study is to compare the effects of conventional syringe, passive ultrasonic irrigation (PUI), and EndoIrrigator Plus on the amount of apically extruded debris. Materials and Methods: Thirty extracted human mandibular premolars were selected and randomly assigned to three groups (n = 10). The root canals were irrigated with conventional syringe, PUI, and EndoIrrigator Plus. Sodium hypochlorite was used as an irrigant, and debris was collected in a previously described experimental model (Myers and Montgomery 1991). It was then stored in an incubator at 37°C for 10 days to evaporate the irrigant before weighing the dry debris. The mean weight of debris was assessed, one-way analysis of variance was used for comparison of values, and post hoc Tukey's test was used between groups (P = 0.05). Results: The EndoIrrigator Plus group extruded significantly less debris than PUI and conventional syringe groups (P < 0.05). Furthermore, PUI group extruded significantly less debris than conventional syringe irrigation group (P < 0.05). Conclusions: 1. All the three irrigation systems were associated with apical extrusion of debris, 2. EndoIrrigator Plus system extruded significantly less debris than the PUI system and the conventional syringe irrigation system, 3. PUI system extruded significantly less debris than the conventional syringe irrigation system.
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Affiliation(s)
- Vidhi Prabhakar Shetty
- Department of Conservative Dentistry and Endodontics, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
| | - Balaram Damodar Naik
- Department of Conservative Dentistry and Endodontics, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
| | - Amit Kashinath Pachlag
- Department of Conservative Dentistry and Endodontics, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
| | - Mahantesh Mrityunjay Yeli
- Department of Conservative Dentistry and Endodontics, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
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Dincer AN, Guneser MB, Arslan D. Apical extrusion of debris during root canal preparation using a novel nickel-titanium file system: WaveOne gold. J Conserv Dent 2018; 20:322-325. [PMID: 29386779 PMCID: PMC5767826 DOI: 10.4103/jcd.jcd_407_16] [Citation(s) in RCA: 12] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim: This study was intended to evaluate the amount of apically extruded debris following root canal preparation with three different instrumentation systems. Materials and Methods: Sixty mandibular incisor teeth were selected and randomly divided into three groups (n = 20/group) according to the instrumentation system used: the ProTaper Next (PTN; Dentsply Maillefer, Ballaigues, Switzerland), the Twisted File Adaptive (TFA; SybronEndo, Orange, CA, USA), and the WaveOne Gold (WOG; Dentsply Maillefer, Ballaigues, Switzerland). All apically extruded debris was collected and dried in preweighed glass vials. The mean weight of the apically extruded debris was obtained using a microbalance. The time for root canal preparation was also recorded. The data were analyzed using a one-way analysis of variance. Results: The mean weights of apically extruded debris were 0.00035 ± 0.00014 g (PTN); 0.00023 ± 0.0001 g (TFA); and 0.00019 ± 0.0001 g (WOG) (P < 0.01). The mean preparation time value was 301,13 ± 62.14 s (PTN); 234.27 ± 34.88 s (TFA); and 239.8 ± 58.6 s (WOG) (P < 0.05). Conclusions: The PTN system extruded more debris than the TFA and WOG systems. The TFA and WOG systems were faster than the PTN system.
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Affiliation(s)
- Asiye Nur Dincer
- Department of Endodontics, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Mehmet Burak Guneser
- 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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Thakur B, Pawar AM, Kfir A, Neelakantan P. Extrusion of Debris from Primary Molar Root Canals following Instrumentation with Traditional and New File Systems. J Contemp Dent Pract 2017; 18:1040-1044. [PMID: 29109318 DOI: 10.5005/jp-journals-10024-2172] [Citation(s) in RCA: 7] [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] [Indexed: 11/23/2022]
Abstract
INTRODUCTION To assess the amount of debris extruded apically during instrumentation of distal canals of extracted primary molars by three instrument systems [ProTaper Universal (PTU), ProTaper NEXT (PTN), and self-adjusting file (SAF)] compared with conventional stainless steel hand K-files (HF, control). MATERIALS AND METHODS Primary mandibular molars (n = 120) with a single distal canal were selected and randomly divided into four groups (n = 30) for root canal instrumentation using group I, HF (to size 0.30/0.02 taper), group II, PTU (to size F3), group III, PTN (to size X3), and group IV, SAF. Debris extruded during instrumentation was collected in preweighed Eppendorf tubes, stored in an incubator at 70°C for 5 days and then weighed. Statistical analysis was performed by one-way analysis of variance (ANOVA), followed by Turkey's post hoc test (p = 0.05). RESULTS All the groups resulted in extrusion of debris. There was statistically significant difference (p < 0.001) in the debris extrusion between the three groups: HF (0.00133 ± 0.00012), PTU (0.00109 ± 0.00005), PTN (0.00052 ± 0.00008), and SAF (0.00026 ± 0.00004). CONCLUSION Instrumentation with SAF resulted in the least debris extrusion when used for shaping root canals of primary molar teeth. CLINICAL SIGNIFICANCE Debris extrusion in primary teeth poses an adverse effect on the stem cells and may also alter the permanent dental germ. Debris extrusion is rarely reported for primary teeth and it is important for the clinician to know which endodontic instrumentation leads to less extrusion of debris.
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Affiliation(s)
- Bhagyashree Thakur
- Department of Dentistry, Sir HN Reliance Foundation Hospital and Research Centre, Mumbai, Maharashtra, India
| | - Ajinkya M Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India, Phone: +919867636233 e-mail:
| | - Anda Kfir
- Department of Endodontology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Prasanna Neelakantan
- Department of Endodontology, Faculty of Dentistry, The University of Hong Kong, Hong Kong
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Saberi E, Zahedani SS, Ebrahimipour S. Apical Extrusion of Intracanal Bacteria with Single File and Multifile Rotary Instrumentation Systems. J Int Soc Prev Community Dent 2017; 7:292-296. [PMID: 29026702 PMCID: PMC5629858 DOI: 10.4103/jispcd.jispcd_199_17] [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: 06/06/2017] [Accepted: 08/24/2017] [Indexed: 11/09/2022] Open
Abstract
Aims and Objectives: Instrumentation techniques may cause extrusion of microorganisms and their products into the periapical region resulting inflammation and treatment failure. The aim of this ex vivo study was comparing the apical bacterial extrusion in canals prepared with single file versus multiple file rotary systems. Materials and Methods: Ninety-two human single-rooted mandibular first premolars were used. Endodontic access cavities were prepared, and root canals were contaminated with an Enterococcus faecalis (E. faecalis) suspension. The samples were incubated at 37°C for 30 days; the contaminated teeth were divided into four groups of 20 specimens each (1: Reciproc, 2: Mtwo, 3: Neoniti A1, 4: Safesider). Six teeth were not infected and each were prepared with one of the above instruments were considered as negative and six teeth which had been previously infected, were used as positive control groups. Extruded bacteria from the apical foramen during instrumentation were collected into vials containing 0.9% NaCl. The microbial samples were taken from the vials and incubated in brain heart agar medium for 24 h. The resulting bacterial titer, in colony-forming units per mL, was determined. The data entered into SPSS 18 software and were analyzed by Kruskal–Wallis and Mann–Whitney U-tests at 0.05 significance level. Results: Mtwo multifile system showed significantly less bacterial extrusion than Safesider (P = 0.015) and Neoniti A1 (P = 0.042) but did not show significant difference with Reciproc system (P = 0.25). Conclusions: All instrumentation systems extruded bacteria beyond the apical foramen. However, this study showed that Mtwo multifile rotary system extruded fewer bacteria.
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Affiliation(s)
- Eshaghali Saberi
- Department of Endodontics, Oral and Dental Diseases Research Center, Dental School, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Shahram Shahraki Zahedani
- Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Sediqe Ebrahimipour
- Department of Endodontics, Faculty of Dentistry and Dental Research Center, Birjand University of Medical Sciences, Birjand, Iran
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Pawar AM, Pawar M, Kfir A, Thakur B, Mutha P, Banga KS. Effect of glide path preparation on apical extrusion of debris in root canals instrumented with three single-file systems: An ex vivo comparative study. J Conserv Dent 2017; 20:110-114. [PMID: 28855758 PMCID: PMC5564236 DOI: 10.4103/0972-0707.212235] [Citation(s) in RCA: 7] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Aim: The aim of this study was to test the effect of new protocol of glide path preparation by 20/0.04 rotary file on apical extrusion of debris when instrumenting fine curved mesial canals in mandibular molars with Self-adjusting File (SAF) and compare it to a glide path prepared by 20/0.02 hand K-file and rotary OneShape (OS) and reciprocating WaveOne (WO) file instrumentation. Materials and Methods: Sixty mandibular molars with curved mesial roots were selected and randomly divided into three groups (n = 20) for instrumentation. In two groups, glide path was prepared using 20/0.02 K-file for instrumentation by OS (size 25/0.06 taper) and WO (size 25/0.08 taper) files; in the remaining group, 20/0.04 rotary file was used for glide path preparation and instrumented by SAF (1.5 mm). The debris extruded during instrumentation was collected in preweighed Eppendorf tubes and stored in an incubator at 70°C for 5 days. Tubes containing the dry extruded debris were then weighed. One-way analysis of variance (ANOVA) was applied to the weights obtained, followed by Tukey's post hoc test for multiple comparison. Results: The mean debris (g) extruded apically was 0.000651 ± 0.000291, 0.000823 ± 0.000319, and 0.000473 ± 0.000238 for Group 1 (20/0.02 + OS), Group 2 (20/0.02 + WO), and Group 3 (20/0.04 + SAF), respectively. The groups exhibited a significant difference (P < 0.01; ANOVA). Group 3 resulted in least debris extrusion compared to Groups 1 and 2 (P < 0.01; Tukey's post hoc test). Conclusion: Glide path prepared to size 20/0.04 and SAF 1.5 mm instrumentation produce less debris in curved mesial canals of mandibular molars, compared to glide path established by 20/0.02 and instrumentation by OS and WO files.
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Affiliation(s)
- Ajinkya M Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Mansing Pawar
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Anda Kfir
- Department of Endodontology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Bhagyashree Thakur
- Department of Dentistry, Sir HN Reliance Foundation Hospital, Mumbai, Maharashtra, India
| | - Pooja Mutha
- Department of Conservative Dentistry and Endodontics, D Y Patil Dental School, Pune, Maharashtra, India
| | - Kulwinder Singh Banga
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India
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Abstract
BACKGROUND All endodontic instrumentation systems tested so far, promote apical extrusion of debris, which is one of the main causes of postoperative pain, flare ups, and delayed healing. OBJECTIVES Of this meta-analysis was to collect and analyze in vitro studies quantifying apically extruded debris while using Hand ProTaper (manual), ProTaper Universal (rotary), Wave One (reciprocating), and self-adjusting file (SAF; vibratory) endodontic instrumentation systems and to determine methods which produced lesser extrusion of debris apically. METHODOLOGY An extensive electronic database search was done in PubMed, Scopus, Cochrane, LILACS, and Google Scholar from inception until February 2016 using the key terms "Apical Debris Extrusion, extruded material, and manual/rotary/reciprocating/SAF systems." A systematic search strategy was followed to extract 12 potential articles from a total of 1352 articles. The overall effect size was calculated from the raw mean difference of weight of apically extruded debris. RESULTS Statistically significant difference was seen in the following comparisons: SAF < Wave One, SAF < Rotary ProTaper. CONCLUSIONS Apical extrusion of debris was invariably present in all the instrumentation systems analyzed. SAF system seemed to be periapical tissue friendly as it caused reduced apical extrusion compared to Rotary ProTaper and Wave One.
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Affiliation(s)
- J Sylvia Western
- Faculty of Dentistry, SEGi University, No. 9, Jalan Teknologi, Kota Damansara, PJU5, Selangor, Malaysia
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Singbal K, Jain D, Raja K, Hoe TM. Comparative evaluation of apically extruded debris during root canal instrumentation using two Ni-Ti single file rotary systems: An in vitro study. J Conserv Dent 2017; 20:64-67. [PMID: 28855748 PMCID: PMC5564245 DOI: 10.4103/0972-0707.212236] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Apical extrusion of debris during instrumentation is detrimental to the patient. AIM The aim of this study was to evaluate the apical extrusion of debris during root canal instrumentation using two single file rotary Ni-Ti systems. MATERIALS AND METHODS Thirty freshly extracted mandibular premolars with straight roots were sterilized and divided into two groups instrumented using: One Shape rotary Ni-Ti system with Endoflare orifice shaper (Group 1) and Neo-Niti rotary Ni-Ti system with C1 orifice shaper (Group 2). Preweighed Eppendorf tubes fitted for each tooth before instrumentation. During instrumentation, 1 mL of distilled water with a 30-gauge needle was used to irrigate after every instrument. Tips of the tooth were irrigated with 2 ml distilled water after removal from Eppendorf tubes. The total volume of irrigant in each group was the same 8 ml. All tubes were incubated at 68°C for 15 days and subsequently weighed. The difference between pre- and post-debris weights was calculated, and statistical analysis was performed using independent t-test and level of significance was set at 0.05. RESULTS The difference between pre- and post-weights was significantly greater for the One Shape system. CONCLUSIONS The Neolix Niti single file was associated with less extrusion compared to One Shape single file system.
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Affiliation(s)
- Kiran Singbal
- Department of Conservative Dentistry, Mahsa University, Selangor, Malaysia
| | - Disha Jain
- Department of Conservative Dentistry and Endodontics, K.M. Shah Dental College, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Kranthi Raja
- Department of Conservative Dentistry, Mahsa University, Selangor, Malaysia
| | - Tan Ming Hoe
- Department of Conservative Dentistry, Mahsa University, Selangor, Malaysia
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Subbiya A, Cherkas PS, Vivekanandhan P, Geethapriya N, Malarvizhi D, Mitthra S. Effect of three different rotary instrumentation systems on postinstrumentation pain: A randomized clinical trial. J Conserv Dent 2017; 20:467-473. [PMID: 29430103 PMCID: PMC5799997 DOI: 10.4103/jcd.jcd_350_16] [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: 12/29/2022] Open
Abstract
Background: Endodontic instrumentation is liable to cause some postinstrumentation pain (PIP). Rotary endodontic instruments differ in their design, metallurgy, surface treatment, etc. Aim: This randomized clinical trial aimed to assess the incidence of PIP after root canal instrumentation with three different rotary endodontic systems which differ in their design, namely, ProTaper, Mtwo, and K3. Materials and Methods: A total of 150 patients between the ages of 25 and 50 were chosen for the study. Teeth with asymptomatic irreversible pulpitis due to carious exposure were selected. The patients received local anesthesia by inferior alveolar nerve block. After preparing the access cavity, root canal instrumentation was done with one of the three instruments (n = 50) and closed dressing was given. PIP was assessed every 12 h for 5 days, and tenderness to percussion was analyzed at the end of 1, 3, and 7 days. Statistical Analysis: Mann–Whitney U-test to determine significant differences at P < 0.01. Results: The PIP and tenderness were less in Mtwo group when compared to ProTaper and K3 groups up to 84 h and 72 h respectively and statistically significant (P < 0.05). There was no statistically significant difference between ProTaper and K3 both in PIP and tenderness. Conclusion: Rotary endodontic instrumentation causes some degree of PIP and tenderness to percussion. Among the instruments used, Mtwo causes less PIP and tenderness when compared to ProTaper and K3, and there was no difference between ProTaper and K3. Clinical Relevance: PIP is highly subjective and may vary among different subjects. The apical (3 mm) taper of ProTaper was 0.08 followed by a smaller taper, whereas, the other two files were of a constant 0.06 taper, which means there could have been a greater apical extrusion and therefore more PIP. Despite, the mean of the age was similar, there could have been a difference in the size of the canal and therefore a difference in apical extrusion and PIP.
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Affiliation(s)
- Arunajatesan Subbiya
- Department of Conservative Dentistry and Endodontics, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
| | - Pavel S Cherkas
- Department of Oral Physiology and Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Paramasivam Vivekanandhan
- Department of Conservative Dentistry and Endodontics, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
| | - Nagarajan Geethapriya
- Department of Conservative Dentistry and Endodontics, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
| | - Dhakshinamoorthy Malarvizhi
- Department of Conservative Dentistry and Endodontics, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
| | - Suresh Mitthra
- Department of Conservative Dentistry and Endodontics, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
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Çiçek E, Koçak MM, Koçak S, Sağlam BC. Comparison of the amount of apical debris extrusion associated with different retreatment systems and supplementary file application during retreatment process. J Conserv Dent 2016; 19:351-4. [PMID: 27563185 PMCID: PMC4979283 DOI: 10.4103/0972-0707.186456] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The type of instrument affects the amount of debris extruded. The aim of this study was to compare the effect of retreatment systems and supplementary file application on the amount of apical debris extrusion. MATERIALS AND METHODS Forty-eight extracted mandibular premolars with a single canal and similar length were selected. The root canals were prepared with the ProTaper Universal system with a torque-controlled engine. The root canals were dried and were obturated using Gutta-percha and sealer. The specimens were randomly divided into four equal groups according to the retreatment procedures (Group 1, Mtwo retreatment files; Group 2, Mtwo retreatment files + Mtwo rotary file #30 supplementary file; Group 3, ProTaper Universal retreatment (PTUR) files; and Group 4, PTUR files + ProTaper F3 supplementary file). The extruded debris during instrumentation were collected into preweighed Eppendorf tubes. The amount of apically extruded debris was calculated by subtracting the initial weight of the tube from the final weight. Three consecutive weights were obtained for each tube. RESULTS No statistically significant difference was found in the amount of apically extruded debris between Groups 1 and 3 (P = 0.590). A significant difference was observed between Groups 1 and 2 (P < 0.05), and between Groups 3 and 4 (P < 0.05). CONCLUSIONS The use of supplementary file significantly increased the amount of apically extruded debris.
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Affiliation(s)
- Ersan Çiçek
- Department of Endodontics, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
| | - Mustafa Murat Koçak
- Department of Endodontics, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
| | - Sibel Koçak
- Department of Endodontics, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
| | - Baran Can Sağlam
- Department of Endodontics, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
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Kasam S, Mariswamy AB. Efficacy of Different Methods for Removing Root Canal Filling Material in Retreatment - An In-vitro Study. J Clin Diagn Res 2016; 10:ZC06-10. [PMID: 27504397 DOI: 10.7860/jcdr/2016/17395.7904] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 10/18/2015] [Accepted: 02/23/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Although success of endodontic therapy has significantly improved in the last few decades due to the introduction of novel materials and techniques, failures of endodontic therapy requiring re-treatment still comprise a significant percentage of patients requiring root canal treatment. AIM To evaluate and compare the effective removal of gutta percha and sealer, amount of apical debris extrusion and time required for gutta percha removal using various endodontic files. MATERIALS AND METHODS Total 48 extracted mandibular premolars were mounted on acrylic blocks and endodontic procedure was carried out using size 40 K file and obturated using guttapercha and zinc oxide eugenol sealer. After one month storage, samples were decoronated, mounted on screw capped vials and subjected to removal of obturated material by four instruments: H files, safe sided H files, protaper universal retreatment rotary system and ultrasonic retreatment tip, grouped as 1, 2, 3, and 4 respectively. Only 2mm of obturated material from the coronal part was removed using no. 3 Gates Glidden drill, guttapercha was softened with a drop of xylene for 2 mins for each canal and retreatment was performed. The retreatment procedure was said to be complete when no visible debris were observed on the instrument flutes. The samples split into two halves and examined under stereomicroscope, photographed, assessed using AUTOCAD software and percentage of remaining filling material in coronal, middle, apical thirds of the canal was calculated in mm(2). Retreatment time was recorded in seconds and apically extruded debris was assessed by microbalance in grams for each tooth. The data was analyzed by using descriptive statistics, ANOVA and Scheffe's post hoc test through SPSS for windows (v 16.0). RESULTS The ultrasonic retreatment tip had less percentage of residual guttapercha/sealer, shorter mean operating time and little apical extrusion with a significant difference (p<0.05) between the other groups. CONCLUSION All techniques retained guttapercha/sealer remnants within the root canal. The ultrasonic retreatment tip proved to be an efficient method of removing obturated material. It was fastest with least apical debris extrusion.
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Affiliation(s)
- Swetha Kasam
- Post Graduate Student, Department of Conservative Dentistry and Endodontics, JSS Dental College and Hospital , Mysore, Karnataka, India
| | - Annapoorna Ballagere Mariswamy
- Professor, Department of Conservative Dentistry and Endodontics, JSS Dental College and Hospital , Mysore, Karnataka, India
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Abstract
BACKGROUND Postoperative inflammation and endodontic failure occur due to apical extrusion of debris. AIM To evaluate the amount of apically extruded debris after preparation of straight root canals in extracted human teeth using three rotary systems. MATERIALS AND METHODS Sixty single-rooted human teeth with single root canal and apical foramen were selected and randomly divided into three experimental groups (n = 20) according to the rotary system used: Group 1 - ProTaper, Group 2 - Revo-S, Group 3 - WaveOne. Apical enlargement was done up to size 40/0.06 for Groups 1 and 2 and 40/0.08 for Group 3. For debris collection, each tooth was held in a preweighed Eppendorf tube fixed inside a glass vial through rubber plug. After instrumentation, each tooth was separated from the Eppendorf tube and the debris adhering to the root surface was collected by washing the root with 1 mL of bi-distilled water and incubated at 70°C for 5 days. The dry weight of extruded debris was weighed in an electronic balance. STATISTICAL ANALYSIS The mean weights of extruded debris were statistically analyzed using GraphPad prism version 6 and the intergroup comparison was done using unpaired t-test. RESULTS There was a statistically significant difference in the mean debris score among all the three groups - ProTaper (0.00065 g), Revo-S (0.00045 g) and WaveOne (0.00089 g). CONCLUSION Revo-S system was associated with significantly less debris extrusion compared with ProTaper or WaveOne.
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Affiliation(s)
- Paramasivam Vivekanandhan
- Department of Conservative Dentistry and Endodontics, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Arunajatesan Subbiya
- Department of Conservative Dentistry and Endodontics, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Suresh Mitthra
- Department of Conservative Dentistry and Endodontics, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Arumugam Karthick
- Department of Conservative Dentistry and Endodontics, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, Tamil Nadu, India
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Mittal R, Singla MG, Garg A, Dhawan A. A Comparison of Apical Bacterial Extrusion in Manual, ProTaper Rotary, and One Shape Rotary Instrumentation Techniques. J Endod 2015; 41:2040-4. [PMID: 26472680 DOI: 10.1016/j.joen.2015.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 05/28/2015] [Revised: 08/31/2015] [Accepted: 09/01/2015] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Apical extrusion of irrigants and debris is an inherent limitation associated with cleaning and shaping of root canals and has been studied extensively because of its clinical relevance as a cause of flare-ups. Many factors affect the amount of extruded intracanal materials. The purpose of this study was to assess the bacterial extrusion by using manual, multiple-file continuous rotary system (ProTaper) and single-file continuous rotary system (One Shape). METHODS Forty-two human mandibular premolars were inoculated with Enterococcus faecalis by using a bacterial extrusion model. The teeth were divided into 3 experimental groups (n = 12) and 1 control group (n = 6). The root canals of experimental groups were instrumented according to the manufacturers' instructions by using manual technique, ProTaper rotary system, or One Shape rotary system. Sterilized saline was used as an irrigant, and bacterial extrusion was quantified as colony-forming units/milliliter. The results obtained were statistically analyzed by using one-way analysis of variance for intergroup comparison and post hoc Tukey test for pair-wise comparison. The level for accepting statistical significance was set at P < .05. RESULTS All the instrumentation techniques resulted in bacterial extrusion, with manual step-back technique exhibiting significantly more bacterial extrusion than the engine-driven systems. Of the 2 engine-driven systems, ProTaper rotary extruded significantly more bacteria than One Shape rotary system (P < .05). CONCLUSIONS The engine-driven nickel-titanium systems were associated with less apical extrusion. The instrument design may play a role in amount of extrusion.
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Affiliation(s)
- Rakesh Mittal
- Department of Conservative Dentistry and Endodontics, Sudha Rustogi College of Dental Sciences and Research, Faridabad, Haryana, India
| | - Meenu G Singla
- Department of Conservative Dentistry and Endodontics, Sudha Rustogi College of Dental Sciences and Research, Faridabad, Haryana, India
| | - Ashima Garg
- Department of Conservative Dentistry and Endodontics, Sudha Rustogi College of Dental Sciences and Research, Faridabad, Haryana, India
| | - Anu Dhawan
- Department of Conservative Dentistry and Endodontics, Sudha Rustogi College of Dental Sciences and Research, Faridabad, Haryana, India.
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Singh A, Arunagiri D, Pushpa S, Sawhny A, Misra A, Khetan K. Apical extrusion of debris and irrigants using ProTaper hand, M-two rotary and WaveOne single file reciprocating system: An ex vivo study. J Conserv Dent 2015; 18:405-8. [PMID: 26430306 PMCID: PMC4578187 DOI: 10.4103/0972-0707.164055] [Citation(s) in RCA: 5] [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] [Received: 04/20/2015] [Revised: 06/11/2015] [Accepted: 07/02/2015] [Indexed: 11/12/2022] Open
Abstract
AIMS The purpose of this ex vivo study was to evaluate and compare the weight of debris and volume of irrigant extruded apically from teeth using different preparation techniques. SUBJECTS AND METHODS Thirty extracted human mandibular premolars with single canals and similar lengths were instrumented using hand ProTaper F2 (25, 0.08; Dentsply Maillefer, Ballaigues, Switzerland), M-two (25, 0.06; VDW, Munich, Germany) and WaveOne Primary (25, 0.08; Dentsply Maillefer, Ballaigues, Switzerland). Debris and irrigant extruded during instrumentation were collected into preweighed Eppendorf tubes. The volume of the irrigant was measured, and then the tubes were stored in an incubator at 70°C for 2 days. The Eppendorf tubes were weighed to obtain the final weight when the extruded debris was included. Three consecutive weights were obtained for each tube. STATISTICAL ANALYSIS USED Data were statistically analyzed by one-way analysis of variance and Student's t-test. RESULTS There were no statistically significant differences among the groups. The WaveOne reciprocating system showed the maximum amount of apical extrusion of debris and irrigant among all the groups. The least amount of debris and irrigant was observed in ProTaper hand instrument (P > 0.05). CONCLUSION All instrumentation techniques were associated with debris and irrigant extrusion.
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Affiliation(s)
- Abhishek Singh
- Department of Conservative Dentistry and Endodontics, Rama Dental College, Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Doraiswamy Arunagiri
- Department of Conservative Dentistry and Endodontics, Rama Dental College, Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Shankarappa Pushpa
- Department of Conservative Dentistry and Endodontics, Rama Dental College, Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Asheesh Sawhny
- Department of Conservative Dentistry and Endodontics, Rama Dental College, Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Abhinav Misra
- Department of Conservative Dentistry and Endodontics, Rama Dental College, Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Kirti Khetan
- Department of Conservative Dentistry and Endodontics, Rama Dental College, Hospital and Research Centre, Kanpur, Uttar Pradesh, India
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Çanakçi BC, Er O, Dincer A. Do the Sealer Solvents Used Affect Apically Extruded Debris in Retreatment? J Endod 2015; 41:1507-9. [PMID: 26238529 DOI: 10.1016/j.joen.2015.02.010] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 02/05/2015] [Accepted: 02/07/2015] [Indexed: 11/20/2022]
Abstract
INTRODUCTION We evaluated apically extruded debris in the retreatment of root canals filled with different root canal sealers and gutta-percha using different solvents. METHODS Ninety human mandibular central and lateral teeth were prepared using the Reciproc #25 .08 nickel-titanium system (VDW GmbH, Munich, Germany) and were divided randomly into 6 groups. In groups 1, 2, and 3, root canals were filled with epoxy resin-based sealer and gutta-percha, and in groups 4, 5, and 6, root canals were filled with zinc oxide-eugenol-based sealer and gutta-percha. Each tooth was placed in a glass vial experimental apparatus. All root canal fillings were removed with the ProTaper Retreatment nickel-titanium system (Dentsply Maillefer, Ballaigues, Switzerland). During the retreatment procedure, in group 1, Resosolv (Pierre Rolland, Merignac, France) was used; in group 4, Endosolv E (Septodont, Paris, France) was used; and in groups 2 and 5, Guttasolv (Septodont) was used as the solvent. In the control groups (groups 3 and 6), no solvent was used. Reciproc #40 .06 was used for the final preparation. The times required for retreatments were recorded. RESULTS The weight of the extruded debris and the time required for retreatment were decreased significantly in the groups in which a solvent that was intended specifically for the root canal sealer was used (groups 1 and 4). In the Guttasolv groups (groups 2 and 5), the amount of apically extruded debris and the time required decreased for both root canal sealers. CONCLUSIONS The amount of apically extruded debris and the duration of retreatment were reduced by the use of a solvent specific to the sealer compared with a gutta-percha solvent or no solvent.
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Affiliation(s)
- Burhan Can Çanakçi
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey.
| | - Ozgur Er
- Department of Endodontics, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - Asiye Dincer
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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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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Pawar AM, Pawar MG, Metzger Z, Kokate SR. The self-adjusting file instrumentation results in less debris extrusion apically when compared to WaveOne and ProTaper NEXT. J Conserv Dent 2015; 18:89-93. [PMID: 25829683 PMCID: PMC4379665 DOI: 10.4103/0972-0707.153057] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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: 08/23/2014] [Revised: 11/30/2014] [Accepted: 12/09/2014] [Indexed: 11/26/2022] Open
Abstract
Aim: The present ex vivo study aimed to evaluate the debris extrusion after instrumenting the root canals by three different files systems. Materials and Methods: Sixty extracted human mandibular premolars with single canals were selected and randomly divided into three groups (n = 20) for instrumentation with three different files. Group 1: WaveOne (primary) single reciprocating file (WO; Dentsply Maillefer, Ballaigues, Switzerland) (25/08), Group 2: Self-adjusting file (SAF; ReDent-Nova, Ra’anana, Israel) (1.5 mm), and Group 3: ProTaper NEXT X1 and X2 (PTN; Dentsply Tulsa Dental, Tulsa, OK) (25/06). Debris extruding by instrumentation were collected into pre-weighed Eppendorf tubes. These tubes were then stored in an incubator at 70°C for 5 days. The tubes were then weighed to obtain the final weight, with the extruded debris. Statistical analysis for the debris extruded apically was performed using one-way analysis of variance and post hoc Tukey's test. Results: The statistical analysis showed a significant difference between all the three groups tested (P < 0.01). The following post hoc Tukey's test confirmed that Group 2 (SAF) exhibited significantly least (P < 0.01) debris extrusion between the three groups tested. Conclusions: The SAF resulted in significantly less extrusion of debris when compared to reciprocating WO and rotary PTN.
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Affiliation(s)
- Ajinkya M Pawar
- Department of Conservative Dentistry and Endodontics, Dnyandeo Yashwantrao Patil Dental School and Hospital, Lohegaon, Pune, India
| | - Mansing G Pawar
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Mumbai, India
| | - Zvi Metzger
- Department of Endodontology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharad R Kokate
- Department of Conservative Dentistry and Endodontics, Yashwant Memorial Trust Dental College and Hospital, Kharghar, Navi-Mumbai, Maharashtra, India
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Ohoka A, Kajita M, Ikenouchi J, Yako Y, Kitamoto S, Kon S, Ikegawa M, Shimada T, Ishikawa S, Fujita Y. EPLIN is a crucial regulator for extrusion of RasV12-transformed cells. J Cell Sci 2015; 128:781-9. [PMID: 25609711 DOI: 10.1242/jcs.163113] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [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: 12/31/2022] Open
Abstract
At the initial stage of carcinogenesis, a mutation occurs in a single cell within a normal epithelial layer. We have previously shown that RasV12-transformed cells are apically extruded from the epithelium when surrounded by normal cells. However, the molecular mechanisms underlying this phenomenon remain elusive. Here, we demonstrate that Cav-1-containing microdomains and EPLIN (also known as LIMA1) are accumulated in RasV12-transformed cells that are surrounded by normal cells. We also show that knockdown of Cav-1 or EPLIN suppresses apical extrusion of RasV12-transformed cells, suggesting their positive role in the elimination of transformed cells from epithelia. EPLIN functions upstream of Cav-1 and affects its enrichment in RasV12-transformed cells that are surrounded by normal cells. Furthermore, EPLIN regulates non-cell-autonomous activation of myosin-II and protein kinase A (PKA) in RasV12-transformed cells. In addition, EPLIN substantially affects the accumulation of filamin A, a vital player in epithelial defense against cancer (EDAC), in the neighboring normal cells, and vice versa. These results indicate that EPLIN is a crucial regulator of the interaction between normal and transformed epithelial cells.
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Affiliation(s)
- Atsuko Ohoka
- Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-0815, Japan
| | - Mihoko Kajita
- Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-0815, Japan
| | - Junichi Ikenouchi
- Department of Biology, Faculty of Sciences, Kyushu University, 6-10-1 Hakozaki, Higashi-ku, Fukuoka 812-8581, Japan
| | - Yuta Yako
- Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-0815, Japan
| | - Sho Kitamoto
- Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-0815, Japan
| | - Shunsuke Kon
- Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-0815, Japan
| | - Masaya Ikegawa
- Genomics, Proteomics and Biomedical Functions, Department of Life and Medical Systems, Faculty of Life and Medical Sciences, Doshisha University, 1-3 Tataramiyakodani, Kyotanabe, Kyoto 610-0394, Japan
| | - Takashi Shimada
- Shimadzu Corporation, Life Science Research Center, 1-3 Kanda, Nishiki-cho, Chiyoda-ku, Tokyo 101-8448, Japan
| | - Susumu Ishikawa
- Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-0815, Japan
| | - Yasuyuki Fujita
- Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University Graduate School of Chemical Sciences and Engineering, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-0815, Japan
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Anton KA, Sinclair J, Ohoka A, Kajita M, Ishikawa S, Benz PM, Renne T, Balda M, Jorgensen C, Matter K, Fujita Y. PKA-regulated VASP phosphorylation promotes extrusion of transformed cells from the epithelium. J Cell Sci 2014; 127:3425-33. [PMID: 24963131 DOI: 10.1242/jcs.149674] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
At the early stages of carcinogenesis, transformation occurs in single cells within tissues. In an epithelial monolayer, such mutated cells are recognized by their normal neighbors and are often apically extruded. The apical extrusion requires cytoskeletal reorganization and changes in cell shape, but the molecular switches involved in the regulation of these processes are poorly understood. Here, using stable isotope labeling by amino acids in cell culture (SILAC)-based quantitative mass spectrometry, we have identified proteins that are modulated in transformed cells upon their interaction with normal cells. Phosphorylation of VASP at serine 239 is specifically upregulated in Ras(V12)-transformed cells when they are surrounded by normal cells. VASP phosphorylation is required for the cell shape changes and apical extrusion of Ras-transformed cells. Furthermore, PKA is activated in Ras-transformed cells that are surrounded by normal cells, leading to VASP phosphorylation. These results indicate that the PKA-VASP pathway is a crucial regulator of tumor cell extrusion from the epithelium, and they shed light on the events occurring at the early stage of carcinogenesis.
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Affiliation(s)
- Katarzyna A Anton
- Department of Cell Biology, UCL Institute of Ophthalmology, University College London, London EC1V 9EL, UK MRC Laboratory for Molecular Cell Biology and Cell Biology Unit, University College London, London WC1E 6BT, UK
| | - John Sinclair
- Division of Cancer Biology, Cell Communication Team, The Institute of Cancer Research, London SW3 6JB, UK
| | - Atsuko Ohoka
- Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University, Sapporo 060-0815, Japan
| | - Mihoko Kajita
- Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University, Sapporo 060-0815, Japan
| | - Susumu Ishikawa
- Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University, Sapporo 060-0815, Japan
| | - Peter M Benz
- Institute for Vascular Signaling, University of Frankfurt, Frankfurt D-60590, Germany
| | - Thomas Renne
- Department of Molecular Medicine and Surgery and Center for Molecular Medicine, Karolinska Institute, Stockholm SE-171 77, Sweden Institute for Clinical Chemistry, University Hospital Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Maria Balda
- Department of Cell Biology, UCL Institute of Ophthalmology, University College London, London EC1V 9EL, UK
| | - Claus Jorgensen
- Division of Cancer Biology, Cell Communication Team, The Institute of Cancer Research, London SW3 6JB, UK
| | - Karl Matter
- Department of Cell Biology, UCL Institute of Ophthalmology, University College London, London EC1V 9EL, UK
| | - Yasuyuki Fujita
- MRC Laboratory for Molecular Cell Biology and Cell Biology Unit, University College London, London WC1E 6BT, UK Division of Molecular Oncology, Institute for Genetic Medicine, Hokkaido University, Sapporo 060-0815, Japan
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Surakanti JR, Venkata RCP, Vemisetty HK, Dandolu RK, Jaya NKM, Thota S. Comparative evaluation of apically extruded debris during root canal preparation using ProTaper™, Hyflex™ and Waveone™ rotary systems. J Conserv Dent 2014; 17:129-32. [PMID: 24778507 PMCID: PMC4001267 DOI: 10.4103/0972-0707.128045] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [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: 07/05/2013] [Revised: 12/10/2013] [Accepted: 01/03/2014] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND AIMS Extrusion of any debris during endodontic treatment may potentially cause post-operative complications such as flare-ups. The purpose of this in vitro study was to assess the amount of apically extruded debris during the root canal preparation using rotary and reciprocating nickel-titanium instrumentation systems. MATERIALS AND METHODS In this study, 60 human mandibular first premolars were randomly assigned to 3 groups (n = 20 teeth/group). The root canals were instrumented according to the manufacturers' instructions using the Reciprocating single-file system WaveOne™ (Dentsply Maillefer, Ballaigues, Switzerland) and full-sequence rotary Hyflex CM™ (Coltene Whaledent, Allstetten, Switzerland) and ProTaper™ (Dentsply Maillefer, Ballaigues, Switzerland) instruments. The canals were then irrigated using bidistilled water. The debris that was extruded apically was collected in preweighed eppendorf tubes and assessed with an electronic balance and compared. STATISTICAL ANALYSIS USED The debris extrusion was compared and statistically analyzed using analysis of variance and the post hoc Student-Newman-Keuls test. RESULTS The WaveOne™ and ProTaper™ rotary instruments produced significantly more debris compared with Hyflex CM™ rotary instruments (P < 0.05). CONCLUSIONS Under the conditions of this study, all systems that were used resulted in extrusion of apical debris. Full-sequence rotary instrumentation was associated with less debris extrusion compared with the use of reciprocating single-file systems.
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Affiliation(s)
- Jayaprada Reddy Surakanti
- Department of Conservative Dentistry & Endodontics, Kamineni Institute of Dental Sciences, Sreepuram, Narketpally, Nalgonda, Andhra Pradesh, India
| | - Ravi Chandra Polavarapu Venkata
- Department of Conservative Dentistry & Endodontics, Kamineni Institute of Dental Sciences, Sreepuram, Narketpally, Nalgonda, Andhra Pradesh, India
| | - Hari Kumar Vemisetty
- Department of Conservative Dentistry & Endodontics, Kamineni Institute of Dental Sciences, Sreepuram, Narketpally, Nalgonda, Andhra Pradesh, India
| | - Ram Kiran Dandolu
- Department of Conservative Dentistry & Endodontics, Kamineni Institute of Dental Sciences, Sreepuram, Narketpally, Nalgonda, Andhra Pradesh, India
| | - Nagendra Krishna Muppalla Jaya
- Department of Conservative Dentistry & Endodontics, Kamineni Institute of Dental Sciences, Sreepuram, Narketpally, Nalgonda, Andhra Pradesh, India
| | - Shirisha Thota
- Department of Conservative Dentistry & Endodontics, Kamineni Institute of Dental Sciences, Sreepuram, Narketpally, Nalgonda, Andhra Pradesh, India
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Garlapati R, Venigalla BS, Patil JD, Raju R, Rammohan C. Quantitative evaluation of apical extrusion of intracanal bacteria using K3, Mtwo, RaCe and protaper rotary systems: An in vitro study. J Conserv Dent 2013; 16:300-3. [PMID: 23956529 PMCID: PMC3740638 DOI: 10.4103/0972-0707.114353] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [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: 01/18/2013] [Revised: 04/25/2013] [Accepted: 05/11/2013] [Indexed: 11/06/2022] Open
Abstract
Aim: This aim of this study was to evaluate the number of bacteria extruded apically during root canal preparation using Four Rotary instrumentation techniques. Materials and Methods: A total of 50 extracted mandibular premolars were selected, access cavities prepared and inserted in to rubber stoppers of 10 mL glass vial. Root canals were contaminated with a suspension of Enterococcus faecalis (E. faecalis) American Type Culture Collection (ATCC) 29212 and incubated for 24 h at 37°C. Debris extruded from the apical foramen during instrumentation was collected into vials. The numbers of Colony-forming units were determined for each sample. Statistical Analysis: The data obtained were analyzed using the one-way ANOVA followed by post-hoc tukey's test with a P = 0.05 as the level for statistical significance. Results: Results suggested a statistically significant difference in the number of colony forming units between four experimental rotary Nickel-Titanium instrumentation groups (P < 0.001). Conclusion: Although, extrusion of bacteria was found in all the experimental groups. There was less bacterial extrusion in K3 Group while more bacterial extrusion was seen in Mtwo Group.
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Affiliation(s)
- Roopadevi Garlapati
- Department of Conservative Dentistry and Endodontics, Sibar Institute of Dental Sciences, Guntur, India
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Ghivari SB, Kubasad GC, Deshpande P. Comparative evaluation of apical extrusion of bacteria using hand and rotary systems : An in vitro study. J Conserv Dent 2012; 15:32-5. [PMID: 22368332 PMCID: PMC3284010 DOI: 10.4103/0972-0707.92603] [Citation(s) in RCA: 13] [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] [Received: 12/07/2010] [Revised: 02/19/2011] [Accepted: 05/21/2011] [Indexed: 11/21/2022] Open
Abstract
Aim: To evaluate the bacteria extruded apically during root canal preparation using two hand and rotary instrumentation techniques. Materials and Methods: Eighty freshly extracted mandibular premolars were mounted in bacteria collection apparatus. Root canals were contaminated with the pure culture of Enterococcus fecalis (ATCC 29212) and dried at 37°C for 24 h. Bacteria extruded were collected, incubated in brain heart infusion agar for 24 h at 36°C and the colony forming units (CFU) were counted. Statistical Analysis: The mean number of colony forming units were calculated by One-way ANOVA and comparison between the groups made by multiple comparison (Dunnet D) test. Results: The step-back technique extruded highest number of bacteria in comparison to other hand and rotary Ni–Ti systems. Conclusion: Under the limitation of this study all hand and rotary instrumentation techniques extruded bacteria. Among all the instrumentation techniques step-back technique extruded more number of bacteria and K-3 system the least. Further in vivo research in this direction could provide more insight into the biologic factors associated and focus on bacterial species that essentially play a major role in post instrumentation flare-ups.
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Affiliation(s)
- Sheetal B Ghivari
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College, Sawangi (Meghe), Wardha, Maharashtra, India
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Ghivari SB, Kubasad GC, Chandak MG, Akarte N. Apical extrusion of debris and irrigant using hand and rotary systems: A comparative study. J Conserv Dent 2011; 14:187-90. [PMID: 21814364 PMCID: PMC3146115 DOI: 10.4103/0972-0707.82622] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [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] [Received: 08/25/2010] [Revised: 10/28/2010] [Accepted: 11/05/2010] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate and compare the amount of debris and irrigant extruded quantitatively by using two hand and rotary nickel-titanium (Ni-Ti) instrumentation techniques. MATERIALS AND METHODS Eighty freshly extracted mandibular premolars having similar canal length and curvature were selected and mounted in a debris collection apparatus. After each instrument change, 1 ml of distilled water was used as an irrigant and the amount of irrigant extruded was measured using the Meyers and Montgomery method. After drying, the debris was weighed using an electronic microbalance to determine its weight. STATISTICAL ANALYSIS USED The data was analyzed statistically to determine the mean difference between the groups. The mean weight of the dry debris and irrigant within the group and between the groups was calculated by the one-way ANOVA and multiple comparison (Dunnet D) test. RESULTS The step-back technique extruded a greater quantity of debris and irrigant in comparison to other hand and rotary Ni-Ti systems. CONCLUSIONS All instrumentation techniques extrude debris and irrigant, it is prudent on the part of the clinician to select the instrumentation technique that extrudes the least amount of debris and irrigant, to prevent a flare-up phenomena.
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Affiliation(s)
- Sheetal B Ghivari
- Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College, Sawangi Meghe, Wardha, India
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Tasdemir T, Er K, Celik D, Yildirim T. Effect of passive ultrasonic irrigation on apical extrusion of irrigating solution. Eur J Dent 2008; 2:198-203. [PMID: 19212547 PMCID: PMC2635903] [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] [Indexed: 10/29/2022] Open
Abstract
OBJECTIVES To determine the influence of passive ultrasonic irrigation (PUI) on apical extrusion of irrigating solution. METHODS Twenty freshly extracted maxillary and mandibular incisors with single straight root canals were instrumented with ProTaper rotary files. During final irrigation, the root canals were filled with 2.5% sodium hypochlorite (NaOCl) solution and PUI was performed with a piezoelectronic unit. A stainless steel instrument (size 15) was inserted into the root canal and the irrigant was ultrasonically activated for one minute. This sequence was repeated three times, resulting in a total PUI time of three minutes. The volume of extruded irrigant was measured by Pipetman pipettes. The data were statistically analyzed with the Mann-Whitney U test. RESULTS The mean volume of apical extruded irrigant was 2.15 muL for the PUI group and 14 muL for the control group. The experimental group extruded significantly smaller amounts of irrigant than the control group (P<.05). CONCLUSIONS The PUI procedure as a final irrigation was associated with less apical extrusion of the irrigating solution.
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Affiliation(s)
- Tamer Tasdemir
- Department of Endodontics, School of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Kursat Er
- Department of Endodontics, School of Dentistry, Karadeniz Technical University, Trabzon, Turkey,Corresponding author: Dr. Kursat Er, Department of Endodontics, School of Dentistry, Karadeniz Technical University, 61080, Trabzon, Turkey. Phone: +90 462 3774735, Fax: +90 462 3253017, E-mail:
| | - Davut Celik
- Department of Endodontics, School of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Tahsin Yildirim
- Department of Restorative Dentistry, School of Dentistry, Karadeniz Technical University, Trabzon, Turkey
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