Abstract
Background: This study evaluated the efficacy of a multisonic technology for the debridement of vital and necrotic pulp tissues in freshly extracted human mandibular molar teeth. Methods: Twelve teeth with a diagnosis of symptomatic irreversible pulpitis (SIP) and twelve teeth with a diagnosis of pulp necrosis with symptomatic apical periodontitis (SAP) were extracted. The GentleWave® procedure was performed on 10 teeth from each group. Four non-treated teeth served as histologic controls. Histological consecutive 5 µm sections were obtained from the apical, middle, and coronal portion of the canals. The canals were evaluated for the presence of pulpal debris and bacteria. Results: In nine out of the ten specimens with SIP, no pulpal debris was detected in any portion of the canals. In the necrotic pulp group, eight out of the ten specimens had no detectable pulpal debris in any portion of the canal spaces. No bacteria were detected in the main canals, isthmuses, or lateral canals, but were detected deep within the dentinal tubules in 10 specimens. Conclusions: This study demonstrated that the multisonic technology was effective at removing vital and necrotic pulp tissue as well as bacteria from the root canal system, including inaccessible areas.
Highlights
The purpose of this study was to evaluate the efficacy of the multisonic technology in the debridement of the complex root canal system of human mandibular molar teeth independent of the pulpal and periapical diagnosis, by examining histologically the root canals for remaining pulp tissue and bacteria
Allconsecutive consecutive histological histological sections sections in with hehematoxylin and eosin confirmed the presence of pulp tissue in the apical, middle, matoxylin and eosin confirmed the presence of pulp tissue in the apical, middle, andand corcoronal portions the mesial and distal roots bothevaluated evaluated groups (Figure2A,B)
The Gram stain of the necrotic group showed the presence of bacteria in all addition, the Gram stain of the necrotic group showed the presence of bacteria in all porportions of both roots as well as in the dentinal tubules near the canal walls (Figure 2C,D)
Summary
Because of this association, managing endodontic disease consists of a combination of mechanical instrumentation and chemical irrigation to reduce the bacterial load [4] to levels compatible with the healing process
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