Abstract

BackgroundIn recent years, the concept of minimally invasive endodontics has been proposed, which could be described as preventing or treating diseases by preserving more dental tissue and creating minimal damage. In the process of root canal preparation, it was recommended to use instruments with a smaller taper to preserve more tooth tissue and improve the preservation rate of the affected teeth. Photon-induced photoacoustic streaming (PIPS) was a new type of laser-activated irrigation technology, which was now widely used in endodontic treatment. The purpose of this article was to evaluate the bactericidal effect of PIPS with NaOCl in root canals with different widths or tapers.MethodsTwenty-three maxillary first molars with three independent root canals were included in this study. The mesiobuccal (MB), distobuccal (DB), and palatal (P) root canals were prepared at sizes of #10/.02, #25/.02, and #25/.06, respectively. After being incubated with a bacterial suspension for 4 weeks, the specimen were irrigated with 2% NaOCl activated by conventional needle irrigation (CNI) (n = 10) or PIPS (n = 10). Three specimen were not treated (control group). Before and after irrigation, the presence of bacteria was assessed with an adenosine 5'-triphosphate (ATP) assay kit and biofilms were assessed using confocal laser scanning microscopy and scanning electron microscopy.ResultsIn specimen prepared using PIPS irrigation, the ATP was reduced by more than 98%. When the root canal taper was 0.02, the size #25 root canals had a higher percentage of dead bacteria than the size #10 root canals in all regions (P < 0.05) in the PIPS group. When the root canal width was #25, the 0.02 taper group had a higher percentage of dead bacteria than the 0.06 taper group in the apical region (P < 0.05), except coronal and middle regions (P > 0.05). PIPS irrigation results in a greater percentage of dead bacteria and reduction of ATP in size #10/.02 root canals than CNI in size #25/.06 root canals in three regions (P < 0.05).ConclusionIncreasing the width from #10 to #25 improves the bactericidal effect of PIPS in the root canal. Increasing the taper of the root canal from 0.02 to 0.06 at size #25 did not affect the bactericidal effects of PIPS. PIPS resulted in more dead bacteria in specimen with smaller tapers and root canal widths than CNI. PIPS can be used to clean the smear layer in the coronal region and open the dentin tubules.Clinical significance: Activation of irrigants with PIPS brought about significant bacterial reduction smaller tapers and width root canals compared to CNI, which was beneficial to prevent excessive loss of tooth tissue and conserve the structural integrity of teeth.

Highlights

  • In recent years, the concept of minimally invasive endodontics has been proposed, which could be described as preventing or treating diseases by preserving more dental tissue and creating minimal damage

  • Clinical significance: Activation of irrigants with Photon-induced photoacoustic streaming (PIPS) brought about significant bacterial reduction smaller tapers and width root canals compared to conventional needle irrigation (CNI), which was beneficial to prevent excessive loss of tooth tissue and conserve the structural integrity of teeth

  • confocal laser scanning microscopy (CLSM) analysis In the CNI group, the percentage of dead intracanal bacteria was highest in root canals sized #10/.02, followed by #25/.02, and #25/.06 (P < 0.05)

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Summary

Introduction

The concept of minimally invasive endodontics has been proposed, which could be described as preventing or treating diseases by preserving more dental tissue and creating minimal damage. Due to the intricate anatomy of root canals, an area of the canal remains untouched during canal preparation. This may continue to exist in the root canal system, leading to pulp disease after treatment [2]. Mechanical preparation and irrigating solutions play key roles in providing debridement and removing vital and necrotic tissue, debris, and microorganisms from the root canal system [3]. Studies have shown that a larger root canal preparation width and taper can improve the effectiveness of root canal irrigation; optimization of the mechanical efficacy of irrigation provided by enlarging the canals may result in weakening of the root structure [4] and increase the risk of root fracture [5]

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