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Akçay A, Gorduysus M, Gorduysus MO, Annamma LM, Müftüoglu S. A Comparative Evaluation of the Cleaning Efficacy of Five Different Root Canal Irrigation Devices: A Histological Study. Eur J Dent 2023. [PMID: 37995725 DOI: 10.1055/s-0043-1774325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023] Open
Abstract
OBJECTIVES This study is aimed to evaluate the cleaning efficacy of five different irrigation systems as SonicMax, RinsEndo, EndoVac, passive ultrasonic irrigation (PUI), and manual needle irrigation (MNI) to histologically evaluate the presence of organic structures and the penetration of irrigation solution. MATERIALS AND METHODS Forty-two single-rooted, extracted human mandibular premolars were used in the study. Each tooth was decoronated at the cementoenamel junction and the root canals were instrumented using ProTaper rotary instruments in a crown-down manner. The specimens were randomly divided into five experimental groups (n = 7) Group (1) SonicMax, group (2) RinsEndo,group (3) EndoVac, group (4) PUI, group (5) MNI, and the control groups (n = 7). Each system used 2.5% sodium hypochlorite (NaOCl), 17% ethylenediamine tetraacetic acid (EDTA), and 2.5% NaOCl, respectively, in the experimental groups. The control group did not receive any final irrigation.The measurements were analyzed by employing two-way analysis of variance multivariate results to show significant differences between the length of the dentin tubules in the apical, middle, and coronal of the six groups. The post-hoc test was used when groups were compared by pairs. RESULTS The results of this study indicate that among the five groups, the RinsEndo and EndoVac were found to be most effective in the cleaning of root canals. The RinsEndo shows highly significant results in the cleaning efficiency of the coronal and middle parts compared with the other groups. The cleaning efficiency in the apical area was the same for RinsEndo and EndoVac. CONCLUSION The result of our study indicates that RinsEndo and EndoVac may be more effective in clinical practice.
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Affiliation(s)
- Alper Akçay
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkiye
| | | | - Mehmet Omer Gorduysus
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Lovely M Annamma
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Sevda Müftüoglu
- Department of Histology and Embryology, Faculty of Medicine, Hacettepe University, Ankara, Turkiye
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de Moraes Cruz V, Duarte MAH, Kato AS, Alcalde MP, Coelho LAS, Tanomaru-Filho M, Gavini G, Vivan RR. Impact of the final agitation system in the irrigant diffusion inside the root canal: A micro-CT analysis. AUST ENDOD J 2023; 49 Suppl 1:315-322. [PMID: 36658667 DOI: 10.1111/aej.12735] [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: 07/28/2022] [Revised: 11/20/2022] [Accepted: 01/09/2023] [Indexed: 01/21/2023]
Abstract
This study evaluated, through micro-computed tomography (micro-CT), the volume of irrigant diffusion by different techniques of final agitation. Sixty mesiobuccal canals were scanned in a micro-CT and standardised according to the volume. They were instrumented with the MTwo 40/04 system and using the Terebrix 35 contrast solution as irrigant, were divided into six groups (n = 10): Conventional irrigation with syringe and needle (CI), EndoActivator (EA), EasyClean (EC), RinsEndo (RE), Utrasonic agitation (UI) and XP-Clean (XP). A second micro-CT scan was performed and the total irrigant volume and in the final 3 mm apical were determined. The data were analysed using the Anova, Kruskal-Wallis and Dunn tests (p < 0.05). UI and XP showed a higher percentage of total diffusion than CI, EA and RS groups (p < 0.05). In apical diffusion, there was no significant difference between groups (p > 0.05). The final agitation system increases the diffusion of irrigating agents inside the root canal.
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Affiliation(s)
- Victor de Moraes Cruz
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Marco Antônio Húngaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Augusto Shoji Kato
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Murilo Priori Alcalde
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Letycia Accioly Simões Coelho
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Mario Tanomaru-Filho
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University, Araraquara, Brazil
| | - Giulio Gavini
- School of Dentistry, Discipline of Endodontics, Universidade de São Paulo - USP, São Paulo, Brazil
| | - Rodrigo Ricci Vivan
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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Gomes BPFA, Aveiro E, Kishen A. Irrigants and irrigation activation systems in Endodontics. Braz Dent J 2023; 34:1-33. [PMID: 37909632 PMCID: PMC10642269 DOI: 10.1590/0103-6440202305577] [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: 05/31/2023] [Accepted: 06/12/2023] [Indexed: 11/03/2023] Open
Abstract
Root canal infections are typically polymicrobial and involve strong bacterial interactions. The goal of endodontic treatment is to remove infected content from the root canal system to allow the healing of a pre-existing periapical lesion or to prevent infection of the periradicular tissues. Instrumentation alone is not capable of touching all of the root canal walls. Therefore, the irrigation process is an essential step in the endodontic treatment. However, due to the complex anatomy of the root canal system, this cleaning is very challenging. Although syringe and needle irrigation associated with the use of chemical substances is still the most used method, it does not guarantee optimal cleaning of the root canals. As a result, not only alternative irrigating substances but also numerous activation systems - which are technologies that aim to optimize the action of irrigating substances, both chemically and physically - have been developed. This work aimed to review the characteristics of both classic and current alternatives of irrigating substances and irrigation activation systems.
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Affiliation(s)
- Brenda P. F. A. Gomes
- Department of Restorative Dentistry, Division of Endodontics,
Piracicaba Dental School - State University of Campinas, UNICAMP, Brazil
| | - Emelly Aveiro
- Department of Restorative Dentistry, Division of Endodontics,
Piracicaba Dental School - State University of Campinas, UNICAMP, Brazil
| | - Anil Kishen
- Department of Dentistry, University of Toronto, Canada
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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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Boutsioukis C, Verhaagen B, van der Sluis LWM, Versluis M. Irrigant flow in the root canal during ultrasonic activation: a numerical fluid-structure interaction model and its validation. Int Endod J 2022; 55:938-949. [PMID: 35762040 PMCID: PMC9545492 DOI: 10.1111/iej.13791] [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: 04/30/2021] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 11/26/2022]
Abstract
Aim The aim of the study was (a) to develop a three‐dimensional numerical model combining the oscillation of a tapered ultrasonic file and the induced irrigant flow along with their two‐way interaction in the confinement of a root canal. (b) To validate this model through comparison with experiments and theoretical (analytical) solutions of the flow. Methodology Two partial numerical models, one for the oscillation of the ultrasonic file and another one for the irrigant flow inside the root canal around the file, were created and coupled in order to take into account the two‐way coupled fluid–structure interaction. Simulations were carried out for ultrasonic K‐files and for smooth wires driven at four different amplitudes in air or inside an irrigant‐filled straight root canal. The oscillation pattern of the K‐files was determined experimentally by Scanning Laser Vibrometry, and the flow pattern inside an artificial root canal was analysed using high‐speed imaging together with Particle Image Velocimetry. Analytical solutions were obtained from an earlier study. Numerical, experimental and analytical results were compared to assess the validity of the model. Results The comparison of the oscillation amplitude and node location of the ultrasonic files and of the irrigant flow field showed a close agreement between the simulations, experiments and theoretical solutions. Conclusions The model is able to predict reliably the file oscillation and irrigant flow inside root canals during ultrasonic activation under similar conditions.
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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
| | - B Verhaagen
- Physics of Fluids Group, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands
| | - L W M van der Sluis
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M Versluis
- Physics of Fluids Group, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands.,Technical Medical (TechMed) Centre and MESA+ Institute for Nanotechnology, University of Twente, Enschede, The Netherlands
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Neelakantan P, Vishwanath V, Taschieri S, Corbella S. Present status and future directions ‐ Minimally invasive root canal preparation and periradicular surgery. Int Endod J 2022; 55 Suppl 4:845-871. [DOI: 10.1111/iej.13750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 11/30/2022]
Affiliation(s)
- P. Neelakantan
- Faculty of Dentistry The University of Hong Kong Hong Kong SAR
| | - V. Vishwanath
- Faculty of Dentistry The University of Hong Kong Hong Kong SAR
| | - S. Taschieri
- Department of Biomedical Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
- Department of Oral Surgery Institute of Dentistry I. M. Sechenov First Moscow State Medical University Moscow Russia
| | - S. Corbella
- Department of Biomedical Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
- Department of Oral Surgery Institute of Dentistry I. M. Sechenov First Moscow State Medical University Moscow Russia
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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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Effect of Er:YAG laser irrigation with different etching modes on the push-out bond strength of fiber posts to the root dentine. Lasers Med Sci 2022; 37:2687-2696. [PMID: 35286527 PMCID: PMC9343313 DOI: 10.1007/s10103-022-03542-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/07/2022] [Indexed: 11/25/2022]
Abstract
The objective of this study was to evaluate the effect of Er:YAG laser irrigation on the push-out bond strength of fiber posts to the root dentine. Sixty extracted human mandibular first premolars were collected and decoronated. The residual roots received endodontic treatment. The treated roots were randomly divided into three groups according to different irrigation protocols: group LAI (Er:YAG laser–activated irrigation), group PUI (passive ultrasonic irrigation, positive control), and group CSI (conventional syringe irrigation, negative control) (n = 20). Each group was divided into two subgroups, either total-etching modes or self-etching modes (n = 10). After fiber post restoration, all roots were sectioned into seven 1.0-mm-thick slices. The slices received a push-out test by a universal test machine. The resin tag on the segments’ bonding interfaces was observed by scanning electron microscope. There were significant differences in the effects of the irrigation method, bonding modes, and root regions on the push-out bond strength among the groups (p < 0.05). The specimens with Er:YAG laser–activated irrigation and self-etching mode showed significantly the highest bonding strength (p < 0.001). The lengths and densities of resin tags in group PUI or group LAI with self-etching modes were longer than those in group CSI with total-etching modes. The laser-activated irrigation with self-etching modes improved the bond strength of fiber post to root dentine compared to the passive ultrasonic irrigation or conventional syringe irrigation with total or self-etching modes.
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Boutsioukis C, Arias-Moliz MT, Chávez de Paz LE. A critical analysis of research methods and experimental models to study irrigants and irrigation systems. Int Endod J 2022; 55 Suppl 2:295-329. [PMID: 35171506 PMCID: PMC9314845 DOI: 10.1111/iej.13710] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 11/28/2022]
Abstract
Irrigation plays an essential role in root canal treatment. The purpose of this narrative review was to critically appraise the experimental methods and models used to study irrigants and irrigation systems and to provide directions for future research. Studies on the antimicrobial effect of irrigants should use mature multispecies biofilms grown on dentine or inside root canals and should combine at least two complementary evaluation methods. Dissolution of pulp tissue remnants should be examined in the presence of dentine and, preferably, inside human root canals. Micro-omputed tomography is currently the method of choice for the assessment of accumulated dentine debris and their removal. A combination of experiments in transparent root canals and numerical modeling is needed to address irrigant penetration. Finally, models to evaluate irrigant extrusion through the apical foramen should simulate the periapical tissues and provide quantitative data on the amount of extruded irrigant. Mimicking the in vivo conditions as close as possible and standardization of the specimens and experimental protocols are universal requirements irrespective of the surrogate endpoint studied. Obsolete and unrealistic models must be abandoned in favour of more appropriate and valid ones that have more direct application and translation to clinical Endodontics.
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Affiliation(s)
- C Boutsioukis
- Department of Endodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M T Arias-Moliz
- Department of Microbiology, Faculty of Dentistry, University of Granada, Granada, Spain
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Raj S, Dhingra A, Jha P, Nikhil V, Ravinder R, Mishra P. To compare the continuous and intermittent irrigation method on the removal of dentin debris from root canals and to evaluate the dynamics of irrigant flow using computational fluid dynamics. J Conserv Dent 2021; 24:94-99. [PMID: 34475688 PMCID: PMC8378498 DOI: 10.4103/jcd.jcd_636_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: 12/18/2020] [Revised: 01/24/2021] [Accepted: 02/03/2021] [Indexed: 11/19/2022] Open
Abstract
Aim: This study aimed to compare the efficiency of continuous and intermittent irrigating methods on the removal of dentin debris from the simulated grooves and to evaluate the dynamics of irrigant using computational fluid dynamics (CFD). Methodology: Seventy-five extracted human permanent maxillary canines were selected. Access cavities were made, working length was determined, and canals were prepared by crown down technique. The teeth were split longitudinally and standard groove 2.0 mm in length was made in split halves and each groove was filled with dentin debris and the images were taken under a microscope (E200). The halves were re-assembled and divided into five groups based on different irrigation methods. Group 1: ultrasonic Irrigation with continuous flow for 3.0 min; Group 2: ultrasonic irrigation with continuous flow for 1.5 min; Group 3: ultrasonic irrigation with intermittent flow for 3.0 min; Group 4: ultrasonic irrigation with the intermittent flow for 1.5 min; and Group 5: syringe irrigation for 1 min. The root halves were again separated and re-evaluated for debris elimination after the irrigation protocol for all the groups separately. The effect of time and method of passive ultrasonic irrigation were compared. For the computational fluid analysis, a GAMBIT 2.2 (Ansys) software was used for mesh construction. FLUENT 6.2 (Ansys) software was used to set the boundary conditions and reconstruction of the canal; flow patterns and turbulence were graphically constructed. Results: The continuous irrigation methods were better at debris removal than intermittent irrigation flow methods. The CFD showed that the turbulence of flow of irrigant was dependent on the inlet velocity and pressure of the irrigant. Conclusion: Debris removal from the simulated grooves was better with continuous irrigation compared with intermittent irrigation. CFD study revealed that the turbulence that was affected by the velocity and pressure of the irrigant introduced and is a variable entity.
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Affiliation(s)
- Shalya Raj
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, India
| | - Anil Dhingra
- Department of Conservative Dentistry and Endodontics, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
| | - Padmanabh Jha
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, India
| | - Vineeta Nikhil
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, India
| | - Rohit Ravinder
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, India
| | - Preeti Mishra
- Department of Conservative Dentistry and Endodontics, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, India
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Magni E, Jäggi M, Eggmann F, Weiger R, Connert T. Apical pressures generated by several canal irrigation methods: A laboratory study in a maxillary central incisor with an open apex. Int Endod J 2021; 54:1937-1947. [PMID: 34022070 PMCID: PMC8518727 DOI: 10.1111/iej.13575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 05/19/2021] [Indexed: 01/13/2023]
Abstract
Aim A laboratory study to determine the apical pressure generated by seven canal irrigation methods in an anterior tooth with an open apex. Methodology Canal irrigation was performed on a 3D‐printed central maxillary incisor with an open apex (maximum diameter of 2.1 mm). Ultrasonically activated irrigation (UAI), sonic activation (EDDY), negative pressure irrigation (EndoVac), the self‐adjusting file (SAF) and the XP‐endo Finisher were employed at tooth length (TL), TL—1 mm, TL—2 mm and TL—3 mm. UAI was tested at three intensity levels additionally. Hydrodynamic irrigation with RinsEndo was performed in the pulp chamber, at the canal orifice, the coronal third, the middle of the canal and at TL. Er:YAG laser activation, at four frequency settings, was performed in the pulp chamber and at the orifice of the canal. The pressure of the fluid towards the canal terminus generated by activation was directly transferred to a pressure sensor with a range of 0 to 120 mmHg and a response time of ≤0.5 ms. The critical threshold for apical extrusion of the irrigant was set at 5.73 mmHg (lower limit of the central venous pressure: 5.88 ± 0.15 mmHg). Each experiment was repeated ten times. The tests were followed by descriptive analyses (maximum, mean, standard deviation, 95% confidence interval). Results EndoVac, the SAF, the XP‐endo Finisher, and UAI never exceeded the critical threshold at any insertion depth or intensity level. Er:YAG laser activation exceeded the critical threshold exclusively at frequency settings that varied from the manufacturer's recommendation. EDDY at TL and RinsEndo at any insertion depth exceeded the critical threshold in 100% of the measurements. EDDY at TL—1,—2, and—3 mm crossed the critical threshold in 30%, 10%, and 20% of the measurements, respectively. Conclusions In a simulated maxillary central incisor with an open apex, irrigation with EndoVac, Er:YAG laser activation, UAI, the SAF, and the XP‐endo Finisher generated apical pressures below the critical threshold of 5.73 mmHg. By contrast, using EDDY and RinsEndo for irrigation produced higher apical pressures that exceeded the critical threshold.
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Affiliation(s)
- Eva Magni
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Marco Jäggi
- Department of Reconstructive Dentistry, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Florin Eggmann
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Roland Weiger
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
| | - Thomas Connert
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Basel, Switzerland
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ÇULHA E, YILDIRIM C. Evaluation of the Effectiveness of Erbium Lasers on Removing Calcium Hydroxide. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.737154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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13
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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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Linden D, Boone M, De Bruyne M, De Moor R, Versiani MA, Meire M. Adjunctive Steps for the Removal of Hard Tissue Debris from the Anatomic Complexities of the Mesial Root Canal System of Mandibular Molars: A Micro–Computed Tomographic Study. J Endod 2020; 46:1508-1514. [DOI: 10.1016/j.joen.2020.05.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/18/2020] [Accepted: 05/21/2020] [Indexed: 11/30/2022]
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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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Xin Y, Yang J, Song KY. [In vitro evaluation of the effectiveness of XP-endo Finisher file on smear layer removal after root canal instrumentation]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:48-52. [PMID: 30854818 DOI: 10.7518/hxkq.2019.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of XP-endo Finisher (XPF) file and passive ultrasonic irrigation (PUI) in the smear layer removal of the root canal. METHODS A total of 60 human single-rooted premolars were selected and decoronated to standardize their canal length to 16 mm. Tooth samples were prepared using a S3 rotary system to prepare root canal with the file size of 3S and then randomly divided into 6 groups according to the final irrigation protocol, as follows: XPF 3 mL of 3% NaOCl for 1 min (group A); XPF 3 mL of 3% NaOCl for 1 min, followed by 4 mL of 17% ethylene diamine tetraacetic acid (EDTA) for 1 min (group B); PUI of 3 mL of 3% NaOCl for 1 min (group C); PUI of 3 mL of 3% NaOCl for 1 min, followed by 4 mL of 17% EDTA for 1 min (group D); 3 mL of 3% NaOCl for 1 min by using a syringe and a 30 G side-vented needle (group E); and 3 mL of 3% NaOCl for 1 min by using a syringe and a 30 G side-vented needle, followed by 4 mL of 17% EDTA for 1 min (group F). After the completion of the root canal preparation, the teeth were split into two longitudinally. The mean numbers of the visible open dentinal tubules in the apical and middle thirds of the root canals were evaluated via scanning electron microscope. RESULTS The whole surfaces of the root canals in groups A, C, and E were covered by a smear layer. Groups A and C possessed significantly higher number of visible open dentinal tubules than in group E (P<0.05), with statistically insignificant difference between groups A and C (P>0.05). The apical third of the samples in groups B and D and in the middle thirds of canals in group F exhibited a small amount of smear layer, and the dentinal tubules were open or semi-open. The root canal surfaces in the apical third of the samples in group F were covered by a smear layer, and the dentinal tubules were sealed or semisealed. The smear layers in the middle third of the samples in groups B and D were removed, and the dentinal tubules were more visibly open than those of the four other groups (P<0.05). The difference between groups B and D were statistically insignificant (P>0.05). CONCLUSIONS The difference between XPF and PUI in terms of the smear layer removal of the root canals was insignificant. Hence, XPF, as a new irrigation agitation technique, can aid in improving smear layer removal.
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Affiliation(s)
- Yue Xin
- Dept. of Conservative Dentistry and Endodontics, The Affiliated Stomatological Hospital of Nanchang University, The Key Laboratory of Oral Biomedicine of Jiangxi Province, Nanchang 330006, China
| | - Jian Yang
- Dept. of Conservative Dentistry and Endodontics, The Affiliated Stomatological Hospital of Nanchang University, The Key Laboratory of Oral Biomedicine of Jiangxi Province, Nanchang 330006, China
| | - Kuang-Yu Song
- Dept. of Microbiology, Jiangxi Medical College, Nanchang University, Nanchang 330006, China
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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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Chhabra N, Gangaramani S, Singbal KP, Desai K, Gupta K. Efficacy of various solutions in preventing orange-brown precipitate formed during alternate use of sodium hypochlorite and chlorhexidine: An in vitro study. J Conserv Dent 2018; 21:428-432. [PMID: 30122826 PMCID: PMC6080170 DOI: 10.4103/jcd.jcd_72_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aim The study evaluated the effectiveness of three intermediate endodontic irrigating solutions in eliminating the residual sodium hypochlorite (NaOCl), thus preventing the formation of the orange-brown precipitate when 2% chlorhexidine (CHX) is used as the final irrigant. Materials and Methods A total of 40 extracted human maxillary anterior teeth were selected, disinfected, and decoronated to obtain a standardized length of 10 mm. The teeth were prepared with Protaper universal rotary files until size F4 using 2.5% NaOCl as an irrigant during instrumentation. The teeth were then randomly divided into four groups of 10 samples each based on the irrigating solutions used during final wash sequence as follows: Group A - (2.5% NaOCl and 2% CHX), Group B - (2.5% NaOCl followed by 70% Isopropyl Alcohol and 2% CHX), Group C - (2.5% NaOCl followed by 6.25% sodium metabisulfite and 2% CHX), and Group D - (2.5% NaOCl followed by 3.86% sodium Thiosulfate and 2% CHX). The roots were sectioned longitudinally and the canal surface was evaluated under dental operating microscope (×16) for the presence of orange-brown precipitate. The results were tabulated as per scoring criteria and statistically analyzed. Statistical Analysis Used One-way ANOVA test and post hoc Tukey's test. Results The lowest mean score was observed in Group C, followed by Group D and Group B, respectively. In comparison, there was a statistically significant (P < 0.001) difference in results between Group C and the other experimental groups. However, there was no statistically significant difference between Group B and Group D. Conclusion Sodium metabisulfite was found to be very effective in preventing the formation of orange-brown precipitate.
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Affiliation(s)
- Naveen Chhabra
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Satish Gangaramani
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Kiran Prabhakar Singbal
- Department of Conservative Dentistry, Faculty of Dentistry, MAHSA University, Kuala Lumpur, Malaysia
| | - Krupa Desai
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Kritika Gupta
- Department of Conservative Dentistry and Endodontics, K M Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
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Shalan LA, Al-Huwaizi HF. Cleaning Efficiency of Root Canal after Irrigation with New Irrigation Technique: A Scanning Electron Microscopic Study. IRANIAN ENDODONTIC JOURNAL 2018; 13:102-107. [PMID: 29692844 PMCID: PMC5800450 DOI: 10.22037/iej.v13i1.17285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: The aim of this study was to evaluate the ability of pressurized water irrigation technique (AquaPick Device) as an intra-canal irrigation technique and compare it with sonic irrigation device (Endoactivator) for their ability to remove smear layer from canals. Methods and Materials: Total number of 80 single rooted teeth (premolars) were prepared, divided into eight main groups, Group 1: Aquapick with apically vented needle/18 mm depth, Group 2: Aquapick with apically vented needle/15 mm depth, Group 3: Endoactivator device/18 mm depth, Group 4: Endoactivator device/15 mm depth, Group5: Aquapick with 2 side vented needle/18 mm depth, Group 6: Aquapick with 2 side vented needle/15 mm depth and two control groups. Then all samples were tested by SEM in 3, 6 and 9-mm distances from the apical foramen. The data were statistically analyzed using Kruskal Wallis and Mann-Whitney U tests. Results: There was a high significant difference among the tested groups with the best removal of smear layer by the use of pressurized water irrigation device with apical vented needle especially at the 3 mm area. Conclusion: Pressurized water irrigation technique could be used as intra-canal irrigation technique with good results.
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Affiliation(s)
- Linz A Shalan
- Department of Conservative and Esthetic Dentistry, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Hussain F Al-Huwaizi
- Department of Conservative and Esthetic Dentistry, College of Dentistry, University of Baghdad, Baghdad, Iraq
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Machado R, Cruz ATG, de Araujo BMDM, Klemz AA, Klug HP, da Silva Neto UX. Tubular dentin sealer penetration after different final irrigation protocols: A confocal laser scanning microscopy study. Microsc Res Tech 2018; 81:649-654. [DOI: 10.1002/jemt.23019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 03/02/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Ricardo Machado
- Clinical Practice Limited to Endodontics; Navegantes Santa Catarina Brazil
| | - Alessandra Timponi Goes Cruz
- Department of Endodontics, School of Life Sciences; Pontifical Catholic University of Paraná; Curitiba Paraná Brazil
| | | | - Adriane Antoniw Klemz
- Department of Endodontics, School of Life Sciences; Pontifical Catholic University of Paraná; Curitiba Paraná Brazil
| | - Hellen Pontes Klug
- Department of Endodontics, School of Life Sciences; Pontifical Catholic University of Paraná; Curitiba Paraná Brazil
| | - Ulisses Xavier da Silva Neto
- Department of Endodontics, School of Life Sciences; Pontifical Catholic University of Paraná; Curitiba Paraná Brazil
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Nagendrababu V, Jayaraman J, Suresh A, Kalyanasundaram S, Neelakantan P. Effectiveness of ultrasonically activated irrigation on root canal disinfection: a systematic review of in vitro studies. Clin Oral Investig 2018; 22:655-670. [DOI: 10.1007/s00784-018-2345-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/15/2018] [Indexed: 12/01/2022]
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Guerreiro-Tanomaru JM, Chávez-Andrade GM, de Faria-Júnior NB, Watanabe E, Tanomaru-Filho M. Effect of Passive Ultrasonic Irrigation on Enterococcus faecalis from Root Canals: An Ex Vivo Study. Braz Dent J 2017; 26:342-6. [PMID: 26312969 DOI: 10.1590/0103-6440201300022] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 04/17/2015] [Indexed: 11/22/2022] Open
Abstract
Endodontic irrigation aims to clean and disinfect the root canal system. Passive ultrasonic irrigation (PUI) is based on the use of an ultrasound-activated instrument into the root canal filled with irrigant. The aim of this study was to evaluate, ex vivo, the effectiveness of PUI in eliminating Enterococcus faecalis from root canals. Seventy-five extracted human single-root teeth were used. After root canal preparation, specimens were inoculated with E. faecalis and incubated at 37 °C for 21 days. Specimens were distributed into five groups (n=15), according to the irrigation method: PUI + saline solution (PUI/SS); PUI + 1% NaOCl (PUI/NaOCl); conventional needle irrigation (CNI) + saline solution (CNI/SS); CNI + 1% NaOCl (CNI/NaOCl); No irrigation (control). Microbiological samples were collected at three time points: initial (21 days after inoculation), post-irrigation (immediately after irrigation), and final (7 days after irrigation). Data were obtained in CFU mL-1 and subjected to analysis by ANOVA and Tukey's tests at 5% significance level. The post-irrigation samples did not demonstrate statistical difference between PUI/SS and CNI/SS nor between PUI/NaOCl and CNI/NaOCl (p>0.05), but PUI/NaOCl and CNI/NaOCl had lower CFU mL-1 number than the other groups (p>0.05). Statistically significant difference was observed between the initial and post-irrigation samples and between the post-irrigation and final samples (p<0.05) in all groups, except in the control. The final samples of all groups presented bacterial counts similar to the initial samples. PUI or CNI with 1% NaOCl contribute to disinfection, but are unable to eradicate E. faecalis from the root canal system.
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Affiliation(s)
| | | | | | - Evandro Watanabe
- Department of Dentistry, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Mário Tanomaru-Filho
- Araraquara Dental School, Department of Restorative Dentistry, Universidade Estadual Paulista, Araraquara, SP, BR
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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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Neuhaus KW, Liebi M, Stauffacher S, Eick S, Lussi A. Antibacterial Efficacy of a New Sonic Irrigation Device for Root Canal Disinfection. J Endod 2016; 42:1799-1803. [PMID: 27780580 DOI: 10.1016/j.joen.2016.08.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/22/2016] [Accepted: 08/25/2016] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Passive ultrasonic irrigation (PUI) is the most widespread method used to activate irrigation solutions. Concerns have been raised that PUI is less effective in curved root canals and is not passive at all. Our aim was to compare a novel passive sonic irrigation (PSI) device (6000 Hz) with PUI and manual irrigation (MI) with respect to their efficiency in removing different endodontic microorganisms from curved and straight root canals. METHODS We performed 2 experiments as follows. In a 3-day infection model, we included 8 groups of single or dual microbial species that were rinsed with 0.9% sodium chloride using PSI, PUI, or MI. Colony-forming units (CFUs) were counted after incubation, and log10 transformations were performed for statistical comparisons. In a 21-d infection model, we tested the same irrigation protocols on 4 groups of microorganisms and used 1.5% sodium hypochlorite as an irrigant. Infection control samples were taken at day 0, 3, 5, and 7 after treatment and were subsequently reincubated. RESULTS Using sodium chloride as an irrigant, the amount of reduction in CFUs compared with the negative control was approximately 3 log10 units for PSI at 6000 Hz, 2 log10 units for PUI, and 1 log10 unit for MI. PSI reduced the microorganism CFUs significantly better than PUI. Using sodium hypochlorite led to a significant reduction in microorganism CFUs even with MI. After 3 days, compared with MI, microorganism regrowth significantly reduced after PSI and PUI treatment, but in these groups, in at least half of the samples, microorganisms were detectable after 7 days. CONCLUSIONS PSI at 6000 Hz might be at least equal to PUI with respect to reduction of the microbial load in curved and straight root canals.
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Affiliation(s)
- Klaus W Neuhaus
- Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Melanie Liebi
- Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Simone Stauffacher
- Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Sigrun Eick
- Laboratory of Oral Microbiology, Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Adrian Lussi
- Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
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Toljan I, Bago I, Jurič, Anić I. Eradication of Intracanal Enterococcus Faecalis Biofilm by Passive Ultrasonic Irrigation and RinsEndo System. Acta Stomatol Croat 2016; 50:14-22. [PMID: 27688422 DOI: 10.15644/asc50/1/3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
AIM The aim of the study was to compare the antimicrobial efficacy of three irrigation techniques after the use of standardized volume of NaOCl and with standardized time and irrigation. METHODOLOGY Forty-eight single rooted teeth were inoculated with an Enterococcus faecalis suspension for 24 h. The remaining six canals served as negative controls. The 36 root canals were randomly distributed into three experimental groups; group 1, conventional syringe irrigation; group 2, automated-dynamic irrigation (RinsEndo); group 3, passive ultrasonic irrigation (PUI). In the first protocol, the standardized volume of 3% NaOCl (20 mL) was used and in the second protocol, and standardized irrigation time (45 seconds) was used. Samples from root canals were cultured and the colony-forming units (CFUs) were counted. RESULTS When the volume of the irrigant was standardized, RinsEndo was more effective than PUI (p<0.01). When the irrigation time was standardized, there were no significant differences between any irrigation techniques (p>0.05). The RinsEndo group had the highest percentage of minimal counts of E. faecalis CFUs. CONCLUSIONS RinsEndo was more effective than PUI only when the volume of the irrigant was standardized. However, the RinsEndo provided higher bacterial reduction in both protocols when using the least amount of the irrigant and providing longer contact time.
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Affiliation(s)
| | - Ivona Bago
- Private Dental Polyclinic, Zagreb, Croatia
| | - Jurič
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia
| | - Ivica Anić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia
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AlRahabi M. Attitudes of general practice dentists in private dental clinics in Almadinah Almunawarah toward novel endodontic technologies. GIORNALE ITALIANO DI ENDODONZIA 2016. [DOI: 10.1016/j.gien.2016.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Seixas FH, Estrela C, Bueno MR, Sousa-Neto MD, Pécora JD. Determination of Root Canal Cleanliness by Different Irrigation Methods and Morphometric Analysis of Apical Third. J Contemp Dent Pract 2015; 16:442-450. [PMID: 26323446 DOI: 10.5005/jp-journals-10024-1704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM The aim of this study was to determine the root canal area before and after the instrumentation 1 mm short of the apical foramen by clinical and cone beam computed tomography (CBCT) methods, and to evaluate the cleanliness of the apical region in mesiodistal flattened teeth by using optical microscopy. MATERIALS AND METHODS Forty-two human single-canal mandibular incisors were instrumented using the Free Tip Preparation technique up to three, four or five instruments from the initial. Cone beam computed tomography scans were acquired of the samples before and after root canal preparation (RCP). Irrigation was performed by conventional or hydrodynamic means, using 2.5% sodium hypochlorite. The samples were prepared for observation under an optical microscope. Images were digitally obtained, analyzed and the results were submitted to statistical analysis (two-way ANOVA complemented by Bonferroni's post-test). RESULTS There was no significant difference between the studied anatomical areas with both CBCT and clinical methods. There were no differences between irrigation methods. It was verified differences between instrumentation techniques. Instrumentation with four instruments from the initial instrument determined a significant increase in the contact area when compared to preparation with three instruments, but RCP with 5 instruments did not result in a better cleanliness. CONCLUSION The analysis with CBCT was not capable to determine the precise shape of surgical apical area comparing to the clinical method. CLINICAL SIGNIFICANCE Both the conventional and hydrodynamic irrigation techniques were not able to promote root canals debris-free. The instruments action in root canal walls was proportional to the number of instruments used from the initial apical instrument.
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Affiliation(s)
- Fábio Heredia Seixas
- Department of Restorative Dentistry, Ribeirao Preto Dental School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry Federal University of Goias, Goiania, GO, Brazil
| | - Mike Reis Bueno
- Department of Oral Diagnosis, School of Dentistry, University of Cuiaba, Cuiaba, MT, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, Ribeirao Preto Dental School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Jesus Djalma Pécora
- Department of Restorative Dentistry, Ribeirao Preto Dental School, University of Sao Paulo, Ribeirao Preto, SP, Brazil, Phone: +55-16-360024792, e-mail:
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Cachovan G, Schiffner U, Altenhof S, Guentsch A, Pfister W, Eick S. Comparative antibacterial efficacies of hydrodynamic and ultrasonic irrigation systems in vitro. J Endod 2015; 39:1171-5. [PMID: 23953293 DOI: 10.1016/j.joen.2013.06.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 04/26/2013] [Accepted: 06/29/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION To ensure root canal treatment success, endodontic microbiota should be efficiently reduced. The in vitro bactericidal effects of a hydrodynamic system and a passive ultrasonic irrigation system were compared. METHODS Single-rooted extracted teeth (n = 250) were contaminated with suspensions of Enterococcus faecalis ATCC 29212, mixed aerobic cultures, or mixed anaerobic cultures. First, the antibacterial effects of the hydrodynamic system (RinsEndo), a passive ultrasonic irrigation system (Piezo smart), and manual rinsing with 0.9% NaCl (the control) were compared. Colony-forming units were counted. Second, the 2 systems were used with 1.5% sodium hypochlorite (NaOCl) alone or NaOCl + 0.2% chlorhexidine (CHX). The colony-forming units in the treated and untreated roots were determined during a period of 5 days. RESULTS Both irrigation systems reduced bacterial numbers more effectively than manual rinsing (P < .001). With NaCl, ultrasonic activated irrigation reduced bacterial counts significantly better than hydrodynamic irrigation (P = .042). The NaOCl + CHX combination was more effective than NaOCl alone for both systems (P < .001), but hydrodynamic irrigation was more effective with NaOCl + CHX than the passive ultrasonic irrigation system. CONCLUSIONS Both irrigation systems, when combined with NaOCl + CHX, removed bacteria from root canals.
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Affiliation(s)
- Georg Cachovan
- Department of Restorative and Preventive Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Uzunoglu E, Görduysus M, Görduysus Ö. A comparison of different irrigation systems and gravitational effect on final extrusion of the irrigant. J Clin Exp Dent 2015; 7:e218-23. [PMID: 26155336 PMCID: PMC4483327 DOI: 10.4317/jced.52158] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 12/15/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The aim of this study was to compare manual needle irrigation (MNI), RinsEndo (RE), and passive ultrasonic irrigation (PUI), and assess the effect of gravity on extrusion from the apex in vitro. MATERIAL AND METHODS The distobuccal roots of molars were used and the canals were instrumented up to F2. Teeth were mounted on models, which permitted visualization and manipulation of the apices for necessary procedures. The models were placed in articulator to simulate the jaw. Six groups (G) were formed as: G1, G2 and G3 represented mandibular positioning of teeth and were irrigated with MNI, RE, and PUI, respectively, while G4, G5, and G6 represented maxillary positioning of teeth and were also irrigated in same sequence. Prior to the final irrigation, 72 cube-shaped foam pieces covered with aluminum foil were weighed and the values were recorded as the initial weights. The cubes were then placed on the apical part of each sample. Final irrigation was performed with distilled water and the cubes were weighed again to determine their final weight. Data were analyzed using Kruskal-Wallis and Mann-Whitney U post-hoc test (p<0.05). RESULTS Irrespective of the irrigation technique used, the amount of irrigant extruded from the apex showed a statistically significant difference related to the effect of gravity (p<0.05). There was no statistically significant difference between irrigation methods (p>0.05). When the irrigation systems were compared to examine the effect of gravity, the significant difference was found between G2 and G5 (p<0.05). CONCLUSIONS Within the limitations of this study, MNI and PUI were found to be reliable irrigation systems. Caution should be exercised when using RinsEndo. Key words:Final irrigation, manual needle irrigation, passive ultrasonic irrigation, RinsEndo.
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Affiliation(s)
- Emel Uzunoglu
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Melahat Görduysus
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Ömer Görduysus
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Piotto Leonardi D, Alfredo Schramm C, Fernando Giovanini A, Mariane Silveira C, Sens Fagundes Tomazinho F, Baratto-Filho F. Influence of Prior Cervical Enlargement on Apical Cleaning Using Single File. THE BULLETIN OF TOKYO DENTAL COLLEGE 2015; 56:85-91. [DOI: 10.2209/tdcpublication.56.85] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Denise Piotto Leonardi
- Department of Dentistry, Positivo University, Rua Professor Pedro Viriato Parigot de Souza
| | - Celso Alfredo Schramm
- Department of Dentistry, Positivo University, Rua Professor Pedro Viriato Parigot de Souza
| | | | | | | | - Flares Baratto-Filho
- Department of Dentistry, Positivo University, Rua Professor Pedro Viriato Parigot de Souza
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CHÁVEZ-ANDRADE GM, GUERREIRO-TANOMARU JM, MIANO LM, LEONARDO RDT, TANOMARU-FILHO M. Radiographic evaluation of root canal cleaning, main and laterals, using different methods of final irrigation. REVISTA DE ODONTOLOGIA DA UNESP 2014. [DOI: 10.1590/rou.2014.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE: To evaluate the efficacy of passive ultrasonic irrigation (PUI) using intermittent or continuous flushing and conventional manual irrigation (CMI) on the cleaning of main and simulated lateral root canals.MATERIAL AND METHOD: The root canals of 24 artificial teeth were prepared and simulated lateral canals were made in the medium and apical thirds of the root. The specimens were divided into three groups: G1- CMI, G2- PUI 1 (intermittent flushing) and G3- PUI 2 (continuous flushing). Root canals were filled with contrast solution and the roots were radiographed pre- and post-irrigation. The digital images were transferred to Image Tool 3.0 software and the areas of root canal completely filled with contrast, and after irrigation with contrast remnant, were measured to obtain percentage data. Statistical analysis between groups was performed by ANOVA and Tukey tests.RESULT: In the apical third, G2 and G3 (PUI) groups showed higher percentage of cleaning than G1 (CMI) (p<0.05).CONCLUSION: Passive ultrasonic irrigation using intermittent flushing promoted a higher cleaning of simulated lateral canals than conventional manual irrigation in the apical third. There were no differences between groups in the main root canal and the middle third.
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Maity I, Meena N, Kumari RA. Single visit nonsurgical endodontic therapy for periapical cysts: A clinical study. Contemp Clin Dent 2014; 5:195-202. [PMID: 24963246 PMCID: PMC4067783 DOI: 10.4103/0976-237x.132321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIMS The aim of this study was to assess the outcome of single sitting root canal treatment (RCT) of asymptomatic teeth with periapical cysts. MATERIALS AND METHODS Ten maxillary anterior teeth showing periapical lesion on the radiograph was further screened by ultrasound with color power Doppler (CPD) for confirmation of a cyst. The average dimension of the lesions ranged from 1.3 to 1.9 cm. Single sitting RCT was performed on all the selected teeth. Postoperative healing was monitored at regular interval of 3 months, 6 months, and 1 year by using subjective feedback, radiograph, and ultrasound with CPD study. RESULTS Eight among the ten cases showed either signs of complete healing or healing in progress by the end of 6-12 months. CONCLUSIONS It was observed that single sitting nonsurgical endodontic management of asymptomatic teeth with periapical cyst confirmed by ultrasound was successful in selected cases.
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Affiliation(s)
- Ipsita Maity
- Department of Conservative Dentistry and Endodontics, GNIDSR, Kolkata, West Bengal, India
| | - N Meena
- Department of Conservative Dentistry and Endodontics, V.S. Dental College and Hospital, Bengaluru, Karnataka, India
| | - R Anitha Kumari
- Department of Conservative Dentistry and Endodontics, V.S. Dental College and Hospital, Bengaluru, Karnataka, India
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Holliday R, Alani A. Traditional and contemporary techniques for optimizing root canal irrigation. ACTA ACUST UNITED AC 2014; 41:51-2, 54, 56-8 passim. [PMID: 24640478 DOI: 10.12968/denu.2014.41.1.51] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED Canal irrigation during root canal treatment is an important component of chemo-mechanical debridement of the root canal system. Traditional syringe irrigation can be enhanced by activating the irrigant to provide superior cleaning properties. This activation can be achieved by simple modifications in current technique or by contemporary automated devices. Novel techniques are also being developed, such as the Self-adjusting File (Re-Dent-Nova, Ra'anana, Israel), Ozone (Healozone, Dental Ozone, London, UK), Photoactivated Disinfection and Ultraviolet Light Disinfection. This paper reviews the techniques available to enhance traditional syringe irrigation, contemporary irrigation devices and novel techniques, citing their evidence base, advantages and disadvantages. CLINICAL RELEVANCE Recent advances in irrigation techniques and canal disinfection and debridement are relevant to practitioners carrying out root canal treatment.
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Tanomaru-Filho M, Loiola LED, Miano LM, Chávez-Andrade GM, Guerreiro-Tanomaru JM. Influência do diâmetro foraminal do canal radicular, do tipo e da penetração de agulha, e do fluxo da solução irrigadora na limpeza e na extrusão apical. REVISTA DE ODONTOLOGIA DA UNESP 2014. [DOI: 10.1590/rou.2014.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Introdução: A irrigação do canal radicular visa a limpeza e desinfecção do sistema de canais radiculares, sem promover extrusão apical. Objetivo: Avaliar a influência do diâmetro foraminal do canal radicular, da penetração e do tipo de agulha, e do fluxo na limpeza e na extrusão apical da solução irrigadora. Material e método: Doze dentes incisivos inferiores humanos com canal único foram instrumentados e, após ampliação foraminal com diferentes diâmetros (LK #40 e 60), os canais radiculares foram preenchidos com solução de contraste radiológico espessada com propilenoglicol e óxido de zinco. Foram utilizados dois tipos de agulhas de irrigação 27G com diferentes designs (abertura apical ou lateral), dois fluxos correspondentes a 15 ou 25 mL/min, e com penetração das agulhas em duas profundidades (3 e 6 mm aquém do ápice). Antes e após irrigação, os dentes foram radiografados utilizando um sistema radiográfico digital. As áreas do canal radicular antes (preenchido pelo contraste) e após irrigação (remanescente do contraste) foram submetidas à subtração de imagens no programa Adobe Photoshop CS4 e mensuradas por meio do programa Image Tool 3.0, obtendo o percentual de limpeza e de extrusão. Os dados foram analisados por meio dos testes ANOVA e Tukey, com nível de significância de 5%. Resultado: Não houve diferença estatística entre o diâmetro foraminal, o tipo e a profundidade de penetração da agulha, e a velocidade do fluxo de irrigação nos parâmetros limpeza (acima de 97%) e extrusão apical (menor do que 0,38 mm2), com p>0,05. Conclusão: Todos os protocolos de irrigação avaliados proporcionaram limpeza do canal radicular e pequena extrusão apical da solução irrigadora.
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Grischke J, Müller-Heine A, Hülsmann M. The effect of four different irrigation systems in the removal of a root canal sealer. Clin Oral Investig 2013; 18:1845-51. [PMID: 24317958 DOI: 10.1007/s00784-013-1161-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 11/27/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The aim of this study was to compare the efficiency of sonic, ultrasonic, and hydrodynamic devices in the removal of a root canal sealer from the surface and from simulated irregularities of root canals. MATERIALS AND METHODS Fifty-three root canals with two standardized grooves in the apical and coronal parts of longitudinally split roots were covered with AH Plus root canal sealer. Compared were the effects of (control) syringe irrigation, (1) CanalBrush, (2) passive ultrasonic irrigation, (3) EndoActivator, and (4) RinsEndo on the removal of the sealer. The specimens were divided into four groups (N = 12) and one control group (N = 5) via randomization. The amount of remaining sealer in the root canal irregularities was evaluated under a microscope using a 4-grade scoring system, whereas the remaining sealer on the root canal surface was evaluated with a 7-grade scoring system. RESULTS Passive ultrasonic irrigation is more effective than the other tested irrigation systems or syringe irrigation in removing sealer from root canal walls (p < 0.01). None of the techniques had a significant effect on cleaning the lateral grooves. CONCLUSIONS Within the limitations of this study protocol ultrasonic irrigation shows a superior effect on sealer removal from the root canal surface during endodontic retreatment. Cleaning of lateral grooves seems not to be possible with one of the techniques investigated. CLINICAL RELEVANCE Incomplete removal of root canal sealer during re-treatment may cause treatment failure. Passive Ultrasonic irrigation seems to be the most effective system to remove sealer from a root canal.
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Affiliation(s)
- J Grischke
- Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Carl-Neubergstr.1, D-30625, Hannover, Germany,
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Deleu E, Meire MA, De Moor RJG. Efficacy of laser-based irrigant activation methods in removing debris from simulated root canal irregularities. Lasers Med Sci 2013; 30:831-5. [PMID: 24091791 DOI: 10.1007/s10103-013-1442-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 09/16/2013] [Indexed: 01/08/2023]
Abstract
In root canal therapy, irrigating solutions are essential to assist in debridement and disinfection, but their spread and action is often restricted by canal anatomy. Hence, activation of irrigants is suggested to improve their distribution in the canal system, increasing irrigation effectiveness. Activation can be done with lasers, termed laser-activated irrigation (LAI). The purpose of this in vitro study was to compare the efficacy of different irrigant activation methods in removing debris from simulated root canal irregularities. Twenty-five straight human canine roots were embedded in resin, split, and their canals prepared to a standardized shape. A groove was cut in the wall of each canal and filled with dentin debris. Canals were filled with sodium hypochlorite and six irrigant activation procedures were tested: conventional needle irrigation (CI), manual-dynamic irrigation with a tapered gutta percha cone (manual-dynamic irrigation (MDI)), passive ultrasonic irrigation, LAI with 2,940-nm erbium-doped yttrium aluminum garnet (Er:YAG) laser with a plain fiber tip inside the canal (Er-flat), LAI with Er:YAG laser with a conical tip held at the canal entrance (Er-PIPS), and LAI with a 980-nm diode laser moving the fiber inside the canal (diode). The amount of remaining debris in the groove was scored and compared among the groups using non-parametric tests. Conventional irrigation removed significantly less debris than all other groups. The Er:YAG with plain fiber tip was more efficient than MDI, CI, diode, and Er:YAG laser with PIPS tip in removing debris from simulated root canal irregularities.
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Affiliation(s)
- Ellen Deleu
- Department of Restorative Dentistry and Endodontology, Dental School, Ghent University, De Pintelaan 185/P8, 9000, Ghent, Belgium
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Castagna F, Rizzon P, da Rosa RA, Santini MF, Barreto MS, Húngaro Duarte MA, Reis Só MV. Effect of passive ultrassonic instrumentation as a final irrigation protocol on debris and smear layer removal-a sem analysis. Microsc Res Tech 2013; 76:496-502. [DOI: 10.1002/jemt.22192] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 01/30/2013] [Accepted: 01/31/2013] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Ricardo Abreu da Rosa
- Conservative Dentistry Department; Federal University of Rio Grande do Sul; RS; Brazil
| | | | - Mirela Sangoi Barreto
- Conservative Dentistry Department; Federal University of Rio Grande do Sul; RS; Brazil
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Maalouf L, Zogheib C, Naaman A. Removal efficiency of calcium hydroxide dressing from the root canal without chemically active adjuvant. J Contemp Dent Pract 2013; 14:188-192. [PMID: 23811644 DOI: 10.5005/jp-journals-10024-1298] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM Compare the efficiency in removing two calcium hydroxide [Ca(OH)2] preparations from root canal and apical third using single use syringe, ultrasonics and RinsEndo((®)) with saline solution. MATERIALS AND METHODS One hundred and eighty human singlerooted teeth were instrumented using ProTaper((®)) rotary system, divided into two groups according to Ca(OH)2 filling. A: Powder mixed with water, B: Pulpdent((®)). Each group was divided into three subgroups for the irrigation: A1, B1: Single use syringe; A2, B2: Ultrasonics; A3, B3: RinsEndo((®)). Teeth were split longitudinally, photographed and imported into Adobe Photoshop. The percentage ratios of Ca(OH)2 remaining in the canal and in the apical third were calculated. Data were statistically analyzed using 'ANOVA two-way' and 'univariate tests'. RESULTS (a) Remnants of medicament were found in all teeth, (b) no statistically significant difference in the elimination of both Ca(OH)2 from the entire canal (p = 0.436), however, mixed powder was better eliminated from the apical third (p = 0.005), (c) no statistically significant difference among the irrigation techniques in the whole canal (p = 0.608), though, RinsEndo((®)) and ultrasonics were the most effective in cleaning the apical third (p = 0.032) when mixed powder was used. CONCLUSION None of the techniques removed completely Ca(OH)2 from the canal. In the apical third, RinsEndo((®)) and ultrasonics were the most effective when mixed powder was used. CLINICAL SIGNIFICANCE Ca(OH)2, the most commonly used intracanal dressing, should be completely eliminated before the obturation to assure a good endodontic sealing. Based on the results of this study, RinsEndo((®)) and ultrasonics were the most effective in removal of Ca(OH)2 especially the powder mixed with water presentation.
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Affiliation(s)
- Lara Maalouf
- Department of Endodontics, Saint Joseph University, Beirut Lebanon.
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Mozo S, Llena C, Forner L. Review of ultrasonic irrigation in endodontics: increasing action of irrigating solutions. Med Oral Patol Oral Cir Bucal 2012; 17:e512-6. [PMID: 22143738 PMCID: PMC3476090 DOI: 10.4317/medoral.17621] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Accepted: 06/23/2011] [Indexed: 11/12/2022] Open
Abstract
Introduction: Effective irrigant delivery and agitation are prerequisites for successful endodontic treatment. Ultrasonic irrigation can be performed with or without simultaneous ultrasonic instrumentation. Existing literature reveals that ultrasonic irrigation may have a very positive effect on chemical, biological and physical debridement of the root canal system as investigated in many in vitro studies.
Objective: The purpose of this review article was to summarize and discuss the available information concerning ultrasonic irrigation in endodontics.
Methods: This article presents an overview of ultrasonic irrigation methods and their debridement efficacy. In this paper the relevant literature on passive ultrasonic irrigation is reviewed. Information from original scientific papers or reviews listed in MEDLINE and Cochrane were included in the review.
Results: The use of ultrasound in the irrigation procedure results in improved canal cleanliness, better irrigant transfer to the canal system, soft tissue debridement, and removal of smear layer and bacteria. There are many in vitro studies, but there is a need to standardize protocols, and correlate the clinical efficacy of ultrasonic devices with improved treatment outcomes. Understanding the basis of ultrasonic irrigation is fundamental for clinicians and researchers to improve the design and use of ultrasonic irrigation.
Key words:Ultrasonic irrigation, ultrasound, smear layer, endodontics.
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Affiliation(s)
- Sandra Mozo
- Postgraduate Endodontics Program, Department of Stomatology, University of Valencia, Spain
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Kaptan F, Karapinar-Kazandag M, Kayahan MB, Bora T, Bayirli G. Potential of an Er:YAG Laser in the Removal of Calcium Hydroxide from Root Canals. Photomed Laser Surg 2012; 30:250-4. [DOI: 10.1089/pho.2011.3093] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Figen Kaptan
- Department of Endodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | | | | | - Toygan Bora
- Private practice limited to endodontics, Istanbul, Turkey
| | - Gunduz Bayirli
- Department of Endodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
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Kure A, Suehara M, Morinaga K, Nakagawa KI. In vitro Evaluation of the Effect of Sonic Vibration on the Cleaning Capability of Root Canal Irrigants. J HARD TISSUE BIOL 2012. [DOI: 10.2485/jhtb.21.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Rödig T, Hirschleb M, Zapf A, Hülsmann M. Comparison of ultrasonic irrigation and RinsEndo for the removal of calcium hydroxide and Ledermix paste from root canals. Int Endod J 2011; 44:1155-61. [DOI: 10.1111/j.1365-2591.2011.01937.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gründling GL, Zechin JG, Jardim WM, de Oliveira SD, de Figueiredo JAP. Effect of Ultrasonics on Enterococcus faecalis Biofilm in a Bovine Tooth Model. J Endod 2011; 37:1128-33. [DOI: 10.1016/j.joen.2011.05.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 04/15/2011] [Accepted: 05/03/2011] [Indexed: 02/05/2023]
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Amato M, Vanoni-Heineken I, Hecker H, Weiger R. Curved versus straight root canals: the benefit of activated irrigation techniques on dentin debris removal. ACTA ACUST UNITED AC 2011; 111:529-34. [PMID: 21310632 DOI: 10.1016/j.tripleo.2010.11.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Revised: 11/01/2010] [Accepted: 11/02/2010] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study was to compare the efficacy of hydrodynamic and ultrasonic-activated irrigation to conventional syringe irrigation in removing dentin debris in straight and curved root canals. STUDY DESIGN Twelve human teeth were selected for study. The root canals of 6 single-rooted premolars with straight canals and 6 molar roots with curved canals were prepared to a size of 45 and split longitudinally. To simulate canal irregularities, 3 standardized holes were cut in 1 canal wall. The canals and holes were then covered with debris. After reassembly, 3 irrigation techniques were compared: syringe irrigation, hydrodynamic irrigation, and ultrasonic irrigation. The amount of debris that remained was evaluated microscopically and graded with a 4-score system. RESULTS The hydrodynamic and ultrasonic irrigation techniques were significantly (P < .001) more efficient as compared with syringe irrigation in both the straight and curved root canals. Ultrasonic irrigation demonstrated a higher efficiency in the straight root canals (P < .01), whereas hydrodynamic irrigation was more efficient in the curved canals (P < .01). CONCLUSIONS In the straight canals, ultrasonic irrigation was the most effective, but in the curved root canals, hydrodynamic irrigation was superior.
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Affiliation(s)
- Mauro Amato
- Department of Periodontology, Endodontology and Cariology, School of Dentistry, University of Basel, Basel, Switzerland.
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45
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Alves FR, Almeida BM, Neves MA, Moreno JO, Rôças IN, Siqueira JF. Disinfecting Oval-shaped Root Canals: Effectiveness of Different Supplementary Approaches. J Endod 2011; 37:496-501. [DOI: 10.1016/j.joen.2010.12.008] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Revised: 12/11/2010] [Accepted: 12/20/2010] [Indexed: 10/18/2022]
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