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Katunarić A, Grgac SF, Gabrić D, Pavelić B, Bago I. Effect of sodium hypochlorite and ethylenediaminotetraacetic acid activated by laser and ultrasonic energy on surface morphology and chemical composition of intracanal dentin. Microsc Res Tech 2024; 87:818-831. [PMID: 38100184 DOI: 10.1002/jemt.24474] [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: 06/18/2023] [Revised: 11/03/2023] [Accepted: 12/05/2023] [Indexed: 03/02/2024]
Abstract
The aim of the study was to evaluate the structural and chemical changes in intracanal dentin after root canal irrigation with sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) using additional activation with a novel Er:YAG Shock Wave-Enhanced Emission Photoacoustic Streaming (SWEEPS), ultrasonic irrigation (UI), and Nd:YAG irradiation. Root canals of extracted human premolars were instrumented with distilled water and distributed into groups according to the irrigation protocol used: Group 1: conventional needle irrigation (CI) with 3% NaOCl; group 2: CI with 15% EDTA; and group 3: CI with NaOCl+EDTA. In group 4, root canals were irrigated with NaOCl+EDTA+NaOCl using the following techniques: CI (group 4A), SWEEPS (group 4B), UI (group 4C). In group 4D, root canals were finally irradiated with Nd:YAG laser. After the irrigation, the intracanal dentin sample was collected and analyzed using spectroscope with a Fourier transformation of infrared spectrum in Attenuated total reflection technique (FTIR-ATR) to calculate apatite/collagen ratio. Scanning electron microscopy (SEM) and energy dispersive x-ray spectrometry (EDS) were used to determine its chemical composition. FTIR-ATR showed no significant difference in the phosphate/amid I ratio between the control and the experimental groups (p > 0.05). SWEEPS and UI of NaOCl+EDTA+NaOCl caused the most pronounced decrease of Ca and P (p < 0.05) value compared to CI and control group, and canal wall erosion. SWEEPS and UI of NaOCl+EDTA+NaOCl caused the most pronounced decrease of Ca and P value and significant canal wall erosion. However, no difference in phosphate/amide ratio was reported among groups. RESEARCH HIGHLIGHTS: SWEEPS and UI of NaOCl+EDTA+NaOCl caused the most pronounced decrease of Ca and P values and significant canal wall erosion. There was no difference in phosphate/amide ratio among the irrigation protocols.
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Affiliation(s)
- Adriana Katunarić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Dragana Gabrić
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Božidar Pavelić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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Silva WO, Amoroso-Silva P, Olivares P, Alcalde MP, Alves FRF, Marceliano-Alves MF. Enhancing debris removal in curved canals: a comparative evaluation of XP-endo Finisher and Passive Ultrasonic Irrigation. Clin Oral Investig 2023; 27:7523-7529. [PMID: 37910237 DOI: 10.1007/s00784-023-05342-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/14/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVES The study aimed to compare the efficacy of XP-endo Finisher and Passive Ultrasonic Irrigation (PUI) in removing hard tissue debris from curved canals. MATERIALS AND METHODS Thirty-four mandibular molars with Vertucci's type II mesial canals were scanned in microcomputed tomography before and after preparation with HyFlex EDM, and accumulated hard tissue debris was quantified. Subsequently, the teeth were randomly divided into two groups according to the supplementary procedure: PUI with the Ultra-X insert or XP-endo Finisher. After the intervention, the specimens underwent another scanning. Two separate analyses were conducted, one for the total canal and another for the isthmus area. Unpaired and paired T-tests were used for inter- and intergroup comparisons, with a significance level set at 5%. RESULTS Both supplementary methods reduced the amount of debris compared to the initial volume. Remarkably, the XP-endo Finisher achieved a significantly higher percentage of debris removal (71% for the total canal and 74% for the isthmus areas) compared to PUI (41% for the total canal and 52% for the isthmus area) (P < 0.05). CONCLUSIONS Both supplementary approaches reduced the amount of hard tissue debris from canal preparation, still XP-endo Finisher showed a higher reduction compared to PUI (p < 0.05). CLINICAL RELEVANCE None of the supplementary methods rendered canals completely free of hard tissue debris. However, the supplementary approach with XP-endo Finisher resulted in lower levels of hard tissue debris than PUI in curved canals with isthmuses.
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Affiliation(s)
- Warley Oliveira Silva
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
- Federal University of Valley of Jequitinhonha and Mucuri (UFVJM), Diamantina, Brazil
| | - Pablo Amoroso-Silva
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Patrícia Olivares
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
| | - Murilo Priori Alcalde
- Faculty of Dentistry of Bauru, Department of Dentistry, Endodontics and Dental Materials, University of São Paulo, Bauru, SP, Brazil
| | - Flávio Rodrigues Ferreira Alves
- Postgraduate Program in Dentistry, University of Grande Rio (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
- Department of Endodontics and Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Av. Abílio Augusto Távora, 2134, Nova Iguaçu, RJ, 26260-045, Brazil
| | - Marília Fagury Marceliano-Alves
- Department of Endodontics and Dental Research, Faculty of Dentistry, Iguaçu University (UNIG), Av. Abílio Augusto Távora, 2134, Nova Iguaçu, RJ, 26260-045, Brazil.
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Merçon IR, de Campos FUF, Fontana CE, Pelegrine RA, Martin ASD, Bueno CEDS. Analysis of antimicrobial efficacy of sodium hypochlorite and ozonated water against biofilm in oval canals. Braz Dent J 2023; 34:33-41. [PMID: 37466523 PMCID: PMC10355262 DOI: 10.1590/0103-6440202305318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 05/23/2023] [Indexed: 07/20/2023] Open
Abstract
This in vitro study compared the antimicrobial efficacy of 2.5% sodium hypochlorite (NaOCl) and 8 µg/mL ozonated water agitated by passive ultrasonic irrigation (PUI) or PUI combined with EndoActivator (EA) against mature multispecies biofilm. One hundred and five oval-shaped mandibular premolars were instrumented, sterilized, and inoculated with Enterococcus faecalis, Candida albicans, and Staphylococcus aureus, divided into: control group - saline; O3 group - ozonated water; O3 PUI group - ozonated water with PUI agitation; O3 PUI+EA group - ozonated water with PUI+EA agitation; NaOCl group - NaOCl; NaOCl PUI group - NaOCl with PUI agitation; and NaOCl PUI+EA group - NaOCl with PUI+EA agitation. Microbiological samples were collected before (S1) and after (S2) the disinfection procedures and the data were statistically analyzed using the Kruskal-Wallis test. In the culture method, there was significant disinfection in the O3 PUI+EA, NaOCl, NaOCl PUI, and NaOCl PUI+EA groups (p˂0.05). The combination of NaOCl with PUI+EA reduced microbial counts to zero (p˂0.05). In the qPCR method, there was a significant reduction in the total count of viable microorganisms in the O3 PUI, O3 PUI+EA, NaOCl, NaOCl PUI, and NaOCl PUI+EA groups (p˂0.05). It can be concluded that 2.5% NaOCl with and without agitation, as well as 8 µg/mL ozonated water with its action enhanced by the agitation techniques, were effective in root canal disinfection, and their antimicrobial efficacy is related to the microorganisms present in the biofilm.
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Affiliation(s)
- Ivy Rodrigues Merçon
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo
Mandic., Campinas, SP, Brasil
| | | | - Carlos Eduardo Fontana
- Graduate Program in Health Sciences, Pontifícia Universidade
Católica de Campinas(PUC Campinas), Campinas, SP, Brasil
| | - Rina Andréa Pelegrine
- Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo
Mandic., Campinas, SP, Brasil
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Teed C, Hussein H, Kishen A. Synchronized Microbubble Photodynamic Activation to Disinfect Minimally Prepared Root Canals. J Endod 2023; 49:198-204. [PMID: 36509168 DOI: 10.1016/j.joen.2022.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/24/2022] [Accepted: 12/03/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the antimicrobial efficacy of a novel irrigation strategy using synchronized microbubble photodynamic activation (SYMPA) in a minimally prepared single canal. METHODS Single-canal mandibular incisors were inoculated with Enterococcus faecalis for 3 weeks and randomly allocated to 4 groups based on the irrigation protocols: (1) control (saline), (2) conventional needle irrigation (CI), (3) ultrasonic-assisted irrigation (UI), and (4) irrigation with SYMPA. The first 3 groups were instrumented to size 25.07v (WaveOne Gold Primary; Dentsply Sirona, Johnson City, TN), and the SYMPA group was minimally prepared to size 20.07v (WaveOne Gold Small, Dentsply Sirona). The apical 5 mm was resected for microbiological assessment using the culture technique (colony-forming unit), adenosine-5'-triphosphate-based viability assay (relative luminescence units), and the percentage of live bacteria using confocal laser scanning microscopy. RESULTS Log colony-forming units from the UI (2.37 ± 0.66) and SYMPA (2.21 ± 0.86) groups showed a reduction compared with the control (5.16 ± 0.75) and CI (4.08 ± 1.19) groups. Relative luminescence unit reduction was significant for UI (619.08 ± 352.78) and SYMPA (415.25 ± 329.51) compared with the control (1213.2 ± 880.03) (P < .05). The percentage of live bacteria was significantly lower in the UI and SYMPA groups compared with the control and CI groups. Although higher microbial reduction was observed in SYMPA compared with UI, there was no statistical significance (P > .05). CONCLUSION SYMPA in minimally prepared canals showed significant antimicrobial efficacy. The novel irrigation strategy using SYMPA could be an effective disinfection strategy for minimally prepared root canals.
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Affiliation(s)
- Christine Teed
- MSc Endodontics Program, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Hebatullah Hussein
- Dental Research Institute, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Department of Endodontics, Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
| | - Anil Kishen
- Dental Research Institute, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
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Tong J, Liu L, Du J, Gao Y, Song D, Huang D. Effect of photon-induced photoacoustic streaming and shock-wave enhanced emission photoacoustic streaming technique on the removal of the smear layer after root canal preparation in curved root canals. J Dent Sci 2023; 18:157-164. [PMID: 36643274 PMCID: PMC9831787 DOI: 10.1016/j.jds.2022.06.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/21/2022] [Indexed: 01/18/2023] Open
Abstract
Background/purpose The efficiency of root canal irrigation has an important impact on the prognosis of root canal treatment. Photon-induced photoacoustic streaming (PIPS) and shock wave enhanced emission photoacoustic streaming (SWEEPS) are the special modality of Er: YAG laser, whether can they improve the efficiency of root canal irrigation remains to be studied. Materials and methods Fifty human teeth with curved root canals were collected and stored in the thymol solution until used in the study. After traditional endodontic cavities preparation, root canals were prepared to size #35 with a 0.04 taper. The final irrigating techniques were as follows: (I) manual dynamic activation (MDA), (II) ultrasonically activated irrigation (UAI), (III) sonically activated irrigation (SAI), (IV) PIPS, and (V) SWEEPS. Fifty teeth were randomly divided into five groups mentioned above. After root canal preparation, the roots were cleaved longitudinally. The dentine surfaces were photographed from the coronal, middle, and apical third of the root by scanning electron microscopy operated at a low vacuum. Two examiners separately graded each image according to the remained smear layer situations. Results PIPS and SWEEPS groups showed fewer smear layers remaining than the others in the middle and the apical third (P < 0.05) of the root canal. In contrast, in the coronal third, five groups showed no significant difference (P > 0.05). Conclusion PIPS and SWEEPS showed superior smear layer clearing efficiency than traditional irrigating techniques in curved root canals.
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Affiliation(s)
- Jiaru Tong
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Liu Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jing Du
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuan Gao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Dongzhe Song
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Corresponding author. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Dingming Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Department of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Corresponding author. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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MacBeth ND. Factually untrue. Br Dent J 2022; 233:243-244. [PMID: 36028662 DOI: 10.1038/s41415-022-4928-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- N D MacBeth
- Gp Capt, Chief Dental Officer Defence, Lichfield, UK
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Comparison of Er:YAG laser and ultrasonic in root canal disinfection under minimally invasive access cavity. Lasers Med Sci 2022; 37:3249-3258. [PMID: 35854018 DOI: 10.1007/s10103-022-03613-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 07/13/2022] [Indexed: 10/17/2022]
Abstract
The disinfection of root canal through minimally invasive access cavity remains questionable. This in vitro study compared the effectiveness of three disinfection measures including conventional irrigation, ultrasonic assisted irrigation, and erbium:yttrium-aluminum-garnet (Er:YAG) laser assisted irrigation through conventionally or minimally invasive access. Sixty-six extracted maxillary first molars were randomly divided into group 1 conventionally invasive access group (CIA) and group 2 computer-guided minimally invasive access group (MIA). Each group was further randomly divided into three subgroups, (A) conventional irrigation (CI), (B) passive ultrasonic agitation (PUI), and (C) Er:YAG laser activated irrigation (LAI). Enterococcus faecalis (E. faecalis) infection model was established inside all root canals after instrumentation was performed up to ProTaper Universal F2. After various disinfection methods, microbial samples were collected from root canals by paper tip method and cultured, and colony forming units (CFU) values of each sample were calculated. Then the root canals were enlarged to the size of F3, after which dentin debris was collected from the F3 file. After dilution and culturing, the CFU value was calculated for each group. Two-way analysis of variance (ANOVA) was performed to test the interaction. The results revealed a significant antagonism (F = 3.394, P = 0.043). The bacterial CFU counts of group B and group C were significantly less than that of group A (P < 0.05), and there was no significant difference between group B and C (P > 0.05). Additionally, group 2A was better than group 1A (P < 0.05); there was no significant difference between group 1B and group 2B, group 1C and group 2C (P > 0.05). Comparison of the bacterial CFU counts in dentin debris after disinfection, the results revealed a significant antagonism (F = 7.224, P = 0.002), and group C had the least. The disinfection effect of Er:YAG laser or ultrasonic assisted computer-guided minimally invasive access is similar to conventionally invasive access, and Er:YAG laser is better than ultrasonic in removing bacteria from dentinal tubules and is easy to operate, which is more suitable for minimally invasive root canal treatment.
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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: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [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-omputed 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)
- C Boutsioukis
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M T Arias-Moliz
- Department of Microbiology, Faculty of Dentistry, University of Granada, Granada, Spain
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Lukač M, Olivi G, Constantin M, Lukač N, Jezeršek M. Determination of Optimal Separation Times for Dual-Pulse SWEEPS Laser-Assisted Irrigation in Different Endodontic Access Cavities. Lasers Surg Med 2020; 53:998-1004. [PMID: 33259683 PMCID: PMC8451836 DOI: 10.1002/lsm.23357] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/05/2020] [Accepted: 11/07/2020] [Indexed: 12/31/2022]
Abstract
Background and Objectives The purpose of this ex vivo study is to investigate whether it is possible to pre‐determine and set the optimal separation times for the SWEEPS Er:YAG laser pulses pair during laser‐assisted irrigation of endodontic root canals based on known lateral dimensions of the endodontic access cavities of different types of teeth. Study Design/Materials and Methods As the optimal SWEEPS laser pulse pair separation for enhanced shockwave generation depends on the life‐cycle of a single‐pulse bubble, measurements of the oscillation time TB of the Er:YAG laser‐generated bubble were made in 23 different endodontic access cavities of different types of teeth progressively widened in three different steps, into larger cavities, for a total of 69 cavities of different shapes and sizes. Different fiber‐tip geometries (flat and radial), laser pulse energies (10 mJ and 20 mJ) and depth of fiber‐tip insertion (2 mm and 4 mm) were also investigated. The obtained data were then analyzed using the reported relationship between the bubble oscillation time and the diameter of a cylindrically shaped cavity. Results A good fit to the relation analogue for ideal cylindrical cavities was found by taking the characteristic diameter of the access cavity to be represented by the cavity diameter either in the mesiodistal (Dmin) or buccolingual (Dmax) direction, or alternatively by the average of the two diameters (Dave). The best fit was obtained for Dmin (R2 = 0.73) followed in order by Dave (R2 = 0.71) and Dmax (R2 = 0.63). Conclusion In spite of the endodontic cavities being non‐cylindrical and of varied shape and size, the bubble oscillation time TB and the corresponding optimal SWEEPS separation time can be well predicted using a single characteristic dimension of the access cavity. This finding enables a simple and practical method for determining optimal conditions for shock wave generation and enhanced photodynamic streaming in differently shaped and sized root canals, leading to improved treatment efficacy and safety of root canal irrigation. Lasers Surg. Med. 2020. © 2020 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals LLC
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Affiliation(s)
- Matjaž Lukač
- Department of Complex Matter, Jozef Stefan Institute, Jamova cesta 39, 1000, Ljubljana, Slovenia
| | - Giovanni Olivi
- Master Laser Dentistry, Catholic University of Sacred Hearth-Rome, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Mihnea Constantin
- Master Laser Dentistry, Catholic University of Sacred Hearth-Rome, Largo Francesco Vito, 1, 00168, Rome, Italy
| | - Nejc Lukač
- Faculty of Mechanical Engineering, University of Ljubljana, Aškerčeva 6, 1000, Ljubljana, Slovenia
| | - Matija Jezeršek
- Faculty of Mechanical Engineering, University of Ljubljana, Aškerčeva 6, 1000, Ljubljana, Slovenia
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Miguéns-Vila R, Martín-Biedma B, De-Deus G, Belladonna FG, Peña-López A, Castelo-Baz P. Micro-computed Tomographic Evaluation of Dentinal Microcracks after Preparation of Curved Root Canals with ProTaper Gold, WaveOne Gold, and ProTaper Next Instruments. J Endod 2020; 47:309-314. [PMID: 33096193 DOI: 10.1016/j.joen.2020.10.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/08/2020] [Accepted: 10/15/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the influence of rotary (ProTaper Next [PTN; Dentsply Maillefer, Ballaigues, Switzerland] and ProTaper Gold [PTG, Dentsply Maillefer]) and reciprocating (WaveOne Gold [WOG, Dentsply Maillefer]) systems in dentinal microcrack generation after the preparation of curved root canals using micro-computed tomographic analysis. METHODS Twenty-four human mandibular molars with curved roots were scanned in a micro-computed tomographic device using an isotropic resolution of 6.78 μm and randomly assigned into 1 of 3 experimental groups (n = 8) according to the root canal instrumentation system used (PTN, PTG, or WOG). Then, the root canals were prepared up to PTN X2, PTG F2, and WOG Primary instruments in the PTN, PTG, and WOG groups, respectively. After canal preparation, each specimen was scanned again. Pre- and postoperative cross-sectional images of the roots (N = 35,304) were analyzed to identify the presence of dentinal microcracks. RESULTS Overall, 26% of the images presented dentinal defects (n = 9188). Dentinal microcracks were observed in 24.6%, 26%, and 27.4% of the postinstrumentation images from the PTN, PTG, and WOG groups, respectively. However, all of these dentinal microcracks were already present in the corresponding preoperative images. No new microcracks were generated after the preparation of curved root canals of mandibular molars using the aforementioned systems. CONCLUSIONS Root canal instrumentation with PTN, PTG, and WOG systems did not induce the formation of new dentinal microcracks.
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Affiliation(s)
- Ramón Miguéns-Vila
- University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain.
| | | | - Gustavo De-Deus
- Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | | | | | - Pablo Castelo-Baz
- University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain
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Measurement of Pressures Generated in Root Canal During Er:YAG Laser-Activated Irrigation. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 38:625-631. [DOI: 10.1089/photob.2019.4776] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Kumar S, Desai K, Palekar A, Biradar B, Chatterjee A, Kumari K. Comparison of the Efficacy of CanalBrush, EndoActivator, and Passive Ultrasonic Irrigation on the Removal of Triple Antibiotic Paste from Root Canal Walls: An In Vitro Study. J Int Soc Prev Community Dent 2020; 10:424-430. [PMID: 33042883 PMCID: PMC7523939 DOI: 10.4103/jispcd.jispcd_13_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/12/2020] [Indexed: 11/17/2022] Open
Abstract
Aim: The aim of this study was to compare the efficacy of CanalBrush (CB), EndoActivator (EA), and Passive Ultrasonic Irrigation (PUI) on the removal of triple antibiotic paste (TAP) from root canal walls. Materials and Methods: Thirty-six extracted human single-rooted teeth were prepared using ProTaper Universal rotary files (DentsplyMaillefer, Ballaigues, Switzerland) up to size F5. The root canals were filled with TAP, and after 21 days, roots were randomly assigned to three groups (n = 10) according to irrigation regimens used: CB, EA, and PUI. In three teeth, TAP was not removed (positive controls), and the other three teeth were not filled with TAP (negative controls). The roots were sectioned, and the amount of TAP remaining was evaluated at the mesial halves of each tooth at ×30 magnification under a stereomicroscope using a 4-grade scoring system. Data were evaluated using the Kruskal–Wallis and Mann–Whitney U tests. Results: There were significant differences among the experimental groups according to the different parts of the root canals (P < 0.05). At the apical and middle third, EA and PUI groups removed more TAP than CB group; however, there was a statistically significant difference only between CB and PUI groups (<0.01 at apical third and <0.05 at middle third). At the coronal third, there was no statistically significant difference between all the three groups (P > 0.05). Conclusion: PUI led to superior results compared to CB in the middle and apical thirds. There was no significant difference between EA and PUI techniques.
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Affiliation(s)
- Santosh Kumar
- Department of Conservative Dentistry and Endodontics, Patna Dental College & Hospital, Patna, Bihar, India
| | - Kavisha Desai
- Department of Conservative Dentistry and Endodontics, Rural Dental College, Pravara Institute of Medical Sciences (PIMS), Loni, Maharashtra, India
| | - Aparna Palekar
- Department of Conservative Dentistry and Endodontics, Rural Dental College, Pravara Institute of Medical Sciences (PIMS), Loni, Maharashtra, India
| | - Baswaraj Biradar
- Department of Conservative Dentistry and Endodontics, Rural Dental College, Pravara Institute of Medical Sciences (PIMS), Loni, Maharashtra, India
| | - Ananjan Chatterjee
- Department of Oral Pathology, Buddha Institute of Dental Sciences & Hospital, Patna, Bihar, India
| | - Khushboo Kumari
- Department of Oral Pathology, Buddha Institute of Dental Sciences & Hospital, Patna, Bihar, India
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Jezeršek M, Lukač N, Lukač M. Measurement of Simulated Debris Removal Rates in an Artificial Root Canal to Optimize Laser-Activated Irrigation Parameters. Lasers Surg Med 2020; 53:411-417. [PMID: 32633876 PMCID: PMC8048517 DOI: 10.1002/lsm.23297] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/15/2020] [Accepted: 06/25/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVES To compare temporal rates of debris removal from an artificial root canal for three laser-assisted irrigation modalities single-pulse super short pulse (SSP), and two dual-pulse X-SWEEPS and AutoSWEEPS, and for two fiber-tip (FT) geometries flat and radial, and to evaluate the dependence of the debris flushing rate on the delay between the SWEEPS laser pulse pair. STUDY DESIGN/MATERIALS AND METHODS Laser-assisted irrigation was performed with a pulsed Er:YAG laser operating in single-pulse SSP and dual-pulse SWEEPS laser modalities. The laser energy was delivered to the water-filled model access cavity through a FT with either a flat or radial ending. The X-SWEEPS modality delivered pairs of laser pulses separated by a fixed adjustable delay, while with the AutoSWEEPS modality the delay was automatically and repeatedly swept between 200 and 600 microseconds. The debris removal rate was determined with the use of a digital camera by measuring the rate at which a simulated debris was being flushed out of the artificial root canal. RESULTS The simulated debris removal rate of the AutoSWEEPS modality is almost three times higher compared with that of the SSP modality. Further, the flat FT outperforms the radial FT by a factor of more than five in the case of SSP, and by more than 10 with AutoSWEEPS. The X-SWEEPS flushing rate exhibits strong dependence on the delay between the SWEEPS pulse pair, with the highest removal rate measured to be more than seven times higher in comparison with SSP. CONCLUSION Dual-pulse laser irrigation modalities (AutoSWEEPS and X-SWEEPS) exhibit significantly higher simulated debris removal rates in comparison with the standard single-pulse SSP laser-assisted irrigation. As opposed to the previously reported dependence of pressure generation on FT geometry, the flat FT's simulated debris removal rate significantly outperforms the radial FT. © 2020 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals LLC.
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Affiliation(s)
- Matija Jezeršek
- Faculty of Mechanical Engineering, University of Ljubljana, Ljubljana, Slovenia
| | - Nejc Lukač
- Faculty of Mechanical Engineering, University of Ljubljana, Ljubljana, Slovenia
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14
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Abusrewil S, Alshanta OA, Albashaireh K, Alqahtani S, Nile CJ, Scott JA, McLean W. Detection, treatment and prevention of endodontic biofilm infections: what's new in 2020? Crit Rev Microbiol 2020; 46:194-212. [PMID: 32233822 DOI: 10.1080/1040841x.2020.1739622] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Endodontic disease, a biofilm infection of the root canal space, is a significant cause of dental morbidity worldwide. Endodontic treatment, or root canal treatment, as it is commonly known is founded on the ability to eradicate microbial biofilm infection and prevent re-infection of the highly complex root canal space. Despite many "advances" in clinical endodontics we have seen little improvement in outcomes. The aim of this critical review paper is to provide a contemporary view of endodontic microbiology and biofilm polymicrobiality, provide an understanding of the host response, and how together these impact upon clinical treatment. Ultimately, it is intended to provide insight into novel opportunities and strategies for the future diagnostics, treatment, and prevention of endodontic disease.
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Affiliation(s)
- Sumaya Abusrewil
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Om Alkhir Alshanta
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Khawlah Albashaireh
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Saeed Alqahtani
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Christopher J Nile
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - James Alun Scott
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - William McLean
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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15
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Lukač M, Lukač N, Jezeršek M. Characteristics of Bubble Oscillations During Laser-Activated Irrigation of Root Canals and Method of Improvement. Lasers Surg Med 2020; 52:907-915. [PMID: 32065416 PMCID: PMC7586965 DOI: 10.1002/lsm.23226] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Laser-activated irrigation of dental root canals is being increasingly used as its efficacy has been shown to be superior compared with conventional techniques. The method is based on laser-initiated localized fluid evaporation and subsequent rapid bubble expansions and collapses, inducing microfluid flow throughout the entire volume of the cavity. The irrigation efficacy can be further improved if optimally delayed "SWEEPS" double laser pulses are delivered into the canal. This study aims to show that the irrigation efficacy, as measured by the induced pressure within the canal, is related to the double pulse delay, with the maximal pressure generated at an optimal delay. The second aim is to find a method of determining the optimal delay for different cavity dimensions and/or laser parameters. STUDY DESIGN/MATERIALS AND METHODS Experiments were made in transparent models of root canals where Er:YAG laser (λ = 2.94 μm, pulse duration tp = 25 or 50 microseconds, and pulse energies up to EL = 40 mJ) was used with a combination of cylindrical and conical fiber-tip geometries (diameters 400 and 600 µm). High-speed photography (60,000 fps) and average pressure measurements inside the canal were used for process characterization. RESULTS The results show that a pressure amplification of more than 1.5 times occurs if the laser pulse delay approximately coincides with the bubble oscillation time. Correlations between normalized oscillation time and canal diameter for a wide range of laser pulse energies (R2 = 0.96) and between the average pressure within the canal and the bubble oscillation periods (R2 = 0.90) were found. A relationship between the bubble oscillation time and the diameter of the treated cavity was found depending on the bubble oscillation time in an infinite fluid reservoir. CONCLUSIONS The bubble oscillation time within a constrained volume can be determined based on the known oscillation time in infinite space, which offers a fast and simple solution for optimization of the laser parameters. These findings enable determination of optimal conditions for shock wave generation, and improvement of root canal irrigation at the same dose of laser energy input, leading to improved treatment efficacy and safety. Lasers Surg. Med. © 2020 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals, Inc.
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Affiliation(s)
| | - Nejc Lukač
- Faculty of Mechanical Engineering, University of Ljubljana, Aškerčeva 6, Ljubljana, 1000, Slovenia
| | - Matija Jezeršek
- Faculty of Mechanical Engineering, University of Ljubljana, Aškerčeva 6, Ljubljana, 1000, Slovenia
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AlRahabi MK, AlKady AM. Current Trends in Practice of Residents in the Saudi Board of Endodontics Program. Eur J Dent 2020; 13:619-624. [PMID: 31891979 PMCID: PMC6938417 DOI: 10.1055/s-0039-3399456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives
The purpose of the current study was to collect information about some techniques and armamentarium currently used by the Saudi Board of Endodontics residents in relation to the technical steps of root canal therapy.
Materials and Methods
A web-based survey was sent to the Saudi Board of Endodontics residents, based in the western area of Saudi Arabia. The survey assessed controversial concepts, and collected information regarding new instruments and materials, used in the technical steps of nonsurgical root canal treatment. A one-sample chi-square test, with a 95% level of significance, was applied to determine whether there were significant differences between respondents’ answers.
Results
A total of 45 out of 50 residents (90%) responded to the questionnaire. The majority of Saudi Board residents of Endodontics, who participated in this survey, used the mean of working length (ML) measured by periapical X-Ray and apex locator in the presence of a radiographic lesion (63.3%), and maintained apical patency in all cases (80.0%). ProTaper Universal (40%) and ProTaper Next (41.2%) were the most common NiTi rotary systems used for root canal instrumentation. Thirty percent of respondents used adjunct device with irrigation, and 80% advocated smear layer removal. Zinc oxide–eugenol-based sealers were the most common used sealers (70%), and most residents (86.6%) did not advocate sealer extrusion.
Conclusions
This study revealed that residents of the Saudi Board of Endodontics program adopt new endodontic technologies. There is, however, a need for more investigations regarding this objective, including responses from all residents in Saudi Arabia.
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Affiliation(s)
- Mothanna K AlRahabi
- Department of Restorative Dental Science, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia
| | - Ayman M AlKady
- Department of Restorative Dental Science, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia
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Küçükkaya Eren S, Uzunoğlu Özyürek E. Influence of cavity design on calcium hydroxide removal from root canal irregularities. CUMHURIYET DENTAL JOURNAL 2019. [DOI: 10.7126/cumudj.605699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Impact of Different Irrigant Agitation Methods on Bacterial Elimination from Infected Root Canals. Dent J (Basel) 2019; 7:dj7030064. [PMID: 31252522 PMCID: PMC6784465 DOI: 10.3390/dj7030064] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 06/09/2019] [Accepted: 06/10/2019] [Indexed: 02/07/2023] Open
Abstract
Activation techniques are essential for root canal disinfection but may result in incomplete removal of bacteria. The aim of our study was to assess the antibacterial action of sonically, ultrasonically and laser-activated irrigation and 5.25% sodium hypochlorite (NaOCl) on Enterococcus faecalis in an infected tooth. Forty-four extracted mandibular premolars were mechanically prepared, sterilized, and inoculated with E. faecalis for 1 week. Bacterial counts after inoculation were evaluated in 4 randomly chosen teeth, remaining root canals were divided into 4 groups. Group A: laser-activated irrigation by photon-induced photoacoustic streaming, Group B: the sonic irrigation by EDDY, Group C: ultrasonic irrigation by EndoUltra, and Group D: 5.25% NaOCl. Colony forming unit (CFU) counts were measured and Kolmogorov-Smirnov, Wilcoxon, Kruskal-Wallis and Mann-Whitney tests were used to determine differences. The mean of CFU was found to significantly decrease in group D, 2110 ± 1015.93 (p < 0.001). Changes in measurement levels followed the same trend over time in groups A 27.40 ± 30.15, B 81.3 ± 85.68 and C 44.40 ± 67.12 (p = 0.141). The average CFU after irrigation in all groups was significantly greater than 0. Within the limitations of this study, all activation techniques were superior to NaOCl 5.25% in reducing E. faecalis from the infected tooth model.
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Galler KM, Grubmüller V, Schlichting R, Widbiller M, Eidt A, Schuller C, Wölflick M, Hiller KA, Buchalla W. Penetration depth of irrigants into root dentine after sonic, ultrasonic and photoacoustic activation. Int Endod J 2019; 52:1210-1217. [PMID: 30828819 DOI: 10.1111/iej.13108] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 02/28/2019] [Indexed: 01/03/2023]
Abstract
AIM To compare penetration depths of endodontic irrigants into the dentinal tubules of extracted teeth when using several activation methods. METHODOLOGY The root canals of 90 extracted human teeth were prepared to size 40, .06 taper. The straight and round-shaped root canals were distributed randomly into six groups, and final irrigation was performed with EDTA and sodium hypochlorite as follows: (I) manual dynamic activation, (II) Ultrasonic, (III) Sonic, (IV) PIPS (photon-induced photoacoustic streaming, (V) SWEEPS (shock-wave enhanced emission photoacoustic streaming) and (0) control without final irrigation or activation. Subsequently, methylene blue was inserted into the canals and activated according to the groups (I-V). Teeth were sectioned horizontally, imaged under a light microscope, and dye penetration depths were measured in six sections per tooth and 24 points on a virtual clock-face per section. Data were analysed statistically by nonparametric tests for whole teeth and separately for coronal, middle and apical thirds. RESULTS Penetration of dye into the dentinal tubules was lowest for the controls. Median penetration depths amounted to 700-900 μm for groups I-V with differences in the apical thirds between group I and the other test groups. Minimum penetration depths were significantly greater for PIPS in the apical thirds (P ≤ 0.046). CONCLUSIONS Greater penetration depths occurred in the apical thirds for ultrasonic, sonic and laser-induced activation compared to manual dynamic activation. PIPS was associated with deeper penetration of irrigants. The novel SWEEPS mode did not increase irrigant penetration.
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Affiliation(s)
- K M Galler
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - V Grubmüller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | | | - M Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - A Eidt
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - C Schuller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - M Wölflick
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - K-A Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - W Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
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