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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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Cong X, Xue M. Evaluation of root-canal isthmus debridement efficacy of 3 kinds of activated irrigation technique. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2022; 40:554-559. [PMID: 38596976 PMCID: PMC9588857 DOI: 10.7518/hxkq.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/12/2022] [Indexed: 04/11/2024]
Abstract
OBJECTIVES This study aimed to compare the capabilities of sonic, ultrasonic, and laser-activated irrigation for debris removal in the root canal isthmus. METHODS A total of 32 human maxillary first premolars with root canal isthmus were prepared by Reciproc Blue, and were randomly divided into four groups (n=8, each group). The groups were subsequently subjected to different regimens as follows: the conventional syringe group (control group) was irrigated by No.27 side opening syringe, the sonic group with EDDY connected pneumatic motor, the ultrasonic group with IRRI Safe connected to a ultrasonic P5 handle, and the laser group with Er:YAG laser device connected to a 9 mm fiber tip for 20 s in each root canal. The first and last four samples in each group were irrigated for 80 and 120 s, respectively. All samples were fixed, decalcified, embedded, sectioned, and stained with hematoxylin-eosin. Image J software was used for measurement analysis of the isthmus and canal debridement efficacy, and SPSS 25.0 was utilized for statistical analysis of all data. RESULTS The isthmus debridement efficacy of conventional syringe irrigation, sonic, ultrasonic, and laser groups after 80 s irrigation were 30.91%±3.14%, 52.22%±0.31%, 83.77%±5.64%, and 77.97%±7.97%, respectively. The isthmus debridement efficacy of the three experimental groups were better than the conventional syringe irrigation group (P<0.05). The isthmus debridement efficacies of ultrasonic and laser groups after 80 s were better than that of the sonic group (P<0.01, P<0.05). However, no significant difference was observed between the ultrasonic and laser groups. The isthmus debridement efficacy of conventional syringe irrigation, sonic, ultrasonic, and laser groups after 120 s were 75.72%±2.38%, 85.66%±4.42%, 88.07%±4.09%, and 89.12%±3.63%, respectively. The isthmus debridement efficacies of the three experimental groups were better than that of the conventional syringe irrigation group (P<0.05), but no significant difference was observed among the groups (P>0.05). The root canal debridement efficacy among the four groups also exhibited no significant difference (P>0.05). The debridement efficacies of the root canal and isthmus after 120 s irrigation were better than those after 80 s irrigation (P<0.01, P<0.001). CONCLUSIONS Ultrasonic, sonic, and laser-activated irrigation have better results in removing debris from the isthmus than conventional syringe irrigation. The isthmus debridement efficacy of sonic- and laser-activated irrigation are slightly better than that of ultrasonic activated irrigation. The debridement efficacies of 120 s irrigation are better than those of 80 s irrigaion.
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Affiliation(s)
- Xinyu Cong
- Dept. of Conservative Dentistry and Endodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - Ming Xue
- Dept. of Conservative Dentistry and Endodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
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Dos Santos MC, da Silveira Teixeira C, da Fonseca Roberti Garcia L, Henriques B, Tay FR, Bortoluzzi EA. Heated distilled water with or without continuous ultrasonic irrigation improves final irrigation efficacy and reduces dentine erosion. J Dent 2020; 103:103507. [PMID: 33098929 DOI: 10.1016/j.jdent.2020.103507] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The present study evaluated the effects of using heated distilled water (HDW), with or without continuous ultrasonic irrigation (CUI), on smear layer removal and deterioration of root dentine microstructure. MATERIALS AND METHODS After chemomechanical preparation, 60 human teeth were longitudinally cleaved into two halves for smear layer quantification at the cervical-third, middle-third and apical root-third of the canal space. After reassembly, the root canals were irrigated with 17 % EDTA, followed by one of the six final irrigation protocols (n = 10) - G1: conventional irrigation (CI)+NaOCl at 25 °C; G2: NaOCl at 25 °C + CUI; G3: CI with DW at 25 °C; G4: DW at 25 °C + CUI; G5: CI + HDW at 65 °C; G6: HDW at 65 °C + CUI. Tooth-halves were processed and examined by scanning electron microscopy. The percentage of opened dentinal tubules in the irrigated areas of the canal space was expressed as a percentage of the total surface area. Dentine erosion was classified by numeric scores. Smear layer removal was analysed with ANOVA and Student-Newman-Keuls tests; dentine erosion was analysed with Cohran-Mantel-Haenstel statistic (α = 0.05). RESULTS The cervical-third had a higher percentage of open dentinal tubules for all groups (p < 0.05). In G2, the middle-third had a lower percentage of open tubules, which was significantly different from the other groups (p < 0.05). Groups that utilised NaOCl as the final irrigant had more extensive erosion when CUI was used. CONCLUSION Heated distilled water, with or without CUI, was as efficient as 1 % NaOCl in the final cleaning of the instrumented canal space. The use of HDW produces less extensive dentine erosion. CLINICAL SIGNIFICANCE Heated distilled water removes smear layers with less deleterious effects on dentine microstructure and may be considered a final irrigant after mechanical preparation and EDTA chelation.
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Affiliation(s)
| | | | | | - Bruno Henriques
- Department of Dentistry, Endodontics Division, Health Sciences Center, Federal University, Brazil; Ceramic and Composite Materials Research Group (CERMAT), Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil; CMEMS-UMinho, University of Minho, Campus de Azurém, Guimarães, Portugal of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Franklin R Tay
- Department of Endodontics, The Dental College of Georgia, Augusta, GA, USA.
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Comparative Analysis of Biofilm Removal Efficacy by Multisonic Ultracleaning System and Passive Ultrasonic Activation. MATERIALS 2019; 12:ma12213492. [PMID: 31731396 PMCID: PMC6862130 DOI: 10.3390/ma12213492] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 10/20/2019] [Accepted: 10/22/2019] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to compare disinfection and the biofilm removal efficacy of the GentleWave System (Sonendo, Inc., Laguna Hills, CA, USA) with passive ultrasonic activation method. Forty-seven freshly extracted human molars were inoculated with Enterococcus faecalis and cultured for five weeks to establish biofilm. Eight molars were tested for confirmation of infection. Four of the eight teeth were not inoculated in order to provide a negative control. The remaining 39 inoculated molars were randomly separated into three treatment groups (n = 13 per group): Group 1-no treatment, Group 2-conventional rotary instrumentation and passive ultrasonic activation, and Group 3-minimal instrumentation and the GentleWave System treatment. Roots were subsequently prepared per standard histological tissue processing procedures. Modified Brown and Brenn stained sections and Hematoxylin and Eosin stained sections were visualized at 4× and 13.5× magnification using a stereomicroscope. The sections were scored and blindly analyzed by two independent evaluators, including a histopathologist, to evaluate the presence of biofilm on canal wall. A significant difference was found between Group 2 and Group 3 in both apical and middle regions (p = 0.001) of the mesial roots of mandibular molars and mesiobuccal roots of maxillary molars. Group 3 revealed significantly less biofilm than the controls (p = 0.003). The GentleWave System demonstrated significantly greater reduction in biofilm within the mesial roots of mandibular molars and mesiobuccal roots of maxillary molars than those treated with conventional rotary instrumentation and passive ultrasonic activation protocol.
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Ultrasonic Irrigant Activation during Root Canal Treatment: A Systematic Review. J Endod 2019; 45:31-44.e13. [PMID: 30558797 DOI: 10.1016/j.joen.2018.09.010] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/05/2018] [Accepted: 09/16/2018] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The aim of this study was to systematically review the evidence on the cleaning and disinfection of root canals and the healing of apical periodontitis when ultrasonic irrigant activation is applied during primary root canal treatment of mature permanent teeth compared with syringe irrigation. METHODS An electronic search was conducted of the Cochrane Library, Embase, LILACS, PubMed, SciELO, and Scopus databases using both free-text key words and controlled vocabulary. Additional studies were sought through hand searching of endodontic journals and textbooks. The retrieved studies were screened by 2 reviewers according to predefined criteria. The included studies were critically appraised, and the extracted data were arranged in tables. RESULTS The electronic and hand search retrieved 1966 titles. Three clinical studies and 45 in vitro studies were included in this review. Ultrasonic activation did not improve the healing rate of apical periodontitis compared with syringe irrigation after primary root canal treatment of teeth with a single root canal. Conflicting results were reported by the in vitro microbiological studies. Ultrasonic activation was more effective than syringe irrigation in the removal of pulp tissue remnants and hard tissue debris based on both clinical and in vitro studies. Ultrasonic activation groups were possibly favored in 13 studies, whereas syringe irrigation groups may have been favored in 3 studies. CONCLUSIONS The level of the available evidence was low, so no strong clinical recommendations could be formulated. Future studies should focus on the antimicrobial effect and healing of apical periodontitis in teeth with multiple root canals.
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Jamleh A, Suda H, Adorno CG. Irrigation effectiveness of continuous ultrasonic irrigation system: An ex vivo study. Dent Mater J 2018; 37:1-5. [PMID: 28883300 DOI: 10.4012/dmj.2016-411] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study evaluated the irrigation extrusion and smear layer (SL) removal of continuous ultrasonic irrigation (CUI). Forty root canals were shaped, embedded in warm sterile saline agar colored with 1% acid red, and distributed into four groups; three groups had the final irrigation sequence of sodium hypochlorite and EDTA solutions performed by using syringe irrigation (SI), EndoVac (EV), and CUI, respectively. Group 4 had the canals ultrasonically irrigated with saline (CUIS). Irrigant extrusion was verified by a color change of the agar. The SL was evaluated under scanning electron microscope. Irrigant extrusion was observed in two and four teeth in the CUI and SI, respectively, whilst none had irrigant extruded in the EV. In term of SL, the CUI was comparable to EV at 1 and 3 mm but different to SI at 1 mm. Although CUI might clean the root canal system effectively, it was unable to avoid irrigant extrusion.
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Affiliation(s)
- Ahmed Jamleh
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Restorative and Prosthetic Dental Sciences, College of Dentistry, Ministry of National Guard Health Affairs
| | - Hideaki Suda
- Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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Gu Y, Perinpanayagam H, Jin DJ, Yoo YJ, Jeong JS, Lim SM, Chang SW, Baek SH, Zhu Q, Kum KY. Effect of Different Agitation Techniques on the Penetration of Irrigant and Sealer into Dentinal Tubules. Photomed Laser Surg 2017; 35:71-77. [DOI: 10.1089/pho.2016.4125] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Yu Gu
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea
- Department of Conservative Dentistry, School of Stomatology, Shandong University, Jinan, China
| | - Hiran Perinpanayagam
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada
| | - David J.W. Jin
- Department of Biology, Siena College, Loudonville, New York
| | - Yeon-Jee Yoo
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Jin-Sun Jeong
- Department of Advanced General Dentistry, Yonsei University Medical Center, Oral Science Institute, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Sang-Min Lim
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Seok-Woo Chang
- Department of Conservative Dentistry, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Seung-Ho Baek
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Qiang Zhu
- Division of Endodontology, Department of Oral Health and Diagnostic Sciences, University of Connecticut Health Center, School of Dental Medicine, Farmington, Connecticut
| | - Kee-Yeon Kum
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul, Republic of Korea
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Konstantinidi E, Psimma Z, Chávez de Paz LE, Boutsioukis C. Apical negative pressure irrigation versus syringe irrigation: a systematic review of cleaning and disinfection of the root canal system. Int Endod J 2017; 50:1034-1054. [PMID: 27898180 DOI: 10.1111/iej.12725] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 11/24/2016] [Indexed: 01/10/2023]
Abstract
The aim of this study was to systematically review and critically analyse the published data on the treatment outcome (primary outcome) and on the cleaning and disinfection of root canals (secondary outcomes) achieved by negative pressure irrigation as compared to syringe irrigation. An electronic search was conducted in EMBASE, LILACS, PubMed, SciELO, Scopus and Web of Knowledge using both free-text keywords and controlled vocabulary. Additional studies were sought through hand searching of endodontic journals and of the relevant chapters of endodontic textbooks. No language restriction was imposed. The retrieved studies were screened by two reviewers according to predefined criteria. Included studies were critically appraised and the extracted data were arranged in tables. The electronic search and hand search retrieved 489 titles. One clinical study and 14 in vitro studies were finally included in the review; none of these studies assessed treatment outcome, four studies assessed the antimicrobial effect, seven studies evaluated the removal of pulp tissue remnants, and four studies investigated the removal of hard tissue debris or both hard tissue debris and pulp tissue remnants. Poor standardization and description of the protocols was evident. Inconclusive results were reported about the cleaning and disinfection accomplished by the two irrigation methods. Negative pressure irrigation was more effective under certain conditions when compared to suboptimal syringe irrigation; however, the variability of the protocols hindered quantitative synthesis. There is insufficient evidence to claim general superiority of any one of these methods. The level of the available evidence is low, and the conclusions should be interpreted with caution.
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Affiliation(s)
- E Konstantinidi
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Z Psimma
- Private Practice, Rotterdam, The Netherlands
| | - L E Chávez de Paz
- Division of Endodontics, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - C Boutsioukis
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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Jiang S, Zou T, Li D, Chang JWW, Huang X, Zhang C. Effectiveness of Sonic, Ultrasonic, and Photon-Induced Photoacoustic Streaming Activation of NaOCl on Filling Material Removal Following Retreatment in Oval Canal Anatomy. Photomed Laser Surg 2015; 34:3-10. [PMID: 26682489 DOI: 10.1089/pho.2015.3937] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study aimed to assess the effectiveness of sonic, ultrasonic and laser [photon-induced photoacoustic streaming (PIPS)] irrigation activation in removing filling remnants from oval root canals after standard canal retreatment procedures with the ProTaper universal rotary retreatment system. METHODS Twenty-eight maxillary first premolars were instrumented with ProTaper NiTi rotary instruments and obturated with gutta-percha and AH Plus sealer using the continuous wave of condensation technique. After storage at 37°C and 100% humidity for 1 week, the specimens were retreated with the ProTaper universal retreatment system for the removal of filling material. Teeth were then randomly assigned into four groups (n = 7): group 1, positive control; group 2, retreated with sonic irrigation; group 3, retreated with ultrasonic irrigation; and group 4, retreated with laser irradiation. The specimens were scanned using micro-CT before instrumentation, after obturation and mechanical retreatment, and after additional activation procedures. The percentage volume of the filling remnants was measured. Specimens were split longitudinally after micro-CT scan, canal walls were examined using scanning electron microscopy (SEM), and the amount of residual filling material was scored. RESULTS The filling materials' removal efficacy in the three experimental groups was higher than that of the control group (p < 0.05), whereas filling materials ranging from 1.46 ± 0.30 to 2.21 ± 0.46 mm(3) remained in the canal in all three experimental groups. Additionally, there was a significantly greater reduction in the amount of filling remnants in the PIPS group than in the sonic and ultrasonic groups (both p < 0.05), and significantly greater reduction in the ultrasonic group than the sonic group (p < 0.05). CONCLUSIONS Activation of NaOCl with PIPS showed significantly better performance than sonic and ultrasonic techniques in removing the filling remnants following mechanical retreatment of oval root canals. The ultrasonic technique also performed better than the sonic technique. However, none of the additional activation procedures was able to completely eliminate the filling remnants.
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Affiliation(s)
- Shan Jiang
- 1 Department of Endodontics and Operative Dentistry I, School and Hospital of Stomatology, Fujian Medical University , Fujian, China
| | - Ting Zou
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Hong Kong SAR, China
| | - Dongxia Li
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Hong Kong SAR, China .,3 Department of Stomatology, Air Force General Hospital of the PLA , Haidian District, Beijing, China
| | - Jeffery W W Chang
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Hong Kong SAR, China
| | - Xiaojing Huang
- 1 Department of Endodontics and Operative Dentistry I, School and Hospital of Stomatology, Fujian Medical University , Fujian, China
| | - Chengfei Zhang
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Hong Kong SAR, China
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Li D, Jiang S, Yin X, Chang JWW, Ke J, Zhang C. Efficacy of Needle, Ultrasonic, and Endoactivator Irrigation and Photon-Induced Photoacoustic Streaming in Removing Calcium Hydroxide from the Main Canal and Isthmus: An In Vitro Micro-Computed Tomography and Scanning Electron Microscopy Study. Photomed Laser Surg 2015; 33:330-7. [PMID: 26067942 DOI: 10.1089/pho.2015.3903] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this in vitro study was to use high-resolution micro-computed tomography (micro-CT) and scanning electron microscopy (SEM) to compare the efficacy of four irrigation techniques [needle, ultrasonic, EndoActivator, and photon-induced photoacoustic streaming (PIPS)] in removing calcium hydroxide (Ca[OH]2) from the root canal and isthmus of maxillary premolars. METHODS Twenty-four maxillary first premolars were selected based on the presence of isthmus regions on micro-CT scans. Root canals were instrumented with an F2 file using ProTaper rotary instruments and filled with Ca(OH)2 paste. Samples were stored at 37°C and 100% humidity for 1 week and randomly divided into four groups (n=6 each), according to irrigation technique. Samples were scanned with micro-CT before instrumentation, after Ca(OH)2 filling, and after irrigation. Ca(OH)2 reduction in the coronal, middle, and apical thirds and in the isthmus were assessed with three-dimensional image analysis. Next, specimens were split longitudinally, and canal walls were examined with SEM for Ca(OH)2 residues. Data were statistically evaluated with the Kruskal-Wallis and Mann-Whitney tests (p=0.05). RESULTS The PIPS and ultrasonic groups showed greater Ca(OH)2 reduction in the apical third and higher cleanliness of the isthmus than the EndoActivator and needle irrigation groups (p<0.05). Ca(OH)2 residue scores in the PIPS and ultrasonic groups were significantly lower than those in the EndoActivator and needle groups in all regions of the root canals (p<0.05). There was no significant difference between PIPS and ultrasonic groups (p>0.05), or between EndoActivator and needle groups (p>0.05). CONCLUSIONS PIPS and ultrasonic irrigation more effectively removed Ca(OH)2 from the main canal and isthmus in maxillary premolars than did EndoActivator or needle irrigation.
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Affiliation(s)
- Dongxia Li
- 1 Department of Stomatology, Air Force General Hospital of the PLA , Haidian District, Beijing, China .,2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| | - Shan Jiang
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| | - Xingzhe Yin
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China .,3 VIP Dental Service & Geriatric Dentistry, School and Hospital of Stomatology, Peking University , Haidian District, Beijing, China
| | - Jeffrey Wen Wei Chang
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
| | - Jie Ke
- 1 Department of Stomatology, Air Force General Hospital of the PLA , Haidian District, Beijing, China
| | - Chengfei Zhang
- 2 Comprehensive Dental Care, Endodontics, Faculty of Dentistry, The University of Hong Kong , Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, China
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Llena C, Forner L, Cambralla R, Lozano A. Effect of three different irrigation solutions applied by passive ultrasonic irrigation. Restor Dent Endod 2015; 40:143-8. [PMID: 25984476 PMCID: PMC4432257 DOI: 10.5395/rde.2015.40.2.143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 12/20/2014] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES This study evaluated the maximum depth and percentage of irrigant penetration into dentinal tubules by passive ultrasonic irrigation (PUI). MATERIALS AND METHODS Thirty extracted human teeth were instrumented and divided into three groups. According to final irrigation regimen, 5.25% sodium hypochlorite (Group A, NaOCl), 2% chlorhexidine (Group B, CHX) and saline solution (Group C, control group) were applied with Irrisafe 20 tips (Acteon) and PUI. Irrigant was mixed with 0.1% rhodamine B. Sections at 2 mm, 5 mm, and 8 mm from the apex were examined with confocal laser scanning microscopy (CLSM). The percentage and maximum depth of irrigant penetration were measured. Kruskal-Wallis test and Mann-Whitney test were performed for overall comparison between groups at each level and for pairwise comparison, respectively. Within a group, Wilcoxon test was performed among different levels. p values less than 0.05 were considered significant. RESULTS In all groups, highest penetration depth and percentage of penetration were observed at the 8 mm level. At 2 mm level, Groups A and B had significantly greater depths and percentages in penetration than Group C (p < 0.05), but there were no significant differences between Groups A and B. At 5 mm level, penetration depths and percentage of penetration was not significantly different among the groups. CONCLUSIONS NaOCl and CHX applied by PUI showed similar depth and percentage of penetration at all evaluated levels.
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Affiliation(s)
- Carmen Llena
- Department of Stomatology, Universitat de València, Valencia, Spain
| | - Leopoldo Forner
- Department of Stomatology, Universitat de València, Valencia, Spain
| | | | - Adrian Lozano
- Department of Stomatology, Universitat de València, Valencia, Spain
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