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1.
Int J Oral Sci ; 16(1): 22, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38429281

RESUMO

Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy (RCT). Recent research, encompassing bacterial etiology and advanced imaging techniques, contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT. Success in RCT hinges on factors like patients, infection severity, root canal anatomy, and treatment techniques. Therefore, improving disease management is a key issue to combat endodontic diseases and cure periapical lesions. The clinical difficulty assessment system of RCT is established based on patient conditions, tooth conditions, root canal configuration, and root canal needing retreatment, and emphasizes pre-treatment risk assessment for optimal outcomes. The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT. These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.


Assuntos
Materiais Restauradores do Canal Radicular , Tratamento do Canal Radicular , Humanos , Consenso , Tratamento do Canal Radicular/métodos , Guta-Percha/uso terapêutico , Necrose da Polpa Dentária/tratamento farmacológico , Retratamento , Cavidade Pulpar , Materiais Restauradores do Canal Radicular/uso terapêutico , Preparo de Canal Radicular
2.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 42(1): 75-81, 2024 Feb 01.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-38475954

RESUMO

OBJECTIVES: This study aimed to compare the differences among four kinds of mechanical Ni-Ti files including T-Flex, Reciproc Blue (RB), ProTaper Gold (PTG), and ProTaper Universal (PTU) in dentinal microcrack generation after root canal preparation in vitro by using micro-computed tomography (micro-CT) analysis. METHODS: A total of 32 freshly extracted double-root-canal premolars with an angle not exceeding 10° were selected and established as root canal preparation models in vitro. Then, the specimens were randomly assigned to four experimental groups (n=8) according to the different Ni-Ti systems used for root canal preparation: group T-Flex, group RB, group PTG, and group PTU. The voxel size of the micro-CT was set at 17.18 µm. Pre- and post-operative cross-sectional images of roots (n=56 940) were scanned and analyzed to identify the presence of dentinal microcracks. The results of each group were expressed by the quantity and percentage of sectional images with microcracks. McNemar test was used to determine whether a significant difference existed in the existence of dentinal microcracks before and after instrumentation. The level of significance was set at P<0.05. RESULTS: Overall, 11.04% of the images presented dentinal defects (n=6 288). Dentinal microcracks were observed in 9.82%, 10.79%, 12.27%, and 11.25% of the post-instrumentation images from groups T-Flex, RB, PTG, and PTU, respectively. However, all these dentinal microcracks were already present in the corresponding pre-operative images. No new microcrack of premolars were generated after the root canal preparation utilizing the aforementioned systems. CONCLUSIONS: Denti-nal microcracks already existed in advance in extracted teeth before root canal preparation. Root canal preparation using the T-Flex, RB, PTG, and PTU systems did not induce the formation of new dentinal microcracks on the straight root canals of premolars.


Assuntos
Ligas , Níquel , Preparo de Canal Radicular , Preparo de Canal Radicular/métodos , Titânio , Microtomografia por Raio-X , Dentina , Cavidade Pulpar
3.
Eur Endod J ; 9(2): 124-132, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38456466

RESUMO

OBJECTIVE: This study aimed to evaluate the effect of WaveOne Glider (WOGG) with Waveone Gold (WOG) primary reciprocation systems on root dentine microcrack formation and to know the effect of TruNatomy Glider (TRNG) with TruNatomy (TRN) prime rotary systems on root dentine microcrack formation. METHODS: In this study, 40 extracted mandibular first molar roots were selected and divided randomly into four groups (n=10). Group MWOG: a manual glide path was performed + WOG primary. Group MTRN: manual glide path performed+TRN prime. Additionally, group WOGG: glide path preparation with WOGG+WOG primary. Finally, for group TRNG, the glide path preparation was performed with TRNG+TRN prime. Micro-CT was used for pre and post-instrumentation image analysis. Statistical analysis was performed using the Kruskal- Wallis test (p<0.05) with Two-way ANOVA. RESULTS: The Kruskal-Wallis test showed no significant differences among all groups in all thirds for pre and post-instrumentation regarding the crack formation. The Two-way ANOVA showed no significant difference or interaction between the ways of glide path preparation, whether manual or reciprocal WOGG, or between the rotary TRNG and the motion used in root canal preparation (rotary TRN or reciprocal WOG) regarding the crack formation and propagation. CONCLUSION: Microcrack formation and propagation occurred independently of using different glide path techniques (manual, rotary, or reciprocal).


Assuntos
Cavidade Pulpar , Preparo de Canal Radicular , Microtomografia por Raio-X , Cavidade Pulpar/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Ouro
4.
Clin Oral Investig ; 28(4): 212, 2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38480541

RESUMO

OBJECTIVES: To assess root canal localization accuracy using a dynamic approach, surgical guides and freehand technique in vitro. MATERIALS AND METHODS: Access cavities were prepared for 4 different 3D printed tooth types by 4 operators (n = 144). Deviations from the planning in angle and bur positioning were compared and operating time as well as tooth substance loss were evaluated (Kruskal-Wallis Test, ANOVA). Operating method, tooth type, and operator effects were analyzed (partial eta-squared statistic). RESULTS: Angle deviation varied significantly between the operating methods (p < .0001): freehand (9.53 ± 6.36°), dynamic (2.82 ± 1.8°) and static navigation (1.12 ± 0.85°). The highest effect size was calculated for operating method (ηP²=0.524), followed by tooth type (0.364), and operator (0.08). Regarding deviation of bur base and tip localization no significant difference was found between the methods. Operating method mainly influenced both parameters (ηP²=0.471, 0.379) with minor effects of tooth type (0.157) and operator. Freehand technique caused most substance loss (p < .001), dynamic navigation least (p < .0001). Operating time was the shortest for freehand followed by static and dynamic navigation. CONCLUSIONS: Guided endodontic access may aid in precise root canal localization and save tooth structure. CLINICAL RELEVANCE: Although guided endodontic access preparation may require more time compared to the freehand technique, the guided navigation is more accurate and saves tooth structure.


Assuntos
Endodontia , Dente , Preparo de Canal Radicular/métodos , Cavidade Pulpar/cirurgia , Tomografia Computadorizada de Feixe Cônico , Endodontia/métodos , Impressão Tridimensional
5.
Am J Dent ; 37(1): 39-46, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38458982

RESUMO

PURPOSE: To investigate the differences between irrigant propagation and temperature changes using laser-activated irrigation (LAI) at different settings in an artificial root canal model. METHODS: Using an artificial resin root canal model, irrigant activation was achieved in 19 experimental groups with eight samples each. A 9,300 nm CO2 laser, two diode lasers with different settings (wavelengths 455, 808, 970, and 980 nm) were compared to 2,940 nm Er:YAG laser and traditional needle irrigation. Er:YAG and CO2 laser were activated in the pulpal chamber only, while diode lasers and needles were inserted into the main root canal. Lasers were activated for 5x 20 seconds resulting in 100 seconds of activation or rinsing for each sample. After each activation of 20 seconds, a photo was taken of the side canals and the propagation of the dye was measured with a digital measuring tool after calibration. Further, the temperature of the irrigant was reported after activation of 20 seconds and repeated 5 times. Data were checked for normality and statistically compared. RESULTS: All lasers increased the irrigant propagation compared to conventional irrigation. Significant differences were found between groups regarding propagation and temperature (P< 0.0027). Er:YAG and CO2 laser had similar effects on irrigant propagation in middle and apical located side-canals with specific power parameters and were superior to diode lasers and syringe irrigation. The irrigant's temperature increased significantly with the diode and CO2 lasers. CLINICAL SIGNIFICANCE: Diode lasers and CO2 lasers have not been established for irrigant activation. 9,300 nm CO2 lasers absorb well in water and were shown to introduce vapor bubble formation and streaming in water. Diode lasers are highly accepted in periodontics. The laser light is not absorbed in water but interacts with bacteria as well as soft tissues and contributes therefore to infection control. With a modified laser tip it was however possible to introduce cavitation and streaming in irrigants.


Assuntos
Dióxido de Carbono , Lasers de Estado Sólido , Lasers Semicondutores , Estudo de Prova de Conceito , Irrigantes do Canal Radicular , Cavidade Pulpar/microbiologia , Água , Preparo de Canal Radicular/métodos
6.
Br Dent J ; 236(5): 364-368, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38459295
7.
J Contemp Dent Pract ; 25(2): 180-185, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38514417

RESUMO

AIM: To evaluate the intensity of postendodontic pain (PEP) using final irrigation with side-vented needle (SV), EndoActivator (EA), and Ultra X (UX) in single-visit endodontics (SVE) with F-One rotary files. MATERIALS AND METHODS: A total 150 patients indicated for endodontic treatment were selected. Single-visit endodontics treatment was performed under local anesthesia. For the final irrigation protocol, they were divided into three groups: group I (SV), group II (EA), and group III (UX). The severity of PEP was assessed using visual analogue scale (VAS) score after 6, 12, 24, and 48 hours. Analgesics taken by patients, for pain, were also recorded. Finally, the data were tabulated and statistically analyzed using SPSS 20.0 software at a level of significance being 0.05. RESULTS: Postendodontic pain was less in group III (UX) and group II (EA) compared with group I (SV) at 6 and 12 hours, which is statistically significant (p < 0.05). There was no statistically significant difference found after 24 hours and 48 hours. CONCLUSION: The intensity of PEP was minimum in patients treated with EndoActivator and ultrasonic along with single rotary file systems. The incidence of analgesic intake was similar in all three groups. How to cite this article: Kathiria NV, Attur K, Bagda KM, et al. Postendodontic Pain Using Single File System with Different Irrigation Protocols in Single-visit Root Canal Treatment: A Randomized Control Trial. J Contemp Dent Pract 2024;25(2):180-185.


Assuntos
Cavidade Pulpar , Preparo de Canal Radicular , Humanos , Preparo de Canal Radicular/métodos , Tratamento do Canal Radicular/métodos , Dor Pós-Operatória , Ultrassom , Ensaios Clínicos Controlados Aleatórios como Assunto
8.
BMC Oral Health ; 24(1): 294, 2024 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-38431556

RESUMO

BACKGROUND: The preparation of the middle mesial (MM) canal of mandibular molars represents a challenge because it is often curved, narrow, and close to the root concave. The purpose of this study was to evaluate the ex vivo shaping ability of 3 nickel-titanium (NiTi) rotary systems in the MM canal using 3D printed resin tooth replicas. METHODS: A permanent mandibular first molar with a MM canal was acquired from a pool of extracted teeth and reproduced by a 3D printer. The resin tooth replicas (n = 18) were equally assigned to 3 groups for the evaluation of the shaping abilities of 3 NiTi rotary systems (OneShape [OS], Twisted Files [TF], and ProTaper Gold [PTG]) according to the manufacturer's recommendations. The tooth replicas were scanned by micro-computed tomography (micro-CT) twice before and after instrumentation of the mesiobuccal (MB), mesiolingual (ML), and MM root canals. After 3D reconstruction, the canal straightening, change of root canal volume and surface area, the mesial and distal canal wall thickness and canal transportation at the levels of 1, 2, and 3 mm below furcation were assessed. One-way variance analysis and Turkey's post hoc test were used for comparisons of the means among different groups, and paired-t test was used to compare the mesial and distal sides of the mesial roots. RESULTS: As compared with OS and TF, the use of PTG in preparation of MM canals resulted in significantly more straightening of canal curvature (p < 0.05), greater post-instrumentation canal volume and surface area, and thinner mesial and distal remaining canal wall thickness at 1, 2 and 3 mm below furcation (all p < 0.05). Regarding the root canal transportation in the mesiodistal direction, there was no significant difference among the 3 instruments (all p > 0.05) after the preparation of the MB and ML canals. However, in the MM canal, more pronounced transportation was detected in the PTG group at 2 mm below furcation, and in the TF group at 3 mm below furcation as compared with the other 2 systems (both p < 0.05). CONCLUSIONS: 3D printed tooth replicas have the advantages of consistency and can be an ideal model to evaluate the shaping ability of different instruments in the MM canal. OS and TF files performed similarly and both are appropriate for shaping the MM canal, while PTG may cause excessive and uneven resin removal, especially near the furcation, and may lead to root fragility and procedural errors.


Assuntos
Ligas , Cavidade Pulpar , Níquel , Humanos , Cavidade Pulpar/diagnóstico por imagem , Microtomografia por Raio-X/métodos , Titânio , Preparo de Canal Radicular , Dente Molar/diagnóstico por imagem , Dente Molar/cirurgia , Impressão Tridimensional , Desenho de Equipamento
9.
BMC Oral Health ; 24(1): 293, 2024 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-38431616

RESUMO

Photon-initiated photoacoustic streaming (PIPS) with an Er: YAG laser has been introduced in root canal treatment to improve irrigation and facilitate the removal of bacteria in the root canal system. This study aimed to compare the antibacterial effectiveness of two different root canal irrigation techniques, conventional needle irrigation (CNI) and PIPS, using 1% sodium hypochlorite (NaOCl), in the treatment of teeth with apical periodontitis. Sixty patients with a total of sixty teeth affected by apical periodontitis were included in this study. The teeth underwent root canal therapy, and after mechanical instrumentation, they were randomly assigned to two groups (n = 30) based on the final irrigation protocol: CNI or PIPS with 1% NaOCl. Bacterial suspensions in the root canals were evaluated using Adenosine 5'-triphosphate (ATP) assay kit after mechanical instrumentation and after final irrigation. Then, a follow-up was conducted after 7 days. The results revealed that final irrigation significantly reduced ATP values in both the CNI and PIPS groups (P < 0.001). The ATP values after final irrigation was greater in the CNI group compared to the PIPS group (P < 0.001). After a 7-day follow-up, percussion tenderness and fistula were significantly resolved in both groups (P < 0.05). A multivariate linear regression model was used to identify the factors that influence post irrigation ATP values. The analysis demonstrated that pre-operative percussion tenderness (P = 0.006), the presence of a fistula (P < 0.001) and the method used in the final irrigation (P < 0.001) had a significant impact on the ATP value after final irrigation. These results indicate that employing PIPS with 1% NaOCl as the final irrigation protocol exhibited superior antibacterial effectiveness and has the potential to enhance clinical outcomes in the treatment of teeth afflicted with apical periodontitis.


Assuntos
Fístula , Periodontite Periapical , Humanos , Cavidade Pulpar , Preparo de Canal Radicular , Antibacterianos/uso terapêutico , Hipoclorito de Sódio/uso terapêutico , Hipoclorito de Sódio/farmacologia , Periodontite Periapical/terapia , Trifosfato de Adenosina , Fístula/tratamento farmacológico , Irrigantes do Canal Radicular/uso terapêutico , Irrigantes do Canal Radicular/farmacologia , Irrigação Terapêutica/métodos
10.
BMC Oral Health ; 24(1): 321, 2024 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-38461300

RESUMO

BACKGROUND: Root canal therapy is one of the main treatments for root canal diseases, and effective irrigation is the key to successful treatment. Side-vented needle is one of the commonly used needle types in clinic. In the real root canal, due to the influence of the curvature of the root canal, the irrigation flow field in different needle directions shows obvious differences. At the same time, changes in root canal curvature and working depth will lead to changes in irrigation efficiency and the flow field. Both the mainstream of the irrigation flow and the shear stress near the wall changes significant. Consequently, either the replacement in the root canal or the removal efficiency of the smear layers is apparently modified. MATERIALS AND METHODS: In this paper, the permanent root canal of the maxillary first molar prepared until 15/04 were scanned by micro-CT, and then imported into the software for 3D reconstruction. The key parameters of flushing efficiency of 30G side needle at different working depths of 4.75 mm, 5 mm, 5.25 mm and 5.5 mm were compared. Meanwhile, the simulated models with different curvatures of 0°, 5°, 10°, 20° and 30° based on the real root canal were reconstructed to investigate the curvature effect on the irrigation efficiency. RESULTS: The results show that moderate working depth (such as 4.75 mm and 5.25 mm in present paper) helps to improve the replacement capacity of irrigation flow. At the same time, the apical pressure decreased as the working depth increased. The curvature of the root canal seriously affects the removal depth of the smear layers of the root canal. A root canal with a large curvature (especially 20° and 30°) can significantly improve the difficulty of irrigation. CONCLUSIONS: (1) Moderate working depth helps to improve the displacement capacity, the ERD of the irrigation flow is generally improved at the working depths of 4.75 mm and 5.25 mm, and the apical pressure will decrease with the increase of working depth. (2) The large curvature of the root canal can significantly improve the difficulty of irrigation. The curvature of the root canal can severely influence the removal depth of the smear layer on the wall. It can be found both the span and the depth of the ESS for little curvatures (5° and 10°) root canals are higher than those for large curvatures (20° and 30°).


Assuntos
Cavidade Pulpar , Camada de Esfregaço , Humanos , Preparo de Canal Radicular/métodos , Hidrodinâmica , Irrigantes do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular , Agulhas , Irrigação Terapêutica
11.
Niger J Clin Pract ; 27(1): 16-21, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38317030

RESUMO

BACKGROUND: The successful outcome of nonsurgical root canal treatment (NS-RCT) is largely dependent on the technical quality of the procedure. OBJECTIVE: To investigate the incidence of separated instruments in endodontic postgraduate clinics between January 2018 and December 2021, and to determine the potential contributory factors that increase the risk of instrument separation. MATERIALS AND METHODS: A retrospective observational study was conducted in the Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia. Data was collected to determine the incidence of separated instruments and their associated variables. Seven variables were analyzed separately: nonsurgical initial or retreatment case, tooth type, tooth arch, tooth location, canal type, root curvature, level of fracture, and file type. RESULTS: A total of 3150 cases were treated, of which 108 cases had separated instruments. The overall incidence of instrument separation was 3.4% while 53.7% of separated instruments occurred in the mandibular molars, followed by 42.6% in the maxillary molars. The highest frequency of instrument separation was recorded in the mesiobuccal canal (35.2%). The level of separation was found to be statistically significant in relation to the management (P < .001). CONCLUSION: Nickel-titanium instruments tend to separate more inside the root canal system than stainless steel instruments. However, under the limitation of this study, the incidence of instrument separation is still quite low, even with postgraduate endodontic residents with limited experience.


Assuntos
Cavidade Pulpar , Endodontia , Humanos , Estudos Retrospectivos , Incidência , Preparo de Canal Radicular/métodos , Tratamento do Canal Radicular , Titânio , Desenho de Equipamento
12.
Eur Endod J ; 9(2): 114 - 123, 2024 03 08.
Artigo em Inglês | MEDLINE | ID: mdl-38377107

RESUMO

OBJECTIVE: This study aimed to examine the shaping ability of six rotary and reciprocating file systems, as well as hybrid techniques in simulated S-shaped root canals. METHODS: A hundred and twenty S-shaped radiopaque thermosetting epoxy resin blocks were grouped according to the system used for biomechanical preparation. Six groups of 15 canals each were prepared using TruNatomy, Procodile, VDW Rotate, Hyflex CM, OneCurve, and WaveOne Gold, respectively. Two additional hybrid (Procodile/Hyflex CM and Procodile/TruNatomy) groups (n=15 each) were added after evaluating the results of individual systems. All canals were enlarged to 0.25 mm apically. Canal transportation, centering ability, diameter increase, and iatrogenic errors were assessed by superimposed pre-operative and post-operative images. AutoCAD was used for data analysis. All groups were statistically compared with analysis of variance and Tukey honest significant difference test (p<0.05). RESULTS: Hyflex CM resulted in the most conservative diameter increase in all thirds (coronal, middle, and apical; p<0.001). Procodile showed the best (p<0.001) centering ability in the coronal and middle thirds, while TruNatomy resulted in the least canal transportation and most centering preparation in the apical third (p<0.001). Hybridisation of Procodile and Hyflex CM produced the least canal transportation and best centering ability in the middle third (p<0.001). No instrument breakage occurred, and no ledge, elbow, or apical zip formation was observed during canal preparation. CONCLUSION: Hybridisation of Procodile and Hyflex CM showed remarkable results in preserving the canal diameter in all thirds and resulted in the least canal transportation and best centering ability in the middle third of the canal. However, when treatment cost and duration limit the clinical applicability of the hybrid technique, clinicians can use a single file system (Hyflex CM or TruNatomy) since it shows satisfactory results in all parameters when compared with a hybrid system.


Assuntos
Cavidade Pulpar , Preparo de Canal Radicular , Biometria
13.
Niger J Clin Pract ; 27(2): 174-179, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38409144

RESUMO

BACKGROUND: This study aimed to compare the effect of different obturation techniques with root canal sealers on the residual filling material after retreatment using SEM. MATERIAL AND METHOD: Sixty (60) single rooted mandibular premolars were selected and instrumented with rotary files using the Mtwo system up to file size 30/.05 taper. The samples were randomly divided to two groups based on the type of sealer and three sub-groups (n=10) based on the obturating technique used. The root fillings were removed using the PTUR system files and the specimens were longitudinally sectioned while digital images were obtained from the root canals with SEM. The time required to reach working lenght were recorded. RESULTS: There was no difference in terms of the smear score when comparing both sealer and obturation technique groups in the apical third. Smear scores were significantly affected by the type of sealer and obturation technique in the medium and coronal thirds of root canals (p<0.05). Higher smear scores were obtained with GFB than AH Plus (p<0.05). The time required to reach working length with GFB was longer than AH Plus (p<0.05). CONCLUSION: Residual filling material was observed in all samples, regardless of the root canal sealer or the obturation technique used. There was a significantly lower smear scores in the AH Plus groups as compared to the GFB.


Assuntos
Materiais Restauradores do Canal Radicular , Humanos , Cavidade Pulpar , Obturação do Canal Radicular/métodos , Preparo de Canal Radicular/métodos , Retratamento , Guta-Percha , Resinas Epóxi
15.
BMC Oral Health ; 24(1): 261, 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38389109

RESUMO

BACKGROUND: Multispecies biofilms located in the anatomical intricacies of the root canal system remain the greatest challenge in root canal disinfection. The efficacy of Er:YAG laser-activated irrigation techniques for treating multispecies biofilms in these hard-to-reach areas has not been proved. The objective of this laboratory study was to evaluate the effectiveness of two Er:YAG laser-activated irrigation techniques, namely, photon-induced photoacoustic streaming (PIPS) and shock wave-enhanced emission photoacoustic streaming (SWEEPS), in treating multispecies biofilms within apical artificial grooves and dentinal tubules, in comparison with conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI), and sonic-powered irrigation (EDDY). Two types of multispecies root canal biofilm models were established in combination with two assessment methods using scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM) with the aim to obtain more meaningful results. METHODS: Ninety extracted human single-rooted premolars were chosen for two multispecies biofilm models. Each tooth was longitudinally split into two halves. In the first model, a deep narrow groove was created in the apical segment of the canal wall. After cultivating a mixed bacterial biofilm for 4 weeks, the split halves were reassembled and subjected to five irrigation techniques: CNI, PUI, EDD, PIPS, and SWEEPS. The residual biofilms inside and outside the groove in Model 1 were analyzed using SEM. For Model 2, the specimens were split longitudinally once more to evaluate the percentage of killed bacteria in the dentinal tubules across different canal sections (apical, middle, and coronal thirds) using CLSM. One-way analysis of variance and post hoc multiple comparisons were used to assess the antibiofilm efficacy of the 5 irrigation techniques. RESULTS: Robust biofilm growth was observed in all negative controls after 4 weeks. In Model 1, within each group, significantly fewer bacteria remained outside the groove than inside the groove (P < 0.05). SWEEPS, PIPS and EDDY had significantly greater biofilm removal efficacy than CNI and PUI, both from the outside and inside the groove (P < 0.05). Although SWEEPS was more effective than both PIPS and EDDY at removing biofilms inside the groove (P < 0.05), there were no significant differences among these methods outside the groove (P > 0.05). In Model 2, SWEEPS and EDDY exhibited superior bacterial killing efficacy within the dentinal tubules, followed by PIPS, PUI, and CNI (P < 0.05). CONCLUSION: Er:YAG laser-activated irrigation techniques, along with EDDY, demonstrated significant antibiofilm efficacy in apical artificial grooves and dentinal tubules, areas that are typically challenging to access.


Assuntos
Lasers de Estado Sólido , Ultrassom , Humanos , Lasers de Estado Sólido/uso terapêutico , Microscopia Eletrônica de Varredura , Microscopia Confocal , Biofilmes , Irrigantes do Canal Radicular/farmacologia , Irrigantes do Canal Radicular/uso terapêutico , Preparo de Canal Radicular/métodos , Cavidade Pulpar , Irrigação Terapêutica/métodos , Hipoclorito de Sódio/farmacologia
16.
BMC Oral Health ; 24(1): 233, 2024 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-38350980

RESUMO

BACKGROUND: Sodium hypochlorite (NaOCl) is the most efficient root canal irrigant to date. The aim of this study was to compare the effect of NaOCl used at different temperatures and concentrations on the compressive strength of root dentin. MATERIALS AND METHODS: Seventy-two extracted human single-canaled straight roots of comparable size and length were selected and randomly divided into six groups (n = 12): Group (A) served as a control with unprepared canals. The other groups were instrumented with rotary ProTaper Universal files up to size F3. Group (B) was irrigated with 1% NaOCl at room temperature, Group (C) with 1% NaOCl heated to 70 °C, Group (D) with 5.25% NaOCl at room temperature, and Group (E) with 5.25% NaOCl heated to 70 °C. Saline was used in Group (F). The roots were sectioned into 2-mm-thick disks that underwent compression testing using a universal testing machine. Data were analyzed using one-way ANOVA and post hoc Tukey tests. The significance level was set at p ≤ 0.05. RESULTS: A total of 255 disks were tested. The control group showed the highest compressive strength (p = 0.0112). However, this did not differ significantly from that of heated (p = 0.259) or unheated (p = 0.548) 1% NaOCl. There were no statistically significant differences between the groups of instrumented teeth. CONCLUSION: Within the conditions of this study, irrigation with NaOCl at different concentrations and temperatures during root canal preparation did not affect the compressive strength of root dentin. CLINICAL RELEVANCE: This study demonstrates that the use of NaOCl as a root canal irrigant is not associated with a clinically relevant decrease in root compressive strength, especially when compared to saline.


Assuntos
Dentina , Hipoclorito de Sódio , Humanos , Cavidade Pulpar , Irrigantes do Canal Radicular/farmacologia , Preparo de Canal Radicular , Hipoclorito de Sódio/farmacologia , Temperatura , Dente
17.
Clin Oral Investig ; 28(2): 139, 2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38332365

RESUMO

OBJECTIVES: This study aimed to describe the effects of two single-file systems on the diversity of the endodontic microbiome of teeth with primary asymptomatic apical periodontitis. MATERIALS AND METHODS: The root canals from single-rooted teeth with apical periodontitis were prepared using either the Reciproc Blue (RB) or the XP-endo Shaper (XPS) instrument system. The latter was followed by a supplementary step with the XP-endo Finisher (XPF) instrument. For irrigation, 5.25% sodium hypochlorite was used. Root canal samples were taken at the baseline (S1), after preparation (S2), and after the supplementary step (S3). DNA was extracted and subjected to high-throughput sequencing using the MiSeq Illumina platform. RESULTS: Samples from 10 teeth from the RB and 7 from the XPS group were subjected to DNA sequencing. Initial samples differed significantly from post-preparation samples in bacterial diversity, with no significant difference when comparing the two instrument systems. The most dominant phyla in S2 were Bacteroidetes, Proteobacteria, Firmicutes, Fusobacteria, and Actinobacteria. The same phyla were found to dominate baseline samples and samples taken after using XPF, but with differences in the ranking of the most dominant ones. At the genus level, the most dominant genera identified after RB instrumentation were Bacteroidaceae [G-1], Fusobacterium, and Staphylococcus, while the most dominant genera after XPS instrumentation were Fusobacterium and Porphyromonas. These genera were also dominant in the initial samples. CONCLUSIONS: Both treatment protocols had measurable effects on the root canal microbial diversity, with no significant differences between them. Most of the dominant taxa involved in the primary infection and probably in the aetiology of apical periodontitis were eliminated or substantially reduced. CLINICAL RELEVANCE: The most dominant taxa that persisted after instrumentation were Fusobacterium, Porphyromonas, Staphylococcus, and Bacteroidaceae [G-1].


Assuntos
Periodontite Periapical , Preparo de Canal Radicular , Humanos , Cavidade Pulpar/microbiologia , Tratamento do Canal Radicular , Periodontite Periapical/microbiologia , Bactérias
18.
Sci Rep ; 14(1): 3795, 2024 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-38361036

RESUMO

This in vitro study evaluated the bacterial reduction provided by the EndoActivator (EA), Easy Clean (EC), passive ultrasonic irrigation (PUI), and XP-Endo Finisher. Eight-four mesial roots of mandibular first molars were instrumented, inoculated with Enterococcus faecalis, and divided into four groups (n. 20). Bacterial reduction in the main canals and dentinal tubules were respectively determined by MTT assays and Live/Dead BackLight technique through confocal laser scanning microscopy (CLSM) at 50, 100, and 150 µm in-depth (n. 10 per group). Statistical analyses were conducted following a significance level of 95% (P < 0.05). A significant statistical difference was just identified between XPF and EC in the main canals. In the dentinal tubules from the main root canals, at 100 and 150 µm in-depths, significant statistical differences were only observed between XPF and EC (P = 0.027) for the former and between XPF and EC (P = 0.011) and XPF and PUI (P = 0.021) for the latter. In the dentinal tubules from the isthmus, at 100 µm in-depth, statistically relevant differences did occur between XPF and EC (P = 0.038) and EC and EA (P = 0.029). At 150 µm in-depth, these differences were only significant by comparing XPF and PUI (P = 0.025) and XPF and EC (P = 0.036). Although no irrigation method could thoroughly disinfect the RCS, bacterial reduction indexes were generally better after using XPF.


Assuntos
Desinfecção , Preparo de Canal Radicular , Preparo de Canal Radicular/métodos , Desinfecção/métodos , Cavidade Pulpar , Irrigantes do Canal Radicular , Tratamento do Canal Radicular/métodos , Bactérias , Hipoclorito de Sódio
19.
In Vivo ; 38(2): 559-566, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38418153

RESUMO

BACKGROUND/AIM: Enterococcus faecalis is the leading cause of endodontic treatment failures. Despite various conventional disinfection approaches, microorganisms often persist in root canals. Photodynamic therapy (PDT) is an adjunct antimicrobial strategy employing a nontoxic photosensitizer (PS) and light source. This study evaluated the antimicrobial effect of PDT using an Nd:YAG laser and resveratrol (RSV) with or without pigment, and confirmed that RSV is nontoxic as a PS. MATERIALS AND METHODS: We employed laser irradiation at a 3W output power, using RSV and red pigment as the PS, on an E. faecalis bacterial solution. Subsequently, colony-forming units were quantified. The impact of RSV on osteoblasts was measured using an MTT assay. RESULTS: E. faecalis counts declined after laser irradiation. The combined application of laser irradiation with RSV, red pigment, or both showed a reduction compared to no irradiation and control groups without RSV and red pigment. The 50% cytotoxic concentration against osteoblast cells from mice incubated with RSV for 48 h was 162 µM. The value with RSV and laser was 201 µM and that with RSV and red pigment was 199 µM. The value with RSV, laser and red pigment was 357 µM. CONCLUSION: The combination of Nd:YAG laser irradiation and RSV as the PS with pigment was efficacious for E. faecalis elimination without inducing any toxic effects on osteoblasts. This combination holds potential as a root canal irrigation strategy.


Assuntos
Anti-Infecciosos , Lasers de Estado Sólido , Fotoquimioterapia , Animais , Camundongos , Lasers de Estado Sólido/uso terapêutico , Enterococcus faecalis/efeitos da radiação , Resveratrol/farmacologia , Biofilmes/efeitos da radiação , Preparo de Canal Radicular , Fármacos Fotossensibilizantes/farmacologia , Cavidade Pulpar
20.
Beijing Da Xue Xue Bao Yi Xue Ban ; 56(1): 99-105, 2024 Feb 18.
Artigo em Chinês | MEDLINE | ID: mdl-38318903

RESUMO

OBJECTIVE: To evaluate the sealing ability of GuttaFlow2 single cone obturation in curved root canals. METHODS: (1) Slight, moderate and severe curved 3D printed root canals were made. After instrumentation, these samples were randomly divided into 2 groups (n = 10) according to different root canal filling techniques: GuttaFlow2 single cone group (GF2) and AH-Plus warm vertical compation group (WVC). All the samples were sectioned at 2 mm to apex (the apical of the root), 4 mm, 6 mm to apex (the middle of the root) and 8 mm to apex (the coronal of the root). The filling void areas were observed by stereomicroscope, and the percentages of void areas in each section were calculated by ImageJ 1.52a. (2) Forty-eight roots of extracted adult molars were selected. After instrumentation, they were randomly divided into 2 groups (n = 8): GF2 group and WVC group. Before root canal filling, the sea-lers were mixed with Rhodamine B dye for visualization under confocal laser scanning microscope. All samples were sectioned at 2 mm to apex (the apical of the root), 5 mm to apex (the middle of the root) and 8 mm to apex(the coronal of the root). Then, the percentages of sealer penetration into dentinal tubules in each section were calculated. RESULTS: At the apical of the root, there were no obvious voids in slight, moderate and severe curved canals in the GF2 group and the WVC group. There was no significant difference between the two groups (P > 0.05). At the middle of the root, there was no significant difference in the percentages of void areas between the two filling methods, but at the coronal of the root, there were more voids in the slight curved root canal in the GF2 group than in the WVC group, and the difference was significant (P = 0.009). The percentages of sealer penetration into dentinal tubules of slight, moderate and severe curved root canals in the GF2 group were 36.10%, 55.80%, 65.08%, respectively. And they were all higher than those in the WVC group (15.78%, 20.70%, 15.61%), respectively, the difference between the two groups was significant (P = 0.001). At the middle of the root, the percentages of sealer penetration into dentinal tubules of slight and moderate curved root canals in GF2 group were also significantly higher than those in the WVC group (P = 0.001). At the coronal of the root, there was no significant difference between the two groups (P > 0.05). CONCLUSION: GuttaFlow2 filling technique has the same sealing effect on the root canal at the apical and middle of the root as the warm vertical technique, but has a better sealing effect on the dentin tubules, especially for severe curved root canal.


Assuntos
Materiais Restauradores do Canal Radicular , Cavidade Pulpar , Preparo de Canal Radicular , Tratamento do Canal Radicular , Obturação do Canal Radicular/métodos , Guta-Percha
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