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Sudhakar S, Gupta N, Ghambir N, Singh R, Singh D. Comparative Evaluation of Intracanal Smear Layer Removal by Different Root Canal Irrigants: A Scanning Electron Microscope Study. Int J Clin Pediatr Dent 2023; 16:633-638. [PMID: 37731794 PMCID: PMC10507302 DOI: 10.5005/jp-journals-10005-2648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
Aim The purpose of the study is to compare and evaluate the efficacy of different root canal irrigants-100, 75, 50, and 25% neem extract, 100, 75, 50, and 25% apple cider vinegar (ACV), a combination of 5.25% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid (EDTA), and saline on smear layer removal using a scanning electron microscope (SEM). Materials and methods A total of 80 freshly extracted single-rooted teeth were collected and divided into 10 groups-group I: normal saline (negative control), group II: NaOCl with EDTA (positive control), group III: 100% neem extract, group IV: 75% neem extract, group V: 50% neem extract, group VI: 25% neem extract, group VII: 100% ACV, group VIII: 75% ACV, group IX: 50% ACV, and group X: 25% ACV. The samples were irrigated with a specific group of irrigants, then split in a longitudinal axis and processed for analysis in an SEM. Microphotographs were obtained and scored according to Torabinejad et al. Results Microphotographs were assessed and showed that 100% neem extract was similar to NaOCl with EDTA, followed by 75% neem extract and 100% ACV. Conclusion This study showed that 100% neem extract removed the smear layer, similar to the NaOCl with EDTA. How to cite this article Sudhakar S, Gupta N, Ghambir N, et al. Comparative Evaluation of Intracanal Smear Layer Removal by Different Root Canal Irrigants: A Scanning Electron Microscope Study. Int J Clin Pediatr Dent 2023;16(4):633-638.
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Affiliation(s)
- S Sudhakar
- Department of Pediatric and Preventive Dentistry, Santosh Dental College, Santosh (Deemed to be University), Ghaziabad, Uttar Pradesh, India
| | - Nidhi Gupta
- Department of Pediatric and Preventive Dentistry, Santosh Dental College, Santosh (Deemed to be University), Ghaziabad, Uttar Pradesh, India
| | - Natasha Ghambir
- Department of Pediatric and Preventive Dentistry, Santosh Dental College, Santosh (Deemed to be University), Ghaziabad, Uttar Pradesh, India
| | - Rashi Singh
- Department of Pediatric and Preventive Dentistry, Santosh Dental College, Santosh (Deemed to be University), Ghaziabad, Uttar Pradesh, India
| | - Divya Singh
- Department of Pediatric and Preventive Dentistry, Santosh Dental College, Santosh (Deemed to be University), Ghaziabad, Uttar Pradesh, India
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de Oliveira RA, Weissheimer T, Só GB, da Rosa RA, Souza MA, Ribeiro RG, Só MVR. Dentinal tubule penetration of sodium hypochlorite in root canals with and without mechanical preparation and different irrigant activation methods. Restor Dent Endod 2023; 48:e1. [PMID: 36875814 PMCID: PMC9982243 DOI: 10.5395/rde.2023.48.e1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/13/2022] [Accepted: 10/04/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives This study evaluated the dentinal penetration depth of 2.5% sodium hypochlorite (NaOCl) in root canals with and without preparation and different irrigant activation protocols. Materials and Methods Sixty-three bovine mandibular incisors were randomly allocated to 6 groups (n = 10): G1, preparation + conventional needle irrigation (CNI); G2, preparation + passive ultrasonic irrigation (PUI); G3, preparation + Odous Clean (OC); G4, no preparation + CNI; G5, no preparation + PUI; G6, no preparation + OC; and CG (negative control; n = 3). Samples were filled with crystal violet for 72 hours. Irrigant activation was performed. Samples were sectioned perpendicularly along the long axis, 3 mm and 7 mm from the apex. Images of the root thirds of each block were captured with a stereomicroscope and analyzed with an image analysis software. One-way analysis of variance, followed by the Tukey post hoc test, and the Student's t-test were used for data analysis, with a significance level of 5%. Results The NaOCl penetration depth was similar when preparation was performed, regardless of the method of irrigation activation (p > 0.05). In the groups without preparation, G6 showed greater NaOCl penetration depth (p < 0.05). The groups without preparation had a greater NaOCl penetration depth than those with preparation (p = 0.0019). Conclusions The NaOCl penetration depth was similar in groups with root canal preparation. Without root canal preparation, OC allowed deeper NaOCl penetration. The groups without preparation had greater NaOCl penetration than those undergoing root canal preparation.
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Affiliation(s)
- Renata Aqel de Oliveira
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Theodoro Weissheimer
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Gabriel Barcelos Só
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Ricardo Abreu da Rosa
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Matheus Albino Souza
- Department of Endodontics, School of Dentistry, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Rodrigo Gonçalves Ribeiro
- Department of Endodontics, School of Dentistry, State University of Western Paraná (UNIOESTE), Cascavel, PR, Brazil
| | - Marcus Vinicius Reis Só
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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Tong J, Liu L, Du J, Gao Y, Song D, Huang D. Effect of photon-induced photoacoustic streaming and shock-wave enhanced emission photoacoustic streaming technique on the removal of the smear layer after root canal preparation in curved root canals. J Dent Sci 2023; 18:157-164. [PMID: 36643274 PMCID: PMC9831787 DOI: 10.1016/j.jds.2022.06.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/21/2022] [Indexed: 01/18/2023] Open
Abstract
Background/purpose The efficiency of root canal irrigation has an important impact on the prognosis of root canal treatment. Photon-induced photoacoustic streaming (PIPS) and shock wave enhanced emission photoacoustic streaming (SWEEPS) are the special modality of Er: YAG laser, whether can they improve the efficiency of root canal irrigation remains to be studied. Materials and methods Fifty human teeth with curved root canals were collected and stored in the thymol solution until used in the study. After traditional endodontic cavities preparation, root canals were prepared to size #35 with a 0.04 taper. The final irrigating techniques were as follows: (I) manual dynamic activation (MDA), (II) ultrasonically activated irrigation (UAI), (III) sonically activated irrigation (SAI), (IV) PIPS, and (V) SWEEPS. Fifty teeth were randomly divided into five groups mentioned above. After root canal preparation, the roots were cleaved longitudinally. The dentine surfaces were photographed from the coronal, middle, and apical third of the root by scanning electron microscopy operated at a low vacuum. Two examiners separately graded each image according to the remained smear layer situations. Results PIPS and SWEEPS groups showed fewer smear layers remaining than the others in the middle and the apical third (P < 0.05) of the root canal. In contrast, in the coronal third, five groups showed no significant difference (P > 0.05). Conclusion PIPS and SWEEPS showed superior smear layer clearing efficiency than traditional irrigating techniques in curved root canals.
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Affiliation(s)
- Jiaru Tong
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liu Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jing Du
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuan Gao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Dongzhe Song
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Corresponding author. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Dingming Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Corresponding author. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Bansal N, Ismail PS, AlMogbel A, Priya R, Mattigatti S, Nara A, AlMutairi F. An in vitro comparative assessment of manual hand file, rotary protaper ni-ti, erbium:yttrium–aluminum–garnet laser, canal brush, and ultrasound methods for smear layer removal. Ann Afr Med 2022; 21:244-249. [DOI: 10.4103/aam.aam_115_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Singla R, Jhamb S, Kaur A, Bhushan J, Uppal A. Dentinal defects after root canal preparation with rotary nickel-titanium files using different irrigants: An in vitro study. J Conserv Dent 2022; 25:193-196. [PMID: 35720826 PMCID: PMC9205345 DOI: 10.4103/jcd.jcd_563_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 01/10/2022] [Accepted: 01/20/2022] [Indexed: 11/10/2022] Open
Abstract
Aim: This in vitro study aims to detect the dentinal defects associated with different irrigants during biomechanical preparation using rotary nickel-titanium (Ni-Ti) files (Hyflex CM). Materials and Methods: For the study, 120 extracted mandibular incisors were taken. Depending on the irrigant used, teeth were divided into six groups (n = 20). In Group 1, teeth were not biomechanically prepared considered as, control group. In Group 2, Group 3, Group 4, Group 5, and Group 6, biomechanical preparation was with Hyflex CM rotary Ni-Ti files using saline, 3% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA), SmearClear, and 2% chlorhexidine (CHX), respectively, as irrigant. IsoMet Saw was used to section samples at 3, 6, and 9 mm from the apex perpendicular to the long axis of tooth. Segments were seen at 30x magnification under a digital stereomicroscope. Statistical Analysis: Statistical analysis was done using two-tailed t-test. Results: Maximum number of dentinal defects was seen with 17% EDTA, followed by 3% NaOCl, SmearClear, and 2% CHX. Conclusions: Irrigation with 17% EDTA causes more dentinal defects as compared to irrigation with 3% NaOCl, SmearClear, and 2% CHX.
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Valencia YM, Vertuan GC, Alcalde MP, Vivan RR, Reis Só MV, Duarte MAH. Effect of Irrigating Agitation after Root End Preparation on the Wall Cleaning and Bond Strength of Calcium Silicate Material in Retrograde Obturation. Eur J Dent 2021; 15:707-713. [PMID: 34303319 PMCID: PMC8630967 DOI: 10.1055/s-0041-1729454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objective
This study aimed to evaluate the cleaning efficacy of irrigant activation with a new ultrasonic tip in root-end preparations and to determine its influence on the bond strength of calcium silicate-based material.
Materials and Methods
Maxillary canines were prepared and filled, and their root ends resected. Root-end cavities were ultrasonically prepared and randomly distributed into four groups according to the final irrigation protocols: G1 (ultrasonic irrigation [UI] + saline solution [SS]), G2 (syringe irrigation [SI] + SS), G3 (UI + ethylenediaminetetraacetic acid [EDTA]), and G4 (SI + EDTA). Cleaning efficacy analysis employed 72 specimens (
n
= 18) split longitudinally for imaging of the same areas by scanning electron microscopy (SEM). The percentage of dentinal tubules opened before and after irrigation was used as evaluation parameter. Push-out testing employed 40 specimens (
n
= 10) sectioned apical region perpendicularly, which slice was placed on a testing machine for the bond strength measurement and failure mode was assessed by SEM. The data were statistically analyzed (α ≤ 0.05).
Results
G3 (UI + EDTA) removed the smear layer more effectively, showed the best tubule opening (
p
< 0.05), and presented the highest mean bond strength values (
p
< 0.05). Failure modes were predominantly adhesive, except for the G3 (UI + EDTA) group, in which they were mainly mixed (80%).
Conclusion
The results of this study suggest that EDTA 17% agitation promoted better cleaning and smear layer removal, improving the push-out bond strength of calcium silicate material in retrograde obturation.
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Affiliation(s)
- Yahir Muñoz Valencia
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Gislene Cristina Vertuan
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Murilo Priori Alcalde
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Rodrigo Ricci Vivan
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Marcus Vinícius Reis Só
- Department of Dentistry, University Federal of the Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
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Silva AM, Alencar CDM, Jassé FFDA, Pedrinha VF, Zaniboni JF, Dantas AAR, de Campos EA, Kuga MC. Effect of post-space irrigation with acid solutions on bond strength and dentin penetrability using a self-adhesive cementation system. J Clin Exp Dent 2021; 13:e564-e571. [PMID: 34188762 PMCID: PMC8223157 DOI: 10.4317/jced.58029] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/20/2021] [Indexed: 12/03/2022] Open
Abstract
Background The aim of this study was to evaluate the effects of surface treatments with 1% peracetic acid (PA), solution containing 17% EDTA (SmearClear, Kerr Endodontics), solution containing a combination of 17% EDTA with 2% chlorhexidine (QMix, Dentsply Sirona) on the post-space root dentin compared to 2.5% sodium hypochlorite (NaOCl) on bond strength and resin tags length in dentin.
Material and Methods Forty human-canine roots were endodontically treated and the post space was prepared. The specimens were randomised into four groups (n = 10): control – irrigation with 2.5% NaOCl solution, PA – irrigation with 1% PA, SmearClear – irrigation with SmearClear solution, and QMix – irrigation with QMix solution. The fibre posts were cemented using a self-adhesive resin system (Relyx U200, 3M ESPE). After six months, the specimens were cross-sectioned and subjected to push-out and confocal laser microscopy tests. One-way ANOVA and Tukey’s tests were used to analyse the data (α= 0.05).
Results PA and QMix presented the highest bond strength values compared to the other groups (p< 0.05). There was no significant difference between the resin tags length in dentin by the groups (p = 0.75).
Conclusions Irrigation of the post space with 1% PA and QMix showed a positive clinical impact on the adhesion between the fiber post and root dentin. However, these materials had no influence on resin tags length in dentin by self-adhesive resin cement. Key words:Fiber post, adhesive cementation, self-adhesive resin cement, root dentin, irrigating solutions.
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Affiliation(s)
- Aryvelto-Miranda Silva
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Cristiane-de Melo Alencar
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | | | - Victor-Feliz Pedrinha
- Department of Restorative Dentistry, Bauru School of Dentistry, University of Sao Paulo (USP), Bauru, SP, Brazil
| | - Joissi-Ferrari Zaniboni
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Andréa-Abi-Rached Dantas
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Edson-Alves de Campos
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Milton-Carlos Kuga
- Department of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
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Mancini M, Cerroni L, Palopoli P, Olivi G, Olivi M, Buoni C, Cianconi L. FESEM evaluation of smear layer removal from conservatively shaped canals: laser activated irrigation (PIPS and SWEEPS) compared to sonic and passive ultrasonic activation-an ex vivo study. BMC Oral Health 2021; 21:81. [PMID: 33618701 PMCID: PMC7901090 DOI: 10.1186/s12903-021-01427-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 02/04/2021] [Indexed: 11/28/2022] Open
Abstract
Background Irrigation of the pulp space is a mandatory step to get rid of all its organic and inorganic content. Activation of the irrigants play a key role in the era of minimally invasive endodontics. The aim of this study was to assess the effectiveness of different irrigants activation methods in removing the smear layer at 1, 3, 5 and 8 mm from the apex from conservatively shaped canals.
Methods Eighty-five human mandibular premolars were selected. Specimens were shaped to TruShape 25/.06 and divided into 5 groups (1 control and 4 test groups) according to the final activation technique (EndoActivator, EA), Ultrasonic (EndoUltra, PUI) and Laser (PIPS and SWEEPS). EDTA (Ethylenediaminetetraacetic acid) followed by NaOCl (Sodium Hypochlorite) and again EDTA were activated for each test group. Specimens were then split longitudinally and observed by Field Emission Scanning Electron Microscopy (FESEM). Blinded evaluation of the presence of smear layer was performed at 1000X magnification, according to a 5-score index system. Comparison between groups were analysed statistically using the Kruskal–Wallis non-parametric analysis of variance. Bonferroni multiple comparison tests were used.
Results At 1 mm only PIPS and SWEEPS performed better than the control group. At 3, 5 and 8 mm from the apex, every activation technique showed statistically significant reduction of smear layer when compared to the control group. PIPS and SWEEPS obtained better cleanliness result compared to EA, while only PIPS was superior to PUI in terms of cleanliness. Conclusions PIPS and SWEEPS showed the best results in conservative canal preparations. Nowadays, contemporary rotary instruments allow fast and minimally invasive shaping of the endodontic space. In this scenario irrigants’ activation may be regarded as a mandatory step to a favourable clinical outcome.
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Affiliation(s)
- Manuele Mancini
- Department of Translational Medicine and Clinical Science, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy.
| | - Loredana Cerroni
- Department of Translational Medicine and Clinical Science, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy
| | - Pietro Palopoli
- Department of Surgical Sciences, Dental School, Endodontics, University of Turin, 10126, Turin, Italy
| | - Giovanni Olivi
- Catholic University of the Sacred Hearth of Rome, Rome, Italy
| | | | | | - Luigi Cianconi
- Department of Translational Medicine and Clinical Science, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy
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Alakshar A, Saleh ARM, Gorduysus MO. Debris and Smear Layer Removal from Oval Root Canals Comparing XP-Endo Finisher, EndoActivator, and Manual Irrigation: A SEM Evaluation. Eur J Dent 2020; 14:626-633. [PMID: 32777834 PMCID: PMC7535965 DOI: 10.1055/s-0040-1714762] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective
This study aimed to assess and compare XP-Endo Finisher (XP) cleaning efficiency with respect to the amount of remaining debris and smear layer versus Max-I-Probe needle (CI), EndoActivator device (EA), and combination of XP-Endo Finisher file with EndoActivator device (XP+EA) in oval root canals.
Materials and Methods
This
in vitro
study was performed on 36 extracted single root/canal mandibular premolars. Radiographic images were taken in buccolingual and mesiodistal projections to evaluate the shape of the root canal and determine whether it met exclusion criteria. All teeth were decoronated and prepared using Reciproc (R40). The samples were divided randomly into four groups: CI, EA, XP, and XP + EA. The root canals were irrigated with 5 mL of 17% EDTA and 2.5% NaOCl, respectively. Apart from the CI group, both solutions were activated by using the tested techniques for 1 minute.
The teeth were split longitudinally, and the best visible identified sections of the roots were used as the representing samples for scanning electron microscope (SEM) evaluation. Each half was divided into the following three parts: 1 mm from the anatomic apex and a standardized photomicrograph with 500x and 1500x magnifications for debris and smear layer were obtained. A five-grade scoring system was utilized to quantify the results at the coronal, middle, and apical regions. Statistical analysis was performed by using the Kruskal–Wallis and Mann–Whitney U tests. Results
Group differences in debris and smear layer scores were found statistically significant for all locations as well as for overall assessment, except for the coronal third. Intragroup comparison of debris and smear layer in CI, EA, and XP had the minimum score at the middle third, with no significant difference compared with the coronal and apical thirds. XP + EA had less debris and smear layer score at the coronal third, significantly different from apical third.
CI and EA had less debris and smear layer compared with XP and XP + EA at all locations with a significant difference at the middle and apical third (
p
< 0.05).
Conclusion
EA and CI showed less debris and smear layer than XP and XP + EA in the middle and apical third. The use of the XP in conjunction with the present irrigation protocol failed to have debris-free dentin surface in the apical portion of most of the root canals.
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Affiliation(s)
- Asmaa Alakshar
- Department of Restorative Dentistry, Ajman University, Ajman, United Arab Emirates
| | | | - Mehmet Omer Gorduysus
- Preventive and Restorative Dentistry Department, College of Dental Medicine, University of Sharjah, United Arab Emirates
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The Effectiveness of Different Final Irrigation Protocols for Removal of Calcium Hydroxide Intracanal Medication from Root Canal. ARS MEDICA TOMITANA 2020. [DOI: 10.2478/arsm-2019-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Calcium hydroxide is the most used intracanalar medicament between apointments. It shoud be properly removed before root canal filling because its remnants could compromise the sealing of root obturation. The aim of this study was to compare the effectiveness of two type of irrigation solutions, EDTA and SmearClear in the removal of calcium hydroxide from root canals. Materials and method: twenty human single rooted teeth were prepared using ProTaper Universal instrumentation till F2, .06 taper. The canals were filled with Ca(OH)2 and after 7 days the Ca(OH)2 was removed using 3 rinses of 5 ml 15% EDTA and 5 ml 5.25% NaOCl alternately (group 1; n=10) or 3 rinses of 5 ml Smear Clear (SybronEndo) and 5 ml 5.25% NaOCl alternately (group 2; n=10). Results: On the final radiographs the best result was found in group 2 where the cleanliness of the total surface of the root canal wall when SmearClear was used obtained better results comparative to NaOCl – 15% EDTA (91.34% to 71.69%). Conclusions: under the limitation of this study, SmearClear was superior in removing Ca(OH)2 material compared to NaOCl and 15% EDTA irrigation solution.
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Dhawan S, Jasuja P, Khurana H, Gakhar E, Singh H. A comparative evaluation of the efficacy of erbium: yttrium-aluminum-garnet and diode lasers in smear layer removal and dentin permeability of root canal after biomechanical preparation - A scanning electron microscopy study. J Indian Soc Pedod Prev Dent 2020; 38:64-70. [PMID: 32174631 DOI: 10.4103/jisppd.jisppd_174_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The chemomechanical preparation of root canal dentin with hand or rotary instruments creates debris and a smear layer. Root canal preparation (RCP) along with irrigants is not effective in cleaning apical portions, and hence, different laser activation systems were used for better cleaning in the apical third. Aim: The aim of this study is to compare the efficacy of erbium: yttrium-aluminum-garnet (Er:YAG) and diode laser irradiation in smear layer removal and dentin permeability after biomechanical preparation using scanning electron microscopic investigation. Material and Methods: Thirty sound single-rooted human teeth were distributed randomly and equally into three groups (n = 10 each) based upon the type of laser irradiation after RCP: Group I (control group) - RCP with ProTaper rotary system using the standard irrigating protocol; Group II - RCP with ProTaper rotary system using the standard irrigating protocol followed by diode laser irradiation; and Group III - RCP with ProTaper rotary system using the standard irrigating protocol followed by Er:YAG laser irradiation. After root sectioning, specimens were dehydrated, then gold plated and observed using a scanning electron microscopy. Then, the smear layer scores were recorded and performed using the statistical analysis. Results: Smear layer removal efficacy of Er:YAG laser was more at coronal, middle, and apical third when compared to Group I and Group II. Debris removal score of Group III (Er:YAG) was better than Group I (17% ethylenediaminetetraacetic acid) and Group II (diode). Conclusion: Er:YAG laser-activated RCP was comparatively efficient in cleaning the smear layer and dentinal tubules opening.
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Affiliation(s)
- Sapna Dhawan
- Department of Pedodontics, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
| | - Purshottam Jasuja
- Department of Preventive Dentistry, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
| | - Heena Khurana
- Department of Preventive Dentistry, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
| | - Ekta Gakhar
- Department of Preventive Dentistry, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
| | - Harveen Singh
- Department of Pedodontics, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
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Hisada A, Nakamura K, Toyota Y, Maeda A, Yoshihara T, Yawaka Y. Effects of root canal irrigations on intracanal medication with calcium hydroxide effects in root external resorption models. PEDIATRIC DENTAL JOURNAL 2019. [DOI: 10.1016/j.pdj.2018.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Bueno CRE, Cury MTS, Vasques AMV, Sarmiento JL, Trizzi JQ, Jacinto RC, Sivieri-Araujo G, Dezan Júnior E. Cleaning effectiveness of a nickel-titanium ultrasonic tip in ultrasonically activated irrigation: a SEM study. Braz Oral Res 2019; 33:e017. [PMID: 30892412 DOI: 10.1590/1807-3107bor-2019.vol33.0017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 01/28/2019] [Indexed: 02/03/2023] Open
Abstract
In endodontic treatment, regardless of the instrumentation technique, the presence of a smear layer covering contaminated dentin walls is always a concern. Thus, irrigation plays an essential role in reducing bacterial load. To enhance irrigation effectiveness, different ultrasonic activation methods and the use of different tips have been studied. This study assessed the cleaning capacity of the novel NiTi ultrasonic tip for smear layer removal using ultrasonically activated irrigation (UAI) with passive or continuous ultrasonic irrigation (PUI or CUI, respectively), compared with conventional irrigation. Forty-five single-rooted human mandibular premolars were decoronated to a standardized length of 16 mm. Instrumentation was performed using the Genius system up to size 50.04 and irrigated with 3% NaOCl. The specimens were divided into three groups (n = 15) according to the final irrigation activation technique: conventional irrigation (CI), as control group; PUI; and CUI, following the manufacturer's protocol. The samples were longitudinally cleaved and analyzed under a scanning electron microscope for smear layer removal according to a cleanliness score for the cervical, middle, and apical thirds. Data were evaluated by means of the Kruskal-Wallis and Tukey's tests, with a 5% level of significance. UAI enhanced cleaning compared to conventional irrigation, mainly at the apical third. CUI showed the best results, with statistically significant lower scores than PUI and CI (p < 0.05). Final irrigant activation with the NiTi tip showed better cleaning capacity than conventional irrigation. In addition, CUI resulted in better smear layer removal than PUI.
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Affiliation(s)
| | - Marina Tolomei Sandoval Cury
- Universidade Estadual Paulista- UNESP, Araçatuba School of Dentistry, Department of Endodontics, Araçatuba, SP, Brazil
| | - Ana Maria Veiga Vasques
- Universidade Estadual Paulista- UNESP, Araçatuba School of Dentistry, Department of Endodontics, Araçatuba, SP, Brazil
| | - Jimena Lama Sarmiento
- Universidade Estadual Paulista- UNESP, Araçatuba School of Dentistry, Department of Endodontics, Araçatuba, SP, Brazil
| | - Juliana Quintino Trizzi
- Universidade Estadual Paulista- UNESP, Araçatuba School of Dentistry, Department of Endodontics, Araçatuba, SP, Brazil
| | - Rogério Castilho Jacinto
- Universidade Estadual Paulista- UNESP, Araçatuba School of Dentistry, Department of Endodontics, Araçatuba, SP, Brazil
| | - Gustavo Sivieri-Araujo
- Universidade Estadual Paulista- UNESP, Araçatuba School of Dentistry, Department of Endodontics, Araçatuba, SP, Brazil
| | - Eloi Dezan Júnior
- Universidade Estadual Paulista- UNESP, Araçatuba School of Dentistry, Department of Endodontics, Araçatuba, SP, Brazil
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UĞUR AYDIN ZELİHA, AKPINAR KEREMENGİN, HEPOKUR CEYLAN, ALTUNBAŞ DEMET. Human Osteoblast Hücre Hattı Üzerinde Qmix, Etilen Diamintetraasetik Asit ve Klorhheksidin’in Sitotoksisitesinin Değerlendirilmesi. CUMHURIYET DENTAL JOURNAL 2018. [DOI: 10.7126/cumudj.438506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Ramachandran N, Podar R, Singh S, Kulkarni G, Dadu S. Effect of ultrasonic activation on calcium ion quantification, smear layer removal, and canal cleaning efficacy of demineralizing irrigants. J Conserv Dent 2018; 21:551-556. [PMID: 30294120 PMCID: PMC6161526 DOI: 10.4103/jcd.jcd_162_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Effective removal of smear layer ensures better penetration of irrigants ensuring root canal disinfection and has the potential of sealing dentinal tubules during obturation. Aim The aim of this study is to evaluate the canal cleaning efficacy and calcium ion liberation with the use of demineralizing irrigants, namely, 17% ethylenediaminetetraacetic acid (EDTA), 7% maleic acid, and 10% citric acid with or without ultrasonic (US) activation. Materials and Methods Crowns of 62 extracted maxillary central incisors were decoronated and root canals prepared. Based on the final irrigant teeth were divided into following groups (n = 10), namely, 10% citric acid, 7% maleic acid, 17% EDTA, and 10% citric acid with US activation, 7% maleic acid with US activation, and 17% EDTA with US activation. Irrigants were subjected to inductively coupled plasma-atomic emission spectroscopy followed by debris scoring and scanning electron microscope analysis. Statistical Analysis One-way analysis of variance with the Bonferroni's correction for multiple testing was employed. Results About 10% citric acid with US activation liberated the highest calcium ions and removed the maximum smear layer. Conclusions Citric acid with US activation is a potentially effective irrigation regimen with sodium hypochlorite.
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Affiliation(s)
- Naren Ramachandran
- Department of Conservative Dentistry and Endodontics, Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Rajesh Podar
- Department of Conservative Dentistry and Endodontics, Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Shishir Singh
- Department of Conservative Dentistry and Endodontics, Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Gaurav Kulkarni
- Department of Conservative Dentistry and Endodontics, Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Shifali Dadu
- Department of Conservative Dentistry and Endodontics, Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Shalan LA, Al-Huwaizi HF. Cleaning Efficiency of Root Canal after Irrigation with New Irrigation Technique: A Scanning Electron Microscopic Study. IRANIAN ENDODONTIC JOURNAL 2018; 13:102-107. [PMID: 29692844 PMCID: PMC5800450 DOI: 10.22037/iej.v13i1.17285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: The aim of this study was to evaluate the ability of pressurized water irrigation technique (AquaPick Device) as an intra-canal irrigation technique and compare it with sonic irrigation device (Endoactivator) for their ability to remove smear layer from canals. Methods and Materials: Total number of 80 single rooted teeth (premolars) were prepared, divided into eight main groups, Group 1: Aquapick with apically vented needle/18 mm depth, Group 2: Aquapick with apically vented needle/15 mm depth, Group 3: Endoactivator device/18 mm depth, Group 4: Endoactivator device/15 mm depth, Group5: Aquapick with 2 side vented needle/18 mm depth, Group 6: Aquapick with 2 side vented needle/15 mm depth and two control groups. Then all samples were tested by SEM in 3, 6 and 9-mm distances from the apical foramen. The data were statistically analyzed using Kruskal Wallis and Mann-Whitney U tests. Results: There was a high significant difference among the tested groups with the best removal of smear layer by the use of pressurized water irrigation device with apical vented needle especially at the 3 mm area. Conclusion: Pressurized water irrigation technique could be used as intra-canal irrigation technique with good results.
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Affiliation(s)
- Linz A Shalan
- Department of Conservative and Esthetic Dentistry, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Hussain F Al-Huwaizi
- Department of Conservative and Esthetic Dentistry, College of Dentistry, University of Baghdad, Baghdad, Iraq
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Xu K, Wang J, Wang K, Gen N, Li J. Micro-computed tomographic evaluation of the effect of the final apical size prepared by rotary nickel-titanium files on the removal efficacy of hard-tissue debris. J Int Med Res 2018; 46:2219-2229. [PMID: 29584511 PMCID: PMC6023043 DOI: 10.1177/0300060518757607] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objective This study was performed to compare the removal efficacy of hard-tissue debris in mandibular first molars prepared to various apical sizes. Methods The mesial root canals of 40 extracted mandibular first molars were prepared by rotary nickel-titanium files to an apical size of #25/0.04 (Group #2504), #30/0.04 (Group #3004), #35/0.04 (Group #3504), and #40/0.04 (Group #4004). Irrigation was performed with 5.25% NaOCl and 17% EDTA. Micro-computed tomography was used to scan the samples before and after root canal preparation. Remnant hard-tissue debris was identified, quantified, and visualized three-dimensionally using shape recognition and image superimposition analysis, and the debris was mapped to its location. Results After preparation, 11.67%±2.99% of the root canals contained hard-tissue debris in Group #2504, 8.00%±2.71% in Group #3004, 7.17%±2.88% in Group #3504, and 4.51%±1.61% in Group #4004. The amount of accumulated hard-tissue debris was significantly less in Group #4004 than in the other groups. However, there were no significant differences between Groups #3004 and #3504. Conclusions An increased final apical size resulted in significantly lower debris accumulation. However, no root canal in any group was completely free from hard-tissue debris, and debris was mostly found in the isthmus of the mesial root canals.
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Affiliation(s)
- Ke Xu
- Department of Endodontics, Stomatological Hospital Affiliated to Soochow University, Suzhou Stomatological Hospital, Suzhou, Jiangsu, China
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
| | - Juan Wang
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
| | - Ke Wang
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
| | - Nan Gen
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
| | - Jin Li
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China
- Jin Li, Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, 136 Hanzhong Road, Nanjing 210029, China.
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Aksel H, Serper A. Concentration and time-dependent effect of initial sodium hypochlorite on the ability of QMix and ethylenediaminetetraacetic acid to remove smear layer. J Conserv Dent 2017; 20:185-189. [PMID: 29279623 PMCID: PMC5706320 DOI: 10.4103/0972-0707.218314] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aims: The aim of this study was to compare the ability of 17% ethylenediaminetetraacetic acid (EDTA) and QMix with different concentrations and time exposures of initial sodium hypochlorite (NaOCl) to remove the smear layer from the root canals. Materials and Methods: Eighty maxillary central incisors were used. After instrumentation, the teeth were divided into eight experimental groups according to the initial and final rinse. About 2.5% and 5% NaOCl were used during instrumentation and for 1 or 3 min was used as postinstrumentation initial irrigants, and 17% EDTA and QMix used as final irrigants. The apical and middle parts of the specimens were observed by scanning electron microscope. Statistical Analysis Used: Data were analyzed using the Kruskal–Wallis, Mann–Whitney, and Friedman's test. Results: Regardless of the type of final irrigant, QMix allowed more smear layer removal than EDTA after using 5% initial NaOCl for 3 min. In the apical part of the root canal walls, the smear layer was not completely removed. Conclusion: QMix and EDTA were similarly effective in smear layer removal at the middle parts of the root canal regardless of the concentration and time exposure of initial NaOCl, while none of the irrigation protocols was able to remove smear layer at the apical parts.
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Affiliation(s)
- Hacer Aksel
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Ahmet Serper
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Schiavotelo TCL, Coelho MS, Rasquin LC, Rocha DGP, Fontana CE, Bueno CEDS. Ex-vivo Smear Layer Removal Efficacy of Two Activated Irrigation Techniques After Reciprocating Instrumentation in Curved Canals. Open Dent J 2017; 11:512-519. [PMID: 29238411 PMCID: PMC5712658 DOI: 10.2174/1874210601711010512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/28/2017] [Accepted: 09/14/2017] [Indexed: 01/10/2023] Open
Abstract
Introduction: This study aimed to compare the effectiveness of two activated irrigation techniques in removing the smear layer after single-file reciprocating instrumentation in curved canals. Materials and Methods: Sixty distobuccal roots of maxillary molars were standardized to create a closed system, and then instrumented using WaveOne Primary (Dentsply Maillefer, Ballaigues, Switzerland) instruments. Fifty-four specimens were randomly distributed into 3 groups for final irrigation: Non-activated irrigation, passive ultrasonic irrigation (PUI), and EndoActivator (EA;Dentsply Maillefer, Tulsa, USA) irrigation. All specimens received 3 mL of 17% EDTA for 1 minute, followed by irrigation with 6 mL of 2.5% NaOCl. The apical, middle and cervical thirds of the specimens were analyzed using scanning electronic microscopy (SEM), and the amount of remaining smear layer on the canal walls was rated by three examiners using a five-category scoring system. Kendall’s concordance coefficient was used to assess inter-rater agreement. Kruskal-Wallis and Mann-Whitney (Bonferroni) tests were used to compare the scores. Results: Kendall’s concordance coefficient was ≥ 0.7, indicating an excellent level of agreement between the raters. No statistically significant difference in irrigation techniques efficacy for removal of the smear layer (p=0.061) was found for the apical third. The scores attributed to the specimens irrigated with the EA system were significantly lower than those of the other groups in the cervical and middle thirds (p< 0.05). Conclusions: The efficacy of the EA system in removing the smear layer in the cervical and middle thirds of root canals instrumented with reciprocating motion was significantly higher than that of either PUI or non-activated irrigation. Both EA and PUI performed similarly in apical third.
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Affiliation(s)
| | - Marcelo Santos Coelho
- Department of Endodontics, School of Dentistry and Medicine, São Leopoldo Mandic University, Campinas, SP, Brazil
| | - Luis Cardoso Rasquin
- Department of Integrated Clinical Dentistry and Diagnostics, School of Dentistry, Federal University of Bahia, Salvador, BA, Brazil
| | - Daniel Guimarães Pedro Rocha
- Department of Endodontics, School of Dentistry and Medicine, São Leopoldo Mandic University, Campinas, SP, Brazil
| | - Carlos Eduardo Fontana
- Department of Endodontics, School of Dentistry and Medicine, São Leopoldo Mandic University, Campinas, SP, Brazil.,Department of Endodontics, School of Dentistry and Medicine, Pontificia Universidade Católica de Campinas, Campinas, SP, Brazil
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Poletto D, Poletto AC, Cavalaro A, Machado R, Cosme-Silva L, Garbelini CCD, Hoeppner MG. Smear layer removal by different chemical solutions used with or without ultrasonic activation after post preparation. Restor Dent Endod 2017; 42:324-331. [PMID: 29142881 PMCID: PMC5682149 DOI: 10.5395/rde.2017.42.4.324] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 10/07/2017] [Indexed: 11/11/2022] Open
Abstract
Objectives This study evaluated smear layer removal by different chemical solutions used with or without ultrasonic activation after post preparation. Materials and Methods Forty-five extracted uniradicular human mandibular premolars with single canals were treated endodontically. The cervical and middle thirds of the fillings were then removed, and the specimens were divided into 9 groups: G1, saline solution (NaCl); G2, 2.5% sodium hypochlorite (NaOCl); G3, 2% chlorhexidine (CHX); G4, 11.5% polyacrylic acid (PAA); G5, 17% ethylenediaminetetraacetic acid (EDTA). For the groups 6, 7, 8, and 9, the same solutions used in the groups 2, 3, 4, and 5 were used, respectively, but activated with ultrasonic activation. Afterwards, the roots were analyzed by a score considering the images obtained from a scanning electron microscope. Results EDTA achieved the best performance compared with the other solutions evaluated regardless of the irrigation method (p < 0.05). Conclusions Ultrasonic activation did not significantly influence smear layer removal.
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Affiliation(s)
- Daniel Poletto
- Department of Restorative Dentistry, Londrina State University (UEL), Londrina, PR, Brazil
| | | | - Andressa Cavalaro
- Clinical Practice Limited to Esthetic Dentistry, Campo Grande, MS, Brazil
| | - Ricardo Machado
- Clinical Practice Limited to Endodontics, Navegantes, SC, Brazil
| | - Leopoldo Cosme-Silva
- Department of Endodontics, São Paulo State University (UNESP) School of Dentistry, Araçatuba, SP, Brazil
| | | | - Márcio Grama Hoeppner
- Department of Restorative Dentistry, Londrina State University (UEL), Londrina, PR, Brazil
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Wagner MH, da Rosa RA, de Figueiredo JAP, Duarte MAH, Pereira JR, Só MVR. Final irrigation protocols may affect intraradicular dentin ultrastructure. Clin Oral Investig 2017; 21:2173-2182. [PMID: 27888349 DOI: 10.1007/s00784-016-2006-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 11/01/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the effect of different irrigation protocols on the root dentin structure using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). MATERIALS AND METHODS Thirty-nine lower bovine incisors were hemisected longitudinally and randomly divided into 13 groups (n = 3). After the root halves were reassembled, it was applied a specific irrigation protocol for each group, as following: G1, distilled water (control); G2, 0.9% saline; G3, saline + 17% EDTA; G4, saline + PUI; G5, saline + PUI + EDTA; G6 to G9 received the same protocol as above replacing 0.9% saline by 2.5% NaOCl; and G10 to G13 by 2% CHX. One-half of each sample was prepared and evaluated using SEM and the other one by TEM observations. RESULTS TEM descriptive analysis showed modifications in dentin organic ultrastructure, characterized by the thinning of dentin collagen fibrils, caused by NaOCl, enhanced by EDTA and/or PUI. SEM analysis showed that NaOCl with PUI caused significantly larger erosion of the peritubular dentin than in all the other groups (P < 0.05), followed by NaOCl + EDTA and NaOCl + EDTA + PUI. CONCLUSIONS NaOCl caused ultrastructural alterations in the dentin collagen, and enhanced by EDTA and/or PUI, promoted peritubular and intertubular erosion. CLINICAL RELEVANCE The effect of irrigating solutions on dentin ultrastructure was still unclear. The acknowledgment about the kind of solution, concentrations, application time, and sequence of use was important to achieve the right sanitization without jeopardizing the dentin ultrastructure quality.
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Affiliation(s)
- Márcia Helena Wagner
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ricardo Abreu da Rosa
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | | | - Marcus Vinicius Reis Só
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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Wang X, Cheng X, Liu B, Liu X, Yu Q, He W. Effect of Laser-Activated Irrigations on Smear Layer Removal from the Root Canal Wall. Photomed Laser Surg 2017; 35:688-694. [PMID: 28394240 DOI: 10.1089/pho.2017.4266] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the effect of laser-activated irrigations (LAI) by using the Erbium: Yttrium Aluminum Garnet (Er:YAG) laser and the Erbium Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser on removing smear layer (SL) from the root canal wall. BACKGROUND DATA LAI has been proposed as an adjuvant to conventional protocols of endodontic treatment to enhance the disinfection, which is a promising protocol for SL removal. MATERIALS AND METHODS SL was generated by preparing the root canals of extracted human teeth to a #35/.04 M3 instrument. The SL then received treatments of one of the following: (A) NaOCl, 5.25% sodium hypochlorite (NaOCl) for 60 sec; (B) EDTA, 17% ethylenediamine tetraacetic acid (EDTA) for 60 sec; (C) NaOCl+EDTA, NaOCl, and EDTA for 30 sec each; (D) LAI+NaOCl, LAI with NaOCl for 60 sec; (E) LAI+EDTA, LAI with EDTA for 60 sec; and (F) LAI+NaOCl+EDTA, LAI with NaOCl, and EDTA for 30 sec each. Efficacies of SL removal were evaluated by using a five-grade scoring system under scanning electron microscopy. RESULTS The laser activations significantly enhanced the effect of the NaOCl, EDTA, and NaOCl+EDTA irrigations in removing SL. The efficacies of SL removal were presented in a descending order of LAI+NaOCl+EDTA, LAI+EDTA>LAI+NaOCl, NaOCl+EDTA>EDTA>NaOCl. CONCLUSIONS Among the treatments, the LAI+NaOCl+EDTA was the most effective protocol in removing SL from the entire root canal wall, which may be effective for root canal treatment.
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Affiliation(s)
- Xiaoli Wang
- 1 State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University , Xi'an, P.R. China
| | - Xiaogang Cheng
- 1 State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University , Xi'an, P.R. China
| | - Baogang Liu
- 2 Department of Stomatology, Lishilu Outpatient Department, Chinese PLA Second Artillery Corps , Beijing, P.R. China
| | - Xin Liu
- 1 State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University , Xi'an, P.R. China
| | - Qing Yu
- 1 State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University , Xi'an, P.R. China
| | - Wenxi He
- 1 State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University , Xi'an, P.R. China
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Toyota Y, Yoshihara T, Hisada A, Yawaka Y. Removal of smear layer by various root canal irrigations in primary teeth. PEDIATRIC DENTAL JOURNAL 2017. [DOI: 10.1016/j.pdj.2016.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pedro FLM, Costa LMAS, Filho GS, Guedes OA, Pereira TM, Borges AH. Assessment of the Amount of Calcium Ions Released after the use of Different Chelating Agents and Agitation Protocols. Open Dent J 2017; 11:133-139. [PMID: 28458729 PMCID: PMC5388784 DOI: 10.2174/1874210601711010133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 01/09/2017] [Accepted: 01/23/2017] [Indexed: 11/26/2022] Open
Abstract
Background: The main goal of endodontic treatment is to achieve cleaning and shaping prior to the filling process. Objective: This study aimed to evaluate, using atomic absorption spectrometry, the release of Calcium ions after the use of different chelating agents and protocols of agitation. Method: Ninety human canine teeth were randomly assigned to one of nine groups (n=10), as follows: 1) 0.2% Chitosan and manual agitation; 2) 0.2% Chitosan and sonic agitation; 3) 0.2% Chitosan and ultrasonic agitation; 4) 17% EDTA and manual agitation; 5) 17% EDTA and sonic agitation; 6) 17% EDTA and ultrasonic agitation; 7) distilled water and manual agitation; 8) distilled water and sonic agitation; 9) distilled water and ultrasonic agitation. Following instrumentation, all chelating substances remained inside the root canal for 3 min. Then the fluid was collected for the identification and quantification of Calcium ions. The amount of Calcium ions released in each group was compared using analysis of variance (ANOVA) and the Kolmogorov-Smirnov and Levene tests followed by Tukey’s post-hoc test. Significance was set at 5%. Results: The groups in which 0.2% Chitosan was used showed the highest concentration of Calcium ions (p<0.05). Concerning the agitation method, ultrasonic agitation showed the greatest values, followed by sonic and manual agitation (all comparisons, p<0.05). Conclusion: The present findings suggest that, among the combinations here tested, Chitosan associated with ultrasonic agitation yielded the greatest release of Calcium ions.
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Olivieri JG, García Font M, Stöber E, de Ribot J, Mercadé M, Duran-Sindreu F. Effect of manual dynamic activation with citric acid solutions in smear layer removal: A scanning electron microscopic evaluation. J Dent Sci 2016; 11:360-364. [PMID: 30894998 PMCID: PMC6395180 DOI: 10.1016/j.jds.2016.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 12/21/2015] [Indexed: 11/19/2022] Open
Abstract
Background/purpose Chelating agents have been used for the removal of the smear layer on teeth. However, due to inadequate volume and/or penetration of the solutions during irrigation, smear layer removal is less effective in the apical third. The purpose of this study was to compare the efficacy of three chelating solutions with and without manual dynamic irrigation in smear layer removal. Materials and methods Sixty-six single-root canal teeth were decoronated, instrumented, and divided into six experimental groups (n = 10) and two control groups (n = 3). The groups received a final rinse with 1 mL of 17% EDTA and 5% or 10% citric acid (CA) for 1 minute, with or without manual dynamic activation, followed by a final 3-mL rinse with 4.2% NaOCl (5 minutes). The teeth were then longitudinally split and prepared for environmental scanning electron microscopy analysis. Digital images (500×) were taken for smear layer removal evaluation at 2 mm, 6 mm, and 10 mm from the working length. Results The most effective smear layer removal occurred with 5% and 10% CA combined with manual dynamic activation (Groups 7 and 8), where significant differences were observed when compared with the EDTA groups (Groups 2 and 6; P < 0.05). We found no significant differences between manual dynamic activation with 5% and 10% CA (Groups 7 and 8) in smear layer or debris removal (P > 0.05). Conclusion Manual dynamic activation of CA improves smear layer removal, and a reduction in CA concentration to 5% does not compromise smear layer removal in comparison with higher concentrations.
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Affiliation(s)
| | | | | | | | | | - Fernando Duran-Sindreu
- Corresponding author. Dentistry Faculty, Universitat Internacional de Catalunya, Josep Trueta, 08195, Sant Cugat del Vallès, Spain.
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Aksel H, Serper A, Kalayci S, Somer G, Erisken C. Effects of QMix and ethylenediaminetetraacetic acid on decalcification and erosion of root canal dentin. Microsc Res Tech 2016; 79:1056-1061. [PMID: 27500784 DOI: 10.1002/jemt.22745] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 07/10/2016] [Accepted: 07/26/2016] [Indexed: 11/10/2022]
Abstract
The aim of this study was to evaluate the effect of initial NaOCl on the decalcification and erosion ability of EDTA and QMix. Sixty-maxillary-incisors were bisected longitudinally and the tooth-halves were used. The experiment was conducted in two-sets. In set-I, 80-tooth halves were treated in the presence or absence of initial NaOCl and EDTA. In set-II, 40-tooth halves were immersed in NaOCl and QMix. After each treatment, calcium-ion release was determined with flame photometry. The erosion was imaged using SEM. Initial NaOCl led to concentration- and time-dependent increase in calcium removal effect of 17% EDTA (p < .05). The rate of calcium removal and root canal wall erosion was considerably more severe with the use of 5% NaOCl for 3 min (p < .05). QMix as a final solution showed less decalcification and erosion than 17% EDTA when used 5% NaOCl as an initial irrigant (p < .05). Optimizing the concentration and application time of NaOCl can decrease the decalcification effect of chelating agents.
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Affiliation(s)
- Hacer Aksel
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
| | - Ahmet Serper
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sukru Kalayci
- Department of Chemistry, Faculty of Arts and Science, Gazi University, Ankara, Turkey
| | - Guler Somer
- Department of Chemistry, Faculty of Arts and Science, Gazi University, Ankara, Turkey
| | - Cevat Erisken
- Biomedical Engineering Department, TOBB University, Ankara, Turkey
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Attur K, Joy MT, Karim R, Anil Kumar VJ, Deepika C, Ahmed H. Comparative analysis of endodontic smear layer removal efficacy of 17% ethylenediaminetetraacetic acid, 7% maleic acid, and 2% chlorhexidine using scanning electron microscope: An in vitro study. J Int Soc Prev Community Dent 2016; 6:S160-5. [PMID: 27652250 PMCID: PMC5022395 DOI: 10.4103/2231-0762.189755] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aim: The aim of the present study was to evaluate the efficiency of different endodontic irrigants in the removal of smear layer through scanning electron microscopic image analysis. Materials and Methods: The present in vitro study was carried out on 45 single-rooted extracted human mandibular premolar teeth with single canal and complete root formation. Teeth were randomly assigned to three groups with 15 teeth in each group. Group I samples were irrigated with 17% ethylenediaminetetraacetic (EDTA) irrigation, Group II with 7% maleic acid irrigation, and Group III with 2% chlorhexidine irrigation. Scanning electron microscope evaluation was done for the assessment of smear layer removal in the coronal, middle, and apical thirds. Comparison of the smear layer removal between the three different groups was done by Kruskal–Wallis test, followed by Mann–Whitney U test for comparing individual groups. A P value less than 0.05 was considered to be statistically significant. Results: Statistically significant difference was seen between the two test groups (17% EDTA vs. 7% maleic acid and 17% EDTA vs. 2% chlorhexidine) in smear layer removal at coronal, middle, and apical thirds of the root canal. The most efficient smear layer removal was seen in Group I with 17% EDTA irrigation compared with other groups (P < 0.05) and the least by 2% chlorhexidine. Conclusion: The present study shows that 17% EDTA efficiently removes the smear layer from root canal walls.
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Affiliation(s)
- Kailash Attur
- Department of Conservative Dentistry and Endodontics, Narsinhbhai Patel Dental College and Hospital, Visnagar, Gujarat, India
| | - Mathew T Joy
- Department of Periodontology, Indira Gandhi Institute of Dental Sciences, Ernakulam, Kerala, India
| | - Riyas Karim
- Department of Periodontology, Indira Gandhi Institute of Dental Sciences, Ernakulam, Kerala, India
| | | | - C Deepika
- Department of Pediatric Dentistry, Sri Balaji Dental College, Moinabad, Telangana, India
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Güldas HE, Kececi AD, Cetin ES, Ozturk T, Kaya BÜ. Evaluation of antimicrobial efficacy of cetrimide and Glycyrrhiza glabra L. extract against Enterococcus faecalis biofilm grown on dentin discs in comparison with NaOCl. Dent Mater J 2016; 35:721-727. [PMID: 27150551 DOI: 10.4012/dmj.2014-338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study aimed to determine the antimicrobial efficacy of NaOCl, cetrimide, and Glycyrrhiza glabra L. extract against Enterococcus faecalis biofilms on dentine discs. Broth microdilution method was used to determine minimal bactericidal concentrations (MBCs) of the agents. A biofilm susceptibility assay was performed using E. faecalis biofilms grown on dentine discs. Minimal bactericidal concentrations (MBCs) of NaOCl (0.5%), cetrimide (0.015%), and G. glabra L. extract (0.25%) were applied for 1, 3, and 5 min, and the mean viable cell counts were recorded and statistically analyzed. There was no significant difference between cetrimide and NaOCl at 1 min (p>0.05). NaOCl was the most effective agent at 3 and 5 min (p<0.05) while G. glabra L. extract was the least (p<0.05). The MBCs of NaOCl, cetrimide, and G. glabra that eliminated the planktonic E. faecalis did not eradicate the biofilms grown on dentin discs.
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Affiliation(s)
- Hilmi Egemen Güldas
- Faculty of Dentistry, Department of Endodontics, University of Süleyman Demirel
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Widbiller M, Eidt A, Hiller KA, Buchalla W, Schmalz G, Galler KM. Ultrasonic activation of irrigants increases growth factor release from human dentine. Clin Oral Investig 2016; 21:879-888. [DOI: 10.1007/s00784-016-1824-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 04/13/2016] [Indexed: 11/24/2022]
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Uzunoglu E, Yilmaz Z, Erdogan O, Görduysus M. Final Irrigation Regimens Affect Fracture Resistance Values of Root-filled Teeth. J Endod 2016; 42:493-5. [DOI: 10.1016/j.joen.2015.12.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 11/24/2015] [Accepted: 12/05/2015] [Indexed: 11/27/2022]
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Yadav HK, Tikku AP, Chandra A, Yadav RK, Patel DK. Efficacy of etidronic acid, BioPure MTAD and SmearClear in removing calcium ions from the root canal: An in vitro study. Eur J Dent 2016; 9:523-528. [PMID: 26929691 PMCID: PMC4745234 DOI: 10.4103/1305-7456.172613] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The purpose of this study was to quantify the amount of calcium ions removed from the root canal by etidronic acid (HEBP), BioPure MTAD, and SmearClear using atomic absorption spectrophotometer. MATERIALS AND METHODS Fifty (n = 50) freshly extracted human mandibular premolar teeth were collected and decoronated at the cementoenamel junction. The canals were prepared in a crown down fashion using the rotary system and copiously irrigated with 1.0% sodium hypochlorite. All specimens were rinsed with the deionized water. Based on the type of chelating agent used, the samples (n = 10) were randomly divided into five (four test and one negative control) groups. Accordingly, Group I - 9% HEBP, Group II - 18% HEBP, Group III - SmearClear, Group IV - BioPure MTAD, and Group V - normal Saline. Subsequent to irrigation, the solution was collected in a test tube and subjected to atomic absorption spectrophotometer for the quantification of calcium ions removed from the root canal. RESULTS The mean concentration of calcium ions removed from the root canal (mean ± standard deviation) in all groups (I-V) were 13.32 ± 0.54 μg/ml, 16.36 ± 0.27 μg/ml, 20.04 ± 0.24 μg/ml, 18.15 ± 0.39 μg/ml, and 8.74 ± 0.49 μg/ml, respectively. CONCLUSIONS SmearClear was the most effective agent for the removal of calcium ions from the root canal. Hence, its combined use with an organic solvent can be recommended for efficient smear layer removal.
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Affiliation(s)
- Hemant Kumar Yadav
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - A P Tikku
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Anil Chandra
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Rakesh Kumar Yadav
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Devendra Kumar Patel
- Analytical Chemistry Laboratory, Regulatory Toxicology Group, CSIR- Indian Institute of Toxicology Research, Lucknow, Uttar Pradesh, India
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Duncan HF, Smith AJ, Fleming GJP, Reid C, Smith G, Cooper PR. Release of bio-active dentine extracellular matrix components by histone deacetylase inhibitors (HDACi). Int Endod J 2016; 50:24-38. [PMID: 26609946 DOI: 10.1111/iej.12588] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 11/19/2015] [Indexed: 01/24/2023]
Abstract
AIM To characterize dentine matrix component (DMC) release and smear layer removal by histone deacetylase inhibitors (HDACis). METHODOLOGY DMCs were extracted from powdered human dentine over 14 days using three HDACis, valproic acid (VPA), trichostatin A (TSA) and suberoylanilide hydroxamic acid (SAHA) and compared with a control extractant, 10% (w/v) EDTA. Protein compositions of the resultant extracts were analysed by 1D-polyacrylamide gel electrophoresis (1D-PAGE), TGF-β-1 and MMP-9 ELISAs and a high-throughput growth factor antibody array. Dentine discs with a standardized smear layer were prepared from human molars and treated with EDTA (17% w/v), polyacrylic acid (PA) (20% v/v) and the experimental HDACis prior to analysis by scanning electron microscopy. Parametric ELISA data were analysed using one-way anova and Tukey's post hoc test, whilst nonparametric smear layer data were analysed by Kruskal-Wallis test and Mann-Whitney U-test (P < 0.05). RESULTS HDACis did not remove smear layer in the presence or absence of PA pre-treatment (P ≥ 0.478). 1D-PAGE analysis demonstrated different protein profiles for EDTA and HDACi extracts. All HDACi solutions released TGF-β-1 although less effectively than EDTA (P < 0.001), whilst MMP-9 was extracted in significantly higher concentration by EDTA and VPA compared with TSA (P < 0.012). Antibody array analysis demonstrated the ability of HDACis to extract a complex cocktail of established/novel growth factors from dentine, albeit significantly less efficiently than EDTA for certain cytokines (TGF-β-1, PDGF-AA, VEGF-A) and significantly more effectively for others (GDF-15, IGF-1, EGRF-1, NGFR, BDNF, SCF-R). CONCLUSIONS HDACi release a range of bioactive DMCs that could promote dentine repair processes in vivo; however, they are ineffective at removing smear layer.
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Affiliation(s)
- H F Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - A J Smith
- Oral Biology, School of Dentistry, University of Birmingham, Birmingham, UK
| | - G J P Fleming
- Material Science Unit, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - C Reid
- Centre for Microscopy and Analysis, Trinity College Dublin, Dublin, Ireland
| | - G Smith
- Oral Biology, School of Dentistry, University of Birmingham, Birmingham, UK
| | - P R Cooper
- Oral Biology, School of Dentistry, University of Birmingham, Birmingham, UK
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Ganesh A, Nagendrababu V, John A, Deivanayagam K. The Effect of Addition of an EPS Degrading Enzyme with and without Detergent to 2% Chlorhexidine on Disruption of Enterococcus faecalis Biofilm: A Confocal Laser Scanning Microscopic Study. J Clin Diagn Res 2015; 9:ZC61-5. [PMID: 26675655 DOI: 10.7860/jcdr/2015/14602.6829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 08/10/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND Enterococcus faecalis is one of the most commonly occurring organisms retrieved from root canal treated teeth that show refractory apical periodontitis. Though it is well known that the ability of E. faecalis to form a matrix-encased biofilm contributes to its pathogenicity, the role of extracellular dextran and DNA in biofilm formation and its effect on the susceptibility of the biofilm to chlorhexidine remains poorly understood. It was hypothesized that the addition of an Extracellular Polymeric Substance (EPS) degrading enzyme along with a detergent to chlorhexidine may increase the susceptibility of the E. faecalis biofilm. AIM To evaluate the sensitivity of Enterococcus faecalis biofilms treated with DNase enzyme and their susceptibility to 2% chlorhexidine used alone or in conjunction with a detergent in a dentin disinfection model and examine under confocal laser scanning microscopy (CLSM). MATERIALS AND METHODS Semi cylindrical shaped dentin specimens were infected with E. faecalis and incubated for 24 hours. Following incubation, the infected dentin specimens were exposed for 3 minutes to the four disinfecting solutions and grouped accordingly. {Group I- Sterile saline, Group II- 2% Chlorhexidine (CHX), Group III- Dnase1 Enzyme + 2% CHX, Group IV- DNase1 Enzyme + 2% CHX & Tween 80. Bacterial viability was then assessed by staining the specimens and examining under CLSM to analyse the proportion of dead and live bacteria within the dentinal tubules. RESULTS The Groups II, III and IV showed statistically significant (p<0.05) percentage of dead bacteria compared to the control (Group I). However there was no significant difference in the killing effectiveness within the experimental groups (II-IV) at (p<0.05). CONCLUSION EPS degrading enzyme (DNase I) disrupts the biofilm and increases the susceptibility of E.faecalis when exposed to 2% Chlorhexidine and the use of a surfactant with this combination significantly contributes to improving the antibacterial efficacy.
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Affiliation(s)
- Arathi Ganesh
- Professor, Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, Sri Ramachandra University , Porur, Chennai, India
| | - Venkateshbabu Nagendrababu
- Senior Lecturer, Department of Restorative Dentistry, International Medical University , Kula Lumpur, Malaysia
| | - Aby John
- Former Post Graduate, Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, Sri Ramachandra University , Porur, Chennai, India
| | - Kandaswamy Deivanayagam
- Dean, Professor and Head, Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, Sri Ramachandra University , Porur, Chennai, India
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Chhabra N, Gyanani H, Kamatagi L. Smear layer removal efficacy of combination of herbal extracts in two different ratios either alone or supplemented with sonic agitation: An in vitro scanning electron microscope study. J Conserv Dent 2015; 18:374-8. [PMID: 26430300 PMCID: PMC4578181 DOI: 10.4103/0972-0707.164035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objectives: The study aimed to evaluate the effectiveness of the combination of two natural extracts in varying ratios for removal of smear layer either alone or supplemented with sonic agitation. Materials and Methods: Fifty extracted single-rooted teeth were collected, disinfected and decoronated below the cementoenamel junction to obtain standardized root length of 10 mm. Root canals were instrumented using rotary files at working length 1 mm short of the apex. Specimens were divided into six groups according to the irrigation protocol as follows: Group A – Distilled water, Group B – 17% ethylenediaminetetraacetic acid, Group C – Herbal extracts in 1:1 ratio, Group D – Herbal extracts in 1:1 ratio supplemented with sonic agitation, Group E – Herbal extracts in 2:1 ratio, Group F – Herbal extracts in 2:1 ratio supplemented with sonic agitation. Specimens were longitudinally sectioned and evaluated under scanning electron microscope for smear layer removal efficacy. Obtained scores were statistically analyzed using one-way analysis of variance and post-hoc test. Results: Among all, Group B showed the best results followed by Group F. Remaining other groups showed inferior outcome (P < 0.05). Conclusion: The combination of two extracts in 2:1 ratio was slightly better than 1:1 ratio and the smear layer removal efficacy was further improved when accompanied with sonic agitation.
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Affiliation(s)
- Naveen Chhabra
- Department of Conservative Dentistry and Endodontics, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Hitesh Gyanani
- Department of Conservative Dentistry and Endodontics, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Laxmikant Kamatagi
- Department of Conservative Dentistry and Endodontics, P. M. N. M. Dental College and Hospital, Bagalkot, Karnataka, India
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Uzunoglu E, Turker SA, Karahan S. The Effect of Increased Temperatures of QMix and EDTA on the Push-out Bond Strength of an Epoxy-resin Based Sealer. J Clin Diagn Res 2015; 9:ZC98-ZC101. [PMID: 26393216 DOI: 10.7860/jcdr/2015/13402.6262] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 05/29/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Bond strength of root canal sealers is mainly influenced by the surface tension of the root canal wall. Heat, or the use of a surfactant might reduce surface tension and it is known that surface tension of an EDTA solution significantly affected from temperature rise. QMix is a novel endodontic irrigant for smear layer removal containing EDTA, chlorhexidine and a detergent. There is no data regarding the influence of the temperature of the EDTA and QMix on the push-out bond strength of root canal sealers. AIM To evaluate effect of temperatures of QMix and EDTA on the bond-strength of AH Plus. MATERIALS AND METHODS Sixty premolars were prepared with ProTaper F4. During preparation 3% NaOCl was performed. Specimens were divided into 4 groups as follows: 5-mL 17% EDTA at 22°C and 37°C; 5-mL QMix at 22°C and 37°C. Three specimens from each group were prepared for observation using SEM. Remaining roots were obturated and prepared for a push-out test. Data was analysed using Anova and Bonferroni tests (p<0.05). RESULTS Samples irrigated with QMix had higher push-out bond strength values than those irrigated with EDTA (p=0.01), regardless of temperature. Samples irrigated with 37°C EDTA resulted in higher bond-strength values than those irrigated with 22°C EDTA (p<0.001). CONCLUSION Temperature of the final irrigant does affect the bond strength values of AH plus to root dentin irrigated with EDTA. Bond strength of AH Plus sealer to root canal dentin may improve with QMix.
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Affiliation(s)
- Emel Uzunoglu
- Research Assistant, Department of Endodontics, Hacettepe University Faculty of Dentistry , Ankara/ Turkey
| | - Sevinc Aktemur Turker
- Research Assistant, Department of Endodontics, Bülent Ecevit University Faculty of Dentistry , Zonguldak/ Turkey
| | - Sevilay Karahan
- Research Assistant, Department of Endodontics, Hacettepe University Faculty of Dentistry , Ankara/ Turkey
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Schmidt TF, Teixeira CS, Felippe MC, Felippe WT, Pashley DH, Bortoluzzi EA. Effect of Ultrasonic Activation of Irrigants on Smear Layer Removal. J Endod 2015; 41:1359-63. [DOI: 10.1016/j.joen.2015.03.023] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 03/23/2015] [Accepted: 03/24/2015] [Indexed: 11/16/2022]
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Gaddala N, Veeramachineni C, Tummala M. Effect of Peracetic Acid as A Final Rinse on Push Out Bond Strength of Root Canal Sealers to Root Dentin. J Clin Diagn Res 2015; 9:ZC75-7. [PMID: 26155568 DOI: 10.7860/jcdr/2015/12254.5960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 04/02/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Smear layer which was formed during the instrumentation of root canals hinders the penetration of root canal sealers to root dentin and affect the bond strength of root canal sealers to root dentin. Final irrigant such as demineralizing agents are used to remove the inorganic portion of the smear layer. In the present study, peracetic acid used as a final rinse, to effect the bond strength of root canal sealers to root dentin. AIM The purpose of the present study was to evaluate the efficacy of peracetic acid as a final irrigant on bond strength of root canal sealers to root dentin. MATERIALS AND METHODS Sixty six freshly extracted human single rooted mandibular premolars were used for this study. After decoronation the samples were instrumented with Protaper upto F3 and irrigated with 5.25% NaOcl. The teeth were then divided into three groups based on final irrigant used: Group-1(control group) Canals were irrigated with distilled water. Group-2: Canals were irrigated with peracetic acid. Group-3: Canals were irrigated with smear clear. Each group was further divided into three subgroups (n=30) based on the sealer used to obturate the canals. Subgroup-1: kerr, Subgroup-2: Apexit plus, Subgroup-3: AH PLUS. Each sealer was mixed and coated to master cone and placed in the canal. The bonding between sealer and dentin surface was evaluated using push out bond strength by universal testing machine. The mean bond strength values of each group were statistically evaluated using Two-way ANOVA followed by Tukey post-hoc test. RESULTS Significant difference was found among the bond strength of the sealers. But, there is no statistically significant difference between the groups irrigated with peracetic acid and smear clear compared to control group. AH Plus showed highest bond strength irrespective of the final irrigant used. CONCLUSION Peracetic acid when employed as final irrigant improved the bond strength of root canal sealers compared to control group but not statistically significant than smear clear.
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Affiliation(s)
- Naresh Gaddala
- PG Student, Department of Conservative Dentistry and Endodontics, Mamata Dental College , Andhra Pradesh, India
| | - Chandrasekhar Veeramachineni
- Professor and HOD, Department of Conservative Dentistry and Endodontics, Mamata Dental College , Andhra Pradesh, India
| | - Muralidhar Tummala
- Reader, Department of Conservative Dentistry and Endodontics, Mamata Dental College , Andhra Pradesh, India
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Carrasco R, Román R, Ojeda M, Vergara C. Sonic versus ultrasonic activation for the cleaning of the root canal after post space preparation: an in vitro study. JOURNAL OF ORAL RESEARCH 2015. [DOI: 10.17126/joralres.2015.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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da Costa Lima GA, Aguiar CM, Câmara AC, Alves LC, dos Santos FAB, do Nascimento AE. Comparison of Smear Layer Removal Using the Nd:YAG Laser, Ultrasound, ProTaper Universal System, and CanalBrush Methods: An In Vitro Study. J Endod 2015; 41:400-4. [DOI: 10.1016/j.joen.2014.11.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 07/31/2014] [Accepted: 11/04/2014] [Indexed: 11/25/2022]
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40
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van der Sluis L, Boutsioukis C, Jiang LM, Macedo R, Verhaagen B, Versluis M. Root Canal Irrigation. SPRINGER SERIES ON BIOFILMS 2015. [DOI: 10.1007/978-3-662-47415-0_9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Guo X, Miao H, Li L, Zhang S, Zhou D, Lu Y, Wu L. Efficacy of four different irrigation techniques combined with 60 °C 3% sodium hypochlorite and 17% EDTA in smear layer removal. BMC Oral Health 2014; 14:114. [PMID: 25201549 PMCID: PMC4168203 DOI: 10.1186/1472-6831-14-114] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 09/03/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Efforts to improve the efficacy of smear layer removal by applying irrigant activation at the final irrigation or by elevating the temperature of the irrigant have been reported. However, the combination of such activation protocols with 60 °C 3% sodium hypochlorite (NaOCl) has seldom been mentioned. The aim of this study was to compare the efficacy in smear layer removal of four different irrigation techniques combined with 60 °C 3% NaOCl and 17% EDTA. METHODS Fifty single-rooted teeth were randomly divided into five groups (n = 10) according to the irrigant agitation protocols used during chemomechanical preparation(Dentsply Maillefer, Ballaigues, Switzerland): a side-vented needle group, a ultrasonic irrigation (UI) group, a NaviTip FX group, an EndoActivator group, and a control group (no agitation). After each instrumentation, the root canals were irrigated with 1 mL of 3% NaOCl at 60 °C for 1 minute, and after the whole instrumentation, the root canals were rinsed with 1 mL of 17% EDTA for 1 minute. Both NaOCl and EDTA were activated with one of the five irrigation protocols. The efficacy of smear layer removal was scored at the apical, middle and coronal thirds. The Data were statistically analyzed using SAS version 9.2 for Windows (rank sum test for a randomised block design and ANOVA). RESULTS No significant differences among the NaviTip FX group, EndoActivator group and control groups, and each of these groups showed a lower score than that of UI group (P < 0.05). Within each group, all three thirds were ranked in the following order: coronal > middle > apical (P < 0.05). In the coronal third, the NaviTip FX group was better than UI group. In the middle and apical third, the differences were not significant among any of the groups. CONCLUSIONS Even without any activation, the combination of 60 °C 3% NaOCl and 17% EDTA could remove the smear layer effectively, similar to NaviTip FX or EndoActivator, and these three protocols were more effective than UI. However, regardless of different types of irrigation technique applied, complete removal of the smear layer was not achieved, particularly in the apical third.
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Affiliation(s)
| | | | | | | | | | | | - Ligeng Wu
- From the Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin 300070, PR China.
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Samiei M, Pakdel SMV, Rikhtegaran S, Shakoei S, Ebrahimpour D, Taghavi P. Scanning electron microscopy comparison of the cleaning efficacy of a root canal system by Nd:YAG laser and rotary instruments. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2014; 20:1240-1245. [PMID: 24887536 DOI: 10.1017/s1431927614000981] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study evaluated the cleaning efficacy of a root canal system by Nd:YAG laser and rotary instruments. Sixty single-rooted human teeth were divided into four experimental groups (n=15). In the first group the teeth were prepared with a step-back technique using conventional K-files. In the second and third groups, tooth preparation was carried out using Nd:YAG laser and rotary NiTi instruments, respectively. Teeth in the fourth group were prepared by combined laser and rotary methods. The smear layer remaining on canal walls was then assessed by scanning electron microscopy in the coronal, middle, and apical portions. The comparison of smear layer removal efficacy between groups was carried out by Kruskal-Wallis and Mann-Whitney U tests. The mean grades of smear layer removal in rotary-laser, rotary, laser and step-back techniques were 1.34 ± 0.18, 2.2 ± 0.28, 1.91 ± 0.25, and 2.42 ± 0.19, respectively. On the whole, differences between rotary-laser and rotary groups, step-back, and the three other techniques (rotary, laser, and rotary-laser) were significant at p=0.034. Based on the findings of this study, the cleaning efficacy of rotary, laser, and rotary-laser techniques were better than the step-back technique and the combined laser and rotary technique was the most efficient method.
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Affiliation(s)
- Mohammad Samiei
- 1Department of Endodontics,Tabriz University of Medical Sciences,Tabriz,Iran
| | - Seyyed Mahdi Vahid Pakdel
- 2Department of Prosthodontics,Student's research committee,Tabriz University of Medical Sciences,Tabriz,Iran
| | - Sahand Rikhtegaran
- 3Department of Restorative dentistry,Tabriz University of Medical Sciences,Tabriz,Iran
| | - Sahar Shakoei
- 1Department of Endodontics,Tabriz University of Medical Sciences,Tabriz,Iran
| | - Delaram Ebrahimpour
- 4Department of Oral medicine,Tabriz University of Medical Sciences,Tabriz,Iran
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Ahmetoglu F, Keles A, Yalcin M, Simsek N. Effectiveness of different irrigation systems on smear layer removal: A scanning electron microscopic study. Eur J Dent 2014; 8:53-57. [PMID: 24966746 PMCID: PMC4054032 DOI: 10.4103/1305-7456.126241] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: To evaluate effectiveness of the apical negative pressure irrigation (EndoVac), passive ultrasonic irrigation (PUI), and conventional needle irrigation (CI) systems on smear layer (SR) removal. Materials and Methods: Sixty single-rooted canines were prepared using NiTi rotary files and subjected to different irrigation regimens: EndoVac with NaOCl (Group 1) or NaOCl/EDTA (Group 2); PUI with NaOCl (Group 3) or NaOCl/EDTA (Group 4); CI with NaOCl (Group 5) or NaOCl/EDTA (Group 6). The roots were split longitudinally. SEM images were taken to evaluate the amount of residual SR. Results: In Groups 1, 3, and 5, there was no removal of SR (P > 0.05). The coronal thirds within Groups 2, 4, and 6 were cleaned completely, but the middle and the apical thirds was achieved partially or completely (P > 0.05). Conclusion: Regardless of which irrigation system was used, the use of NaOCl alone failed to remove the SR. In NaOCl/EDTA combination groups, the SR was removed partially or completely and no statistical significance. This study demonstrated that in order to remove the SR should be used EDTA solution for final irrigation in the root canal, regardless of the technique in each of the three.
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Affiliation(s)
- Fuat Ahmetoglu
- Department of Endodontics, Faculty of Dentistry, Inonu University, Malatya, Turkiye
| | - Ali Keles
- Department of Endodontics, Faculty of Dentistry, Inonu University, Malatya, Turkiye
| | - Muhammet Yalcin
- Department of Restorative Dentistry, Faculty of Dentistry, Inonu University, Malatya, Turkiye
| | - Neslihan Simsek
- Department of Endodontics, Faculty of Dentistry, Inonu University, Malatya, Turkiye
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An in vitro evaluation of passive ultrasonic agitation of different irrigants on smear layer removal after post space preparation: a scanning electron microscopic study. J Indian Prosthodont Soc 2014; 13:240-6. [PMID: 24431741 DOI: 10.1007/s13191-012-0151-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Accepted: 06/30/2012] [Indexed: 10/28/2022] Open
Abstract
This study evaluated the removal of debris and smear layer after post space preparation using different irrigations and passive ultrasonic agitation. Sixty human premolars were decoronated and post space prepared after endodontic therapy. The samples were then randomly divided into three experimental groups (Groups A, B, C) and one control group (Group D) with fifteen samples in each group. Groups A and B samples were treated with 10 % citric acid and 17 % ethylenediamintetraacetic acid (EDTA), respectively and passive ultrasonic agitation was done, rinsed with sodium hypochlorite and finally flushed with saline. Group C samples were conditioned with 36 % phosphoric acid and then rinsed with saline. The control group was treated with 3 % sodium hypochlorite, passive ultrasonic agitation done and flushed with saline. The samples were sectioned and evaluated for debris and smear layer removal under scanning electron microscope. 10 % citric acid showed the best removal of smear layer when compared with 17 % EDTA and 36 % phosphoric acid, but was not statistically significant (p > 0.05). The difference in scoring for debris and smear layer removal in the coronal, middle and apical third of post space of experimental groups in comparison with control group was statistically significant (p < 0.001).
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Kamel WH, Kataia EM. Comparison of the efficacy of Smear Clear with and without a canal brush in smear layer and debris removal from instrumented root canal using WaveOne versus ProTaper: a scanning electron microscopic study. J Endod 2013; 40:446-50. [PMID: 24565669 DOI: 10.1016/j.joen.2013.09.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Revised: 09/15/2013] [Accepted: 09/19/2013] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The aim of this study was to compare by scanning electron microscopy the presence of smear layer and debris on root canal walls after preparation with the single-file system WaveOne (Dentsply Maillefer, Ballaigues, Switzerland) versus the rotary ProTaper system (Dentsply Maillefer, Ballaigues, Switzerland) under 2 final irrigant regimens. METHODS Forty freshly extracted single-rooted human teeth were randomly divided into 4 groups (n = 10). The ProTaper and ProTaper and rotary CanalBrush (Coltène Whaledent GmbH+ Co KG, Langenau, Germany) groups were instrumented with the ProTaper system. Groups WaveOne and WaveOne and rotary CanalBrush were instrumented with the WaveOne system. The irrigant in all groups was 2 mL 5.25% sodium hypochlorite (NaOCl) solution, whereas the final irrigation after preparation in the ProTaper and WaveOne groups was 1 mL Smear Clear solution (Sybron Endo, Orange, CA) and then 5.25% NaOCl applied with a plastic syringe, and in the ProTaper and rotary CanalBrush and WaveOne and rotary CanalBrush groups, it was 1 mL Smear Clear solution and then 5.25% NaOCl (rotary CanalBrush agitation). Roots were processed for scanning electron microscopic examination for debris and smear layer scoring. Data were statistically analyzed. RESULTS All groups showed more efficient smear layer and debris removal coronally than in the middle and apical regions, whereas the mean total debris score and the mean smear layer score in all groups were less in the WaveOne and rotary CanalBrush groups than the ProTaper and rotary CanalBrush and the WaveOne and ProTaper groups. CONCLUSIONS Using the rotary CanalBrush in canals prepared with WaveOne produced the cleanest canal walls, and the WaveOne system gave superior results compared with the ProTaper system.
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Affiliation(s)
- Wael H Kamel
- Department of Endodontics, Faculty of Dental Medicine, Al-Azhar University (Assiut Branch), Assiut, Egypt.
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Cehreli ZC, Uyanik MO, Nagas E, Tuncel B, Er N, Comert FD. A comparison of residual smear layer and erosion following different endodontic irrigation protocols tested under clinical and laboratory conditions. Acta Odontol Scand 2013; 71:1261-6. [PMID: 23445247 DOI: 10.3109/00016357.2012.757647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To compare the smear layer removal efficacy and erosive effects of different irrigation protocols under clinical and laboratory conditions. MATERIALS AND METHODS Mandibular third molars (n = 32) of 30-45 year-old patients were instrumented with rotary files and were randomly assigned to one of the following groups for final irrigation: (1) 5.25% NaOCl; (2) 17% EDTA; and (3) BioPure MTAD. Thereafter, the teeth were immediately extracted and processed for micromorphological investigation. In vitro specimen pairs were prepared by repeating the clinical experiments on freshly-extracted mandibular third molars. To compare open and closed systems, laboratory experiments were repeated on 32 additional teeth with enlarged apical foramen. The cleanliness of the root canals and the extent of erosion were assessed by environmental scanning electron microscopy. RESULTS Specimens prepared under clinical and laboratory conditions had similar cleanliness and erosion scores (p > 0.05). Under both conditions, the tested solutions were more effective in removing the smear layer in the coronal and middle regions than in the apical one. Comparison of closed and open systems showed similar levels of cleanliness and erosion in all regions (p > 0.05), with the exception of 17% EDTA showing significantly higher levels of cleanliness and erosion in the apical third of open-end specimens. CONCLUSIONS Based on clinical correlates of in vitro root canal cleanliness and erosion, laboratory testing of root canal irrigants on extracted teeth with closed apices can serve as a reliable method to simulate the clinical condition. EDTA was the most effective final irrigation solution in removing the smear layer at the expense of yielding the greatest erosive effect.
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Affiliation(s)
- Zafer C Cehreli
- Department of Pediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
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Aranda-Garcia AJ, Kuga MC, Chavéz-Andrade GM, Kalatzis-Sousa NG, Hungaro Duarte MA, Faria G, Reis Só MV, Faria-Junior NB. Effect of final irrigation protocols on microhardness and erosion of root canal dentin. Microsc Res Tech 2013; 76:1079-83. [DOI: 10.1002/jemt.22268] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 06/27/2013] [Accepted: 07/07/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Arturo Javier Aranda-Garcia
- Department of Restorative Dentistry; Araraquara Dental School, UNESP - Univ Estadual Paulista Araraquara; SP Brazil
| | - Milton Carlos Kuga
- Department of Restorative Dentistry; Araraquara Dental School, UNESP - Univ Estadual Paulista Araraquara; SP Brazil
| | | | | | - Marco Antonio Hungaro Duarte
- Department of Restorative Dentistry; Endodontics and Dental Materials, Bauru Dental School,; USP - Sao Paulo University; Bauru SP Brazil
| | - Gisele Faria
- Department of Restorative Dentistry; Araraquara Dental School, UNESP - Univ Estadual Paulista Araraquara; SP Brazil
| | - Marcus Vinicius Reis Só
- Department of Conservative Dentistry; Rio Grande do Sul Federal University, UFRGS, Porto Alegre; RS Brazil
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Shen Y, Gao Y, Lin J, Ma J, Wang Z, Haapasalo M. Methods and models to study irrigation. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/etp.12029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Aranda-Garcia AJ, Kuga MC, Vitorino KR, Chávez-Andrade GM, Duarte MAH, Bonetti-Filho I, Faria G, Só MVR. Effect of the root canal final rinse protocols on the debris and smear layer removal and on the push-out strength of an epoxy-based sealer. Microsc Res Tech 2013; 76:533-7. [PMID: 23440741 DOI: 10.1002/jemt.22196] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 01/29/2013] [Accepted: 02/03/2013] [Indexed: 11/07/2022]
Abstract
The aim of the present study was to evaluate the efficacy of QMiX, SmearClear, and 17% EDTA for the debris and smear layer removal from the root canal and its effects on the push-out bond strength of an epoxy-based sealer by scanning electron microscopy (SEM). Forty extracted human canines (n = 10) were assigned to the following final rinse protocols: G1-distilled water (control), G2-17% EDTA, G3-SmearClear, and G4-QMiX. The specimens were submitted to a SEM analysis to evaluate the presence of debris and smear layer, respectively, in the apical or cervical segments. In sequence, forty extracted human maxillary canines with the root canals instrumented were divided into four groups (n = 10) similar to the SEM analysis study. After the filling with AH Plus, the roots were transversally sectioned to obtain dentinal slices. The specimens were submitted to a push-out bond strength test using an electromechanical testing machine. The statistical analysis for the SEM and push-out bond strength studies were performed using the Kruskal-Wallis and Dunn tests (α = 5%). There was no difference among the G2, G3, and G4 efficacy in removing the debris and smear layer (P > 0.05). The efficacy of these groups was superior to the control group. The push-out bond strength values of G2, G3, and G4 were superior to the control group. The ability to remove the debris and smear layer by SmearClear and QMiX was as effective as the 17% EDTA. The final rinse with these solutions promoted similar push-out bond strength values.
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Affiliation(s)
- Arturo Javier Aranda-Garcia
- Department of Restorative Dentistry, Araraquara Dental School, UNESP-University Estadual Paulista, Araraquara, São Paulo, Brazil
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Al-Ali M, Sathorn C, Parashos P. Root canal debridement efficacy of different final irrigation protocols. Int Endod J 2012; 45:898-906. [PMID: 22486845 DOI: 10.1111/j.1365-2591.2012.02046.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To compare the smear layer and debris removal effectiveness of four root canal irrigation protocols as well as their effectiveness in removing remaining soft tissues in curved root canals. METHODOLOGY The mesiobuccal and mesial root canals of 107 extracted human maxillary and mandibular molars were instrumented using Mtwo rotary NiTi instruments then randomly divided into four groups according to a final rinse protocol: Group 1 (n = 28) - manual agitation of 1% NaOCl and 15% EDTA; Group 2 (n = 26) - CanalBrush agitation of 1% NaOCl and 15% EDTA; Group 3 (n = 26) - 3% H(2) O(2) alternated with 1% NaOCl; Group 4 (n = 27) - passive ultrasonic agitation of 1% NaOCl and 15% EDTA. All irrigation protocols were performed in a closed system. Eleven roots per group were prepared and histologically stained (H&E) to assess percentage of remaining pulpal tissues in the apical thirds. The remaining specimens were split longitudinally and examined under scanning electron microscope at ×2000 magnification to assess smear layer and debris removal. Image Pro Plus 6.0 software was used to analyse smear layer and remaining pulp tissue. Debris presence was scored by two blinded investigators using a five-point scale. Data were analysed using Univariate analysis of variance (GenStat 13, α = 0.05). RESULTS CanalBrush and passive ultrasonic irrigation were equally effective with significantly less smear layer and debris than manual agitation and H(2) O(2) alternated with NaOCl (P < 0.05). The H(2) O(2) alternated with NaOCl protocol was significantly more effective in removing pulp tissue remnants in the apical level than manual agitation (P = 0.009) and passive ultrasonic irrigation (P = 0.01). CONCLUSIONS CanalBrush was as effective as passive ultrasonic irrigation in smear layer and debris removal. Alternating H(2) O(2) with NaOCl was effective in removing soft tissues from root canal complexities. Further studies are required to evaluate effectiveness of this regimen taking into account irrigant volume differences and effect of root canal system configuration.
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Affiliation(s)
- M Al-Ali
- Melbourne Dental School, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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