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Ling D, Chen Y, Chen G, Zhang Y, Wang Y, Wang Y, He F. Outcome of nonsurgical management of large cyst-like periapical lesions using a modified apical negative pressure irrigation system: a case series study. BMC Oral Health 2024; 24:336. [PMID: 38491469 PMCID: PMC10943812 DOI: 10.1186/s12903-024-04110-2] [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: 01/17/2024] [Accepted: 03/05/2024] [Indexed: 03/18/2024] Open
Abstract
OBJECTIVE To assess the effectiveness of a self-constructed modified apical negative pressure irrigation (ANPI) system employing commonly used clinical instruments in nonsurgical root canal therapy (NSRCT) for large cyst-like periapical lesions (LCPLs). METHODS From 2017 to 2022, 35 patients diagnosed with LCPLs (5-15 mm) via preoperative clinical and radiographic evaluations of endodontic origin underwent NSRCT combined with ANPI. These patients were subjected to postoperative clinical and radiographic follow-up at 3 months, 6 months, 1 year, 2 years, 3 years, and 4 years, with a CBCT scan specifically conducted at 6-month follow-up. Through the reconstruction of three-dimensional cone beam computed tomography (CBCT) data, an early prognosis was facilitated by monitoring changes in lesion volume. Various treatment predictors-including sex, type of treatment, lesion size, preoperative pain, jaw, type of teeth involved, sealer extrusion, and the number of root canals-were meticulously analyzed. The evaluation of post-treatment outcomes leveraged both clinical observations and radiographic data collected during the follow-up periods. The Kruskal‒Wallis test and one-way ANOVA were also conducted to determine the independent factors influencing treatment outcomes. A significance level of 5% was established. RESULTS Thirty-five teeth from 35 patients with a median age of 28 years (range 24-34) were treated; the median follow-up duration was 19 months (range 12-26). The overall success rate was 91.4%, with a median lesion reduction of 77.0% (range 54.2-96.4%) at 6 months. Patients under 30 years of age exhibited a significantly greater success rate than older patients did (100.0% vs. 80.0%, p = 0.037). Other factors, such as sex, jaw, treatment type, preoperative pain, cyst size, tooth location, sealer extrusion, and the number of roots, did not significantly impact treatment outcomes. CONCLUSIONS Despite limitations related to the observational case-series study design and relatively small sample size, our findings suggest that utilizing the ANPI in the NSRCT for LCPLs may hold promise. The notably higher success rate in patients younger than 30 years is worth noting.
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Affiliation(s)
- Danhua Ling
- Department of General Dentistry, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
- Department of Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, 166 Qiutao North Road, Shangcheng District, Hangzhou, Zhejiang Province, China
| | - Yun Chen
- School of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Gongpei Chen
- Department of General Dentistry, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Yanzhen Zhang
- Department of General Dentistry, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Yanhong Wang
- Department of Comprehensive Dentistry, Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, 311221, China
| | - Ying Wang
- Department of General Dentistry, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Fuming He
- Department of Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, 166 Qiutao North Road, Shangcheng District, Hangzhou, Zhejiang Province, China.
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Guimaraes TS, Marceliano-Alves MFV, Provenzano JC, Olivares PP, Limoeiro AGS, Alves FRF, Dias LA. Morphological assessment of the isthmus in mesial root canals of first mandibular molars. ACTA ODONTOLOGICA LATINOAMERICANA : AOL 2023; 36:163-168. [PMID: 38345278 PMCID: PMC10867857 DOI: 10.54589/aol.36/3/163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/01/2023] [Indexed: 02/15/2024]
Abstract
Root canal morphology and its anatomical variations pose a great challenge to endodontists. Aim The aim of this in silico study was to perform a qualitative and quantitative analysis of the threedimensional morphological characteristics of the isthmus in the mesial root canals of mandibular molars using microcomputed tomography (micro-CT). Material and Method Six hundred first mandibular molars were selected, including 317 with two mesial canals with isthmuses between the canals, and fully formed root. Isthmus morphology was determined in 3D longitudinal sections using Fan et al. (2010) classification. Root length, and the volume and area of apical and coronal level were measured. Additionally, the structural model index (SMI) of the canals were also assessed. Results The prevalence of isthmuses in the mesial root canals was 32% type II, 29% type III, 22% type IV, and 17% type I. The root length was found to be 9.1±0.5 mm, the volume and area, of all root canal system, were 41.8±40.1 mm3 and 63.6±24.2 mm2 respectively. The isthmi volume and area alone were 11.06±9.03 mm3 and 30.02±11.02 mm2. The study confirmed that isthmuses are present in mesial canals of mandibular first molars, being more frequent in the apical third. Conclusion The high prevalence of isthmuses with complex morphological features underscores the importance of using intracanal medications to disinfect areas unprepared by instruments.
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Affiliation(s)
- Thiago S Guimaraes
- Universidade Estácio de Sá, Departamento de Endodontia, Rio de Janeiro, Brasil
| | | | - José C Provenzano
- Universidade Nova Iguaçu, Programa de Pós-Graduação em Odontologia (Endodontia), Nova Iguaçu, Brasil
| | - Patricia P Olivares
- Universidade Nova Iguaçu, Programa de Pós-Graduação em Odontologia (Endodontia), Nova Iguaçu, Brasil
| | | | - Flavio RF Alves
- Universidade Nova Iguaçu, Programa de Pós-Graduação em Odontologia (Endodontia), Nova Iguaçu, Brasil
| | - Luciana A Dias
- Universidade Nova Iguaçu, Programa de Pós-Graduação em Odontologia (Endodontia), Nova Iguaçu, Brasil
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Chan CW, Romeo VR, Lee A, Zhang C, Neelakantan P, Pedullà E. Accumulated Hard Tissue Debris and Root Canal Shaping Profiles Following Instrumentation with Gentlefile, One Curve, and Reciproc Blue. J Endod 2023; 49:1344-1351. [PMID: 37516238 DOI: 10.1016/j.joen.2023.07.019] [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: 05/19/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 07/31/2023]
Abstract
INTRODUCTION This laboratory study aimed to evaluate the accumulated hard tissue debris (AHTD) and shaping performance following root canal instrumentation with a novel stainless steel rotary system (Gentlefile; MedicNRG, Kibbutz Afikim, Israel) compared with two single-file nickel-titanium instruments of different kinematics through micro-computed tomography (micro-CT) analysis. METHODS Thirty isthmus-containing mesial roots of human mandibular molars with a curvature of 15°-35° were scanned with micro-CT at an isotropic resolution of 12 μm and randomly assigned to three groups (n = 10) according to the instruments used for canal preparation: Gentlefile (GF; #23/.04), One Curve (OC; #25/.06; Micro-Mega, Besancon, France), and Reciproc Blue R25 (RB; #25/.08; VDW, Munich, Germany). The AHTD, unprepared canal surface area, volume changes, surface area changes, and transportation were evaluated by comparing preoperative and postoperative micro-CT images. In addition, the time required for canal preparation was recorded. Data were statistically analyzed using the one-way analysis of variance (ANOVA) test or the Kruskal-Wallis test at a significance level of 5%. RESULTS No significant differences were observed in the percentage of AHTD or in the unprepared canal surface area between the three groups (P > .05). The RB group demonstrated a significantly greater percentage increase in volume and surface area than the GF group (P < .05). The GF and OC groups showed significantly less transportation at 3 mm from the apex than the RB group (P < .001). The OC group required significantly less time for instrumentation than the RB and GF groups (P < .05). CONCLUSIONS Instrumentation with GF (#23/.04), OC, and RB yielded similar levels of AHTD and unprepared surface area in isthmus-containing curved canals. GF achieved this with less dentin removal and apical transportation, at the expense of a longer preparation time.
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Affiliation(s)
- Chi Wai Chan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Virginia Rosy Romeo
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Angeline Lee
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Chengfei Zhang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
| | - Prasanna Neelakantan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China; Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA.
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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Chinta PR, Kalla N, Dhavala PC, Satyavathi DPS, Rolla SA, Uppalapati P. Comparative Evaluation of Different Irrigant Agitating Devices for Debris Removal from the Mesial Roots of Mandibular Molars: An In Vitro Study. J Contemp Dent Pract 2023; 24:449-453. [PMID: 37622621 DOI: 10.5005/jp-journals-10024-3533] [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] [Indexed: 08/26/2023]
Abstract
AIM To evaluate the efficiency of debris removal from the mesial root canals and isthmus of mesial roots of mandibular molars after final irrigant agitation with XP-endo Shaper, EndoVac (EV), plastic finishing file, and conventional needle irrigation. METHODS AND MATERIALS Forty extracted human mandibular first molar teeth with the isthmus between the mesial roots were selected, access cavities were prepared and distal roots were decoronated. All the mesial root specimens were mounted in acrylic, sectioned at the coronal, middle, and apical thirds, along with the resin block, and examined for debris in the canals and isthmus before the start of the procedure using a stereomicroscope and were mounted back in a custom-made jig. After determination of the working length, they were allocated to the following four different irrigant activation groups (n = 10): Group I-XP-endo Finisher; group II-EndoVac; group III-plastic finishing file; and group IV-standard needle irrigation. After biomechanical preparation (BMP) till F3, final agitation was done for debris removal with the respective agitating devices, and all the samples were examined under a stereomicroscope for the amount of debris in the canal after final agitation. RESULTS Of all the irrigation devices used, the XP-endo Finisher and EV showed more debris removal when compared to other groups (p < 0.05). The plastic finishing file in continuous rotation was more efficient in cleaning debris compared with conventional needle irrigation (p < 0.05). CONCLUSION The XP-endo Finisher and EV showed a significant difference in cleaning efficacy than the plastic finishing files. So, these can be used as adjunctive for agitating the final irrigant. CLINICAL SIGNIFICANCE The irrigant agitation devices promote the penetration of irrigants into the intricate root canal anatomy and increase their antibacterial and tissue-dissolving effectiveness thereby improving the success rate and treatment outcome.
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Affiliation(s)
- Priyanka Reddy Chinta
- Department of Conservative Dentistry and Endodontics, GSL Dental College & Hospital, Rajanagaram, Andhra Pradesh, India, Phone: +91 9493672455, e-mail: , Orcid: https://orcid.org/0000-0002-7463-9443
| | - Nagalakshmi Kalla
- Department of Conservative Dentistry and Endodontics, GSL Dental College & Hospital, Rajanagaram, Andhra Pradesh, India
| | - Padma Chaitanya Dhavala
- Master of Dental Surgery in Department of Conservative Dentistry and Endodontics, Drs Sudha & Nageswara rao Siddhartha institute of dental sciences, Gannavaram, Andhra Pradesh, India
| | - Damarla Poorna Samudra Satyavathi
- Master of Dental Surgery in Department of Conservative Dentistry and Endodontics, Drs Sudha & Nageswara rao Siddhartha institute of dental sciences, Gannavaram, Andhra Pradesh, India
| | - Sanjay Adarsh Rolla
- Department of Conservative Dentistry and Endodontics, GSL Dental College & Hospital, Rajanagaram, Andhra Pradesh, India
| | - Pragnya Uppalapati
- Department of Conservative Dentistry and Endodontics, GSL Dental College & Hospital, Rajanagaram, Andhra Pradesh, India
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Rodrigues CT, Jacobs R, Ezeldeen M, Vasconcelos KDF, Lambrechts P, Tanomaru Filho M, Pinto JC, Duarte MAH. How does nano-focus computed tomography impact the quantification of debris within the root canal system? Braz Oral Res 2023; 37:e059. [PMID: 37341232 DOI: 10.1590/1807-3107bor-2023.vol37.0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 01/05/2023] [Indexed: 06/22/2023] Open
Abstract
The aim of this study was to compare the quantification of hard-tissue debris by using micro-computed tomography (micro-CT) and nano-focus computed tomography (nano-CT) after root canal instrumentation. Ten mandibular molars containing an isthmus in the mesial root were scanned in a SkyScan 1172 micro-CT device with a voxel size of 12.8 µm and in a NanoTom nano-CT device with 5.5 µm. The mesial root canals were irrigated with 5 mL of saline solution at the orifice level, instrumented with Reciproc R25 files and a second scanning was performed by micro-CT and nano-CT devices for post-instrumentation images. DataViewer software was used for registering the pre- and post-operative micro-CT and nano-CT images. The root canal and the debris were segmented for quantitative analysis of the volume of the canal and volume of debris using CTAn software. Statistical analysis was performed using the T test for comparison between volume of the canal after instrumentation and volume of debris in both image modalities. The level of significance was set at p < 0.05. Nano-CT images showed higher values of debris when compared with micro-CT (p < 0.05) after root canal instrumentation. No difference was observed between the volume of the root canal after instrumentation in the two imaging methods used (p > 0.05). Nano-CT technology can be recommended as a more precise method for quantitative analysis of hard-tissue debris. Moreover, in Endodontic research it is a promising method, as it is capable of providing higher spatial and contrast resolution, faster scanning and higher image quality.
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Affiliation(s)
- Clarissa Teles Rodrigues
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
| | - Reinhilde Jacobs
- University Hospitals Leuven, Faculty of Medicine, Department of Imaging and Pathology, Leuven, Belgium
| | - Mostafa Ezeldeen
- University Hospitals Leuven, Faculty of Medicine, Department of Imaging and Pathology, Leuven, Belgium
| | | | - Paul Lambrechts
- University Hospitals Leuven, KU Leuven and Dentistry, Department of Oral Health Sciences, Endodontology, Leuven, Belgium
| | - Mario Tanomaru Filho
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | - Jader Camilo Pinto
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Restorative Dentistry, Araraquara, SP, Brazil
| | - Marco Antonio Hungaro Duarte
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru, SP, Brazil
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Rödig T, Westbomke V, Haupt F, Münster M, Baxter S. Effect of preparation size on the removal of accumulated hard-tissue debris from the mesial root canal system of mandibular molars using SWEEPS technology. Clin Oral Investig 2023; 27:2787-2796. [PMID: 36642725 PMCID: PMC10264281 DOI: 10.1007/s00784-023-04862-1] [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: 05/09/2022] [Accepted: 01/06/2023] [Indexed: 01/17/2023]
Abstract
OBJECTIVES This study assessed the influence of preparation size on the efficacy of shock wave-enhanced emission photoacoustic streaming (SWEEPS) and conventional irrigation (CI) on removal of accumulated hard tissue debris (AHTD) from isthmus-containing mandibular molars using micro-computed tomographic analysis. MATERIALS AND METHODS Sixty extracted mandibular molars with two mesial canals connected by an isthmus were selected. Canals were shaped with Mtwo instruments (VDW, Munich, Germany) up to sizes 25/.06, 40/.04 or 40/.06 (n = 20), and specimens were distributed into 2 final irrigation groups (n = 10): SWEEPS and CI. Roots were scanned at a resolution of 10.5 µm before and after preparation and final irrigation. Data sets were co-registered, and the percentage reduction of AHTD calculated for each specimen was statistically compared using analysis of variance with a of 5% significance level. RESULTS The preparation size did not significantly influence the percentage reduction of AHTD (p < 0.05), whereas the final irrigation technique had a significant effect on debris removal (p < 0.05). A significant reduction of AHTD was achieved after final irrigation in all groups (p < 0.05); however, SWEEPS was associated with a significantly greater percentage reduction of debris than CI (p < 0.05). None of the specimens presented a completely clean isthmus. CONCLUSIONS Removal of AHTD was not significantly affected by the preparation size. SWEEPS was associated with significantly less debris than CI. CLINICAL RELEVANCE SWEEPS performed significantly better than CI regarding the removal of AHTD from isthmus-containing mandibular molars irrespective of the preparation size.
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Affiliation(s)
- Tina Rödig
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
| | - Valerie Westbomke
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Franziska Haupt
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Marc Münster
- Endopur, Clinic for Endodontology, Frankfurt, Germany
| | - Steffi Baxter
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
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Montaser OK, Fayyad DM, Abdelsalam N. Efficacy of different irrigant activation techniques for cleaning root canal anastomosis. BMC Oral Health 2023; 23:142. [PMID: 36906530 PMCID: PMC10007824 DOI: 10.1186/s12903-023-02835-0] [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: 10/12/2022] [Accepted: 02/23/2023] [Indexed: 03/13/2023] Open
Abstract
OBJECTIVE This study compared in vitro the anastomosis cleaning efficacy of different irrigant activation techniques at different levels; control group non-activation (NA), passive ultrasonic irrigation (PUI) using Irrisafe, and EDDY sonic activation. METHODS Sixty anastomosis-containing mesial roots of mandibular molars were mounted in resin, sectioned at 2, 4, and 6 mm from the apex. Then reassembled and instrumented in a copper cube. For the irrigation technique roots were randomly divided into 3 groups (n = 20): group 1: NA, group 2: Irrisafe, group 3: EDDY. Stereomicroscopic images of anastomoses were taken after instrumentation and after irrigant activation. ImageJ program was used to calculate the percentage of anastomosis cleanliness. The percentage of cleanliness was calculated before and after final irrigation within each group and were then compared using paired t-tests. Intergroup and intragroup analyses were performed to compare between different activation techniques at the same root canal level (2, 4 and 6 mm) (intergroup) and to evaluate if each technique had different cleanliness efficacy according to the root canal level (intragroup) using one-way analysis of variance and post hoc tests (p < 0.05). RESULTS All three irrigation techniques significantly improved anastomosis cleanliness (p < 0.001). Both activation techniques were significantly better than the control group at all levels. Intergroup comparison revealed that EDDY significantly achieved the best overall anastomosis cleanliness. The difference between EDDY and Irrisafe was significant in favor to EDDY at 2 mm and insignificant at 4 and 6 mm. The intragroup comparison showed that improvement in anastomosis cleanliness (i2-i1) in the needle irrigation without activation group (NA) was significantly higher in the apical 2 mm level compared to the 4 & 6 levels. While the difference in anastomosis cleanliness improvement (i2-i1) between levels in both Irrisafe and EDDY groups was insignificant. CONCLUSIONS Irrigant activation improves anastomosis cleanliness. EDDY was the most efficient in cleaning anastomoses located in the critical apical part of the root canal. CLINICAL RELEVANCE Cleaning and disinfection of the root canal system followed by apical and coronal sealing is the key for healing or prevention of apical periodontitis. Remnants of debris and microorganisms retained within the anastomoses (isthmuses), or other root canal irregularities may lead to persistent apical periodontitis. Proper irrigation and activation are essential for cleaning root canal anastomoses.
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Affiliation(s)
- O K Montaser
- Department of Endodontics, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
| | - D M Fayyad
- Department of Endodontics, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt
| | - N Abdelsalam
- Department of Endodontics, Faculty of Dentistry, Suez Canal University, Ismailia, Egypt.
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Girelli CFM, de Lima CO, Silveira FF, Lacerda MFLS, Nunes E. Marginal gaps and voids using two warm compaction techniques and different sealers: a micro-CT study. Clin Oral Investig 2023:10.1007/s00784-023-04866-x. [PMID: 36695972 DOI: 10.1007/s00784-023-04866-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/13/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To assess the percentage of marginal gaps and voids in oval-shaped canals obturated by using two warm compaction techniques with a Bio-C sealer and AH Plus Jet. MATERIALS AND METHODS Forty canines with oval canals were scanned by microcomputed tomography (micro-CT), and root canal preparation was performed with an XP-endo Shaper system and irrigated with 5.25% sodium hypochlorite. Then, the specimens were paired into four groups (n=10) according to the root canal filling technique and endodontic sealer: Bio-C sealer and continuous wave of condensation, Bio-C sealer and Tagger's hybrid, AH Plus Jet and continuous wave of condensation, and AH Plus Jet and Tagger's hybrid. After root canal filling, a new scan was performed. The percentage of marginal gaps and voids was calculated with the ImageJ software, and the data were analyzed statistically using two-way ANOVA and Tukey tests, with a significance level of 5%. RESULTS The percentage of marginal gaps was significantly lower in the Bio-C sealer than in AH Plus Jet (p=0.021) regardless of the technique. However, no difference was found in the percentage of voids between root canal filling techniques and the endodontic sealer (p>0.05). CONCLUSION Both sealers and techniques demonstrated good quality of root canal filling. However, the use of the Bio-C sealer enhanced the filling ability by reducing marginal gaps, regardless of the root canal filling technique. CLINICAL RELEVANCE This study highlights the better performance of the Bio-C sealer in the quality of the root canal filling, reducing marginal gaps when compared to AH Plus Jet independent of the technique.
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Affiliation(s)
| | - Carolina Oliveira de Lima
- Department of Dentistry, Federal University of Juiz de Fora, R. São Paulo, 745 - Centro, Governador Valadares, Minas Gerais, 35010-180, Brazil
| | - Frank Ferreira Silveira
- Department of Dentistry, Pontifical Catholic University of Minas Gerais (PUC-MG), Minas Gerais, Belo Horizonte, Brazil
| | | | - Eduardo Nunes
- Department of Dentistry, Pontifical Catholic University of Minas Gerais (PUC-MG), Minas Gerais, Belo Horizonte, Brazil
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Al-Jadaa A, Saidi Z, Mahmoud M, Al-Taweel R, Zehnder M. Assessment of Irrigant Agitation Devices in Simulated Closed and Open Root Canal Systems. J Endod 2023; 49:438-444.e6. [PMID: 36642215 DOI: 10.1016/j.joen.2023.01.002] [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: 11/08/2022] [Revised: 01/06/2023] [Accepted: 01/06/2023] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The in vitro efficacy of irrigant activation devices has not been contrasted to their safety. This was attempted in this study using apically closed versus patent simulated root canal systems in epoxy resin models, with the latter featuring a simulated periapical lesion. METHODS All 72 models had 2 joining canals connected by an isthmus, which was filled with dentin debris. The simulated periapical lesion was filled with colored gelatin in the 36 respective models. Canals were irrigated with 1.3% sodium hypochlorite. Samples were divided into 4 subgroups per system (n = 9): conventional irrigation, sonic low (EndoActivator; Dentsply Sirona, Charlotte, NC) and high frequency (EDDY; VDW, Munich, Germany), and ultrasonic agitation of the irrigant (always applying 3 cycles of 20 seconds). The total cleared surface areas (mm2) in the simulated isthmus and periapical lesion were compared between systems and devices using parametric tests (P < .05). RESULTS The cleaning of the isthmus was more effective in the apically open compared with the closed systems and was also significantly influenced by the agitation method (P < .001). In the closed systems, EDDY and ultrasonic agitation achieved the significantly (P < .05) best cleaning of the isthmus. In the open systems, ultrasonic agitation showed the single best result (P < .05). EDDY caused by far the highest and ultrasonic agitation the lowest dissolution of the gelatin in the simulated periapical lesion. CONCLUSIONS Under the conditions of this study, ultrasonic agitation of a previously administered sodium hypochlorite irrigant was more laterally targeted and thus safer and more effective than sonic agitation methods.
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Affiliation(s)
- Anas Al-Jadaa
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Zehraa Saidi
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Maise Mahmoud
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Rahaf Al-Taweel
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Matthias Zehnder
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
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Comparison of Herbal Agents with Sodium Hypochlorite as Root Canal Irrigant: A Systematic Review of In Vitro Studies. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:8967219. [PMID: 34868334 PMCID: PMC8639255 DOI: 10.1155/2021/8967219] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 11/10/2021] [Indexed: 11/18/2022]
Abstract
During endodontic treatment, eliminating microorganisms from the root canals should be considered with utmost importance. Before filling the canal, every effort should be made to ensure optimal shaping and adequate disinfection of the root canal system. This systematic review aimed to compare the efficacy of herbal agents with sodium hypochlorite (NaOCl) in reducing the microbial load while used as a root canal irrigant. The research question in the present study was to assess “Is there a significant difference in reducing microbial load comparing sodium hypochlorite (NaOCl) and herbal agents.” Electronic databases (PubMed, Scopus, and Web of Science) were searched from their start dates to November 2020 using strict inclusion and exclusion criteria and reviewed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Only in vitro studies comparing herbal agents with NaOCl regarding antimicrobial efficiency were included. Two reviewers independently assessed the included article. 825 articles were obtained from an electronic database. Twenty papers were included for review of the full text. Eleven papers were excluded because they did not meet the inclusion criteria. Finally, nine articles were included in the systematic review. The present systematic review was at the in vitro level; therefore, the result cannot translate the exact clinical conditions. This systematic review concludes that herbal agents cannot be used as a main irrigant for canal disinfection.
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Hülsmann M. A critical appraisal of research methods and experimental models for studies on root canal preparation. Int Endod J 2021; 55 Suppl 1:95-118. [PMID: 34800299 DOI: 10.1111/iej.13665] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/17/2021] [Indexed: 01/02/2023]
Abstract
It is the aim of this review to present a critical overview and summary on the contemporary possibilities, limitations and challenges of research related to root canal preparation. Frequently used research tools and contemporary research designs will be presented and discussed critically focussing on shortcomings and benefits with special regard to clinical relevance and scientific evidence. A plethora of experimental set-ups for assessing the shaping of root canals have been described in the endodontic literature using a considerable number of techniques and instruments. Nevertheless, it can be stated that scientific evidence demonstrating the clinical impact of many investigated topics is questionable or even missing. Instead of technical, radiographic and geometrical parameters, further research should focus on biological aspects and clinical evidence of the impact of root canal preparation on the outcome of root canal treatment.
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Affiliation(s)
- Michael Hülsmann
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
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12
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Afhkami F, Ahmadi P, Chiniforush N, Sooratgar A. Effect of different activations of silver nanoparticle irrigants on the elimination of Enterococcus faecalis. Clin Oral Investig 2021; 25:6893-6899. [PMID: 34476616 DOI: 10.1007/s00784-021-03979-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 05/04/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study aimed to compare the efficacy of silver nanoparticles (AgNPs) irrigating solution alone and following activation with photon-induced photoacoustic streaming (PIPS), photodynamic therapy (PDT) with indocyanine green (ICG), passive ultrasonic irrigation (PUI), and manual dynamic activation (MDA) method for elimination of Enterococcus faecalis (E. faecalis) from the root canal system. MATERIALS AND METHODS A total of 59 extracted human single-rooted teeth were collected and prepared. E. faecalis was inoculated into the root canals and incubated for 4 weeks. The teeth were then randomly divided into five experimental groups (n = 10): the AN group, irrigation with AgNPs alone; the AN/ICG/DL group, irrigation with AgNPs and ICG, then activation with diode laser; the AN/PIPS group, irrigation with AgNPs and activation with 0.3 W Er: YAG laser; the AN/MDA group, irrigation with AgNPs and activation with tapered gutta-percha; and the AN/PUI group, irrigation with AgNPs and activation with ultrasonic. Also, two control groups of irrigation with 2.5% sodium hypochlorite (n = 5) and no intervention (n = 4) were also used. Samples were collected from the dentinal chips before and after the intervention, and the percentage of reduction in colony count was calculated. RESULTS A significant reduction in E. faecalis colony count was noted in all groups (P < 0.05). Maximum reduction in colony count was noted in AN/PIPS and AN/PUI groups by 91.03 and 91.29%, respectively. Minimum reduction was noted in the AN group alone. CONCLUSION Activation with PUI and PIPS enhanced the efficacy of AgNPs irrigating solution for elimination of E. faecalis from the root canal system. CLINICAL RELEVANCE AgNPs activated by ultrasound or PIPS can be used as an adjunct for disinfection of the root canal system in endodontic treatment.
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Affiliation(s)
- Farzaneh Afhkami
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, End of North Kargar Street, Tehran, 1439955991, Iran
| | - Paniz Ahmadi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Science, Tehran, 1441987566, Iran
| | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Science, Tehran, 1441987566, Iran
| | - Aidin Sooratgar
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, End of North Kargar Street, Tehran, 1439955991, Iran.
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13
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Alsofi L, Al Harbi M, Al-Habib M, Stauber M, Balto K. Micro-cleanliness of Hard Tissue Debris After Advanced Irrigation and Comparison Between EndoVac and XP-endo Finisher: A Microcomputed Tomographic Study. J Int Soc Prev Community Dent 2021; 11:457-462. [PMID: 34430508 PMCID: PMC8352053 DOI: 10.4103/jispcd.jispcd_430_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/25/2021] [Accepted: 04/24/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction: Conventional irrigation techniques do not remove debris adequately. The remaining tissue debris cause infection inside the root canal and may also affect the seal of the root canal. The study aimed to compare the ability of EndoVac (EV) with XP-endo finisher (XPF) in debris removal using micro-CT analysis. Materials and Methods: We used 12 lower first permanent molar human teeth for this study. The root canals were instrumented using a small TF adaptive system. Then, the volume of debris was calculated. Teeth were divided into two groups, according to advanced irrigation methods, with six teeth per group: EV group and XPF group. The volume of debris was calculated again. The paired-sample t-test was used to compare the volume of the debris before and after the use of advanced irrigation methods with the statistical significance of P < 0.05. The percentage of debris reduction was also calculated. Results: Both EV and XPF showed a significant decrease of debris in the mesial canals (P < 0.05), whereas EV only showed a significant reduction of debris in the distal canals. Conclusion: Both EV and XPF were able to significantly reduce debris after instrumentation in the mesial canals of lower first mandibular molars. Clinical Significance: The study provides insight into the recent advanced methods used in debris removal and canal disinfection.
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Affiliation(s)
- Loai Alsofi
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Muhanad Al Harbi
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Ministry of Health, Dental Division, Jeddah, Saudi Arabia
| | - Mey Al-Habib
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Khaled Balto
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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14
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Iandolo A, Amato M, Abdellatif D, Barbosa AFA, Pantaleo G, Blasi A, Franco V, Silva EJNL. Effect of different final irrigation protocols on pulp tissue dissolution from an isthmus model. AUST ENDOD J 2021; 47:538-543. [PMID: 33905149 DOI: 10.1111/aej.12518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/12/2021] [Accepted: 04/11/2021] [Indexed: 12/21/2022]
Abstract
This study assessed the pulp tissue dissolution from isthmus of a two-rooted maxillary premolar using different final irrigation protocols. After root canal preparation, the surface of the tooth was reduced to an extent that the isthmus could be observed, and 1 mg of pulp tissue was introduced into the isthmus which was covered with a glass slide. Following six groups were tested: syringe and needle; subsonic activation; sonic activation; ultrasonic activation; heating followed by sonic activation; and heating followed by ultrasonic activation. Before and after each experiment a photograph of the isthmus was taken at 30× to register the area of the pulp tissue. Statistical analysis was performed with Kruskal-Wallis and Mann-Whitney tests (P < 0.05). Syringe and needle group showed the lower value of pulp tissue dissolution followed by subsonic irrigation procedures. Pulp tissue dissolution was significantly higher when heating was followed by sonic or ultrasonic activation.
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Affiliation(s)
- Alfredo Iandolo
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Massimo Amato
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Dina Abdellatif
- Department of Endodontics, Faculty of Dentistry, University of Alexandria, Alexandria, Egypt
| | - Ana Flávia A Barbosa
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil
| | - Giuseppe Pantaleo
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Andrea Blasi
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Vittorio Franco
- Dentistry, Faculty of Medicine and Surgery, University of Siena, Siena, Italy
| | - Emmanuel J N L Silva
- Department of Endodontics, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil.,Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil
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15
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Tanaka T, Yahata Y, Handa K, Venkataiah SV, Njuguna MM, Kanehira M, Hasegawa T, Noiri Y, Saito M. An experimental intraradicular biofilm model in the pig for evaluating irrigation techniques. BMC Oral Health 2021; 21:177. [PMID: 33827540 PMCID: PMC8028066 DOI: 10.1186/s12903-021-01536-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 03/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We established an in vivo intraradicular biofilm model of apical periodontitis in pigs in which we compared the efficacy of different irrigant activation techniques for biofilm removal. METHODS Twenty roots from the deciduous mandibular second premolar of 5 male pigs were used. After pulpectomy, canals were left open for 2 weeks and then sealed for 4 weeks to enable the development of an intracanal biofilm. The intraradicular biofilms was evaluated using SEM and bacterial 16S rRNA gene-sequencing. To investigate the efficacy of biofilm removal, root canal irrigations were performed using conventional needle, passive ultrasonic, subsonic, or laser-activated irrigation. Real-time PCR was conducted to quantitate the remaining biofilm components. Statistical analysis was performed using ANOVA followed by a Tukey kramer post-hoc test with α = 0.05. RESULTS The pulp exposure model was effective in inducing apical periodontitis and SEM analysis revealed a multi-layer biofilm formation inside the root canal. 16S rRNA sequence analysis identified Firmicutes, Bacteroidetes, and Fusobacteria as the predominant bacterial phyla components, which is similar to the microbiome profile seen in humans. None of the tested irrigation techniques completely eradicated the biofilm components from the root canal, but the subsonic and laser-activated irrigation methods produced the lowest bacterial counts (p < 0.05). CONCLUSIONS An experimental intraradicular biofilm model has been successfully established in pigs. Within the limitations of the study, subsonic or laser-activated irrigation demonstrated the best biofilm removal results in the pig system.
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Affiliation(s)
- Toshinori Tanaka
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aobaku, Sendai, Miyagi, 980-8575, Japan
| | - Yoshio Yahata
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aobaku, Sendai, Miyagi, 980-8575, Japan.
| | - Keisuke Handa
- Division of Molecular Biology and Oral Biochemistry, Department of Oral Science, Graduate School of Dentistry, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, Kanagawa, 238-8580, Japan
| | - Suresh V Venkataiah
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aobaku, Sendai, Miyagi, 980-8575, Japan
| | - Mary M Njuguna
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aobaku, Sendai, Miyagi, 980-8575, Japan
| | - Masafumi Kanehira
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aobaku, Sendai, Miyagi, 980-8575, Japan
| | - Tatsuya Hasegawa
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aobaku, Sendai, Miyagi, 980-8575, Japan
| | - Yuichiro Noiri
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakko-cho-dori, Chuo-ku, Niigata, Niigata, 951-8514, Japan
| | - Masahiro Saito
- Division of Operative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aobaku, Sendai, Miyagi, 980-8575, Japan
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16
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Ordinola-Zapata R, Crepps JT, Arias A, Lin F. In vitro apical pressure created by 2 irrigation needles and a multisonic system in mandibular molars. Restor Dent Endod 2021; 46:e14. [PMID: 33680903 PMCID: PMC7906849 DOI: 10.5395/rde.2021.46.e14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/21/2020] [Accepted: 12/27/2020] [Indexed: 11/12/2022] Open
Abstract
Objectives The aim of this study was to evaluate the apical pressure generated by 2 endodontic irrigation needles and the GentleWave system in mandibular molars. Materials and Methods The mesial and distal root canals of 12 mandibular molars were irrigated with a 30-gauge close-end needle or with a 30-gauge open-end needle. Procedures were performed in the mesial and distal canals. The GentleWave procedure and irrigation at 1 mm from the apex in the distal roots using an open-end needle were used, respectively, as negative and positive controls. The apical pressure was measured using a data acquisition pressure setup. Apical pressure exerted by the different needles in the 2 different canal types was statistically compared using 2-way analysis of variance. Results Significant differences were found in the apical pressure for both needles and the canal type. The lowest values were obtained with close-end needles and in mesial canals. Negative apical pressure values were obtained using GentleWave. Conclusions The needle and the canal type influenced the apical pressure. The GentleWave procedure produced negative apical pressure.
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Affiliation(s)
- Ronald Ordinola-Zapata
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Joseph T Crepps
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Ana Arias
- Conservative Dentistry Department, School of Dentistry, Universidad Complutense de Madrid, Madrid, Spain
| | - Fei Lin
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA.,Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, China
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17
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Effect of Propolis Nanoparticles against Enterococcus faecalis Biofilm in the Root Canal. Molecules 2021; 26:molecules26030715. [PMID: 33573147 PMCID: PMC7866495 DOI: 10.3390/molecules26030715] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 01/16/2021] [Accepted: 01/17/2021] [Indexed: 12/17/2022] Open
Abstract
To determine the antibacterial effect of propolis nanoparticles (PNs) as an endodontic irrigant against Enterococcus faecalis biofilm inside the endodontic root canal system. Two-hundred-ten extracted human teeth were sectioned to obtain 6 mm of the middle third of the root. The root canal was enlarged to an internal diameter of 0.9 mm. The specimens were inoculated with E. faecalis for 21 days. Following this, specimens were randomly divided into seven groups, with 30 dentinal blocks in each group including: group I-saline; group II-propolis 100 µg/mL; group III-propolis 300 µg/mL; group IV-propolis nanoparticle 100 µg/mL; group V-propolis nanoparticle 300µg/mL; group VI-6% sodium hypochlorite; group VII-2% chlorhexidine. Dentin shavings were collected at 200 and 400 μm depths, and total numbers of CFUs were determined at the end of one, five, and ten minutes. The non-parametric Kruskal-Wallis and Mann-Whitney tests were used to compare the differences in reduction in CFUs between all groups, and probability values of p < 0.05 were set as the reference for statistically significant results. The antibacterial effect of PNs as an endodontic irrigant was also assessed against E. faecalis isolates from patients with failed root canal treatment. Scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM) were also performed after exposure to PNs. A Raman spectroscope, equipped with a Leica microscope and lenses with curve-fitting Raman software, was used for analysis. The molecular interactions between bioactive compounds of propolis (Pinocembrin, Kaempferol, and Quercetin) and the proteins Sortase A and β-galactosidase were also understood by computational molecular docking studies. PN300 was significantly more effective in reducing CFUs compared to all other groups (p < 0.05) except 6% NaOCl and 2% CHX (p > 0.05) at all time intervals and both depths. At five minutes, 6% NaOCl and 2% CHX were the most effective in reducing CFUs (p < 0.05). However, no significant difference was found between PN300, 6% NaOCl, and 2% CHX at 10 min (p > 0.05). SEM images also showed the maximum reduction in E. faecalis with PN300, 6% NaOCl, and 2% CHX at five and ten minutes. CLSM images showed the number of dead cells in dentin were highest with PN300 compared to PN100 and saline. There was a reduction in the 484 cm-1 band and an increase in the 870 cm-1 band in the PN300 group. The detailed observations of the docking poses of bioactive compounds and their interactions with key residues of the binding site in all the three docking protocols revealed that the interactions were consistent with reasonable docking and IFD docking scores. PN300 was equally as effective as 6% NaOCl and 2% CHX in reducing the E. faecalis biofilms.
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18
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Machado R, da Silva I, Comparin D, de Mattos BAM, Alberton LR, da Silva Neto UX. Smear layer removal by passive ultrasonic irrigation and 2 new mechanical methods for activation of the chelating solution. Restor Dent Endod 2021; 46:e11. [PMID: 33680900 PMCID: PMC7906843 DOI: 10.5395/rde.2021.46.e11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/24/2020] [Accepted: 06/29/2020] [Indexed: 02/04/2023] Open
Abstract
Objectives The aim of this study was to compare smear layer removal by conventional application (CA), passive ultrasonic irrigation (PUI), EasyClean (EC), and XP-Endo Finisher (XPF), using 17% ethylenediaminetetraacetic acid (EDTA) after chemomechanical preparation, as evaluated with scanning electron microscopy (SEM). Materials and Methods Forty-five single-rooted human mandibular premolars were selected for this study. After chemomechanical preparation, the teeth were randomly divided into 5 groups according to the protocol for smear layer removal, as follows: G1 (control): CA of distilled water; G2 (CA): CA of 17% EDTA; G3 (PUI): 17% EDTA activated by PUI; G4 (EC): 17% EDTA activated by EC; and G5 (XPF): 17% EDTA activated by XPF. SEM images (×1,000) were obtained from each root third and scored by 3 examiners. Data were evaluated using the Kruskal-Wallis and Dunn tests (p < 0.05). Results In the apical third, there were no statistically significant differences among the groups (p > 0.05). In the cervical and middle thirds, the experimental groups performed better than the control group (p < 0.05); however, G2 presented better results than G3, G4, and G5 (p < 0.05), which showed no differences among one another (p > 0.05). Conclusions No irrigation method was able to completely remove the smear layer, especially in the apical third. Using CA for the chelating solution performed better than any form of activation.
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Affiliation(s)
- Ricardo Machado
- Department of Endodontics, Pontifical Catholic University of Paraná - PUCPR, Curitiba, Paraná, Brazil
| | - Isadora da Silva
- Department of Endodontics, Paranaense University - UNIPAR, Francisco Beltrão, Paraná, Brazil
| | - Daniel Comparin
- Department of Endodontics, Paranaense University - UNIPAR, Francisco Beltrão, Paraná, Brazil
| | | | - Luiz Rômulo Alberton
- Department of Veterinary Medicine, Paranaense University- UNIPAR, Umuarama, Paraná, Brazil
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Rodrigues CT, Jacobs R, Vasconcelos KF, Lambrechts P, Rubira-Bullen IRF, Gaêta-Araujo H, Oliveira-Santos C, Duarte MAH. Influence of CBCT-based volumetric distortion and beam hardening artefacts on the assessment of root canal filling quality in isthmus-containing molars. Dentomaxillofac Radiol 2021; 50:20200503. [PMID: 33400563 DOI: 10.1259/dmfr.20200503] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES To evaluate the influence of artefacts in cone beam CT (CBCT) images of filled root canals in isthmus-containing molars. METHODS 10 teeth presenting canals with an isthmus were instrumented and filled with a thermoplasticised obturation technique. The teeth were scanned using a micro-CT device and two CBCT devices: 3D Accuitomo 170 (ACC) and NewTom VGi evo (NT), with different acquisition protocols: larger and smaller voxel size. Three examiners assessed the CBCT images for: (1) detection of filling voids; (2) assessment of under- or overestimation of the filling material and (3) resemblance of CBCT images to the reference standard. Analyses of Task 1 yielded accuracy, sensitivity and specificity for detection of filling voids. For tasks 2 and 3, statistical analysis was performed using Wilcoxon test. The level of significance was set at p < .05. RESULTS For Task 1, ACC showed higher sensitivity, whereas NT presented higher specificity. No significant difference was found between the protocols in ACC, however, for NT, differences between protocols were significant for all diagnostic values. In Task 2, visualisation of the filling was overestimated for NT, while for ACC, underestimation was observed. For Task 3, images with smaller voxel size were more similar to the reference image, for both CBCT devices. CONCLUSIONS Different artefacts compromise the detection of filling voids on CBCT images of canals in mandibular molars with isthmus. ACC and NT present rather similar diagnostic accuracy, even though artefact expression remains device-specific.
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Affiliation(s)
- Clarissa Teles Rodrigues
- Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Reinhilde Jacobs
- Department of Imaging and Pathology, Faculty of Medicine, OMFS IMPATH Research Group, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Karla Faria Vasconcelos
- Department of Imaging and Pathology, Faculty of Medicine, OMFS IMPATH Research Group, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, Endodontology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium.,Biomaterials-BIOMAT, Leuven, Belgium
| | | | - Hugo Gaêta-Araujo
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Christiano Oliveira-Santos
- Department of Stomatology, Public Oral Health, and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Marco Antonio Hungaro Duarte
- Department of Restorative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
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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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21
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Guerreiro MYR, Belladonna FG, Monteiro LPB, Lima CO, Silva EJNL, Brandão JMS. The influence of the addition of surfactants to sodium hypochlorite on the removal of hard tissue debris. Int Endod J 2020; 53:1131-1139. [PMID: 32294253 DOI: 10.1111/iej.13307] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 04/07/2020] [Indexed: 11/26/2022]
Abstract
AIM To evaluate the effect of the addition of surfactants to sodium hypochlorite (NaOCl) on the removal of accumulated hard tissue debris (AHTD), before and after final irrigation with 17% EDTA, from mesial canals of mandibular molars through microcomputed tomographic (micro-CT) analysis. METHODOLOGY Thirty moderately curved mandibular mesial roots with Vertucci type II canal configuration were selected and scanned in a micro-CT device at an isotropic resolution of 22.9 μm. The specimens were assigned to three groups (n = 10) with respect to the root length, degree of curvature of the mesial root, volume and 3D anatomy of the root canals according to the irrigating solution used during root canal preparation: 2.5% NaOCl and 0.1% Benzalkonium Chloride, 2.5% NaOCl and 0.1% Tween 80 and 2.5% NaOCl without additives. The root canals were instrumented up to Reciproc R25 instrument. Then, the specimens were scanned again after canal preparation and after final irrigation with 17% EDTA, and the registered data sets were examined to evaluate the percentage of AHTD. For comparison between the different groups before and after using 17% EDTA, the Kruskal-Wallis test was used with a significance level of 5%. For comparison between the same groups before and after using 17% EDTA, the Wilcoxon test was used with a significance level of 5%. RESULTS None of the irrigant solutions tested was able to completely eliminate hard tissue debris from mesial canals of mandibular molars. There were no significant differences in the percentage of AHTD amongst the different irrigation solutions (P > 0.05). Final irrigation with 17% EDTA significantly reduced the percentage of AHTD (P < 0.05), without differences amongst the groups (P > 0.05). CONCLUSIONS The addition of surfactants to NaOCl did not affect the removal of AHTD from mesial canals of extracted mandibular molars. Final irrigation with 17% EDTA significantly improved AHTD removal.
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Affiliation(s)
- M Y R Guerreiro
- Department of Endodontics, Federal University of Pará, Belém, Brazil
| | - F G Belladonna
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil
| | - L P B Monteiro
- Department of Endodontics, Federal University of Pará, Belém, Brazil
| | - C O Lima
- Department of Endodontics, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - E J N L Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Brazil.,Department of Endodontics, State University of Rio de Janeiro, Rio de Janeiro, Brazil.,Department of Endodontics, Grande Rio University, Duque de Caxias, Brazil
| | - J M S Brandão
- Department of Endodontics, Federal University of Pará, Belém, Brazil
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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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Tolentino EDS, Amoroso-Silva PA, Alcalde MP, Honório HM, Iwaki LCV, Rubira-Bullen IRF, Húngaro-Duarte MA. Limitation of diagnostic value of cone-beam CT in detecting apical root isthmuses. J Appl Oral Sci 2020; 28:e20190168. [PMID: 32236352 PMCID: PMC7105288 DOI: 10.1590/1678-7757-2019-0168] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 12/06/2019] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Isthmuses are reported as common anatomic complexities in teeth often associated with failures in endodontic treatment. They should be considered before starting treatment and a preoperative computed tomography scan (CT) may demonstrate these complexities. OBJECTIVE To assess the diagnostic value of the highest resolution settings of a cone-beam CT (CBCT) system in identifying and measuring apical isthmuses, using micro-CT as reference. METHODOLOGY After micro-CT scanning, 40 humans' lower first molars with isthmuses in the apical-3 mm of mesial roots were scanned by the highest resolution settings of the New Generation i-Cat ® CBCT equipment. Two blinded observers recorded the detection of isthmuses in CBCT scans. The lengths of isthmuses were compared between micro-CT and CBCT to assess the diagnostic value of CBCT. Quantitative data for sensitivity were represented as percentages (95% confidence interval). The Bland-Altman method was used to assess differences between gold standard lengths (micro-CT) and CBCT lengths. RESULTS BCT demonstrated 30 positive findings, representing sensitivity for isthmus identification of 75% (95% CI=0.4114-1.1364). Differences between the lengths in micro-CT (1.99±0.40 mm) and CBCT (1.53±0.41 mm) were significant (p<0.0001). CONCLUSION The CBCT device used presented limited diagnostic value in the identification and measurement of apical isthmuses in the mesial roots of lower molars. In some cases, the actual anatomy of the apical root canal may not be completely delineated in this type of CBCT system, even using the highest resolution settings.
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Affiliation(s)
| | | | - Murilo Priori Alcalde
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, São Paulo, Brasil
| | - Heitor Marques Honório
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil
| | | | - Izabel Regina Fischer Rubira-Bullen
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Cirurgia, Estomatologia, Patologia e Radiologia, Bauru, São Paulo, Brasil
| | - Marco Antônio Húngaro-Duarte
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, São Paulo, Brasil
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Yang Q, Liu MW, Zhu LX, Peng B. Micro‐CT study on the removal of accumulated hard‐tissue debris from the root canal system of mandibular molars when using a novel laser‐activated irrigation approach. Int Endod J 2019; 53:529-538. [DOI: 10.1111/iej.13250] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Q. Yang
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education School and Hospital of Stomatology Wuhan University Wuhan China
| | - M. W. Liu
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education School and Hospital of Stomatology Wuhan University Wuhan China
| | - L. X. Zhu
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education School and Hospital of Stomatology Wuhan University Wuhan China
| | - B. Peng
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education School and Hospital of Stomatology Wuhan University Wuhan China
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Ye WH, Yeghiasarian L, Cutler CW, Bergeron BE, Sidow S, Xu HHK, Niu LN, Ma JZ, Tay FR. Comparison of the use of d-enantiomeric and l-enantiomeric antimicrobial peptides incorporated in a calcium-chelating irrigant against Enterococcus faecalis root canal wall biofilms. J Dent 2019; 91:103231. [PMID: 31712128 DOI: 10.1016/j.jdent.2019.103231] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To compare the anti-biofilm efficacy of two antimicrobial peptides (AMPs), 1018 and DJK-5, in disrupting canal wall biofilms in the isthmus, canal and dentinal tubules of single-rooted maxillary premolars. METHODS Enterococcus faecalis single-species biofilms were formed in-situ in the root canal system of the premolars (n = 91). Confocal laser scanning microscopy, bacterial sampling, colony-forming unit counting, XTT assay, lactate dehydrogenase assay and phenol-sulphuric acid method were used to identify the anti-biofilm efficacy of both AMPs and their influence on bacterial metabolic activity. RESULTS Both AMPs disrupted in-situ E. faecalis biofilms and altered their metabolic activity. At 20 μg/mL, the d-enantiomeric AMP DJK-5 killed 55.5 %, 57.3 % and 55.8 % of biofilm bacteria in the isthmus, canal and dentinal tubules, respectively, in 1 min. In contrast, the l-enantiomeric AMP 1018 only eradicated 25.6 %, 25.5 % and 27.5 % of biofilm bacteria in the isthmus, canal and dentinal tubules, respectively, within the same time. Anti-biofilm efficacy of the root canal irrigants tested were in the order: 6 % NaOCl > 20 μg/mL DJK-5 > 10 μg/mL DJK-5 > 20 μg/mL 1018 > 10 μg/mL 1018 > 0.9 % NaCl. CONCLUSIONS The present results are confirmatory of previous studies, in that d-enantiomeric AMPs exhibit more potent antibacterial properties than l-enantiomeric AMPs against E. faecalis biofilms within the canal space. Nevertheless, the potency of both AMPs are concentration-dependent. Incorporation of these agents into EDTA, a non-antibacterial calcium-chelating irrigant for removal of the inorganic component of the canal space debris, does not reduce the efficacy of either AMP. CLINICAL SIGNIFICANCE The present study provides the proof of concept that incorporation of an antimicrobial peptide into a calcium-chelating root canal irrigant enhances the disinfection of intratubular single-species biofilms during smear layer and smear plug removal.
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Affiliation(s)
- Wei-Hu Ye
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | | | - Brian E Bergeron
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Stephanie Sidow
- The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Hockin H K Xu
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Li-Na Niu
- The Dental College of Georgia, Augusta University, Augusta, GA, USA; State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China; The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China.
| | - Jing-Zhi Ma
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Franklin R Tay
- The Dental College of Georgia, Augusta University, Augusta, GA, USA.
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De‐Deus G, Simões‐Carvalho M, Belladonna FG, Cavalcante DM, Portugal LS, Prado CG, Souza EM, Lopes RT, Silva EJNL. Arrowhead design ultrasonic tip as a supplementary tool for canal debridement. Int Endod J 2019; 53:410-420. [DOI: 10.1111/iej.13236] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/09/2019] [Accepted: 10/14/2019] [Indexed: 12/22/2022]
Affiliation(s)
- G. De‐Deus
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - M. Simões‐Carvalho
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - F. G. Belladonna
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - D. M. Cavalcante
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - L. S. Portugal
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - C. G. Prado
- Department of Endodontics Fluminense Federal University Niterói Rio de Janeiro Brazil
| | - E. M. Souza
- Department of Dentistry II Federal University of Maranhão São Luís Maranhão Brazil
| | - R. T. Lopes
- Nuclear Engineering Program Federal University of Rio de Janeiro Rio de Janeiro Rio de Janeiro Brazil
| | - E. J. N. L. Silva
- Department of Endodontics Grande Rio University Duque de Caxias Rio de Janeiro Brazil
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Rödig T, Koberg C, Baxter S, Konietschke F, Wiegand A, Rizk M. Micro-CT evaluation of sonically and ultrasonically activated irrigation on the removal of hard-tissue debris from isthmus-containing mesial root canal systems of mandibular molars. Int Endod J 2019; 52:1173-1181. [PMID: 30773661 DOI: 10.1111/iej.13100] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 02/13/2019] [Indexed: 01/23/2023]
Abstract
AIM To evaluate the efficacy of sonically and ultrasonically activated irrigation on removal of accumulated hard-tissue debris (AHTD) in mesial root canal systems of mandibular molars using micro-computed tomographic (micro-CT) analysis. METHODOLOGY Forty mesial roots of mandibular molars with two independent canals joined apically by an isthmus (Vertucci type II) were selected. The root canals were instrumented using Reciproc R25 instruments, and specimens were scanned at a resolution of 10.5 μm. Subsequently, n = 10 roots were assigned to each of the four final irrigation groups such that the group means and variances were almost identical: sonically activated irrigation with EndoActivator (EA) or EDDY (ED), ultrasonically activated irrigation (UAI) and manual irrigation without activation (MI). The final irrigation procedures were performed using a total of 5 mL 1% NaOCl and 5 mL 15% EDTA per canal over 5 min with activation time of 4 × 20 s. Reconstructed data sets were coregistered, and the mean percentage reduction of AHTD after final irrigation was compared statistically between groups using analysis of variance at a significance level set at 5%. RESULTS A significant reduction of AHTD was achieved after final irrigation in all groups (P < 0.05), ranging from 44.1% to 66.8%. The vol% of debris after irrigation was 3.7 ± 1.9% for EA, 3.3 ± 2.3% for ED, 2.1 ± 1.6% for UAI and 4.4 ± 2.3% for MI, with no significant difference between groups (P > 0.05). CONCLUSIONS None of the final irrigation protocols completely removed AHTD from mesial root canal systems in extracted human mandibular molars. Sonically and ultrasonically activated irrigation performed no better compared to manual irrigation.
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Affiliation(s)
- T Rödig
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - C Koberg
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - S Baxter
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - F Konietschke
- Institute of Biometry and Clinical Epidemiology, Charité - University Medical Center Berlin, Berlin, Germany
| | - A Wiegand
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - M Rizk
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
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Comparative Evaluation of Endovac and Conventional Irrigating Syringe on Apical Extrusion in Primary Molars. An in vitro Study. J Clin Pediatr Dent 2018; 42:355-360. [PMID: 29763357 DOI: 10.17796/1053-4625-42.5.6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The present study was undertaken to evaluate and compare the apical extrusion of irrigant and depth of irrigant penetration into dentine using the EndoVac irrigating system and manual irrigation system in primary molar teeth. STUDY DESIGN Twenty five extracted primary molars satisfying the inclusion and exclusion criteria were divided into two groups with 29 roots in each group with an equal distribution of apical foramen area. The teeth were mounted in pre-weighed glass bottles and the canals were irrigated with 5.25% sodium hypochlorite solution mixed with acid fuchsin using either of irrigating systems according to the group ascertained. The amount of irrigant extruded was recorded. The roots were sectioned at two mm, four mm and six mm from the apex and examined under a stereomicroscope for depth of irrigant penetration. RESULTS Apical extrusion of the irrigant solution was significantly less with the EndoVac system (1.18±1.04) when compared with the manual irrigation system (2.3±1.55) (P=0.002)*. Results showed that greater irrigant penetration was achieved using the EndoVac irrigation system compared to the manual irrigation system (P= 0.000)*. With both the irrigation systems, the depth of irrigant penetration was better in the six mm sections followed by the four mm sections and two mm sections (P=0.000)*. CONCLUSION The EndoVac irrigation system demonstrated better efficacy compared to manual irrigation system with less apical extrusion and better depth of irrigant penetration into dentine.
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De-Deus G, Belladonna FG, de Siqueira Zuolo A, Perez R, Carvalho MS, Souza EM, Lopes RT, Silva EJNL. Micro-CT comparison of XP-endo Finisher and passive ultrasonic irrigation as final irrigation protocols on the removal of accumulated hard-tissue debris from oval shaped-canals. Clin Oral Investig 2018; 23:3087-3093. [PMID: 30417226 DOI: 10.1007/s00784-018-2729-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 10/22/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the effectiveness of the XP-endo Finisher instrument and passive ultrasonic irrigation (PUI) as final irrigation protocols on the removal of accumulated hard-tissue debris (AHTD) from oval-shaped canals using micro-computed tomographic (micro-CT) analysis. METHODS Twenty mandibular incisors were anatomically pair-matched based on similar morphological dimensions (length, volume, aspect ratio, and configuration) through micro-CT analysis, prepared with Reciproc R25 instrument, scanned again, and assigned to one of the two experimental groups (n = 10), according to the final irrigation protocol: XP-endo Finisher and PUI. After the final irrigation protocols, the specimens were rescanned and the registered datasets were examined to quantify the amount of AHTD. Data were statistically analyzed using Student's t test with a significance level of 5%. RESULTS The final irrigation protocols were highly similar in terms of volumetric percentage reduction of AHTD (P = 1.000). CONCLUSIONS XP-endo Finisher and PUI showed the same effectiveness on the removal of AHTD. None of the tested final irrigation protocols completely removed the AHTD from oval-shaped root canals. CLINICAL RELEVANCE AHTD may be considered clinically relevant because it could harbor bacterial contents away from the disinfection procedures. Both final irrigation protocols were effective on the removal of AHTD.
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Affiliation(s)
- Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Av. Henrique Dodsworth 85 Apto 808 - Lagoa, Niterói, Rio de Janeiro, RJ, 22061-030, Brazil.
| | - Felipe Gonçalves Belladonna
- Department of Endodontics, Fluminense Federal University, Av. Henrique Dodsworth 85 Apto 808 - Lagoa, Niterói, Rio de Janeiro, RJ, 22061-030, Brazil
| | - Arthur de Siqueira Zuolo
- Department of Endodontics, Fluminense Federal University, Av. Henrique Dodsworth 85 Apto 808 - Lagoa, Niterói, Rio de Janeiro, RJ, 22061-030, Brazil
| | - Renata Perez
- Department of Endodontics, Fluminense Federal University, Av. Henrique Dodsworth 85 Apto 808 - Lagoa, Niterói, Rio de Janeiro, RJ, 22061-030, Brazil
| | - Marco Simões Carvalho
- Department of Endodontics, Fluminense Federal University, Av. Henrique Dodsworth 85 Apto 808 - Lagoa, Niterói, Rio de Janeiro, RJ, 22061-030, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Ricardo Tadeu Lopes
- Nuclear Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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Varela P, Souza E, de Deus G, Duran-Sindreu F, Mercadé M. Effectiveness of complementary irrigation routines in debriding pulp tissue from root canals instrumented with a single reciprocating file. Int Endod J 2018; 52:475-483. [PMID: 30317653 DOI: 10.1111/iej.13028] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 10/09/2018] [Indexed: 11/30/2022]
Affiliation(s)
- P. Varela
- Department of Endodontics; Universitat Internacional de Catalunya; Barcelona Spain
| | - E. Souza
- Department of Dentistry II; Federal University of Maranhão; São Luis Brazil
| | - G. de Deus
- Department of Endodontics; Grande Rio University; Duque de Caxias Brazil
| | - F. Duran-Sindreu
- Department of Endodontics; Universitat Internacional de Catalunya; Barcelona Spain
| | - M. Mercadé
- Department of Dentistry; Universitat de Barcelona; Barcelona Spain
- IDIBELL Institute; Barcelona Spain
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Debris Removal from the Mesial Root Canal System of Mandibular Molars with Laser-activated Irrigation. J Endod 2018; 44:1697-1701. [PMID: 30241679 DOI: 10.1016/j.joen.2018.06.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/12/2018] [Accepted: 06/14/2018] [Indexed: 11/22/2022]
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De‐Deus G, Belladonna FG, Simões‐Carvalho M, Cavalcante DM, Ramalho CNMJ, Souza EM, Lopes RT, Silva EJNL. Shaping efficiency as a function of time of a new heat‐treated instrument. Int Endod J 2018; 52:337-342. [DOI: 10.1111/iej.13000] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 08/14/2018] [Indexed: 11/30/2022]
Affiliation(s)
- G. De‐Deus
- Department of Endodontics Fluminense Federal University Niterói, Rio de Janeiro Brazil
| | - F. G. Belladonna
- Department of Endodontics Fluminense Federal University Niterói, Rio de Janeiro Brazil
| | - M. Simões‐Carvalho
- Department of Endodontics Fluminense Federal University Niterói, Rio de Janeiro Brazil
| | - D. M. Cavalcante
- Department of Endodontics Fluminense Federal University Niterói, Rio de Janeiro Brazil
| | - C. N. M. J. Ramalho
- Department of Endodontics Fluminense Federal University Niterói, Rio de Janeiro Brazil
| | - E. M. Souza
- Department of Dentistry II Federal University of Maranhão São Luís Brazil
| | - R. T. Lopes
- Nuclear Engineering Program Federal University of Rio de Janeiro Rio de Janeiro Brazil
| | - E. J. N. L. Silva
- Department of Endodontics Grande Rio University Rio de Janeiro Brazil
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De-Deus G, Belladonna FG, Zuolo AS, Simões-Carvalho M, Santos CB, Oliveira DS, Cavalcante DM, Silva EJNL. Effectiveness of Reciproc Blue in removing canal filling material and regaining apical patency. Int Endod J 2018; 52:250-257. [DOI: 10.1111/iej.12991] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 08/05/2018] [Indexed: 12/11/2022]
Affiliation(s)
- G. De-Deus
- Department of Endodontics; Fluminense Federal University; Niterói Brazil
| | - F. G. Belladonna
- Department of Endodontics; Fluminense Federal University; Niterói Brazil
| | - A. S. Zuolo
- Department of Endodontics; Fluminense Federal University; Niterói Brazil
| | - M. Simões-Carvalho
- Department of Endodontics; Fluminense Federal University; Niterói Brazil
| | - C. B. Santos
- Department of Endodontics; Fluminense Federal University; Niterói Brazil
| | - D. S. Oliveira
- Department of Endodontics; Fluminense Federal University; Niterói Brazil
| | - D. M. Cavalcante
- Department of Endodontics; Fluminense Federal University; Niterói Brazil
| | - E. J. N. L. Silva
- Department of Endodontics; Grande Rio University; Duque de Caxias Rio de Janeiro Brazil
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Belladonna FG, Carvalho MS, Cavalcante DM, Fernandes JT, de Carvalho Maciel AC, Oliveira HE, Lopes RT, Silva EJNL, De-Deus G. Micro–computed Tomography Shaping Ability Assessment of the New Blue Thermal Treated Reciproc Instrument. J Endod 2018; 44:1146-1150. [DOI: 10.1016/j.joen.2018.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/25/2018] [Accepted: 03/09/2018] [Indexed: 11/25/2022]
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Parhizkar A, Nojehdehian H, Asgary S. Triple antibiotic paste: momentous roles and applications in endodontics: a review. Restor Dent Endod 2018; 43:e28. [PMID: 30135847 PMCID: PMC6103545 DOI: 10.5395/rde.2018.43.e28] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 04/10/2018] [Indexed: 12/23/2022] Open
Abstract
This study investigated the latest findings and notions regarding ‘triple antibiotic paste’ (TAP) and its applications in dentistry, particularly endodontics. TAP is a combination of 3 antibiotics, ciprofloxacin, metronidazole, and minocycline. Despite the problems and pitfalls research pertaining to this paste has unveiled, it has been vastly used in endodontic treatments. The paste's applications vary, from vital pulp therapy to the recently introduced regeneration and revascularisation protocol. Studies have shown that the paste can eliminate the root canal microorganisms and prepare an appropriate matrix for further treatments. This combination is able to remove diverse groups of obligate and facultative gram-positive and gram-negative bacteria, providing an environment for healing. In regeneration protocol cases, this allows the development, disinfection, and possible sterilization of the root canal system, so that new tissue can infiltrate and grow into the radicular area. Moreover, TAP is capable of creating a discipline in which other wanted and needed treatments can be successfully performed. In conclusion, TAP, as an antibacterial intracanal medication, has diverse uses. Nevertheless, despite its positive effects, the paste has shown drawbacks. Further research concerning the combined paste and other intracanal medications to control microbiota is a must.
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Affiliation(s)
- Ardavan Parhizkar
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hanieh Nojehdehian
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Asgary
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Comparative Evaluation of the Efficacy of EndoVac and Conventional Irrigating Systems in Primary Molars - An in Vitro Study. J Clin Pediatr Dent 2018; 42:140-145. [PMID: 29087794 DOI: 10.17796/1053-4628-42.2.10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The present study was undertaken to evaluate and compare the apical extrusion of irrigant and depth of irrigant penetration into the dentinal tubules using the EndoVac irrigating system and the manual irrigation system in primary molar teeth. STUDY DESIGN Twenty five extracted primary molars satisfying the inclusion and exclusion criteria were divided into two groups of 29 roots in each group with an equal distribution of apical foramen area. The teeth were mounted in pre-weighed glass bottles and the canals were irrigated with both the irrigating systems using 5.25% sodium hypochlorite solution mixed with acid fuchsin which enables the irrigating solution to penetrate efficiently into the dentinal tubules. The amount of irrigant extruded was recorded. The roots were sectioned at 2mm, 4mm and 6mm from the apex and examine the depth of irrigant penetration into the dentinal tubules under a stereomicroscope. RESULTS Apical extrusion of the irrigant was significantly less with the EndoVac system (1.18±1.04gms) when compared to manual irrigation system (2.3±1.55gms) (P<0.05). EndoVac irrigation system showed greater depth of irrigant penetration into the dentinal tubules (49.90±17.52mm, 32.17±12.20mm and 15.70±8.91mm) compared to the manual irrigation system (30.48±16.27mm, 14.74±9.67mm and 5.59±7.09mm) at 6mm, 4mm and 2mm respectively (P<0.05). Results showed that the depth of irrigant penetration into the dentinal tubules with both the irrigating systems was found to be significantly greater in the six mm sections compared to the four mm and two mm sections (P<0.05). CONCLUSION The EndoVac irrigation system showed significantly greater efficacy compared to the manual irrigation system in primary molars with less amount of irrigant extrusion and better depth of irrigant penetration into the dentinal tubules.
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Silva EJNL, Carvalho CR, Belladonna FG, Prado MC, Lopes RT, De-Deus G, Moreira EJL. Micro-CT evaluation of different final irrigation protocols on the removal of hard-tissue debris from isthmus-containing mesial root of mandibular molars. Clin Oral Investig 2018; 23:681-687. [DOI: 10.1007/s00784-018-2483-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 05/02/2018] [Indexed: 11/27/2022]
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Tomaszewska IM, Skinningsrud B, Jarzębska A, Pękala JR, Tarasiuk J, Iwanaga J. Internal and external morphology of mandibular molars: An original micro-CT study and meta-analysis with review of implications for endodontic therapy. Clin Anat 2018; 31:797-811. [DOI: 10.1002/ca.23080] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 03/08/2018] [Accepted: 03/20/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Iwona M. Tomaszewska
- Department of Anatomy; Jagiellonian University Medical College; Krakow Poland
- International Evidence-Based Anatomy Working Group; Krakow Poland
| | - Bendik Skinningsrud
- Department of Anatomy; Jagiellonian University Medical College; Krakow Poland
- International Evidence-Based Anatomy Working Group; Krakow Poland
| | - Anna Jarzębska
- Department of Anatomy; Jagiellonian University Medical College; Krakow Poland
| | - Jakub R. Pękala
- Department of Anatomy; Jagiellonian University Medical College; Krakow Poland
- International Evidence-Based Anatomy Working Group; Krakow Poland
| | - Jacek Tarasiuk
- Micro- and Nanotomography Laboratory, Faculty of Physics; AGH University of Science and Technology; Krakow Poland
| | - Joe Iwanaga
- Seattle Science Foundation; Seattle Washington
- Department of Anatomy, Kurume University School of Medicine; Division of Gross and Clinical Anatomy; Kurume Fukuoka Japan
- Dental and Oral Medical Center, Kurume University School of Medicine; Kurume Fukuoka Japan
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Neelakantan P, Khan K, Hei Ng GP, Yip CY, Zhang C, Pan Cheung GS. Does the Orifice-directed Dentin Conservation Access Design Debride Pulp Chamber and Mesial Root Canal Systems of Mandibular Molars Similar to a Traditional Access Design? J Endod 2018; 44:274-279. [DOI: 10.1016/j.joen.2017.10.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 09/25/2017] [Accepted: 10/23/2017] [Indexed: 11/16/2022]
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40
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Duarte PHM, da Silva PB, Rosa RAD, Montagner F, Duarte MAH, Kuga MC, Só MVR. Effect of ethanol on the antimicrobial properties of chlorhexidine over oral biofilm. Microsc Res Tech 2018; 81:408-412. [PMID: 29341381 DOI: 10.1002/jemt.22992] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 11/07/2017] [Accepted: 12/28/2017] [Indexed: 11/12/2022]
Abstract
The aim of this study was to evaluate the effect of 95% ethanol irrigation, with 5 or 10 min of action, on the antibacterial properties of 2% chlorhexidine (CHX), on oral biofilm, evaluated with confocal laser scanning microscopy (CLSM). Oral biofilm development was induced in 80 sterilized bovine dentin blocks, distributed in two groups (5 or 10 min) and 4 subgroups, according to time and the solution used: Saline (SALINE5, SALINE10); Saline followed by CHX (SALINE/CHX5, SALINE/CHX10); Ethanol (ETHANOL5, ETHANOL10), Ethanol followed by CHX (ETHANOL/CHX5, ETHANOL/CHX10). The surface of the block was dyed with Live/Dead® BacLight. Images from different areas were analyzed by BioImage L program. The total biovolum (µm³), biovolum of live cells (green), percentage of live cells of the thickness of the biofilm visualized in CLSM and on surface biofilm were evaluated. Total biovolum and biovolum of living cells showed similar results among the different groups (p > .05). The percentage of living cells in total thickness of the biofilm also was similar among the groups (p > .05), except ETHANOL5, SALINE/CHX10, ETHANOL10, and ETHANOL/CHX10 that showed lower percentage than SALINE5 (p < .05). The ETHANOL10 and ETHANOL/CHX10 also showed lower percentage of living cells than ETHANOL/CHX5 and SALINE10 (p < .05). In relation to biofilm surface, SALINE/CHX5, SALINE/CHX10, ETHANOL5, ETHANOL10, ETHANOL/CHX5, and ETHANOL/CHX10 showed a lower percentage of living cells percentage than SALINE5 and SALINE10 groups (p < .05). Therefore, ethanol has no effect on antimicrobial properties of 2% chlorhexidine, prior when used as endodontic irrigating solution.
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Affiliation(s)
- Pedro Henrique Marks Duarte
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Paula Barcellos da Silva
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Ricardo Abreu da Rosa
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Francisco Montagner
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | - Milton Carlos Kuga
- Department of Restorative Dentistry, Araraquara Dental School, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Marcus Vinícius Reis Só
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Schiavotelo TCL, Coelho MS, Rasquin LC, Rocha DGP, Fontana CE, Bueno CEDS. Ex-vivo Smear Layer Removal Efficacy of Two Activated Irrigation Techniques After Reciprocating Instrumentation in Curved Canals. Open Dent J 2017; 11:512-519. [PMID: 29238411 PMCID: PMC5712658 DOI: 10.2174/1874210601711010512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/28/2017] [Accepted: 09/14/2017] [Indexed: 01/10/2023] Open
Abstract
Introduction: This study aimed to compare the effectiveness of two activated irrigation techniques in removing the smear layer after single-file reciprocating instrumentation in curved canals. Materials and Methods: Sixty distobuccal roots of maxillary molars were standardized to create a closed system, and then instrumented using WaveOne Primary (Dentsply Maillefer, Ballaigues, Switzerland) instruments. Fifty-four specimens were randomly distributed into 3 groups for final irrigation: Non-activated irrigation, passive ultrasonic irrigation (PUI), and EndoActivator (EA;Dentsply Maillefer, Tulsa, USA) irrigation. All specimens received 3 mL of 17% EDTA for 1 minute, followed by irrigation with 6 mL of 2.5% NaOCl. The apical, middle and cervical thirds of the specimens were analyzed using scanning electronic microscopy (SEM), and the amount of remaining smear layer on the canal walls was rated by three examiners using a five-category scoring system. Kendall’s concordance coefficient was used to assess inter-rater agreement. Kruskal-Wallis and Mann-Whitney (Bonferroni) tests were used to compare the scores. Results: Kendall’s concordance coefficient was ≥ 0.7, indicating an excellent level of agreement between the raters. No statistically significant difference in irrigation techniques efficacy for removal of the smear layer (p=0.061) was found for the apical third. The scores attributed to the specimens irrigated with the EA system were significantly lower than those of the other groups in the cervical and middle thirds (p< 0.05). Conclusions: The efficacy of the EA system in removing the smear layer in the cervical and middle thirds of root canals instrumented with reciprocating motion was significantly higher than that of either PUI or non-activated irrigation. Both EA and PUI performed similarly in apical third.
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Affiliation(s)
| | - Marcelo Santos Coelho
- Department of Endodontics, School of Dentistry and Medicine, São Leopoldo Mandic University, Campinas, SP, Brazil
| | - Luis Cardoso Rasquin
- Department of Integrated Clinical Dentistry and Diagnostics, School of Dentistry, Federal University of Bahia, Salvador, BA, Brazil
| | - Daniel Guimarães Pedro Rocha
- Department of Endodontics, School of Dentistry and Medicine, São Leopoldo Mandic University, Campinas, SP, Brazil
| | - Carlos Eduardo Fontana
- Department of Endodontics, School of Dentistry and Medicine, São Leopoldo Mandic University, Campinas, SP, Brazil.,Department of Endodontics, School of Dentistry and Medicine, Pontificia Universidade Católica de Campinas, Campinas, SP, Brazil
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42
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Aw V. Discuss the role of microorganisms in the aetiology and pathogenesis of periapical disease. AUST ENDOD J 2017; 42:53-9. [PMID: 27506189 DOI: 10.1111/aej.12159] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The literature indicates that microorganisms have a critical role in the aetiology and pathogenesis of apical periodontitis. The advancement in microbiological study methods has allowed for the identification of newer species associated with the disease process. At our current understanding, however, the exact roles of specific microorganisms in apical periodontitis are not fully understood but the poly-microbial aetiology of the disease appears to be supported by the literature. The endodontic microbiota is comprised of a subset of microbiota present in the oral cavity, consisting of predominantly anaerobic bacterial species, some fungal and viral species. The pathogenesis of apical periodontitis is essentially the result of a complex interplay between bacterial and host factors, giving rise to a range of presentations depending on the balance of the interaction. The role of endodontic microbiota in the initiation and persistence of apical periodontitis means that the mainstay of endodontic treatment is the elimination of such bacteria. A challenge to the resolution of apical periodontitis after treatment lies in the inadequacy of treatment protocol in completely eradicating the pathogenic species and the inherent ability of certain species to survive the treatment. This issue should be the focus of future research as we continually search for more predictable treatment methods of achieving the resolution of apical periodontitis.
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Affiliation(s)
- Vincent Aw
- Dentistry and Oral Health, La Trobe University, Bendigo, Victoria, Australia
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43
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Lopes RMV, Marins FC, Belladonna FG, Souza EM, De-Deus G, Lopes RT, Silva EJNL. Untouched canal areas and debris accumulation after root canal preparation with rotary and adaptive systems. AUST ENDOD J 2017; 44:260-266. [DOI: 10.1111/aej.12237] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Rosa Maria Vianna Lopes
- Department of Endodontics; School of Dentistry; Grande Rio University (UNIGRANRIO); Duque de Caxias Rio de Janeiro Brazil
| | - Fernanda Cunha Marins
- Department of Endodontics; School of Dentistry; Grande Rio University (UNIGRANRIO); Duque de Caxias Rio de Janeiro Brazil
| | | | - Erick Miranda Souza
- Department of Dentistry II; Federal University of Maranhão; São Luis Maranhão Brazil
| | - Gustavo De-Deus
- Department of Endodontics; Fluminense Federal University (UFF); Niterói Rio de Janeiro Brazil
| | - Ricardo Tadeu Lopes
- Nuclear Engineering Program; Federal University of Rio de Janeiro (UFRJ); Rio de Janeiro Rio de Janeiro Brazil
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44
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Biofilms in Endodontics-Current Status and Future Directions. Int J Mol Sci 2017; 18:ijms18081748. [PMID: 28800075 PMCID: PMC5578138 DOI: 10.3390/ijms18081748] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 07/31/2017] [Accepted: 08/08/2017] [Indexed: 01/05/2023] Open
Abstract
Microbiota are found in highly organized and complex entities, known as biofilms, the characteristics of which are fundamentally different from microbes in planktonic suspensions. Root canal infections are biofilm mediated. The complexity and variability of the root canal system, together with the multi-species nature of biofilms, make disinfection of this system extremely challenging. Microbial persistence appears to be the most important factor for failure of root canal treatment and this could further have an impact on pain and quality of life. Biofilm removal is accomplished by a chemo-mechanical process, using specific instruments and disinfecting chemicals in the form of irrigants and/or intracanal medicaments. Endodontic research has focused on the characterization of root canal biofilms and the clinical methods to disrupt the biofilms in addition to achieving microbial killing. In this narrative review, we discuss the role of microbial biofilms in endodontics and review the literature on the role of root canal disinfectants and disinfectant-activating methods on biofilm removal.
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45
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Lili Y, Yan Z, Shijun Z, Shuai Z, Na W, Jie X, Shue H, Zhiyuan X. [Clinical application of cone beam computed tomography combined with micro-ultrasound technique in treating three mesial canals in mandibular first molars]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2017; 35:384-388. [PMID: 28853504 DOI: 10.7518/hxkq.2017.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective The aim of this study is to investigate the influence of cone beam computed tomography (CBCT) and micro-ultrasound technique for the treatment of three mesial canals in mandibular first molars. The three mesial canals according to Pomeranz's classification were characterized. Methods A total of 75 permanent mandibular first molars for root canal treatment were randomly selected from patients belonging to the age group of 14-60 years. After preparing the access cavity and locating the main canals, the middle mesial canal orifices in all teeth were determined with an endodontic explorer under direct vision (StageⅠ), under magnification with the aid of micro-ultrasound (Stage Ⅱ), and with the combined use of CBCT and micro-ultrasound to remove the dentin wall and calcifications (Stage Ⅲ). Results Middle mesial canals were detected in 4.0%, 18.7%, and 22.7% of the teeth in StagesⅠ-Ⅲ, respectively. Statistical analysis showed significant differences (P<0.05) between StagesⅠand Ⅱ with regard to middle mesial canal detection. The number of Stage Ⅲ was more than that of Stage Ⅱ. The difference between the two stages was no significant. Among the 17 middle mesial canals, "confluent", "fin" and "independent" anatomies were 52.9%, 35.3%, and 11.8%. Conclusion When used with adjunctive aids, including CBCT, micro-ultrasound facilitates dental clinicians in the location and treatment of middle mesial canals.
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Affiliation(s)
- Yang Lili
- Dept. of Stomatology, People's Hospital of Cangzhou, Cangzhou 061000, China
| | - Zhang Yan
- Dept. of Stomatology, People's Hospital of Cangzhou, Cangzhou 061000, China
| | - Zhao Shijun
- Dept. of Stomatology, People's Hospital of Cangzhou, Cangzhou 061000, China
| | - Zhang Shuai
- Dept. of Stomatology, People's Hospital of Cangzhou, Cangzhou 061000, China
| | - Wang Na
- Dept. of Stomatology, People's Hospital of Cangzhou, Cangzhou 061000, China
| | - Xu Jie
- Dept. of Stomatology, People's Hospital of Cangzhou, Cangzhou 061000, China
| | - Hu Shue
- Dept. of Stomatology, People's Hospital of Cangzhou, Cangzhou 061000, China
| | - Xu Zhiyuan
- Dept. of Stomatology, People's Hospital of Cangzhou, Cangzhou 061000, China
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46
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Zuolo ML, Zaia AA, Belladonna FG, Silva EJNL, Souza EM, Versiani MA, Lopes RT, De-Deus G. Micro-CT assessment of the shaping ability of four root canal instrumentation systems in oval-shaped canals. Int Endod J 2017; 51:564-571. [DOI: 10.1111/iej.12810] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 06/27/2017] [Indexed: 11/29/2022]
Affiliation(s)
- M. L. Zuolo
- Endodontic Division; Department of Restorative Dentistry; Piracicaba Dental School; State University of Campinas; Piracicaba São Paulo Brazil
| | - A. A. Zaia
- Endodontic Division; Department of Restorative Dentistry; Piracicaba Dental School; State University of Campinas; Piracicaba São Paulo Brazil
| | - F. G. Belladonna
- Department of Endodontics; Fluminense Federal University; Niterói Rio de Janeiro Brazil
| | - E. J. N. L. Silva
- Department of Endodontics; Grande Rio University; Duque de Caxias Rio de Janeiro Brazil
| | - E. M. Souza
- Department of Dentistry II; Federal University of Maranhão; São Luís Maranhão Brazil
| | - M. A. Versiani
- Department of Restorative Dentistry; Dental School of Ribeirão Preto; University of São Paulo; São Paulo São Paulo Brazil
| | - R. T. Lopes
- Nuclear Engineering Program; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - G. De-Deus
- Department of Endodontics; Fluminense Federal University; Niterói Rio de Janeiro Brazil
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Malentacca A, Uccioli U, Mannocci F, Bhuva B, Zangari D, Pulella C, Lajolo C. The comparative effectiveness and safety of three activated irrigation techniques in the isthmus area using a transparent tooth model. Int Endod J 2017; 51 Suppl 1:e35-e41. [DOI: 10.1111/iej.12748] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 01/23/2017] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - F. Mannocci
- Conservative Dentistry and Endodontology; Guy's Dental Hospital; King's College London Dental Institute; London UK
| | - B. Bhuva
- Conservative Dentistry and Endodontology; Guy's Dental Hospital; King's College London Dental Institute; London UK
| | | | | | - C. Lajolo
- Oral Medicine and Pathology; School of Dentistry; Catholic University; Rome Italy
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48
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Ekici MA, Helvacıoğlu Kıvanç B, Ekici A, Uzun Ö. Farklı endodontik irrigasyon aktivasyon teknikleri kullanılarak yapay oluklardan debriz uzaklaştırılması: ex vivo. ACTA ODONTOLOGICA TURCICA 2017. [DOI: 10.17214/gaziaot.273922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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49
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Keleş A, Alçin H, Sousa-Neto MD, Versiani MA. Supplementary Steps for Removing Hard Tissue Debris from Isthmus-containing Canal Systems. J Endod 2016; 42:1677-1682. [DOI: 10.1016/j.joen.2016.07.025] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 07/29/2016] [Accepted: 07/29/2016] [Indexed: 11/29/2022]
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50
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Lorencetti KT, Silva-Sousa YTC, Nascimento GED, Messias DCF, Colucci V, Abi Rached-Junior F, Silva SRC. Influence of apical enlargement in cleaning of curved canals using negative pressure system. Braz Dent J 2016; 25:430-4. [PMID: 25517780 DOI: 10.1590/0103-6440201302435] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 10/06/2014] [Indexed: 11/22/2022] Open
Abstract
This study aimed to evaluate, by scanning electron microscopy (SEM), the cleaning of canal walls with moderate curvature subjected to biomechanical preparation with different final diameters using apical negative pressure irrigation. Thirty-two mesiobuccal roots of molars were divided into 4 groups (n=8) according to the instrument's final diameter: GI: 30.02, GII: 35.02, GIII: 40.02 and GIV: 45.02. Irrigating procedure was performed at each change of instrument with 1% NaOCl using the Endovac system. Final irrigation was conducted with 17% EDTA for 5 min. The SEM photomicrographs were evaluated under 35× and 1000× magnification, by three calibrated examiners, in a double-blind design. Data were submitted to Kruskal-Wallis and Dunn's post hoc tests (α=0.05). Canals instrumented with 30.02 and 35.02 final diameters showed more debris, statistically different from the other groups (p<0.05). Comparing each root canal third, for the cervical and apical portions no statistically significant difference (p>0.05) was found among the four groups. Regarding the presence of smear layer, canals with 30.02 final diameter showed the highest scores, statistically different from the 45.02 group (p<0.05) and similar to the 35.02 and the 40.02 groups (p>0.05). Although none of the studied diameters completely removed debris and smear layer, it may be concluded that instrumentation with higher final diameters was more effective in cleaning the root canals with moderate curvature.
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Affiliation(s)
| | | | | | | | - Vivian Colucci
- Dental School, University of Ribeirão Preto, Ribeirão Preto, SP, Brazil
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