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Cheung MC, Peters OA, Parashos P. Global survey of endodontic practice and adoption of newer technologies. Int Endod J 2023; 56:1517-1533. [PMID: 37800848 DOI: 10.1111/iej.13982] [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: 07/14/2023] [Revised: 09/07/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
AIM To investigate current endodontic practices, adoption of technologies and continuing education attendance within specialist endodontic practice globally and to identify geographic trends. METHODOLOGY A web-based survey of endodontic association members in Australia, Britain, Canada, Italy, New Zealand and the USA on routine treatment preferences, armamentarium and education attendance was conducted. Chi-squared, independent sample t-tests, Cochran's Q test and McNemar's test were performed. RESULTS The survey was completed by 543 endodontists or endodontic post-graduate students. Almost all respondents used the dental operating microscope (DOM, 91.3%), engine-driven nickel-titanium instruments (NiTi, 97.6%), electronic apex locators (EAL, 93.0%), cone-beam computed tomography (CBCT, 91.2%) and calcium silicate-based materials (CSBMs, 93.7%). Dental dam was always used by 99.1%. Over half used irrigation adjuncts (81.8%), warm vertical compaction (74.6%) and heat-treated NiTi (60.2%). Geographic comparison between AP (Asia-Pacific, n = 78), AM (Americas, n = 402) and EM (Europe and Middle East, n = 63) was performed. AM and EM preferred single-visit treatment more (p < .001) and used higher sodium hypochlorite concentrations than AP. AM had more access to CBCT in the workplace (86.6%) than AP (65.4%, p < .001) and used CBCT for routine preoperative assessment (39.6%) more than EM (7.3%, p < .001). Almost all of EM used irrigation adjuncts (95.2%), more than AM (78.1%, p = .001). AP used steroid/antibiotic medicaments most (p < .001) and had the highest attendance at continuing education programmes. CONCLUSION Several endodontic-specific armamentaria have reached almost complete adoption within global specialist endodontic practice, whilst the continued uptake of newer technologies should be followed over time. Some practising philosophies varied significantly across different geographic regions.
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Affiliation(s)
| | - Ove Andreas Peters
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Peter Parashos
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
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Cheung MC, Parashos P. Current endodontic practice and use of newer technologies in Australia and New Zealand. Aust Dent J 2023; 68:186-196. [PMID: 37382301 DOI: 10.1111/adj.12967] [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] [Accepted: 06/17/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND This study investigated endodontic clinical preferences, adoption of newer technologies and information sources among dentists and endodontists. METHODS Dental and endodontic society members in Australia and New Zealand were surveyed online regarding their endodontic treatment preferences, armamentarium, information sources and continuing professional education (CPE) attendance. RESULTS Complete responses were received from 71 endodontic specialists or postgraduates (Group E) and 139 general dentists (Group D). Most of Group E used dental operating microscopes (95.8%), endodontic cone-beam computed tomography (CBCT; 98.6%) and calcium silicate-based materials (CSBMs; 97.2%), significantly more (P < 0.001) than Group D (86.3% used loupes, <32% used CBCT for endodontics or CSBMs). Most respondents used dental dam always for endodontics (94.3%), electronic apex locators (EAL; 81.0%) and engine-driven nickel-titanium (NiTi) instruments (91.4%); Group E had more experience with engine-driven NiTi (P < 0.001). Endodontic CPE attendance was highest at dental association programs (P < 0.001) while hands-on NiTi training attendance was highest via commercial companies (P < 0.05). Online information sources were commonly used (38.8% of Group D, 59.2% of Group E). CONCLUSION Dental dam, EAL and engine-driven NiTi were almost universally used. The endodontic group reported high adoption of newer endodontic technologies. Endodontic CPE and information sources should be further surveyed as online engagement evolves. © 2023 Australian Dental Association.
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Affiliation(s)
- M C Cheung
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
| | - P Parashos
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
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3
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Materials, Methods, and Equipment used by General Dentists of Southeastern Iran for Endodontic Treat-ment. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2022. [DOI: 10.52547/jrdms.7.4.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Boutsioukis C, Arias-Moliz MT. Present status and future directions - irrigants and irrigation methods. Int Endod J 2022; 55 Suppl 3:588-612. [PMID: 35338652 PMCID: PMC9321999 DOI: 10.1111/iej.13739] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/21/2022] [Indexed: 11/30/2022]
Abstract
Irrigation is considered the primary means of cleaning and disinfection of the root canal system. The purpose of this review was to set the framework for the obstacles that irrigation needs to overcome, to critically appraise currently used irrigants and irrigation methods, to highlight knowledge gaps and methodological limitations in the available studies and to provide directions for future developments. Organization of bacteria in biofilms located in anatomic intricacies of the root canal system and the difficulty to eliminate them is the main challenge for irrigants. Sodium hypochlorite remains the primary irrigant of choice, but it needs to be supplemented by a chelator. Delivery of the irrigants using a syringe and needle and activation by an ultrasonic file are the most popular irrigation methods. There is no evidence that any adjunct irrigation method, including ultrasonic activation, can improve the long‐term outcome of root canal treatment beyond what can be achieved by instrumentation and syringe irrigation. It is necessary to redefine the research priorities in this field and investigate in greater depth the penetration of the irrigants, their effect on the biofilm and the long‐term treatment outcome. New studies must also focus on clinically relevant comparisons, avoid methodological flaws and have sufficiently large sample sizes to reach reliable conclusions. Future multidisciplinary efforts combining the knowledge from basic sciences such as Chemistry, Microbiology and Fluid Dynamics may lead to more effective antimicrobials and improved activation methods to bring them closer to the residual biofilm in the root canal system.
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Affiliation(s)
- C Boutsioukis
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M T Arias-Moliz
- Department of Microbiology, Faculty of Dentistry, University of Granada, Granada, Spain
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Mehta DL, Abraham S, Kamble AB, Vaswani SD, Najan HB, Mehta PL. Spectrophotometric analysis of the color stability of white mineral trioxide aggregate in contact with four different irrigating solutions - An in vitro study. J Conserv Dent 2021; 23:377-383. [PMID: 33623240 PMCID: PMC7883782 DOI: 10.4103/jcd.jcd_412_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/16/2020] [Accepted: 09/25/2020] [Indexed: 11/04/2022] Open
Abstract
Aims This study aims to compare the color stability of white mineral trioxide aggregate (wMTA) in contact with four irrigating solutions. Settings and Design Original research study. Subjects and Methods Fifty cylindrical discs of wMTA, 10 mm in diameter and 2 mm in height were prepared using a mold. Samples were incubated at a temperature of 37°C and at 100% humidity for the material to reach its optimal mechanical properties. The samples were divided into 6 groups: Group A: dry (n = 5); Group B: distilled water (DW) (n = 5); Group C: 5% sodium hypochlorite (NaOCl) (n = 10); Group D: 2% chlorhexidine gluconate (CHX) (n = 10); Group E: 17% aqueous ethylene diamine tetra-acetic acid (EDTA) (n = 10); Group F: 0.2% Chitosan (n = 10) Each disc was immersed into the irrigating solution for a period of 24 h. All the specimens were photographed using a digital camera before and after immersion. The assessment of color change of each disc of wMTA was conducted by a spectrophotometer. The Commission Internationale de l'eclairage system was used to calculate the differences in color. Statistical Analysis Used Statistical Package for the Social Sciences version 16.0 (Chicago, IL, USA) at a significance level of P < 0.05 was used. Results All groups except group A exhibited discoloration of wMTA. The mean values for change in color was highest with Group D, followed by Group C, F, E, B, and group A. Only Group B when compared to group A did not show any statistically significant difference (P = 0.948) whereas all the other four groups showed a highly statistically significant difference (P < 0.001). Conclusions 2% CHX causes maximum discoloration of wMTA followed by 5% NaOCl, 0.2% Chitosan and least discoloration with 17% aqueous EDTA and DW.
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Affiliation(s)
- Disha Lalit Mehta
- Department of Conservative Dentistry and Endodontics, SMBT Dental College and Hospital, Sangamner, Maharashtra, India
| | - Sathish Abraham
- Department of Conservative Dentistry and Endodontics, SMBT Dental College and Hospital, Sangamner, Maharashtra, India
| | - Aradhana Babu Kamble
- Department of Conservative Dentistry and Endodontics, SMBT Dental College and Hospital, Sangamner, Maharashtra, India
| | - Sneha Dhruvkumar Vaswani
- Department of Conservative Dentistry and Endodontics, SMBT Dental College and Hospital, Sangamner, Maharashtra, India
| | - Harshal B Najan
- Department of Conservative Dentistry and Endodontics, SMBT Dental College and Hospital, Sangamner, Maharashtra, India
| | - Puneet Lalit Mehta
- Department of Periodontics, Saveetha Dental College, Chennai, Tamil Nadu, India
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Virdee SS, Ravaghi V, Camilleri J, Cooper P, Tomson P. Current trends in endodontic irrigation amongst general dental practitioners and dental schools within the United Kingdom and Ireland: a cross-sectional survey. Br Dent J 2020:10.1038/s41415-020-1984-x. [PMID: 32855518 DOI: 10.1038/s41415-020-1984-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Aims To investigate current trends in endodontic irrigation amongst general dental practitioners (GDPs) and dental schools within UK and Ireland. Secondly, to evaluate if significant differences exist between the irrigant practices of National Health Service (NHS) and private GDPs.Methodology In 2019, an online questionnaire was distributed to the 18 dental schools within the UK and Ireland and 8,568 GDPs. These surveys explored current trends in teaching and usage of endodontic irrigants. Chi-squared tests were performed to make comparisons between NHS and private GDPs (α <0.01).Results All 18 dental schools (100%) and 495 GDPs (6%) returned valid questionnaires. Three hundred and thirty (66.7%) practitioners were NHS and 165 (33.3%) were private. There was strong consensus on irrigation teaching amongst dental schools. These results aligned with GDP responses in terms of irrigant selection (sodium hypochlorite [NaOCl]); NaOCl concentration (≤3%); ethylenediaminetetraacetic acid (EDTA) contact time (>0-5 minutes); final rinse protocols (penultimate EDTA rinse); irrigant temperature (room); and agitation techniques (manual dynamic activation; >0-60 seconds). There was, however, considerable variation in NaOCl contact time and GDPs infrequently used chelating agents or agitation techniques. Compared with private practitioners, NHS GDPs used significantly lower NaOCl contact times and concentrations, less EDTA and activation techniques, and more chlorhexidine (P <0.01).Conclusions Overall, irrigation teaching within the UK and Ireland is consistent and evidence-based. Furthermore, trends in irrigant usage amongst UK GDPs are now more aligned with these teaching practices. Significant differences were, however, observed between NHS and private practitioners.
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Affiliation(s)
- Satnam Singh Virdee
- Clinical Lecturer & Speciality Registrar in Restorative Dentistry, PhD Student, University of Birmingham School of Dentistry, Mill Pool Way, Birmingham, UK; Part-Time General Dental Practitioner, Abbey House Dental Practice, 9 Abbey Street, Stone, ST15 8PA, UK.
| | - Vahid Ravaghi
- Lecturer in Dental Public Health, University of Birmingham School of Dentistry, Mill Pool Way, Birmingham, UK
| | - Josette Camilleri
- Reader in Restorative Dentistry, University of Birmingham School of Dentistry, Mill Pool Way, Birmingham, UK
| | - Paul Cooper
- Professor of Oral Biology, Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Phillip Tomson
- Senior Clinical Lecturer & Consultant in Restorative Dentistry, University of Birmingham, Mill Pool Way, Birmingham, B5 7EG, UK
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Khoshroo K, Shah B, Johnson A, Baeten J, Barry K, Tahriri M, Ibrahim MS, Tayebi L. A new phantom to evaluate the tissue dissolution ability of endodontic irrigants and activating devices. Restor Dent Endod 2020; 45:e45. [PMID: 33294410 PMCID: PMC7691255 DOI: 10.5395/rde.2020.45.e45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to introduce a gelatin/bovine serum albumin (BSA) tissue standard, which provides dissolution properties identical to those of biological tissues. Further, the study evaluated whether the utilization of endodontic activating devices led to enhanced phantom dissolution rates. MATERIALS AND METHODS Bovine pulp tissue was obtained to determine a benchmark of tissue dissolution. The surface area and mass of samples were held constant while the ratio of gelatin and BSA were varied, ranging from 7.5% to 10% gelatin and 5% BSA. Each sample was placed in an individual test tube that was filled with an appropriate sodium hypochlorite solution for 1, 3, and 5 minutes, and then removed from the solution, blotted dry, and weighed again. The remaining tissue was calculated as the percent of initial tissue to determine the tissue dissolution rate. A radiopaque agent (sodium diatrizoate) and a fluorescent dye (methylene blue) were added to the phantom to allow easy quantification of phantom dissolution in a canal block model when activated using ultrasonic (EndoUltra) or sonic (EndoActivator) energy. RESULTS The 9% gelatin + 5% BSA phantom showed statistically equivalent dissolution to bovine pulp tissue at all time intervals. Furthermore, the EndoUltra yielded significantly more phantom dissolution in the canal block than the EndoActivator or syringe irrigation. CONCLUSIONS Our phantom is comparable to biological tissue in terms of tissue dissolution and could be utilized for in vitro tests due to its injectability and detectability.
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Affiliation(s)
- Kimia Khoshroo
- Marquette University School of Dentistry, Milwaukee, WI, USA
| | - Brinda Shah
- Marquette University School of Dentistry, Milwaukee, WI, USA
| | | | | | | | | | - Mohamed S. Ibrahim
- Marquette University School of Dentistry, Milwaukee, WI, USA.,Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Lobat Tayebi
- Marquette University School of Dentistry, Milwaukee, WI, USA
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AlRahabi MK, AlKady AM. Current Trends in Practice of Residents in the Saudi Board of Endodontics Program. Eur J Dent 2020; 13:619-624. [PMID: 31891979 PMCID: PMC6938417 DOI: 10.1055/s-0039-3399456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives
The purpose of the current study was to collect information about some techniques and armamentarium currently used by the Saudi Board of Endodontics residents in relation to the technical steps of root canal therapy.
Materials and Methods
A web-based survey was sent to the Saudi Board of Endodontics residents, based in the western area of Saudi Arabia. The survey assessed controversial concepts, and collected information regarding new instruments and materials, used in the technical steps of nonsurgical root canal treatment. A one-sample chi-square test, with a 95% level of significance, was applied to determine whether there were significant differences between respondents’ answers.
Results
A total of 45 out of 50 residents (90%) responded to the questionnaire. The majority of Saudi Board residents of Endodontics, who participated in this survey, used the mean of working length (ML) measured by periapical X-Ray and apex locator in the presence of a radiographic lesion (63.3%), and maintained apical patency in all cases (80.0%). ProTaper Universal (40%) and ProTaper Next (41.2%) were the most common NiTi rotary systems used for root canal instrumentation. Thirty percent of respondents used adjunct device with irrigation, and 80% advocated smear layer removal. Zinc oxide–eugenol-based sealers were the most common used sealers (70%), and most residents (86.6%) did not advocate sealer extrusion.
Conclusions
This study revealed that residents of the Saudi Board of Endodontics program adopt new endodontic technologies. There is, however, a need for more investigations regarding this objective, including responses from all residents in Saudi Arabia.
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Affiliation(s)
- Mothanna K AlRahabi
- Department of Restorative Dental Science, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia
| | - Ayman M AlKady
- Department of Restorative Dental Science, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia
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Cochrane S, Burrow MF, Parashos P. Effect on the mechanical properties of human and bovine dentine of intracanal medicaments and irrigants. Aust Dent J 2018; 64:35-42. [DOI: 10.1111/adj.12655] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2018] [Indexed: 11/28/2022]
Affiliation(s)
- S Cochrane
- The Melbourne Dental School; Faculty of Medicine; Dentistry and Health Sciences; The University of Melbourne; Melbourne Victoria Australia
| | - MF Burrow
- The Melbourne Dental School; Faculty of Medicine; Dentistry and Health Sciences; The University of Melbourne; Melbourne Victoria Australia
| | - P Parashos
- The Melbourne Dental School; Faculty of Medicine; Dentistry and Health Sciences; The University of Melbourne; Melbourne Victoria Australia
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Eliyas S, Briggs PFA, Gallagher JE. Assessing a training programme for primary care dental practitioners in endodontics of moderate complexity: Pilot data on skills enhancement and treatment outcomes. Br Dent J 2018; 225:617-628. [PMID: 30310203 DOI: 10.1038/sj.bdj.2018.807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2018] [Indexed: 11/09/2022]
Abstract
Aims To explore the impact of dedicated training to extend the skills of primary care practitioners on the quality of endodontic care, using clinical, radiographic and patient-related outcomes. Methods The quality of endodontic treatment performed at the beginning and end of training to become dentists with extended skills (DES) in endodontics was assessed in vitro and in vivo from endo-training blocks and self-reported logbooks containing clinical notes and radiographs respectively. The quality of endodontic care delivered by DES post-training was measured using clinical and radiographic outcomes. Patient-related outcomes were assessed using a self-report questionnaire, including the Oral Health Impact Profile – Endodontic Outcome Measure (OHIP-EOM). Results Data on eight dentists were examined pre-and post-training, five of whom participated in further follow-up investigations on the quality of endodontic care delivered to their patients. Significant improvements in skills were seen for all domains in vitro (p <0.05), and for all domains of the clinical treatment process, and achieving the correct working length of the root filling as seen by radiography in vivo (p <0.05). The quality of the clinical process was maintained following training. Positive patient outcome (OHIP-EOM) scores were recorded (mean score of 34.72, SD = 10.74, n = 120 pre-treatment and 25.85, SD = 7.74, n = 47 representing reduced impact at follow-up). The majority of patients reported being satisfied, or very satisfied, with the service they received (72.5%, n = 98); would use the service again (68.1%, n = 92); and would recommend the service to friends and family (74.8%, n = 101). Conclusions Findings suggest that training for dentists working in practice can be successful in enhancing skills and changing practice, with evidence of high patient satisfaction and good clinical and patient-related outcomes. Pilot results must be interpreted with caution and further research is required.
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Affiliation(s)
- S Eliyas
- St George's University Hospital's NHS Foundation Trust and Hodsoll House Specialist Practice, Kent
| | - P F A Briggs
- Barts Health NHS Trust, Whitechapel, London, UK.,Health Education England London and South East, Stewart House, Russell Square London, UK
| | - J E Gallagher
- King's College London Dental Institute, Population and Patient Health Division, London, UK
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Nogo-Zivanovic D, Bjelovic L, Ivanovic V, Kanjevac T, Tanaskovic I. Consideration of the Therapeutic Potential of Irrigants in Endodontic Therapy. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2018. [DOI: 10.1515/sjecr-2016-0095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Abstract
The main objective of endodontic treatment is to remove vital and necrotic remnants of pulp tissue and microorganisms and their toxic products from the root canal. During chemo-mechanical endodontic preparation, a smear layer is formed on the wall of the canals. Due to an inability to remove all tissue remnants and the smear layer from the root canal by mechanical instrumentation, it is necessary to use irrigation to ensure sufficient cleaning and disinfection of the largest part of the root canalicular system. The most commonly used irrigants are sodium hypochlorite (Na-OCl), ethylenediaminetetraacetic acid (EDTA), citric acid and chlorhexidine (CHX). Recently, the irrigants QMix and MTAD have been introduced to the market. They are a mixture of different components having antimicrobial, organolytic and mineralytic effects on canal detritus and the smear layer. This review article investigates irrigants in terms of the nature of their effect, their efficiency, optimal concentration, and method of use, and the interactions between the irrigants most commonly used in endodontic therapy are discussed, with special emphasis on QMix and MTAD.
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Affiliation(s)
- Dajana Nogo-Zivanovic
- Department for Restorative Dentistry and Endodontics, Faculty of Medicine , University of East Sarajevo , Foca , Bosnia and Herzegovina
| | - Ljiljana Bjelovic
- Department for Restorative Dentistry and Endodontics, Faculty of Medicine , University of East Sarajevo , Foca , Bosnia and Herzegovina
| | - Vladimir Ivanovic
- Department of Restorative Odontology and Endodontics, School of Dental Medicine , University of Belgrade , Belgrade , Serbia
| | - Tatjana Kanjevac
- Department of Preventive and Pediatric Dentistry, Faculty of Medical Sciences , University of Kragujevac , Kragujevac , Serbia
| | - Irena Tanaskovic
- Department of Histology and Embryology, Faculty of Medical Sciences , University of Kragujevac , Kragujevac , Serbia
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Survey of Endodontic Irrigants Used by Dentists With Varying Years of Professional Experience. BALKAN JOURNAL OF DENTAL MEDICINE 2018. [DOI: 10.2478/bjdm-2018-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Summary
Background/Aim: The aim of the present study was to describe the use of irrigants by dentists in Bulgaria in relation to their years of professional experience. Material and Methods: The data were collected with the help of a questionnaire. The survey included questions concerning frequency of irrigants applied, their respective concentrations, as well as spectrum of disinfectants used in endodontics. In addition, information about respondents’ age, years of professional experience, gender, and main areas of continuing education was collected. The statistical analysis was performed with the help of IBM SPSS Statistics 22.0. Results: 219 replies were analysed (response rate 27,3%). The majority of the respondents (31.1%) had 21 to 30 years of professional experience. 18.7% had over 30 years. Most of the practitioners reported their continuing education to be in the area of general dentistry - 52%, while about 1.2 % had specialised in endodontics. Dentists with long-standing professional experience use predominantly H2O2 - 78%. Dentists with least experience use 17% EDTA - 53.6%. No significant differences were established for the use of sodium hypochlorite and 2% chlorhexidine. 82% of the respondents use conventional needle 27G for intracanal irrigation; 60% never use ultrasonic irrigation. Conclusions: The analysis of the usage of irrigants shows that many general dental practitioners do not follow the quality recommended protocols for endodontic irrigation protocols.
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Krishnan U, Saji S, Clarkson R, Lalloo R, Moule AJ. Free Active Chlorine in Sodium Hypochlorite Solutions Admixed with Octenidine, SmearOFF, Chlorhexidine, and EDTA. J Endod 2017; 43:1354-1359. [DOI: 10.1016/j.joen.2017.03.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 03/14/2017] [Accepted: 03/20/2017] [Indexed: 10/19/2022]
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Differences in disinfection protocols for root canal treatments between general dentists and endodontists: A Web-based survey. J Am Dent Assoc 2017; 146:536-43. [PMID: 26113101 DOI: 10.1016/j.adaj.2015.01.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Revised: 01/25/2015] [Accepted: 01/28/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND The purpose of this study was to determine whether differences exist in disinfection protocols between endodontists and general dentists. METHODS The authors sent an invitation to participate in a Web-based survey to 950 dentists affiliated with the Spanish Board of Dentistry. Participants responded to 9 questions about irrigation protocols and other factors related to disinfection during root canal therapy. RESULTS A total of 238 (25.05%) study participants successfully completed and returned the surveys. Among these participants, 50% were general dentists and 50% were endodontists. The authors found no statistically significant differences in respondents' first choice of an irrigant solution (that is, sodium hypochlorite), but they noted statistically significant differences in the protocols used by general dentists and by endodontists in relation to the concentration of sodium hypochlorite (P = .0003), the use and type of irrigant used to remove the smear layer (P = 5.39 × 10(-10)), the use of adjuncts to irrigation (P = 5.98 × 10(-8)), the enlargement of the apical preparation when shaping a necrotic tooth (P = .001), and the maintenance of apical patency throughout the debridement and shaping procedure (P = .04). CONCLUSIONS General dentists and endodontists embrace different disinfection protocols. The results of the survey demonstrated that endodontists keep up to date with protocols published in the literature, whereas general dentists use protocols learned during their dental training. Both groups of clinicians should be aware of the importance of disinfection techniques and their relationship to treatment outcomes. PRACTICAL IMPLICATIONS Controlling microorganisms during a root canal treatment, especially in cases with necrotic pulp, is essential to improve treatment outcomes. Clinicians should update their protocols and also consider referring patients to a specialist when their protocols are based on traditional techniques, especially in those cases with necrotic pulp.
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Voveraityte V, Gleizniene S, Lodiene G, Grabliauskiene Z, Machiulskiene V. Spectrophotometric analysis of tooth discolouration induced by mineral trioxide aggregate after final irrigation with sodium hypochlorite: An in vitro
study. AUST ENDOD J 2016; 43:11-15. [DOI: 10.1111/aej.12149] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Valdone Voveraityte
- Department of Dental and Oral Pathology; Faculty of Odontology; Lithuanian University of Health Sciences; Kaunas Lithuania
| | - Simona Gleizniene
- Department of Dental and Oral Pathology; Faculty of Odontology; Lithuanian University of Health Sciences; Kaunas Lithuania
| | - Greta Lodiene
- Department of Dental and Oral Pathology; Faculty of Odontology; Lithuanian University of Health Sciences; Kaunas Lithuania
| | - Zivile Grabliauskiene
- Department of Dental and Oral Pathology; Faculty of Odontology; Lithuanian University of Health Sciences; Kaunas Lithuania
| | - Vita Machiulskiene
- Department of Dental and Oral Pathology; Faculty of Odontology; Lithuanian University of Health Sciences; Kaunas Lithuania
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Willershausen I, Wolf TG, Schmidtmann I, Berger C, Ehlers V, Willershausen B, Briseño B. Survey of root canal irrigating solutions used in dental practices within Germany. Int Endod J 2014; 48:654-60. [PMID: 25088019 DOI: 10.1111/iej.12360] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 07/31/2014] [Indexed: 11/28/2022]
Abstract
AIM Irrigant usage information in relation to years of professional experience was collected from general dentists in different German federal states by means of a questionnaire. METHODOLOGY A short survey concerning endodontic treatment and use of irrigants was mailed to 4240 dentists or delivered to 3720 dental offices as an extra page in a journal in eight German states. Detailed information concerning the most frequently used irrigants, their concentrations, the spectrum of disinfectants used in root canal treatment concepts for vital and nonvital pulps, main topics of continuing education as well as years of professional experience was collected. The statistical analysis of differences found amongst the dentists in relation to professional experience or federal state was performed using the chi-square test. RESULTS Of a total of 7960 invitations, 1630 replies were evaluated (response rate 20.5%). The majority of the dentists (57.3%) had >20 years of professional experience, 23% had >30 years. Dentists with long-standing professional experience (20-30 years) used H2 O2 significantly more often than dentists with less experience (P < 0.001), and of the older colleagues (>30 years of professional experience), 14.6% never used NaOCl, whilst the younger colleagues almost always used it (P < 0.001). Differences were also found for the usage of irrigants amongst dentists from the various German states. CONCLUSIONS Whilst NaOCl was used in almost all states, regional differences were found regarding the choice of additional irrigants, which were mainly determined by the irrigation protocols taught at different universities.
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Affiliation(s)
- I Willershausen
- Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - T G Wolf
- Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - I Schmidtmann
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Johannes Gutenberg University, Mainz, Germany
| | - C Berger
- Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - V Ehlers
- Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - B Willershausen
- Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - B Briseño
- Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Savani GM, Sabbah W, Sedgley CM, Whitten B. Current Trends in Endodontic Treatment by General Dental Practitioners: Report of a United States National Survey. J Endod 2014; 40:618-24. [DOI: 10.1016/j.joen.2014.01.029] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 01/15/2014] [Accepted: 01/15/2014] [Indexed: 10/25/2022]
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Clarkson RM, Smith TK, Kidd BA, Evans GE, Moule AJ. Assessment of residual active chlorine in sodium hypochlorite solutions after dissolution of porcine incisor pulpal tissue. Aust Dent J 2013; 58:428-33. [DOI: 10.1111/adj.12115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 02/22/2013] [Accepted: 03/13/2013] [Indexed: 11/30/2022]
Affiliation(s)
- R M Clarkson
- School of Dentistry, The University of Queensland
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Gopikrishna V, Pare S, Pradeep Kumar A, Lakshmi Narayanan L. Irrigation protocol among endodontic faculty and post-graduate students in dental colleges of India: A survey. J Conserv Dent 2013; 16:394-8. [PMID: 24082565 PMCID: PMC3778618 DOI: 10.4103/0972-0707.117486] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 04/05/2013] [Accepted: 05/25/2013] [Indexed: 11/20/2022] Open
Abstract
Background: Irrigation protocol is the most critical step during the disinfection of an infected root canal system. Aim: The purpose of this study was to determine the root canal irrigation trends being practiced among the endodontic teaching faculty and post-graduate students in the dental colleges present in India. Materials and Methods: A postal invitation to participate in this national survey was sent to the Department of Conservative Dentistry and Endodontic of 294 Dental Colleges present in India. A total of 2389 forms were successfully delivered out of which 794 duly filled forms were received back. Survey participants were asked about their irrigant selection, irrigant concentration, smear layer removal protocol, and use of adjuncts during irrigation. Results: This survey elicited a positive response rate of 33.23%. Our data indicated that 92.8% of respondents use sodium hypochlorite (NaOCl) as the primary endodontic irrigant, with 26 gauge needle being most preferred for syringe irrigation, with 49.3% of them using it at a concentration of 2.6-4.0%. 68% of our respondents aim to remove the smear layer during the endodontic treatment while 47% reported using ultrasonic activation as an adjunct during their irrigation protocol. Conclusions: The findings of this survey are that the majority of teaching institutions in India are employing NaOCl (2.6-4.0%) as the primary endodontic irrigant. The concept of smear layer removal is high (68%), and there is a general trend (78%) to modify the irrigation protocol according to the status of the pulp, status of the periapex and in retreatment cases.
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Affiliation(s)
- Velayutham Gopikrishna
- Department of Conservative Dentistry and Endodontics, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
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Clarkson RM, Kidd B, Evans GE, Moule AJ. The Effect of Surfactant on the Dissolution of Porcine Pulpal Tissue by Sodium Hypochlorite Solutions. J Endod 2012; 38:1257-60. [DOI: 10.1016/j.joen.2012.05.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 05/12/2012] [Accepted: 05/17/2012] [Indexed: 10/28/2022]
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Irrigation Trends among American Association of Endodontists Members: A Web-based Survey. J Endod 2012; 38:37-40. [DOI: 10.1016/j.joen.2011.08.013] [Citation(s) in RCA: 137] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 08/08/2011] [Accepted: 08/09/2011] [Indexed: 11/17/2022]
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Clarkson RM, Podlich HM, Moule AJ. Influence of Ethylenediaminetetraacetic Acid on the Active Chlorine Content of Sodium Hypochlorite Solutions When Mixed in Various Proportions. J Endod 2011; 37:538-43. [DOI: 10.1016/j.joen.2011.01.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Revised: 01/14/2011] [Accepted: 01/15/2011] [Indexed: 10/18/2022]
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Bronnec F, Bouillaguet S, Machtou P. Ex vivo assessment of irrigant penetration and renewal during the final irrigation regimen. Int Endod J 2010; 43:663-72. [DOI: 10.1111/j.1365-2591.2010.01723.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Clarkson RM, Moule AJ, Podlich H, Kellaway R, Macfarlane R, Lewis D, Rowell J. Dissolution of porcine incisor pulps in sodium hypochlorite solutions of varying compositions and concentrations. Aust Dent J 2008; 51:245-51. [PMID: 17037892 DOI: 10.1111/j.1834-7819.2006.tb00437.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The solubility of dental pulp tissue in sodium hypochlorite has been extensively investigated but results have been inconsistent; due most likely to variations in experimental design, the volume and/or rate of replenishment of the solutions used and the nature of the tissues assessed. Traditionally, the sodium hypochlorite solutions used for endodontic irrigation in Australia have been either Milton or commercial bleach, with Milton being the most common. Recently, a range of Therapeutic Goods Administration (TGA) approved proprietary sodium hypochlorite solutions, which contain surfactant, has become available. Some domestic chlorine bleaches now also contain surfactants. The purpose of this study was to perform new solubility assessments, comparing Milton with new TGA approved products, Hypochlor 1% and Hypochlor 4% forte, and with a domestic bleach containing surfactant (White King). METHODS Ten randomly assigned pulp samples of porcine dental pulp of approximately equal dimensions were immersed in the above solutions, as well as representative concentrations of sodium hydroxide. Time to complete dissolution was measured and assessed statistically. RESULTS White King 4% showed the shortest dissolution time, closely followed by Hypochlor 4% forte. White King 1% and Hypochlor 1% each took around three times as long to completely dissolve the samples of pulp as their respective 4% concentrations, while Milton took nearly 10 times as long. The sodium hydroxide solutions showed no noticeable dissolution of the pulp samples. CONCLUSIONS The composition and content of sodium hypochlorite solutions had a profound effect on the ability of these solutions to dissolve pulp tissue in vitro. Greater concentrations provided more rapid dissolution of tissue. One per cent solutions with added surfactant and which contained higher concentrations of sodium hydroxide were significantly more effective in dissolution of pulp tissue than Milton.
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KISHEN ANIL. Mechanisms and risk factors for fracture predilection in endodontically treated teeth. ACTA ACUST UNITED AC 2006. [DOI: 10.1111/j.1601-1546.2006.00201.x] [Citation(s) in RCA: 197] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sum CP, Neo J, Kishen A. What We Leave Behind In Root Canals After Endodontic Treatment: Some Issues and Concerns. AUST ENDOD J 2005; 31:94-100. [PMID: 16392730 DOI: 10.1111/j.1747-4477.2005.tb00312.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The benefits of using sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) as endodontic irrigants, and calcium hydroxide as an inter-appointment medicament, are well known to dentists. Many steps undertaken during endodontic treatment and retreatment are rather mechanical in nature, and less attention is committed to understanding the biological issues underlying endodontic treatment and retreatment. It should be noted that dentine is the fundamental substrate in endodontic treatment, and its properties and characteristics are the key determinant of nearly all disease and post-disease processes in the teeth. In this article the effects and counter-effects of NaOCl and EDTA on root canal dentine, and some other related issues are reviewed. This information will enable clinicians to use the beneficial effects of these chemicals, while necessary steps are considered to reduce their harmful effects on dentine substrate.
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Affiliation(s)
- Chee Peng Sum
- Department of Restorative Dentistry, National University of Singapore.
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Abstract
BACKGROUND Rotary NiTi technology was introduced into Australia approximately 10 years ago. Little information is available in the dental literature to explain the adoption of new technology in dentistry. The aim of this paper is to identify and describe demographic features in the uptake of rotary NiTi technology within Australia. METHODS In 2001, a questionnaire survey was mailed to a stratified systematic sample of general dentists and endodontists in Australia. The numbers of dentists in each state adopting the new technology were recorded and the results tabulated and graphed. RESULTS The response rate for the survey was 87 per cent. Overall, 26 per cent of responders used rotary NiTi instruments with a significantly higher proportion of endodontists (64 per cent) than general dentists (22 per cent). A significantly lower proportion of South Australian metropolitan general dentists used rotary NiTi compared with metropolitan dentists in all other states combined. The rate of uptake by South Australian dentists was lower than the other states. A significantly higher proportion of Queensland endodontists were using rotary NiTi compared with endodontists in New South Wales. A significantly greater proportion of rural dentists had tried and abandoned the new technology than metropolitan dentists. CONCLUSIONS The adoption of rotary NiTi in Australia appears to conform to diffusion of innovation theory and has reached a critical mass making it self-sustaining.
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Affiliation(s)
- P Parashos
- School of Dental Science, The University of Melbourne, Victoria.
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