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Alquria TA, Acharya A, Tordik P, Griffin I, Martinho FC. Impact of root canal disinfection on the bacteriome present in primary endodontic infection: A next generation sequencing study. Int Endod J 2024; 57:1124-1135. [PMID: 38700876 DOI: 10.1111/iej.14074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 07/03/2024]
Abstract
AIM To investigate the bacteriome present in teeth with primary endodontic infection (PEI) and apical periodontitis (AP) and to determine quantitatively and qualitatively the impact of chemomechanical preparation (CMP) using 2.5% sodium hypochlorite NAOCl on the bacteriome found in PEI with AP using the Illumina MiSeq platform. METHODOLOGY Thirty-six paired samples from 18 patients were successfully sequenced and analysed. Samples were collected at two sampling times: before (s1) and after (s2) CMP using 2.5% NaOCl. The DNA was extracted from s1 and s2 samples and quantified using quantitative PCR (qPCR). All 36 samples were sequenced using the Illumina MiSeq platform. Raw V3-V4 amplicon sequencing data were processed with the DADA2 pipeline to generate amplicon sequence variants (ASVs). Alpha diversity metrics representing abundance (Chao1) and diversity and evenness (Shannon, Simpson) were computed. The paired-sample Wilcoxon's test was used to compare alpha diversity metrics and qPCR counts between s1 and s2. The PERMANOVA method (with 999 permutations) was applied to compare community composition between sample types (s1 versus s2) and between patient IDs. ALDEx2 (ANOVA-like differential expression tool for high-throughput sequencing data) to investigate differentially abundant taxa between s1 and s2. A paired-sample Wilcoxon's test was used to compare alpha diversity metrics and qPCR counts between s1 and s2. RESULTS The qPCR counts were significantly higher in s1 compared to s2 (p = .0007). The Chao1 index indicated no difference in alpha diversity (p < .7019); whereas Shannon (p = .0056) and Simpson (p = .02685) indexes showed higher values in s2. The PERMANOVA test using Adonis2 showed a significant effect of sample time on community composition (R2 = .0630, p = .012). Patient ID also showed a significant effect on community composition (R2 = .6961, p = .001). At the genus level, Dialister, Mogibacterium, Prevotella, and Olsenella were differentially enriched at s1, while Actinomyces, Stenotrophomonas_unclassified, Enterococcus_unclassified, and Actinomyces_unclassified were differentially enriched in s2. CONCLUSION The bacteriome present in teeth with PEI with AP is complex and diverse. CMP using 2.5% NaOCl showed a high quantitatively and qualitatively disinfectant impact on the bacteriome present in PEI with AP.
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Affiliation(s)
- Theeb Abdullah Alquria
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Aneesha Acharya
- Department of Periodontics and Oral Implantology, Dr D.Y. Patil Dental College and Hospital, Dr D Y Patil Vidyapeeth, Pune, India
- Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Patricia Tordik
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Ina Griffin
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Frederico C Martinho
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
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Pai ARV. Injection of sodium hypochlorite into soft tissues of the oral cavity: A literature review with clinical preventive recommendations. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101581. [PMID: 37544507 DOI: 10.1016/j.jormas.2023.101581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/30/2023] [Indexed: 08/08/2023]
Abstract
Injection of sodium hypochlorite (NaOCl) solution instead of local anaesthetic (LA) solution is an iatrogenic error with serious consequences including medico-legal implications. Such cases have been reported despite recommended precautionary measures. The purpose of this article is to review the literature on such cases and present clinical preventive recommendations. Electronic search was conducted in PubMed/Medline, Google Scholar, Cochrane, Scopus, Lilacs, ScienceDirect, and Crossref databases for articles reporting accidental or mistaken or inadvertent injection of NaOCl instead of LA during dental or endodontic treatment. Articles reporting NaOCl accident due to extrusion or injection of NaOCl beyond root confines were excluded. A total of 11 articles were found and reviewed. Data pertaining to the patient, injected NaOCl, cause, clinical manifestations, management, hospitalization, healing and recovery, and long-term or residual effects were extracted, compiled, and analysed for interpretation and discussion. Injection of NaOCl instead of LA into the soft tissues leads to varying clinical manifestations with unpredictable extent, outcome, and recovery period. The onus lies with the clinician to prevent it. Therefore, a clinician must take all the precautionary measures and confirm the identity of LA and NaOCl solutions before delivering them. The presented clinical recommendations assist clinicians to prevent it, including its potential medico-legal consequences. However, in case of such an unfortunate event, it is crucial to immediately identify and quickly manage it to limit the tissue damage or complications.
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Affiliation(s)
- A R Vivekananda Pai
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Manipal University College Malaysia (MUCM), Jalan Batu Hampar, Bukit Baru, Melaka 75150, Malaysia.
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Uematsu T, Yahata Y, Ohnishi K, Suzuki S, Kanehira M, Tanaka T, Sudo S, Suresh VV, Saito M. Irrigation with reduced sodium hypochlorite solution concentration using laser-induced cavitation is effective and safe in rat intraradicular biofilm model. AUST ENDOD J 2023; 49:544-553. [PMID: 37489629 DOI: 10.1111/aej.12783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 07/08/2023] [Accepted: 07/08/2023] [Indexed: 07/26/2023]
Abstract
This study aimed to investigate the optimal sodium hypochlorite solution (NaOCl) concentration to effectively remove the root canal biofilm without stimulating periradicular inflammation using coronal laser-activated irrigation (CLAI). To compare the efficacy of different NaOCl concentrations combined with CLAI in removing the biofilm, an in vivo intraradicular biofilm rat model was used. Root canals were irrigated using an Er:YAG laser with either 5% or 0.5% NaOCl. Biofilm removal efficacy of CLAI was compared to that of conventional needle irrigation using scanning electron microscopy (SEM) and quantitative polymerase chain reaction (qPCR). Histological observation of CLAI-associated periradicular inflammation was also conducted. In both the 5% and 0.5% CLAI groups, SEM observation showed the opening of the dentin tubules and biofilm removal. qPCR analysis indicated that the residual bacteria counts after cleaning were significantly lower in the 5% and 0.5% CLAI groups than in the conventional needle irrigation and positive control groups (Tukey test, p < 0.05), and no significant difference was observed between the 5% and 0.5% CLAI groups (p > 0.05). Periapical inflammation in the 5% CLAI group revealed the most severe, including significant neutrophilic and lymphocytic infiltration with abscess formation, while only mild vasodilation was observed in the 0.5% CLAI group. CLAI can remove the biofilm independently of chemical action, which avoids the risks associated with high NaOCl concentrations. Therefore, this root canal irrigation technique ensures safety and effectiveness, promising to contribute to new treatment strategies intended to remove intraradicular biofilm.
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Affiliation(s)
- Takehiro Uematsu
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Yoshio Yahata
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Koyuki Ohnishi
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Shigeto Suzuki
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Masafumi Kanehira
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Toshinori Tanaka
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Susumu Sudo
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Venkata Venkataiah Suresh
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Masahiro Saito
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Vijayaraghavan S, Menon K. Comparative Evaluation of Human Pulp Tissue Dissolution by 500-ppm and 200-ppm Hypochlorous Acid and 5.25% Sodium Hypochlorite: An In Vitro Study. J Contemp Dent Pract 2023; 24:103-106. [PMID: 37272141 DOI: 10.5005/jp-journals-10024-3462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIM The aim of this study was to assess, in vitro, the human pulp dissolution capacity of 500 ppm and 200 ppm of hypochlorous acid in comparison with 5.2% sodium hypochlorite (NaOCl). MATERIALS AND METHODS Forty pulp tissue samples were standardized to a weight of 9 mg and divided into four groups according to the irrigating solution used: 5.25% NaOCl, 500 ppm hypochlorous acid, 200 ppm hypochlorous acid, and distilled water. Eppendorf tubes carrying 2 mL of the irrigants were taken and the pulp tissue samples were placed in the tubes for the specified time interval: Subgroup A: 30 minutes and subgroup B: 60 minutes. After the designated time interval, the solution from each sample tube was filtered using Whatman filter paper and left for drying overnight. The residual weight was calculated by filtration method. The mean dissolution time for each experimental group at the different time intervals was statistically analyzed. RESULTS Mean tissue dissolution increases with an increase in the time period. Approximately 5.25% NaOCl was most effective at both time intervals followed by 500-ppm hypochlorous acid at 60 minutes. Least amount of tissue dissolution was shown by 200-ppm of hypochlorous acid at 30 minutes. Distilled water did not show the ability to dissolve human pulp tissue. CONCLUSION Within the limitations of the study, 5.25% NaOCl dissolved the pulp tissue most efficiently at both time intervals and both concentrations. Human pulp tissue dissolution by hypochlorous acid was found to gradually increase with time and with an increase in its concentration. CLINICAL SIGNIFICANCE With the basic information that hypochlorous acid does have the capacity to dissolve human pulp tissue, further research can be undertaken to assess methods to increase its efficiency. Sooner than later, hypochlorous acid may be able to completely replace the toxic NaOCl in clinical practice, as the irrigant of choice during root canal therapy.
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Affiliation(s)
- Siddheswaran Vijayaraghavan
- Department of Conservative Dentistry & Endodontics, College of Dental Sciences, Davanagere, Karnataka, India
| | - Krutika Menon
- Department of Conservative Dentistry & Endodontics, College of Dental Sciences, Davanagere, Karnataka, India, Phone: +91 8792865377, e-mail:
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Advances in the Role of Sodium Hypochlorite Irrigant in Chemical Preparation of Root Canal Treatment. BIOMED RESEARCH INTERNATIONAL 2023; 2023:8858283. [PMID: 36685672 PMCID: PMC9859704 DOI: 10.1155/2023/8858283] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 01/15/2023]
Abstract
Irrigation of root canal system is of great significance to the success of endodontic treatment, where sodium hypochlorite (NaOCl) is the most widely used irrigant in chemical preparation. NaOCl functions by eliminating bacterial biofilms and dissolving organic tissue, which may vary according to several factors such as the microbiology of root canal infection and the concentration of the irrigant. It has been proposed that the effectiveness of NaOCl could be enhanced via several methods, including heating the irrigant, applying in conjunction with certain reagents, or activating by agitation techniques. Despite its antibacterial and tissue-dissolving capacities, NaOCl should be used with caution to avoid detrimental effect due to its cytotoxicity and negative effect on dentin properties. In this narrative review, we discussed the factors that affect the properties of NaOCl, the methods to improve its efficacy, and the side effects that might occur in clinical practice.
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Rhodes SC. Ultrasonic Device Complications in Endodontics: An Analysis of Adverse Events From the Food and Drug Administration Manufacturer and User Facility Device Experience. J Patient Saf 2022; 18:269-275. [PMID: 34508038 DOI: 10.1097/pts.0000000000000909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The author conducted a study to determine the frequency and types of adverse events associated with endodontic ultrasonic devices as reported to the U.S. Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database. METHODS Endodontic ultrasonic device-related adverse events reported to the MAUDE database from January 1, 2016, to October 31, 2020, were accessed and reviewed. RESULTS A total of 1258 adverse event reports were submitted to the FDA MAUDE database, as classified under FDA product code ELC (ultrasonic scaler) during the study period. Among these reports, 403 were specific to the dedicated use of the 2 main types of ultrasonic devices used in endodontic treatment: ultrasonic tip devices and irrigation-related devices. Device malfunction-associated events, consisting primarily of device breakage, comprised 393 of the 1258 adverse event reports, whereas the remaining 10 reports were identified as being patient injury-related reports. CONCLUSIONS The frequency, root causes, and economic costs of ultrasonic tip device breakage remain largely unstudied. Ultrasonic endodontic device-related adverse events and patient injuries occurring within clinical practice may be underreported at the present time. Consequently, the risks and ultimate impacts to patients from ultrasonic endodontic device breakage, malfunction and unknown cause-related adverse events, and patient injuries during their clinical usage remain largely unknown at the present time. Eight of the 10 patient injury-related reports made to the FDA MAUDE database during the period under study, containing descriptions of varying degrees of injury severity, were associated with an irrigation-related device.
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Affiliation(s)
- S Craig Rhodes
- From the Department of Endodontics, Center for Advanced Dental Education, Saint Louis University, Saint Louis, Missouri
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Boutsioukis C, Arias‐Moliz MT, Chávez de Paz LE. A critical analysis of research methods and experimental models to study irrigants and irrigation systems. Int Endod J 2022; 55 Suppl 2:295-329. [PMID: 35171506 PMCID: PMC9314845 DOI: 10.1111/iej.13710] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 11/28/2022]
Abstract
Irrigation plays an essential role in root canal treatment. The purpose of this narrative review was to critically appraise the experimental methods and models used to study irrigants and irrigation systems and to provide directions for future research. Studies on the antimicrobial effect of irrigants should use mature multispecies biofilms grown on dentine or inside root canals and should combine at least two complementary evaluation methods. Dissolution of pulp tissue remnants should be examined in the presence of dentine and, preferably, inside human root canals. Micro-computed tomography is currently the method of choice for the assessment of accumulated dentine debris and their removal. A combination of experiments in transparent root canals and numerical modeling is needed to address irrigant penetration. Finally, models to evaluate irrigant extrusion through the apical foramen should simulate the periapical tissues and provide quantitative data on the amount of extruded irrigant. Mimicking the in vivo conditions as close as possible and standardization of the specimens and experimental protocols are universal requirements irrespective of the surrogate endpoint studied. Obsolete and unrealistic models must be abandoned in favour of more appropriate and valid ones that have more direct application and translation to clinical Endodontics.
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Affiliation(s)
- Christos Boutsioukis
- Department of EndodontologyAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
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Tilakchand M, Hegde S, Naik B. Evaluation of the efficacy of a novel antibiotic-steroid paste versus conventionally used intracanal antibiotic pastes and irrigating solutions against a 3-week-old biofilm of Enterococcus faecalis. J Conserv Dent 2021; 23:436-440. [PMID: 33911349 PMCID: PMC8066661 DOI: 10.4103/jcd.jcd_304_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 06/08/2020] [Accepted: 06/28/2020] [Indexed: 11/04/2022] Open
Abstract
Introduction Intracanal medicaments have been used during endodontic regenerative procedures to eradicate endodontic pathogens. Aims The aim of our study was (1) to evaluate the antimicrobial efficacy of a novel antibiotic-steroid paste over the regularly used calcium hydroxide (Ca (OH)2), double antibiotic paste (DAP), and modified triple antibiotic paste (M-TAP) and (2) to check the antimicrobial efficacy of irrigating solutions, Chlorhexidine (CHX), and sodium hypochlorite (NaOCl) against a 3-week-old Enterococcus faecalis (E. faecalis) biofilm. Materials and Methods A total of 112 human extracted teeth were contaminated with E. faecalis for a period of 21 days. A novel antibiotic-steroid paste, Ca (OH) 2, DAP, M-TAP, and a placebo were placed inside the canal, sealed, and incubated in an aerobic environment at 37°C. For irrigating solutions, each prepared sample was immersed in 1 ml of sterile saline for 1 min, followed by irrigating and immersion with 1.5% NaOCl and 2% CHX for 5 min. An antimicrobial assessment was performed at the end of 2 days and 7 days, with seven teeth from each group, for each time interval. Dentin debris collected was transferred to the respective medium for culture. After 24 h, colonies were counted using classical bacterial counting technique as colony-forming units. Results Statistical analysis revealed that the novel antibiotic-steroid paste showed a statistically insignificant difference when compared to DAP, which had the highest antimicrobial properties. Conclusion This novel functional paste has antimicrobial efficacy comparable with that of DAP.
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Affiliation(s)
- Mahima Tilakchand
- Department of Conservative Dentistry and Endodontics, SDM College of Dental Science, Dharwad, Karnataka, India
| | - Sannidhi Hegde
- Department of Conservative Dentistry and Endodontics, SDM College of Dental Science, Dharwad, Karnataka, India
| | - Balaram Naik
- Department of Conservative Dentistry and Endodontics, SDM College of Dental Science, Dharwad, Karnataka, India
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Daood U, Parolia A, Matinlinna J, Yiu C, Ahmed HMA, Fawzy A. Properties of a modified quaternary ammonium silane formulation as a potential root canal irrigant in endodontics. Dent Mater 2020; 36:e386-e402. [PMID: 33010944 DOI: 10.1016/j.dental.2020.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/28/2020] [Accepted: 09/09/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Evaluate a new modified quaternary ammonium silane irrigant solution for its antimicrobial, cytotoxic and mechanical properties of dentine substrate. METHODS Root canal preparation was performed using stainless steel K-files™ and F4 size protaper with irrigation protocols of 6% NaOCl + 2% CHX; 3.5% QIS; 2% QIS and sterile saline. Biofilms were prepared using E. faecalis adjusted and allowed to grow for 3 days, treated with irrigants, and allowed to grow for 7 days. AFM was performed and surface free energy calculated. MC3T3 cells were infected with endo irrigant treated E. faecalis biofilms. Raman spectroscopy of biofilms were performed after bacterial re-growth on root dentine and exposed to different irrigation protocols and collagen fibers analysed collagen fibers using TEM. Antimicrobial potency against E. faecalis biofilms and cytoxicity against 3T3 NIH cells were also. Resin penetration and MitoTracker green were also evaluated for sealer penetration and mitochondrial viability. Data were analysed using One-way ANOVA, principal component analysis and post-hoc Fisher's least-significant difference. RESULTS Elastic moduli were maintained amongst control (5.5 ± 0.9) and 3.5% QIS (4.4 ± 1.1) specimens with surface free energy higher in QIS specimens. MC3T3 cells showed reduced viability in 6%NaOCl+2%CHX specimens compared to QIS specimens. DNA/purine were expressed in increased intensities in control and 6% NaOCl + 2% CHX specimens with bands around 480-490 cm-1 reduced in QIS specimens. 3.5% QIS specimens showed intact collagen fibrillar network and predominantly dead bacterial cells in confocal microscopy. 3.5% QIS irrigant formed a thin crust-type surface layer with cytoplasmic extensions of 3T3NIH spread over root dentine. Experiments confirmed MitoTracker accumulation in 3.5% treated cells. SIGNIFICANCE Novel QIS root canal irrigant achieved optimum antimicrobial protection inside the root canals facilitating a toxic effect against the Enterococcus faecalis biofilm. Root dentine substrates exhibited optimum mechanical properties and there was viability of fibroblastic mitochondria.
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Affiliation(s)
- Umer Daood
- Division of Clinical Dentistry, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia.
| | - Abhishek Parolia
- Division of Clinical Dentistry, School of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Jukka Matinlinna
- Dental Materials Science, Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR, China
| | - Cynthia Yiu
- Pediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Pokfulam, Hong Kong, China Hong Kong Special Administrative Region
| | - Hany Mohamed Aly Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Amr Fawzy
- UWA Dental School, University of Western Australia, Nedlands, WA 6009, Australia
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Han-Hsing Lin J, Karabucak B, Lee SM. Effect of sodium hypochlorite on conventional and heat-treated nickel-titanium endodontic rotary instruments - An in vitro study. J Dent Sci 2020; 16:738-743. [PMID: 33854727 PMCID: PMC8025147 DOI: 10.1016/j.jds.2020.08.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/30/2020] [Indexed: 12/03/2022] Open
Abstract
Background/purpose Sodium hypochlorite (NaOCl) is a highly alkaline solution which exhibits antimicrobial properties. However, it causes corrosion to endodontic rotary files. This study investigated the effect of NaOCl on the metal surface of five different unused endodontic rotary files in vitro. Materials and methods Two non-heat-treated nickel-titanium (NiTi) files, ProTaper, BioRace, and three heat-treated NiTi files, VortexBlue, TRUShape, and EdgeFile X7 files, were immersed in 4% NaOCl for 5, 10, and 20 min, and 1, 6 and 24 h. The corrosion susceptibility was evaluated by visual inspection and scanning electron microscopy (SEM). Results In the TRUShape group, the black particulate matter was mostly formed at the file's curvature and shaft. A large amount of precipitate accumulated in the EdgeFile group. The extent and prevalence of surface defects were found to be consistently higher in EdgeFile X7 instruments than in any other instruments. EdgeFile X7 and TRUShape files exhibited a greater corrosive tendency to NaOCl than BioRace, ProTaper, and VortexBlue not only under visual inspection, but also under SEM analysis after prolonged immersion (1, 6, 24 h) in 4% NaOCl. However, shorter immersion periods (5, 10, 20 min) showed little surface corrosion across all experimental groups. Conclusion Within the limitations of this study, EdgeFile X7 and TRUShape files exhibit greater corrosive tendencies to NaOCl in vitro than BioRace, ProTaper, and VortexBlue files after prolonged immersion in 4% NaOCl. However, shorter immersion periods, which more closely approximate clinical conditions during single root canal therapy, may not show surface corrosion across all experimental groups.
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Affiliation(s)
- Jack Han-Hsing Lin
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, USA
- Elite Dental Clinic, Taipei, Taiwan
| | - Bekir Karabucak
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, USA
| | - Su-Min Lee
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, USA
- Corresponding author. Department of Endodontics, School of Dental Medicine, University of Pennsylvania, 240 S. 40th Street Philadelphia, PA 19104-6030, USA. Fax: +1 215 573 2148.
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Khoshroo K, Shah B, Johnson A, Baeten J, Barry K, Tahriri M, Ibrahim MS, Tayebi L. A new phantom to evaluate the tissue dissolution ability of endodontic irrigants and activating devices. Restor Dent Endod 2020; 45:e45. [PMID: 33294410 PMCID: PMC7691255 DOI: 10.5395/rde.2020.45.e45] [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: 11/16/2019] [Revised: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to introduce a gelatin/bovine serum albumin (BSA) tissue standard, which provides dissolution properties identical to those of biological tissues. Further, the study evaluated whether the utilization of endodontic activating devices led to enhanced phantom dissolution rates. MATERIALS AND METHODS Bovine pulp tissue was obtained to determine a benchmark of tissue dissolution. The surface area and mass of samples were held constant while the ratio of gelatin and BSA were varied, ranging from 7.5% to 10% gelatin and 5% BSA. Each sample was placed in an individual test tube that was filled with an appropriate sodium hypochlorite solution for 1, 3, and 5 minutes, and then removed from the solution, blotted dry, and weighed again. The remaining tissue was calculated as the percent of initial tissue to determine the tissue dissolution rate. A radiopaque agent (sodium diatrizoate) and a fluorescent dye (methylene blue) were added to the phantom to allow easy quantification of phantom dissolution in a canal block model when activated using ultrasonic (EndoUltra) or sonic (EndoActivator) energy. RESULTS The 9% gelatin + 5% BSA phantom showed statistically equivalent dissolution to bovine pulp tissue at all time intervals. Furthermore, the EndoUltra yielded significantly more phantom dissolution in the canal block than the EndoActivator or syringe irrigation. CONCLUSIONS Our phantom is comparable to biological tissue in terms of tissue dissolution and could be utilized for in vitro tests due to its injectability and detectability.
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Affiliation(s)
- Kimia Khoshroo
- Marquette University School of Dentistry, Milwaukee, WI, USA
| | - Brinda Shah
- Marquette University School of Dentistry, Milwaukee, WI, USA
| | | | | | | | | | - Mohamed S. Ibrahim
- Marquette University School of Dentistry, Milwaukee, WI, USA.,Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Lobat Tayebi
- Marquette University School of Dentistry, Milwaukee, WI, USA
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Abstract
COVID-19 (also known as coronavirus) has had a profound impact on dentistry, with all elective treatment grinding to a halt initially and a slow phased return to normal services. The guidance available regarding treating dental emergencies is currently advice, analgesia and antimicrobials, where indicated in the first instance. Some patients cannot be managed successfully with this approach and require face-to-face consultation. Unless dental practices have the appropriate PPE and follow strict infection prevention and control guidance, face-to-face consultation may not be possible. If treatment is required, this is based on minimum intervention and avoidance of aerosol generating procedures (AGPs) on patients who are free of COVID-19. COVID-19-positive or suspected patients still require treatment at designated Urgent Dental Care centres.The aim of this article is to provide an insight into the COVID-19 pandemic and its implications on current emergency dental care. Commonly presenting dental conditions which require endodontic management will be discussed. Finally, an endodontic management protocol is suggested. The intention of the protocol is to describe practical techniques to minimise potential viral load and reduce risk of COVID-19 transmission when AGPs are instigated.
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Affiliation(s)
- Khawer Ayub
- Department of Restorative Dentistry, King's College Hospital Dental Institute, Denmark Hill, London, SE5 9RW, UK.
| | - Aws Alani
- Department of Restorative Dentistry, King's College Hospital Dental Institute, Denmark Hill, London, SE5 9RW, UK
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Grigsby D, Ordinola-Zapata R, McClanahan SB, Fok A. Postoperative Pain after Treatment Using the GentleWave System: A Randomized Controlled Trial. J Endod 2020; 46:1017-1022. [PMID: 32553417 PMCID: PMC7387160 DOI: 10.1016/j.joen.2020.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 03/27/2020] [Accepted: 04/21/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Cleaning and shaping are necessary to allow for the delivery of irrigants and medicaments to the apical third of the canal. Standard treatment irrigation generally uses a conventional needle and some frequency of sonic activation. The GentleWave System (GWS; Sonendo, Inc, Laguna Hills, CA) combines irrigant delivery with multisonic activation. This randomized clinical trial aimed to determine if the GWS significantly decreases the incidence and intensity of postoperative pain. METHODS Patients used a numeric rating scale to record their pain level at the 6-hour time point before treatment. All participants were randomly divided into 2 groups and were blind to the treatment they received. The standard (control) group received endodontic treatment with conventional side-vented needle irrigation and ultrasonic activation. The second group received treatment with the GWS. Following treatment, patients used a numeric rating scale to record their pain level at 6, 24, 72, and 168 hours. RESULTS In the standard treatment group, 72.2% of patients experienced at least 1 occurrence of postoperative pain, whereas in the GWS group, 83.3% of patients experienced at least 1 occurrence of postoperative pain. The highest pain intensity level for both treatments occurred at the 6-hour posttreatment time point. All pain decreased with time after the 6-hour posttreatment time point (P < 1.237e-7). CONCLUSIONS There was no significant difference in the incidence or intensity of postoperative pain after either treatment group. However, both groups reported a statistically significant decrease in pain with time.
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Affiliation(s)
- Daryl Grigsby
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota.
| | - Ronald Ordinola-Zapata
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota
| | - Scott B McClanahan
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota
| | - Alex Fok
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota
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Conte MC, Silveira Teixeira C, Bortoluzzi EA, Felippe WT, Santos LGP, Pandolfo MT, Agostim Cancelier P, Fonseca Roberti Garcia L. Effect of medicaments used in endodontic regeneration on the morphological characteristics of bovine radicular dentin: Experimental immature tooth model. Microsc Res Tech 2020; 83:354-361. [DOI: 10.1002/jemt.23421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/10/2019] [Accepted: 11/20/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Maira C. Conte
- Department of Dentistry ‐ Endodontics DivisionHealth Sciences Center, Federal University of Santa Catarina Florianópolis Santa Catarina Brazil
| | - Cleonice Silveira Teixeira
- Department of Dentistry ‐ Endodontics DivisionHealth Sciences Center, Federal University of Santa Catarina Florianópolis Santa Catarina Brazil
| | - Eduardo A. Bortoluzzi
- Department of Dentistry ‐ Endodontics DivisionHealth Sciences Center, Federal University of Santa Catarina Florianópolis Santa Catarina Brazil
| | - Wilson T. Felippe
- Department of Dentistry ‐ Endodontics DivisionHealth Sciences Center, Federal University of Santa Catarina Florianópolis Santa Catarina Brazil
| | - Luciane G. P. Santos
- Department of Semiology and ClinicSchool of Dentistry, Federal University of Pelotas Pelotas Rio Grande do Sul Brazil
| | - Mariana T. Pandolfo
- Department of Dentistry ‐ Endodontics DivisionHealth Sciences Center, Federal University of Santa Catarina Florianópolis Santa Catarina Brazil
| | - Patrícia Agostim Cancelier
- Department of Dentistry ‐ Endodontics DivisionHealth Sciences Center, Federal University of Santa Catarina Florianópolis Santa Catarina Brazil
| | - Lucas Fonseca Roberti Garcia
- Department of Dentistry ‐ Endodontics DivisionHealth Sciences Center, Federal University of Santa Catarina Florianópolis Santa Catarina Brazil
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Algahtani F, Huang X, Haapasalo M, Wang Z, Hieawy A, Zhang D, Aleksejuniene J, Shen Y. Fatigue resistance of ProTaper gold exposed to high-concentration sodium hypochlorite in double curvature artificial canal. Bioact Mater 2019; 4:245-248. [PMID: 31528756 PMCID: PMC6739284 DOI: 10.1016/j.bioactmat.2019.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/10/2019] [Accepted: 07/30/2019] [Indexed: 01/28/2023] Open
Abstract
This study aimed to evaluate and compare the fatigue resistance of ProTaper Gold (PTG) and ProTaper Universal (PTU) in artificial single and double curvature canals in 5% sodium hypochlorite (NaOCl) at body temperature (37 °C). PTG and PTU files (size F1) were subjected to fatigue tests in two different artificial ceramic canals. The single curvature model had a 60° curvature angle with a 5 mm radius. The double curvature model had a 60° curvature angle with a 5 mm radius and a second 30° curvature with a 2 mm radius. A file segment was introduced into the artificial canal and immersed in water or 5% NaOCl at 37 °C. The total number of cycles to fracture (NCF) was recorded. Data were analyzed using t-test and linear regression analysis. The NCF of all files was significantly influenced by the type of NiTi metal alloy (P < .01), canal curvatures (P < .01), and the environmental conditions (P < .05). PTG had higher fatigue resistance than PTU files in both single and double curvature canals (P < .05). The NCF of PTU files in 5% NaOCl was shorter than that in water (P < .05). The mean length of broken PTG was significantly shorter than those of PTU files in both single and double curvature canals (P < .01). The fatigue performance of PTG is better than that of PTU in both single and double curvature. Environmental conditions may affect the fatigue behavior of PTU files with single curvature.
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Affiliation(s)
- Fahda Algahtani
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada.,College of Dentistry, Princess Nourah Bint Abdulrahman University, Saudi Arabia
| | - Xiangya Huang
- Department of Conservative Dentistry and Endodontics, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada
| | - Markus Haapasalo
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada
| | - Zhejun Wang
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada
| | - Ahmed Hieawy
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada
| | - Duo Zhang
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada
| | - Jolanta Aleksejuniene
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada
| | - Ya Shen
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada
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Lane J, Bonsor S. Survival rates of teeth treated with bacterial photo-dynamic therapy during disinfection of the root canal system. Br Dent J 2019; 226:333-339. [DOI: 10.1038/s41415-019-0026-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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17
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Calcium Hypochlorite Solutions - An In Vitro Evaluation of Antimicrobial Action and Pulp Dissolution. Eur Endod J 2019; 4:15-20. [PMID: 32161881 PMCID: PMC7006560 DOI: 10.14744/eej.2018.64936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 11/19/2018] [Accepted: 11/29/2018] [Indexed: 11/20/2022] Open
Abstract
Objective: To compare the antimicrobial activity and tissue dissolution capacity of calcium hypochlorite (Ca(OCl)2) solution with sodium hypochlorite (NaOCl) solution at 0.5%, 1.0%, 2.5%, and 5.25% concentrations. Methods: To determine the inhibition halos produced by the tested substances against Enterococcus faecalis, the agar diffusion method was employed. Additionally, the broth contact method was used to determine the time required for the inhibition of E. faecalis. Bovine pulp fragments were used to test the dissolution. Half of the pulps were freely deposited samples in cell culture wells, and the remaining samples were fixed on bovine dentine bases. Results: For both Ca(OCl)2 and NaOCl solutions, the greatest inhibition zones were observed at 5.25% con-centration. However, the most significant inhibition zone was measured with 5.25% Ca(OCl)2 solution (17.38 mm). Hypochlorite solutions at 2.5% and 5.25% concentrations required less time to inhibit E. faecalis than those at 0.5% and 1.0% concentrations (P<0.05). There was no difference in inhibition times between 2.5% and 5.25% hypochlorite solutions (P>0.05). The most effective hypochlorite solution concentrations were 5.25% and 2.5% for dissolving pulp fragments (P<0.05). Additionally, suspended pulp fragments were more susceptible to dissolution than fragments attached to dentine blocks (P<0.05), except for 0.5% Ca(OCl)2. Conclusion: Ca(OCl)2 solutions showed antimicrobial activity against E. faecalis and can dissolve pulp tissues. Future studies are warranted to examine the suitability of Ca(OCl)2 in the chemico–mechanical preparation of the root canal system.
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Arruda ME, Neves MA, Diogenes A, Mdala I, Guilherme BP, Siqueira JF, Rôças IN. Infection Control in Teeth with Apical Periodontitis Using a Triple Antibiotic Solution or Calcium Hydroxide with Chlorhexidine: A Randomized Clinical Trial. J Endod 2018; 44:1474-1479. [DOI: 10.1016/j.joen.2018.07.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/28/2018] [Accepted: 07/02/2018] [Indexed: 01/03/2023]
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Tejada S, Baca P, Ferrer-Luque CM, Ruiz-Linares M, Valderrama MJ, Arias-Moliz MT. Influence of dentine debris and organic tissue on the properties of sodium hypochlorite solutions. Int Endod J 2018; 52:114-122. [DOI: 10.1111/iej.12986] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 07/13/2018] [Indexed: 11/29/2022]
Affiliation(s)
- S. Tejada
- Department of Microbiology; University of Granada; Granada Spain
| | - P. Baca
- Department of Stomatology; School of Dentistry; University of Granada; Granada Spain
| | - C. M. Ferrer-Luque
- Department of Stomatology; School of Dentistry; University of Granada; Granada Spain
| | - M. Ruiz-Linares
- Department of Stomatology; School of Dentistry; University of Granada; Granada Spain
| | - M. J. Valderrama
- Department of Statistics and Operations Research; School of Pharmacy; University of Granada; Granada Spain
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Nogo-Zivanovic D, Bjelovic L, Ivanovic V, Kanjevac T, Tanaskovic I. Consideration of the Therapeutic Potential of Irrigants in Endodontic Therapy. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2018. [DOI: 10.1515/sjecr-2016-0095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Abstract
The main objective of endodontic treatment is to remove vital and necrotic remnants of pulp tissue and microorganisms and their toxic products from the root canal. During chemo-mechanical endodontic preparation, a smear layer is formed on the wall of the canals. Due to an inability to remove all tissue remnants and the smear layer from the root canal by mechanical instrumentation, it is necessary to use irrigation to ensure sufficient cleaning and disinfection of the largest part of the root canalicular system. The most commonly used irrigants are sodium hypochlorite (Na-OCl), ethylenediaminetetraacetic acid (EDTA), citric acid and chlorhexidine (CHX). Recently, the irrigants QMix and MTAD have been introduced to the market. They are a mixture of different components having antimicrobial, organolytic and mineralytic effects on canal detritus and the smear layer. This review article investigates irrigants in terms of the nature of their effect, their efficiency, optimal concentration, and method of use, and the interactions between the irrigants most commonly used in endodontic therapy are discussed, with special emphasis on QMix and MTAD.
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Affiliation(s)
- Dajana Nogo-Zivanovic
- Department for Restorative Dentistry and Endodontics, Faculty of Medicine , University of East Sarajevo , Foca , Bosnia and Herzegovina
| | - Ljiljana Bjelovic
- Department for Restorative Dentistry and Endodontics, Faculty of Medicine , University of East Sarajevo , Foca , Bosnia and Herzegovina
| | - Vladimir Ivanovic
- Department of Restorative Odontology and Endodontics, School of Dental Medicine , University of Belgrade , Belgrade , Serbia
| | - Tatjana Kanjevac
- Department of Preventive and Pediatric Dentistry, Faculty of Medical Sciences , University of Kragujevac , Kragujevac , Serbia
| | - Irena Tanaskovic
- Department of Histology and Embryology, Faculty of Medical Sciences , University of Kragujevac , Kragujevac , Serbia
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21
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Scott MB, Zilinski GS, Kirkpatrick TC, Himel VT, Sabey KA, Lallier TE. The Effects of Irrigants on the Survival of Human Stem Cells of the Apical Papilla, Including Endocyn. J Endod 2018; 44:263-268. [DOI: 10.1016/j.joen.2017.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 09/01/2017] [Accepted: 09/01/2017] [Indexed: 12/24/2022]
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Abstract
Prevention or treatment of apical periodontitis is aimed at disinfecting the root canal system so that the periradicular tissues are not vulnerable to attack from microbiota within the tooth. This is achieved by a process of cleaning and shaping the root canal space. The fundamental principles underlying this process have not changed in decades. In contrast, the armamentarium available to the clinician continues to evolve rapidly. The use of specially designed nickel titanium (NiTi) files to create a glidepath allows the clinician to manage tight curved canals more predictably in situations which would otherwise have proved too difficult using conventional techniques. Other files, designed to shape the canal, have been developed using metallurgic principles which permit NiTi files to be more flexible and resistant to cyclic fatigue. These newer systems also require fewer instruments to prepare a canal and some, which have adopted a reciprocating (rotational) motion, may only require one file. Progress is also being made in enhancing efficacy of irrigant activity using negative apical pressure systems, sonic and ultrasonic agitation techniques. These contemporary techniques used to clean and shape the root canal system should result in improved confidence and predictability when managing endodontic disease.
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Affiliation(s)
- Phillip L Tomson
- The University of Birmingham College of Medical and Dental Sciences, School of Dentistry, St Chad's Queensway, Birmingham B4 6NN, UK
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23
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Shemesh A, Ben Itzhak J, Solomonov M. Minimally Invasive Treatment of Class 4 Invasive Cervical Resorption with Internal Approach: A Case Series. J Endod 2017; 43:1901-1908. [DOI: 10.1016/j.joen.2017.04.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 04/21/2017] [Accepted: 04/24/2017] [Indexed: 12/21/2022]
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24
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Huang X, Shen Y, Wei X, Haapasalo M. Fatigue Resistance of Nickel-titanium Instruments Exposed to High-concentration Hypochlorite. J Endod 2017; 43:1847-1851. [DOI: 10.1016/j.joen.2017.06.033] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 06/23/2017] [Accepted: 06/26/2017] [Indexed: 11/28/2022]
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25
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Gu LS, Huang XQ, Griffin B, Bergeron BR, Pashley DH, Niu LN, Tay FR. Primum non nocere - The effects of sodium hypochlorite on dentin as used in endodontics. Acta Biomater 2017; 61:144-156. [PMID: 28801267 DOI: 10.1016/j.actbio.2017.08.008] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/28/2017] [Accepted: 08/07/2017] [Indexed: 10/19/2022]
Abstract
The medical literature is replete with the maxim 'primum non nocere', cautioning health care providers to avoid doing any harm to human subjects in their delivery of medical care. Sodium hypochlorite (NaOCl) is a well-established irrigant for root canal treatment because of its antimicrobial and organic tissue remnant dissolution capability. However, little is known about the deleterious effect of this strong oxidizing agent on the integrity of human mineralized dentin. Iatrogenically-induced loss of dentin integrity may precipitate post-treatment root fracture and has potential medico-legal complications. In the present work, transmission electron microscopy provided evidence for collagen destruction in the surface/subsurface of dentin treated with high NaOCl concentrations and long contact times. Size exclusion chromatography showed that the hypochlorite anion, because of its small size, penetrated the water compartments of apatite-encapsulated collagen fibrils, degraded the collagen molecules and produced a 25-35µm thick, non-uniform "ghost mineral layer" with enlarged, coalesced dentinal tubules and their lateral branches. Fourier transform-infrared spectroscopy identified increases in apatite/collagen ratio in NaOCl-treated dentin. The apatite-rich, collagen-sparse dentin matrix that remained after NaOCl treatment is more brittle, as shown by the reductions in flexural strength. Understanding the deleterious effects of NaOCl on mineralized dentin enables one to balance the risks and benefits in using high NaOCl concentrations for lengthy periods in root canal debridement. Delineating the mechanism responsible for such a phenomenon enables high molecular weight, polymeric antimicrobial and tissue dissolution irrigants to be designed that abides by the maxim of 'primum non nocere' in contemporary medical practices. STATEMENT OF SIGNIFICANCE The antimicrobial and tissue-dissolution capacities of NaOCl render it a well-accepted agent for root canal debridement. These highly desirable properties, however, appear to be intertwined with the untoward effect of collagen matrix degradation within mineralized dentin. Because of its small size, the hypochlorite anion is capable of infiltrating mineralized collagen and destroying the collagen fibrils, producing a mineral-rich, collagen sparse ghost mineral matrix with reduced flexural strength. Findings from the present work challenge the biosafety of NaOCl when it is used in high concentrations and for lengthy time periods during root canal treatment, and laid the background work for future biomaterials design in debridement of the canal space.
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Chromographic Analysis and Cytotoxic Effects of Chlorhexidine and Sodium Hypochlorite Reaction Mixtures. J Endod 2017; 43:1545-1552. [DOI: 10.1016/j.joen.2017.04.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/28/2017] [Accepted: 04/17/2017] [Indexed: 11/21/2022]
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Tartari T, Bachmann L, Maliza AGA, Andrade FB, Duarte MAH, Bramante CM. Tissue dissolution and modifications in dentin composition by different sodium hypochlorite concentrations. J Appl Oral Sci 2016; 24:291-8. [PMID: 27383711 PMCID: PMC5022212 DOI: 10.1590/1678-775720150524] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 02/15/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To determine the organic matter dissolution and changes in dentin chemical composition promoted by different concentrations of NaOCl over time. MATERIAL AND METHODS Fragments of bovine muscle tissue were weighed before and after 5, 10, and 15 min of immersion in the groups (n=10): G1- 0.9% saline solution; G2- 1% NaOCl; G3- 2.5% NaOCl; and G4- 5% NaOCl. Bovine dentin fragments were subjected to the same irrigants and absorption spectra were collected by Attenuated Total Reflectance of Fourier Transform Infrared Spectroscopy (ATR-FTIR) before and after 0,5, 1, 2, 3, 5, 8, and 10 min of immersion in the solutions. The ratios of the amide III/phosphate and carbonate/phosphate absorption bands were determined. The tissue dissolution and carbonate/phosphate ratios were submitted to the two-way analysis of variance (ANOVA) with Tukey's multiple-comparison test (α<0.05) and to the one-way analysis of variance with Tukey's (α<0.05). The amide III/phosphate ratio was analyzed by Friedman test (α<0.05) and the Kruskal-Wallis test with Dunn's post-hoc (α<0.05). RESULTS The increase in NaOCl concentration and contact time intensified the dissolution of organic matter and dentin collagen with reduction in the amide III/phosphate ratio. Significant differences between all groups (p<0.05) were observed in the dissolution of organic matter at 10 min and in the amide III/phosphate ratio between the saline solution and 5% NaOCl at 5 min. The carbonate/phosphate ratio decreased significantly in G2, G3, and G4 after 0,5 min of immersion (p<0.05), but more alterations did not occur in the subsequent periods (p>0.05). Intergroup differences were not observed in this ratio (p>0.05). CONCLUSIONS The increase in the exposure time and in the concentration of NaOCl solution lead to an increase in the tissue dissolution and dentin collagen deproteination. Furthermore, some carbonate ions are removed from the dentin inorganic phase by the NaOCl.
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Affiliation(s)
- Talita Tartari
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | - Luciano Bachmann
- - Universidade de São Paulo, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Departamento de Física, Ribeirão Preto, SP, Brasil
| | - Amanda Garcia Alves Maliza
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | - Flaviana Bombarda Andrade
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | - Marco Antonio Hungaro Duarte
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
| | - Clovis Monteiro Bramante
- - Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, SP, Brasil
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Wang Z, Maezono H, Shen Y, Haapasalo M. Evaluation of Root Canal Dentin Erosion after Different Irrigation Methods Using Energy-dispersive X-ray Spectroscopy. J Endod 2016; 42:1834-1839. [DOI: 10.1016/j.joen.2016.07.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 07/29/2016] [Accepted: 07/29/2016] [Indexed: 11/27/2022]
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29
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D'Arcangelo C, Di Nardo Di Maio F, Stracci N, Spoto G, Malagnino VA, Caputi S. Pulp-Dissolving Ability of Several Endodontic Irrigants: A Spectro-Photometry Evaluation. Int J Immunopathol Pharmacol 2016; 20:381-6. [PMID: 17624251 DOI: 10.1177/039463200702000219] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of this study is to test the dissolving action of different concentrations of NaOCl (0.5%, 2.5% and 5%) and EDTA 17% on bovine pulp tissue, testing solutions at three different times (1, 5, 10 minutes). 100 mg. of dental pulp placed into a becher with 20 ml of solution was evaluated using a spectrophotometer. A solution of NaOCl 5% showed the highest solubility value. Samples treated with 2.5% NaOCl showed solubility values of 0.98 in one minute, 29.1 in five minutes and 57 in ten minutes. Groups treated with NaOCl 0.5% showed small dissolving modifications. 17% EDTA showed the lowest values of solubility. 5% NaOCl solution showed highest pulp dissolving ability, even a 2.5% solution showed high dissolving ability but in longer times.
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Affiliation(s)
- C D'Arcangelo
- Department of Oral Sciences, University of Chieti, Italy.
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Samiei M, Shahi S, Abdollahi AA, Eskandarinezhad M, Negahdari R, Pakseresht Z. The Antibacterial Efficacy of Photo-Activated Disinfection, Chlorhexidine and Sodium Hypochlorite in Infected Root Canals: An in Vitro Study. IRANIAN ENDODONTIC JOURNAL 2016; 11:179-83. [PMID: 27471527 PMCID: PMC4947840 DOI: 10.7508/iej.2016.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 04/04/2016] [Accepted: 04/22/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study compared the efficacy of light-activated low-power laser, 2% chlorhexidine (CHX) and 2.5% NaOCl in eliminating Enterococcus faecalis (E. faecalis) from the root canal system. METHODS AND MATERIALS The root canals of 60 maxillary central incisors were contaminated with E. faecalis and then the bacteria were incubated for 24 h. All the root canals were instrumented in a crown-down manner with #4 and 3 Gates-Glidden drills, followed by RaCe rotary files (40/0.10, 35/0.08, and 30/0.06). The samples were randomly assigned to three experimental groups and one control group (n=15). In the control group no intervention was made. In the photo-activated disinfection (PAD) group, laser therapy was undertaken with diode laser beams (with an output power of 100 mW/cm(2)) for 120 sec. For the other two experimental groups, root canals were irrigated either with 5 mL of 2% CHX or 2.5% NaOCl solutions, respectively. The Kruskal-Wallis test was used to compare the CFU values of the bacteria and post-hoc Bonferroni test was used for pairwise comparisons. The level of significance was set at 0.05. RESULTS The inhibition of bacterial growth in all the experimental groups was significantly superior to the control group (P<0.05). There was no significant difference between the effect of PAD and 2% CHX (P=0.05). The effect of 2.5% NaOCl was significantly better than that of the PAD technique (P<0.001). In addition, 2.5% NaOCl was significantly better than 2% CHX (P=0.007). CONCLUSION Photodynamic therapy was effective in reducing the E. faecalis counts in comparison with the control group, but 2.5% NaOCl solution was the most effective protocol.
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Affiliation(s)
- Mohammad Samiei
- Department of Endodontics, Dental and Periodontal Research Center, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahriar Shahi
- Department of Endodontics, Dental and Periodontal Research Center, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Ardalan Abdollahi
- Department of Endodontics, Dental and Periodontal Research Center, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahsa Eskandarinezhad
- Department of Endodontics, Dental and Periodontal Research Center, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ramin Negahdari
- Department of Prosthodontics, Dental and Periodontal Research Center, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
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Palazzi F, Blasi A, Mohammadi Z, Fabbro MD, Estrela C. Penetration of Sodium Hypochlorite Modified with Surfactants into Root Canal Dentin. Braz Dent J 2016; 27:208-16. [DOI: 10.1590/0103-6440201600650] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 02/16/2016] [Indexed: 11/22/2022] Open
Abstract
Abstract The aim of this study was to evaluate the effect of concentration, exposure time and temperature of sodium hypochlorite (NaOCl) added with surfactants on its penetration into dentinal tubules. Sixty-five extracted human permanent maxillary anterior teeth with single canals were prepared by ProTaper SX hand-operated instruments. The teeth were then sectioned perpendicular to the long axis. The crowns and apical thirds of all the teeth were removed. The remaining roots were processed into 4-mm-long blocks and stained overnight in crystal violet. One hundred and thirty stained blocks were further split into halves and treated by nine different types of NaOCl-based solutions. Three solutions were added with surfactants (Hypoclean, H6, Chlor-Xtra) and the others were regular hypochlorites at increasing concentrations (1%, 2%, 4%, 5.25%, <6%, 6% NaOCl) from different brands. The dentin blocks were exposed to the solutions for 2, 5, and 20 min at 20 °C, 37 °C and 45 °C, respectively. The depth of NaOCl penetration was determined by bleaching of the stain and measured by light microscopy at 20 and 40. Statistical comparisons were made by using a generalized linear model with Bonferroni's post-hoc correction. The shortest penetration (81±6.6 μm) was obtained after incubation in 1% NaOCl for 2 min at 20 °C; the highest penetration (376.3±3.8 μm) was obtained with Chlor-Xtra for 20 min at 45 °C. Varying NaOCl concentration produced a minimal effect while temperature and exposure time had a significant direct relationship with NaOCl penetration into dentinal tubules, especially those with lowered surface tension. The exposure time and temperature of sodium hypochlorite as well as the addition of surfactants may influence the penetration depth of irrigants into dentinal tubules.
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Affiliation(s)
| | | | - Zahed Mohammadi
- Hamedan University of Medical Sciences, Iran; Iranian Center for Endodontic Research, Iran
| | - Massimo Del Fabbro
- Università degli Studi di Milano, Italy; Istituto Ortopedico Galeazzi, Italy
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Christo JE, Zilm PS, Sullivan T, Cathro PR. Efficacy of low concentrations of sodium hypochlorite and low-powered Er,Cr:YSGG laser activated irrigation against an Enterococcus faecalis biofilm. Int Endod J 2016; 49:279-86. [PMID: 25772335 DOI: 10.1111/iej.12447] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 03/06/2015] [Indexed: 11/29/2022]
Abstract
AIM To establish the antibacterial efficacy of low concentrations of sodium hypochlorite with and without Er,Cr:YSGG laser activation on Enterococcus faecalis biofilms in extracted teeth. METHODOLOGY The root canals of 96 decoronated single-rooted extracted human teeth were prepared to a size 40, 0.06 taper 1 mm beyond the apex. They were mounted within a flow cell, which was sterilized before pumping a nutrient media through the root canals. The flow cell was inoculated with E. faecalis (ATCC 700802) and cultivated for 4 weeks. The root-ends were sealed, and the roots were then subjected to one of six treatment groups: group 1: syringe irrigation (SI) with saline (control) using a 27 -gauge Monoject needle 1 mm from the apex for 2 min; group 2: as for group 1 but with 1% NaOCl; group 3: as for group 1 but with 4% NaOCl; group 4: 0.5% NaOCl irrigation for 15 s followed by laser-activated irrigation (LAI) with four 15-s cycles replenishing the irrigant between cycles; group 5: as for group 4 but with 1% NaOCl as the irrigant; group 6: as for group 4 but with 4% NaOCl as the irrigant. Following treatment, teeth were crushed and viable bacteria were quantitated by serial dilution and plating. The colony-forming unit values were compared between groups using one-way anova and Tukey-adjusted post hoc tests. A two-tailed P value of <0.05 was considered statistically significant. RESULTS The mean number of cells recovered from the 1% NaOCl SI group was significantly higher than that from the 4% NaOCl LAI group (P = 0.02). CONCLUSION Within the limitations of this laboratory study, low-powered (0.5 W) Er,Cr:YSGG laser activation did not improve the antibacterial effect of low concentrations of sodium hypochlorite.
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Affiliation(s)
- J E Christo
- Discipline of Endodontics, The University of Adelaide, Adelaide, SA, Australia
| | - P S Zilm
- Oral Microbiology Laboratory, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - T Sullivan
- Discipline of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | - P R Cathro
- Discipline of Endodontics, The University of Adelaide, Adelaide, SA, Australia
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Ertuğrul İF, Maden M, Orhan EO, Özkorucuklu SP. The effect of micro-electric current and other activation techniques on dissolution abilities of sodium hypochlorite in bovine tissues. BMC Oral Health 2015; 15:161. [PMID: 26681346 PMCID: PMC4683763 DOI: 10.1186/s12903-015-0152-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 12/14/2015] [Indexed: 11/10/2022] Open
Abstract
Background The aim of the study was to evaluate the effects of micro-electric current on sodium hypochlorite’s (NaOCl’s) tissue-dissolution abilities, compared with other activation methods, including sonic, ultrasonic, pipetting, and temperature. Methods Bovine muscle tissues (n = 154) with standard sizes and weights were prepared and divided into two temperature groups: room temperature and 45 °C. Each temperature group was divided into seven sub-groups by activation methods: D = distilled water (−control); NaOCl = 5.25 % passive NaOCl (+ control); P = 5.25 % NaOCl with pipetting; SA = 5.25 % NaOCl with sonic activation; UA = 5.25 % NaOCl with ultrasonic activation; E-NaOCl = 5.25 % NaOCl with micro-electric current; and E-NaOCl + P = 5.25 % NaOCl with micro-electric current and pipetting. Specimens were weighed before and after treatment. Average, standard deviation, minimum, maximum, and median were calculated for each group. Resulting data were analyzed statistically using multi-way ANOVA and Tukey HSD tests. The level of the alpha-type error was set at < 0.05. Results At room temperature, the E-NaOCl + P group dissolved the highest amount of tissue (p < 0.05), and the UA, SA, and P groups dissolved significantly higher amounts of tissue than did the positive control or E-NaOCl groups (p < 0.05). At 45 °C, there was no significant difference between the SA and E-NaOCl groups (p > 0.05), and the E-NaOCl + P group dissolved a higher amount of tissue than any other group (p < 0.05). Conclusions Using NaOCl with micro-electric current can improve the tissue-dissolving ability of the solution. In addition, this method can be combined with additional techniques, such as heating and/or pipetting, to achieve a synergistic effect of NaOCl on tissue dissolution.
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Affiliation(s)
| | - Murat Maden
- Department of Endodontics, Ağız Diş Sağlığı Merkezi, Aydın, Turkey.
| | - Ekim Onur Orhan
- Department of Endodontics, Faculty of Dentistry, Osmangazi University, Eskişehir, Turkey.
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de Almeida LHS, Leonardo NGES, Gomes APN, Giardino L, Souza EM, Pappen FG. Pulp tissue dissolution capacity of sodium hypochlorite combined with cetrimide and polypropylene glycol. Braz Dent J 2015; 24:477-81. [PMID: 24474288 DOI: 10.1590/0103-6440201302041] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 08/16/2013] [Indexed: 11/22/2022] Open
Abstract
This study evaluated the influence of the addition of cetrimide and polypropylene glycol to sodium hypochlorite (NaOCl) on its capacity to dissolve pulp tissue. Bovine pulp fragments with standardized weight and volume were immersed for 5, 15 and 30 min in 2 mL of NaOCl and Hypoclean (NaOCl added with cetrimide and polypropylene glycol) solutions at 5.25%, 2.5%, 1%, 0.5% and 0.25% and afterwards re-weighted. Distilled water was used as a control. The percentage of tissue loss was considered for statistical analysis (univariate ANOVA, SPSS, v. 17.0) at 5% significance level. There was no tissue dissolution in the control group. NaOCl added with surfactants (Hypoclean) dissolved more pulp tissue (p<0.05) than NaOCl alone. Tissue dissolution was directly dependent on the concentration of solutions (p<0.05), and also on the time range (p<0.05). The combination of NaOCl at high and low concentrations with the surfactants cetrimide and polypropylene glycol increased significantly its capacity to dissolve pulp tissue.
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Affiliation(s)
| | | | - Ana Paula Neutzling Gomes
- Department of Semiology and Clinics, School of Dentistry, UNIPel - Federal University of Pelotas, PelotasRS, Brazil
| | - Luciano Giardino
- Department of Endodontics, School of Dentistry, University of Torino, Italy
| | | | - Fernanda Geraldo Pappen
- Department of Semiology and Clinics, School of Dentistry, UNIPel - Federal University of Pelotas, PelotasRS, Brazil
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PITOME AW, CRUZ ATG, HECK AR, FARIA MIA, ARAGÃO EMD. Avaliação da capacidade de dissolução de tecido pulpar bovino pelo hipoclorito de sódio em diferentes concentrações. REVISTA DE ODONTOLOGIA DA UNESP 2015. [DOI: 10.1590/1807-2577.0063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ResumoIntroduçãoO hipoclorito de sódio é a substância química auxiliar do tratamento endodôntico mais utilizada devido à sua ação antimicrobiana e à sua capacidade de dissolver matéria orgânica.ObjetivoO objetivo do presente estudo foi comparar a velocidade de dissolução de fragmentos de tecido pulpar bovino em diferentes concentrações de hipoclorito de sódio.Material e métodoFragmentos de tecido pulpar bovino, com peso determinado, foram imersos em 20 mL de hipoclorito de sódio, em frascos de Becker colocados em uma incubadora/agitadora. Foram testadas as concentrações de 1%, 2,5% e 5%, com pH 11, a 36°C. As amostras foram avaliadas visualmente durante a agitação, com auxílio de lupa, até sua completa dissolução. A velocidade de dissolução de cada fragmento foi determinada em miligramas por minuto e a velocidade média de cada grupo, analisada pelos métodos estatísticos de Kruskal-Wallis e Dunn's Multiple.ResultadoHouve diferença estatisticamente significante entre a concentração de 1%, que apresentou a menor velocidade, e as demais.ConclusãoA velocidade de dissolução do hipoclorito de sódio, nas concentrações testadas, se torna mais rápida com o aumento da concentração.
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Cullen JK, Wealleans JA, Kirkpatrick TC, Yaccino JM. The Effect of 8.25% Sodium Hypochlorite on Dental Pulp Dissolution and Dentin Flexural Strength and Modulus. J Endod 2015; 41:920-4. [DOI: 10.1016/j.joen.2015.01.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 01/26/2015] [Accepted: 01/26/2015] [Indexed: 10/23/2022]
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Wang Y, Xiao S, Ma D, Huang X, Cai Z. Minimizing Concentration of Sodium Hypochlorite in Root Canal Irrigation by Combination of Ultrasonic Irrigation with Photodynamic Treatment. Photochem Photobiol 2015; 91:937-41. [PMID: 25892274 DOI: 10.1111/php.12459] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Accepted: 04/13/2015] [Indexed: 12/13/2022]
Affiliation(s)
- Yanhuang Wang
- School and Hospital of Stomatology; Fujian Medical University; Fuzhou Fujian China
- Key Laboratory of Stomatology (FMU); Fujian Province University; Fuzhou Fujian China
| | - Suli Xiao
- School and Hospital of Stomatology; Fujian Medical University; Fuzhou Fujian China
- Key Laboratory of Stomatology (FMU); Fujian Province University; Fuzhou Fujian China
| | - Dianfu Ma
- School and Hospital of Stomatology; Fujian Medical University; Fuzhou Fujian China
- Fujian Anxi County Hospital; Quanzhou Fujian China
| | - Xiaojing Huang
- School and Hospital of Stomatology; Fujian Medical University; Fuzhou Fujian China
- Key Laboratory of Stomatology (FMU); Fujian Province University; Fuzhou Fujian China
| | - Zhiyu Cai
- School and Hospital of Stomatology; Fujian Medical University; Fuzhou Fujian China
- Department of Stomatology; Fujian Medical University Union Hospital; Fuzhou Fujian China
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del Carpio-Perochena A, Bramante CM, de Andrade FB, Maliza AGA, Cavenago BC, Marciano MA, Amoroso-Silva P, Duarte MH. Antibacterial and dissolution ability of sodium hypochlorite in different pHs on multi-species biofilms. Clin Oral Investig 2015; 19:2067-73. [DOI: 10.1007/s00784-015-1431-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Accepted: 02/10/2015] [Indexed: 11/29/2022]
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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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Ertugrul IF, Maden M, Orhan EO, Ozkorucuklu SP, Aglarca AV. Rapid tissue dissolution efficiency of electrically-activated sodium hypochlorite on bovine muscle. Eur J Dent 2014; 8:464-468. [PMID: 25512725 PMCID: PMC4253100 DOI: 10.4103/1305-7456.143622] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objective: Sodium hypochlorite (NaOCl) is a common antimicrobial and tissue-dissolving irrigant. The aim of this in vitro study is to evaluate and compare dissolution capacities of sodium hypochlorite solutions after electrically activation (E-NaOCl) on bovine muscle specimens at various time periods and concentrations. Materials and Methods: Three sodium hypochlorite solutions of 1.25%, 2.5%, and 5% were tested at 3-min. and 5-min. with and without activation by electrically. Distilled water and NaOCl solutions without electrically activation were used as controls. Pieces of bovine muscle tissue (34 ± 2 mg) were placed in 10 mL of each solution at room temperature. In the group of E-NaOCl, electrically activation was performed through the potentiostat. The tissue specimens were weighed before and after treatment, and the percentage of weight loss was calculated. Results: Weight loss of the tissue increased with the concentration of E-NaOCl and NaOCl. Higher concentration and electrically activation considerably enhanced the efficacy of sodium hypochlorite. The effect of electrically activation on tissue dissolution was much greater than that of same concentrations in the groups of NaOCl (P < 0.001). Tissue weight loss was significantly higher in 2.5% and 5% E-NaOCl at 3 min. than in 2.5% and 5% NaOCl at 5 min. (P < 0.05). There were not any significant differences between the 2.5% E-NaOCl and 5% NaOCl at 5 min. (P > 0.05). Conclusion: Electrically activation can improve the tissue-dissolving effectiveness of sodium hypochlorite.
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Affiliation(s)
- Ihsan Furkan Ertugrul
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkiye
| | - Murat Maden
- Department of Endodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkiye
| | - Ekim Onur Orhan
- Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkiye
| | | | - Ali Vasfi Aglarca
- Department of Biostatistics and Medical Information, Suleyman Demirel University School of Medicine, Isparta, Turkiye
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van der Waal SV, van Dusseldorp NE, de Soet JJ. An Evaluation of the Accuracy of Labeling of Percent Sodium Hypochlorite on Various Commercial and Professional Sources: Is Sodium Hypochlorite from These Sources Equally Suitable for Endodontic Irrigation? J Endod 2014; 40:2049-52. [DOI: 10.1016/j.joen.2014.08.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 08/05/2014] [Accepted: 08/26/2014] [Indexed: 10/24/2022]
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Taneja S, Mishra N, Malik S. Comparative evaluation of human pulp tissue dissolution by different concentrations of chlorine dioxide, calcium hypochlorite and sodium hypochlorite: An in vitro study. J Conserv Dent 2014; 17:541-5. [PMID: 25506141 PMCID: PMC4252927 DOI: 10.4103/0972-0707.144590] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/30/2014] [Accepted: 08/23/2014] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Irrigation plays an indispensable role in removal of tissue remnants and debris from the complicated root canal system. This study compared the human pulp tissue dissolution by different concentrations of chlorine dioxide, calcium hypochlorite and sodium hypochlorite. MATERIALS AND METHODS Pulp tissue was standardized to a weight of 9 mg for each sample. In all,60 samples obtained were divided into 6 groups according to the irrigating solution used- 2.5% sodium hypochlorite (NaOCl), 5.25% NaOCl, 5% calcium hypochlorite (Ca(OCl)2), 10% Ca(OCl)2, 5%chlorine dioxide (ClO2) and 13% ClO2. Pulp tissue was placed in each test tube carrying irrigants of measured volume (5ml) according to their specified subgroup time interval: 30 minutes (Subgroup A) and 60 minutes (Subgroup B). The solution from each sample test tube was filtered and was left for drying overnight. The residual weight was calculated by filtration method. RESULTS Mean tissue dissolution increases with increase in time period. Results showed 5.25% NaOCl to be most effective at both time intervals followed by 2.5% NaOCl at 60 minutes, 10%Ca(OCl)2 and 13% ClO2 at 60 minutes. Least amount of tissue dissolving ability was demonstrated by 5% Ca(OCl)2 and 5% ClO2 at 30 minutes. Distilled water showed no pulp tissue dissolution. CONCLUSION Withinthe limitations of the study, NaOCl most efficiently dissolved the pulp tissue at both concentrations and at both time intervals. Mean tissue dissolution by Ca(OCl)2 and ClO2 gradually increased with time and with their increase in concentration.
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Affiliation(s)
- Sonali Taneja
- Department of Conservative Dentistry and Endodontics, Institute of Technology and Science Centre for Dental Studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Neha Mishra
- Department of Conservative Dentistry and Endodontics, Institute of Technology and Science Centre for Dental Studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Shubhra Malik
- Department of Conservative Dentistry and Endodontics, Institute of Technology and Science Centre for Dental Studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
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Hamama H, Yiu C, Burrow M. Current update of chemomechanical caries removal methods. Aust Dent J 2014; 59:446-56; quiz 525. [PMID: 25131424 DOI: 10.1111/adj.12214] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2014] [Indexed: 11/27/2022]
Abstract
Chemomechanical caries removal is an excellent method for minimally invasive caries excavation, and the removal agents are either sodium hypochlorite (NaOCl)- or enzyme-based. The NaOCl-based agents include GK-101, GK-101E (Caridex) and Carisolv, and the enzyme-based agents include Papacarie and the experimental material, Biosolv. This review outlines the changes in chemomechanical caries removal methods and focuses on recently published laboratory and clinical studies. The historical development, mechanism of action, excavation time and biological effects on pulp and dental hard tissues are described. Based on existing evidence, the currently available chemomechanical caries removal methods are viable alternatives to conventional rotary instrument methods. Chemomechanical methods could be extremely useful in very anxious, disabled and paediatric patients. It does seem some of these agents would still benefit from quicker excavation times in order to achieve more universal acceptance. However, as a means of conserving the caries-affected dentine, chemomechanical caries removal is possibly much more successful than conventional rotary instrumentation.
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Affiliation(s)
- H Hamama
- Faculty of Dentistry, Prince Philip Dental Hospital, University of Hong Kong, Hong Kong SAR, China; Department of Conservative Dentistry, Faculty of Dentistry, Mansoura University, Egypt
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A Panoramic Survey of Air Force Basic Trainees: How Research Translates into Clinical Practice. J Endod 2014; 40:1332-7. [DOI: 10.1016/j.joen.2014.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 05/09/2014] [Accepted: 05/12/2014] [Indexed: 11/19/2022]
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Tartari T, Guimarães BM, Amoras LS, Duarte MAH, Silva e Souza PAR, Bramante CM. Etidronate causes minimal changes in the ability of sodium hypochlorite to dissolve organic matter. Int Endod J 2014; 48:399-404. [DOI: 10.1111/iej.12329] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 05/31/2014] [Indexed: 11/29/2022]
Affiliation(s)
- T. Tartari
- Department of Endodontics; Dental School of Bauru; University of São Paulo; Bauru SP Brazil
| | - B. M. Guimarães
- Department of Endodontics; Dental School of Bauru; University of São Paulo; Bauru SP Brazil
| | - L. S. Amoras
- Department of Endodontics; Dental School; Federal University of Pará; Belém PA Brazil
| | - M. A. H. Duarte
- Department of Endodontics; Dental School of Bauru; University of São Paulo; Bauru SP Brazil
| | | | - C. M. Bramante
- Department of Endodontics; Dental School of Bauru; University of São Paulo; Bauru SP Brazil
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Chrepa V, Kotsakis GA, Pagonis TC, Hargreaves KM. The Effect of Photodynamic Therapy in Root Canal Disinfection: A Systematic Review. J Endod 2014; 40:891-8. [DOI: 10.1016/j.joen.2014.03.005] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 03/03/2014] [Accepted: 03/04/2014] [Indexed: 11/25/2022]
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Ceyhanli KT, Turkun M, Erdilek N, Peskersoy C, Kose T. Evaluation of the apical adaptation performance of various root canal instruments. Eur J Dent 2014; 7:S041-S044. [PMID: 24966727 PMCID: PMC4054078 DOI: 10.4103/1305-7456.119070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the apical root canal adaptation performance of various root canal instruments. MATERIALS AND METHODS A total of 40 freshly extracted single-rooted mandibular incisors were used in this study. Coroner parts of all teeth were removed from cemento-enamel junction and root canal of each tooth was explored with a size 8 K-file until the tip of the file was just visible at the apex. Working lengths (WLs) were determined as 1 mm short of these measurements. ProTaper, K-file, profile and hedstroem files were inserted into the root canals of 10 teeth to the WL following the flaring of the coronal and middle thirds. Instruments were fixed in the root canals with acrylic resin. The apical 1 mm of each root tip was ground on wet sandpaper to expose the canal and the instrument at the WL and the apical region of each tooth was examined under stereomicroscope. The stereoscopic images of the teeth were digitized and analyzed with software in order to determine the differences between the areas of root canals and file tips. Result data were analyzed using the one-way analysis of variance test (P = 0.05). RESULTS There were no significant differences between apical file/root canal areas of the evaluated instruments (P > 0.05). CONCLUSIONS None of the evaluated instruments performed a perfect adaptation with the apical root canal surface at the WL in mandibular incisors. Therefore, total removal of the debris from the apical canal surface may not be achieved when these filing instruments are used.
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Affiliation(s)
- K Tolga Ceyhanli
- Department of Endodontics, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkiye
| | - Murat Turkun
- Department of Restorative Dentistry, Faculty of Dentistry, Ege University, Izmir, Turkiye
| | - Necdet Erdilek
- Department of Endodontics, Faculty of Dentistry, Ege University, Izmir, Turkiye
| | - Cem Peskersoy
- Department of Restorative Dentistry, Faculty of Dentistry, Ege University, Izmir, Turkiye
| | - Timur Kose
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Izmir, Turkiye
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Restoration of strip crown with a resin-bonded composite cement in early childhood caries. Case Rep Dent 2014; 2013:581934. [PMID: 24490090 PMCID: PMC3794541 DOI: 10.1155/2013/581934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 08/22/2013] [Indexed: 12/04/2022] Open
Abstract
Background. Early childhood caries is a widely prevalent disease throughout the world. It is necessary to treat this condition in early childhood; however, child behavior management may be particularly challenging during treatment. To overcome this challenge, we used Carigel to remove caries and RelyX Unicem resin cement for strip crown restoration. It not only has the desired aesthetic effect but is also more effective for primary teeth, which are used for a shorter period than permanent teeth are. Case Presentation. We report a case of three pediatric patients with early childhood caries, in whom caries was removed by using Carigel to avoid the risk of pulpal exposure associated with high-speed handpieces. Subsequently, aesthetic restoration was performed using strip crown with RelyX Unicem self-adhesive resin cement. Conclusion. RelyX Unicem has the following advantages: (1) not requiring have any special skills for the dentist for performing the procedure, (2) decreased occurrence of bubbles during injection of the cement, and (3) overall short duration of the procedure. Thus, it is appropriate for the treatment of pediatric patients whose behavior is difficult to manage. However, further studies are required in order to establish the use of RelyX Unicem as a stable restorative material in early childhood caries.
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Martin DE, De Almeida JFA, Henry MA, Khaing ZZ, Schmidt CE, Teixeira FB, Diogenes A. Concentration-dependent Effect of Sodium Hypochlorite on Stem Cells of Apical Papilla Survival and Differentiation. J Endod 2014; 40:51-5. [DOI: 10.1016/j.joen.2013.07.026] [Citation(s) in RCA: 186] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 07/29/2013] [Accepted: 07/30/2013] [Indexed: 02/07/2023]
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