Root Canal Debridement Research Articles

Assessment of Smear Layer Removal and Push-Out Bond Strength Efficacy of Traditional and Herbal Root Canal Irrigants Across Different Root Levels: An In Vitro Study.

Endodontic therapy requires meticulous root canal debridement, pathogen elimination, and effective obturation to prevent microbial intrusion. The presence of the smear layer hinders sealer penetration, compromising sealing effectiveness. Sodium hypochlorite and chlorhexidine are esteemed endodontic irrigants. Herbal extracts like neem and tulsi, with antimicrobial and anti-inflammatory properties, show promise for root canal irrigation. The study aimed to evaluate the efficacy of various irrigants in removing the smear layer and enhancing push-out bond strength at different root canal levels. One hundred mandibular premolars with single canals were collected, and 50 samples each were used for the smear layer and push-out bond strength analysis. Neem and tulsi extracts were prepared for irrigation. Teeth were decoronated, and up to 30 (6%) canals were prepared and were randomly divided into five groups based on irrigants used. A smear layer examination was conducted after longitudinally sectioning the tooth and sections were observed in a scanning electron microscope (SEM). Obturation was done in the remaining samples, and the push-out bond strength was assessed using a universal test machine. Sodium hypochlorite showed the highest smear layer removal efficacy followed by chlorhexidine, neem, tulsi leaves with rose water extract, and normal saline. Chlorhexidine exhibited the highest push-out bond strength, with the coronal third presenting the strongest values, followed by neem, tulsi with rose water, normal saline, and sodium hypochlorite. The study underscores the potential of herbal irrigants in endodontic therapy, indicating promising results while emphasizing the necessity for further clinical trials to validate their efficacy and other properties.

Comparative Evaluation of Ultrasonic and Sonic Irrigant Activation Systems: Assessing Extrusion Risk, Debridement, and Biofilm Removal in Distinct Apical Preparation Sizes

This study aims to compare the effectiveness of ultrasonically and sonically activated irrigation in terms of extrusion risk, root canal debridement, and biofilm removal, considering distinct apical preparation sizes, through an ex vivo study in human teeth. Instrumented teeth, to an apical size of 35/.06 or 50/.06, were assigned to three different irrigation procedures: ultrasonically activated irrigation, sonically activated irrigation, and conventional manual irrigation. Apical extrusion risk was evaluated by quantifying irrigant and debris extrusion (n = 10/group). Debris evaluation and smear layer removal from the root canal wall were conducted by scanning electron microscopy (SEM) (n = 5/group), and the elimination of a mature biofilm of Enterococcus faecalis was assessed through resazurin assay and SEM (n = 10/group). For statistical analyses, Student’s paired t-test and the ANOVA with post-hoc Tukey were used. Activated irrigations exhibited a higher risk of extrusion for the larger apical size, while the risk for manual irrigation remained independent of the apical size. Substantially fewer residual debris and smear layers were observed after the activation of the irrigant, and there was a notable enhancement in biofilm elimination compared to manual irrigation (p < 0.05). Notably, the effectiveness of both activated irrigations was more pronounced in root canals prepared to a size 50/.06, with ultrasonic activation showing enhanced improvements. The findings of this study underscore the substantial impact of both ultrasonically and sonically activated irrigation on the effectiveness of root canal disinfection and debridement. This impact is especially prominent with larger apical size, albeit accompanied by an increased risk of extrusion.

Experimental Evaluation of a Novel Device to Quantify Canal Cleanliness: An In Vitro Study

Endodontic treatments are performed to avoid extractions and maintain the natural dentition. Root canal treatments are undertaken to eliminate or prevent an infection within the root canal system. Chemical and mechanical root canal debridement are the main methods used in endodontics to remove necrotic tissue, microorganisms, and microbial byproducts from the canal. However, to date there is no objective method to clinically determine the proper root canal disinfection level and thus proceed with the obturation. Clinicians just rely on their experience and habits or can trust in empirical methods such as the insertion of paper cones inside the canal and then check their appearance after the removal. Even in the in vitro and ex vivo scientific studies there is no objective method to analyze and compare the efficacy of different endodontic chemo-mechanical techniques and materials. The most frequently used method is to visually analyze some areas with a scanning electron microscope (SEM), even if the resulting images are hardly quantifiable and could greatly vary according to the analyzed area. A new device to clinically test the cleanliness of a root canal and display the result in an objective score was recently developed. The device analyzes the luminescence generated by an enzyme cycling method that process the adenosine triphosphate (ATP), adenosine diphosphate (ADP) and adenosine monophosphate (AMP) present in organic residues. The aim of the present in vitro study was to test the efficacy and reliability of this novel device (Endocator) in a controlled in vitro environment, before using it in clinical practice. The device sensitivity was tested on 5 single canal resin blocks. Three consecutive sampling were executed by one operator for each block to test the device repeatability. Results were recorded according to Endoscore (ES) and relative light unit (RLU) scales. Descriptive analysis and comparison between the 5 resin blocks and the 3 consecutive sampling were performed. Only the comparison between the first and third measurements both for ES (p = 0.00115999) and RLU (p = 0.00532749) resulted significant. Endocator was able to determine small variations of canal contamination in a controlled laboratory environment, showing high sensitivity and repeatability.

Effectiveness of white tea-mediated silver nanoparticles as an intracanal irrigant against Enterococcus faecalis: An in vitro study.

The probability of a positive outcome of root canal therapy is substantially higher if the infection is eradicated successfully before the obturation of the root canal system. Irrigation is an essential aspect of root canal debridement, as it enables more thorough cleaning than is possible with root canal instrumentation alone. To overcome the side effects of chemical irrigants, there has been a search for herbal medicines as substitutes. The aim of the present study was to explore the antimicrobial efficacy of white tea-mediated silver nanoparticles (AgNPs) formulated as an intracanal irrigant against Enterococcus faecalis, and to compare it with the efficacy of chlorhexidine and sodium hypochlorite irrigants. The experimental groups were as follows: group I - white tea-mediated AgNPs; group II - 2% chlorhexidine; and group III - 2.5% sodium hypochlorite. The characterization of AgNPs was performed using ultraviolet-visible (UV-Vis) spectroscopy and transmission electron microscopy (TEM) analysis. Enterococcus faecalis was inoculated onto Mueller-Hinton agar plates. The disks impregnated with irrigants were placed on the inoculated plates and incubated aerobically at 37°C for 24 h. Then, the growth inhibition zones were measured. Statistical analysis was performed using the one-way analysis of variance (ANOVA) and the post hoc tests. A concentration of 50 μL of white tea-mediated AgNPs exhibited the greatest zone of inhibition (32 ±2 mm), followed by 2% chlorhexidine (25 ±1 mm) and 2.5% sodium hypochlorite (23 ±3 mm). White tea-mediated AgNPs showed promising results in the elimination of E. faecalis, being superior to chlorhexidine and sodium hypochlorite irrigants.

Antimicrobial Efficacy of Simvastatin and Double Antibiotic Paste as Intracanal Medicaments: A Randomised Clinical Study

Abstract Introduction: Root canal debridement, irrigation and a microorganism-free environment are key factors in the success of root canal treatment. Intracanal medicaments are used to enhance root canal disinfection. Simvastatin is derived from lovastatin and is a semisynthetic medication. This study compares and evaluates the effect of simvastatin and double antibiotic paste (DAP) as an intracanal medicament in single-rooted teeth with apical periodontitis using colony-forming units (CFUs)/ml. Materials and Methods: Twenty-eight patients with single-rooted teeth diagnosed with apical periodontitis were selected. Under aseptic conditions, patency was gained, sterile saline solution was deposited in the canal and the first sample (S1) was collected. Cleaning and shaping were then carried out following an appropriate technique depending on the configuration of the canal. After irrigation and biomechanical preparation, teeth were randomly assigned to two different groups, and the test intracanal medicament was applied to the root canals. Coronal openings were sealed with temporary restorative cement. The second sample (S2) was collected after 7 days. The samples obtained were checked for a reduction in the bacterial load. They were incubated aerobically for 48 h, and the CFUs were calculated. The Mann–Whitney U and Wilcoxon’s signed-rank tests were used to analyse the results statistically. Results: A significant reduction in bacterial count was present after administration of the intracanal medicament. On intergroup comparison, there was no statistically significant difference in bacterial decrease between the two groups. Comparatively, the mean reduction in the bacterial count was higher in the DAP group. Conclusion: It can be concluded that DAP and simvastatin were effective in the reduction of the bacterial count in single-rooted teeth diagnosed with apical periodontitis. However, DAP demonstrated a better performance in the reduction of bacterial counts.

Comparative Analysis of Photosensitizer Penetration Depth in Root Canal Debridement for Endodontic Disinfection.

Microbial agents play a crucial role in periapical lesions and despite mechanical preparation, presence of persistent bacteria in root canal system is a challenge. Photodynamic therapy offers a debridement method, utilizing photosensitizers such as Curcumin, Indocyanine Green (ICG), and Methylene Blue (MB). This study aimed to assess and compare the penetration depth of these photosensitizers on the lateral surface of the root canal. The crown of 30 single-rooted teeth were separated by a diamond disc. The canals were prepared using a rotary system and were rinsed with 10 mL of 2.5% NaOCl. In order to remove the smear layer debris, 17% EDTA was placed in the root canal for 1 min, then rinsed with NaOCl and saline. The teeth were sterilized by autoclave and randomly assigned to three groups that filled with curcumin, ICG, or MB. Subsequently, they were incubated for 10 min and dried up by paper. Longitudinal sections were cut, and penetration depth of the photosensitizers in coronal, middle, and apical sections were measured using a stereomicroscope. Curcumin demonstrated a higher average penetration depth (3000 µm) than MB, and MB showed higher penetration depth than ICG. Significantly different penetration depths were observed in pairwise comparisons among all three groups (P<0.005). Curcumin with its superior average penetration depth, emerges as a promising choice for effective root canal disinfection in endodontic treatments. Consideration of these findings may enhance the selection of photosensitizers in clinical applications.

The Complexity of the Root Canal Anatomy and Its Influence on Root Canal Debridement in the Apical Region: A Review.

The main goal of root canal treatment is to eliminate the infection in the complex root canal system for the long-term preservation of a functional tooth. Proper debridement of the root canal system, especially in the apical portion, is essential for successful root canal treatment. The complexity of the canal anatomy in the apical region plays a crucial role in reducing the microbial load. Therefore, clinicians must have a thorough knowledge of the anatomy of the root canal system and its variations, especially in the apical portion. Root canal configurations in cross-section have been classified as round, oval, long oval, flattened, or irregularly shaped. Treating oval, long oval, flattened, or irregularly shaped canals is challenging and should be approached differently than a circular canal. Recognizing the root canal shape and apical anatomy determines the different strategies to be used in cleaning, shaping, and obturation to achieve the best result of root canal treatment. The recent development of the instrumentation system improves the treatment outcome for clinicians and patients. This review aimed to discuss the definition, prevalence, and instrumentation for cleaning and shaping in the apical area with the complexity of root canal systems. Therefore, with the aid of this review, we can better understand the variations in the anatomy of the root canal, especially at the apical portion.

Evaluation of root-canal isthmus debridement efficacy of 3 kinds of activated irrigation technique.

This study aimed to compare the capabilities of sonic, ultrasonic, and laser-activated irrigation for debris removal in the root canal isthmus. A total of 32 human maxillary first premolars with root canal isthmus were prepared by Reciproc Blue, and were randomly divided into four groups (n=8, each group). The groups were subsequently subjected to different regimens as follows: the conventional syringe group (control group) was irrigated by No.27 side opening syringe, the sonic group with EDDY connected pneumatic motor, the ultrasonic group with IRRI Safe connected to a ultrasonic P5 handle, and the laser group with Er:YAG laser device connected to a 9 mm fiber tip for 20 s in each root canal. The first and last four samples in each group were irrigated for 80 and 120 s, respectively. All samples were fixed, decalcified, embedded, sectioned, and stained with hematoxylin-eosin. Image J software was used for measurement analysis of the isthmus and canal debridement efficacy, and SPSS 25.0 was utilized for statistical analysis of all data. The isthmus debridement efficacy of conventional syringe irrigation, sonic, ultrasonic, and laser groups after 80 s irrigation were 30.91%±3.14%, 52.22%±0.31%, 83.77%±5.64%, and 77.97%±7.97%, respectively. The isthmus debridement efficacy of the three experimental groups were better than the conventional syringe irrigation group (P<0.05). The isthmus debridement efficacies of ultrasonic and laser groups after 80 s were better than that of the sonic group (P<0.01, P<0.05). However, no significant difference was observed between the ultrasonic and laser groups. The isthmus debridement efficacy of conventional syringe irrigation, sonic, ultrasonic, and laser groups after 120 s were 75.72%±2.38%, 85.66%±4.42%, 88.07%±4.09%, and 89.12%±3.63%, respectively. The isthmus debridement efficacies of the three experimental groups were better than that of the conventional syringe irrigation group (P<0.05), but no significant difference was observed among the groups (P>0.05). The root canal debridement efficacy among the four groups also exhibited no significant difference (P>0.05). The debridement efficacies of the root canal and isthmus after 120 s irrigation were better than those after 80 s irrigation (P<0.01, P<0.001). Ultrasonic, sonic, and laser-activated irrigation have better results in removing debris from the isthmus than conventional syringe irrigation. The isthmus debridement efficacy of sonic- and laser-activated irrigation are slightly better than that of ultrasonic activated irrigation. The debridement efficacies of 120 s irrigation are better than those of 80 s irrigaion.

Recent root canal irrigation protocol followed by endodontists and postgraduate students of endodontics for root canal therapy in Central India

Background: One of the main purposes of root canal treatment is the complete debridement of root canals. Regardless of the instrumentation technique used 35% or more of the root canal surfaces have been observed to remain uninstrumented. To remove debris and address these uninstrumented surfaces, it is necessary to copiously irrigate the root canal. Many adjuncts have also been developed and being used in an effort to improve the delivery and effectiveness of these irrigants. Although much research have been conducted on different root canal treatment regime and irrigants used in dentistry, only a little data can be found on the widespread practice or acceptance of such methods. Aims and Objectives: The purpose of this survey was therefore to ascertain the current trends in the use of root canal irrigants and irrigation protocol followed by Endodontists and Postgraduate students across Central India (Madhya Pradesh). Material and Methods: A questionnaire-based survey was conducted and participants were asked to fill in responses to some questions regarding their preferences for root canal irrigation like irrigant selection, irrigant concentration, technique used for delivery and activation of irrigants, etc. Results: The majority of the respondents considered both irrigations as well as instrumentation to be of equal importance. Also, the majority of respondents prefer full-strength sodium hypochlorite (5.25%) while only a few have been found to use its lower concentration (3%). Conclusion: It is essential for future prospects to get an awareness of the properties and actions of irrigants and incorporate them into practice for executing a successful endodontic treatment.

Current Trends in Root Canal Irrigation.

Chemical and mechanical root canal debridement are the primary methods used in endodontic therapy to remove all dead tissue, bacteria, and microbial byproducts from the canal. Sodium hypochlorite, a powerful organic tissue dissolver with a broad spectrum of antibacterial properties, is an excellent choice for disinfecting surfaces. Chelating agents, on the other hand, may be used to remove the inorganic components found on the smear layer. This irrigation method is capable of removing the smear layer; however, it is less effective in the apical third. While using irrigant activation devices, irrigating solutions need to be in direct contact with the whole root canal wall surfaces, especially in the apical portions of tiny root canals. The role of irrigants is extremely important because they help not only to clean the canal but also to allow the seepage of the medicaments into the canal system. Thus, the canal needs to be healthy before the obturation procedure. Nowadays, many irrigants have been studied and hence compilation of the various available sources and their effect has to be studied both in vivo and in vitro. The correlation between the irrigants and the canal cleanliness is of utmost importance, as the success of endodontic root canal treatment depends on its proper activation and characteristics. Hence, this review incorporates the current use of various irrigating solutions and their advantages and disadvantages. In the future, endodontists may employ the novel irrigants and irrigant activation devices that were discovered in this study.

Laser-fluorescence assessment of sodium hypochlorite quenching reversal agents on human dentine

BackgroundLaser-fluorescence diagnostic technology for real-time clinical assessment of residual bacteria could help assist in determining the endpoints for root canal debridement. Sodium hypochlorite (NaOCl) can however quench fluorescence and lead to false low reading. This study aims to evaluate various antioxidant for their ability to recover quenched fluorescence in dentine treated with NaOCl. MethodsHuman dentine fluorescence was measured using 655 nm laser at baseline and again after a 2 min application of 4% NaOCl. The putative recovery agents were then applied, and the fluorescence measured after 5, 10, 20, 30 and 60 min. Recovery from quenching was also assessed using laser confocal scanning microscopy (CLSM) with a bound tetracycline fluorophore using 488 nm excitation. ResultsA 5 min application of vitamin E oil or buffered 2% lignocaine solution (1:80,000 adrenaline) was effective in regaining quenched fluorescence within the following 5 mins. Distilled water, sodium thiosulfate, unbuffered 2% lignocaine with 1:80000 adrenaline and phosphate buffered saline were less effective, and of equal performance. Ascorbic acid and butylated hydroxyanisole were not effective and had deleterious effects on the levels of dentine fluorescence. CLSM provided confirmation of recovery from quenched fluorescence using vitamin E oil. ConclusionBased on these findings, reversal agents should be employed when assessing the fluorescence of dentine that has been exposed to NaOCl or other quenching agents.

THERAPEUTIC EFFECTS OF CURCUMIN IN ROOT CANAL PROCEDURE - A REVIEW

Successful Endodontic therapy aims at thorough debridement of root canals and complete elimination of microorganisms from the root canals. Currently, research in the eld of herbal products has increased due to its varied advantages. Curcumin, a phytochemical obtained from rhizomes of Curcuma longa, shows broad spectrum antimicrobial activity. It is a natural polyphenol that is commonly used as a spice and coloring and avoring agent in South Asian countries. Over the last decade, Curcumin is becoming popular in Endodontics due to its excellent pharmacological attributes like antimicrobial, antifungal, antiviral, antiseptic and anti-oxidant properties. Curcumin also acts as a natural photosensitizer with the ability to provide targeted therapy and has good photophysical properties. It is less cytotoxic compared to sodium hypochlorite and is cost-effective. There is a quest for newer treatment strategies to prevent endodontic failures and Post-treatment apical periodontitis, caused by persistent intraradicular infection. Photodynamic therapy is one such adjunctive therapy found to be effective in the treatment of secondary infections with several invitro studies showing curcumin as an effective photosensitizer in root canal disinfection against resistant gram-positive bacterial species. This review article is a collection of invitro studies describing applications of curcumin in endodontics, its photosensitizing properties, functions and effects of curcumin in Endodontic therapy.

Influence of apical preparation size and final irrigation protocol on the debridement of oval root canals.

This study assessed the influence of apical preparation size and final irrigation protocol on the debridement of the apical third of oval root canals of mandibular molars. Seventy-seven distal roots were divided into 7 groups (n = 11): Control: without instrumentation or irrigation; Group 30CI: ProTaper Next (up to size 30; PTN) + conventional irrigation (CI); Group 30UAI: PTN + ultrasonically activated irrigation (UAI); Group 30XPF: PTN + XP-endo Finisher (XPF); Group 40CI: PTN + ProDesign Logic (up to size 40; PDL) + CI; Group 40UAI: PTN + PDL + UAI; and Group 40XPF: PTN + PDL + XPF. The total volume of irrigating solutions used per root canal in all the experimental groups was 33 mL of 2.5% sodium hypochlorite (NaOCl) and 6 mL of 17% ethylenediaminetetraacetic acid (EDTA). After specimen processing and histological analysis under a digital microscope (100x), the percentages of untouched canal walls (UCW) and remaining debris (RD) were assessed using Image J software. A descriptive and exploratory analysis was conducted, indicating that the data failed to meet the assumptions of an analysis of variance. Therefore, generalized linear models were used to assess the effects of the different instrumentation and irrigation protocols, as well as the interaction among them, on the percentage of UCW and RD. No significant difference was found among the irrigation protocols regarding the percentage of UCW, irrespective of apical preparation size (p>0.05). However, UCW and RD were significantly lower in groups 40CI, 40UAI and 40XPF than in groups 30CI, 30UAI and 30XPF (p<0.05). The percentage of RD was significantly lower in the UAI and XPF groups than in the CI groups, irrespective of apical preparation size (p<0.05). The difference between preparation sizes 30 and 40, with respect to RD, was higher when CI was used (p<0.05). In conclusion, instrumentation up to apical preparation size 40 resulted in lower percentages of UCW and RD than up to apical preparation size 30. Use of UAI or XPF resulted in lower percentages of RD than CI.

Efficacy of Root Canal Instrumentation and Fracture Strength Assessment in Primary Molars after Preparing Two Different Shapes of Access Cavity: An Ex Vivo Histological Study.

Aim and objectiveTo evaluate the efficacy of root canal instrumentation and fracture strength assessment in primary molars after preparing different shapes of access cavity design.Materials and methodsSixty extracted primary mandibular molars with at least 2/3rd roots were randomly, equally divided into two groups based on shapes of the access cavities; Group I: Traditional access cavity (TAC), Group II: Conservative access cavity (CAC). Each group was further subdivided into two subgroups with 15 samples each. After, root canal debridement, samples in subgroup 1 were sectioned for histological evaluation of root canal instrumentation efficacy, while subgroup 2 were assessed for fracture strength using a Universal Testing Machine. The data were analyzed statistically using Mann–Whitney and post hoc Tukey tests, with a p value <0.05.ResultsTraditional access cavity showed statistically significant root canal debridement efficacy (p < 0.05) compared with CAC. Statistically significant differences were obtained between fracture strength values among the two groups (p < 0.05), with considerably higher fracture strength in the CAC group than TAC.ConclusionTraditional access cavity design resulted in complete root canal debridement but caused weakening of tooth structure due to low fracture strength, necessitating the use of full coverage restoration postendodontic therapy.How to cite this articleSinghal Y, Srivastava N, Rana V, et al. Efficacy of Root Canal Instrumentation and Fracture Strength Assessment in Primary Molars after Preparing Two Different Shapes of Access Cavity: An Ex Vivo Histological Study. Int J Clin Pediatr Dent 2021;14(4):518–524.

A Comparative Evaluation of Smear Layer Removal by Using Four Different Irrigation Solutions like Root Canal Irrigants: An In Vitro SEM Study

The present study aimed to evaluate and compare the efficacy of 17% ethylenediaminetetraacetic acid (EDTA), 18% etidronic acid, 10% citric acid, and 7% maleic acid in the removal of smear layer at the apical third of the root canals. Sixty single-rooted teeth were equally divided into four study groups (n = 15), according to the type of irrigant used (17% EDTA, 18% etidronic acid, 10% citric acid, and 7% maleic acid) to remove the smear layer effectively from apical third of root canal. In each group, respective irrigant was used with 5.25% of sodium hypochlorite during instrumentation. Each study sample was then sectioned longitudinally and removal of smear layer was observed using a scanning electron microscope (SEM) at 2000×. A 7% maleic acid revealed better smear layer removal than all other three groups at apical third. A 10% citric acid was found to be more efficient than EDTA and etidronic acid. The intergroup comparison was performed using Mann-Whitney U test, and there was no significant difference between all the study groups, except maleic acid. The present study compared the effect of various irrigants as an adjunct with 5.25% of sodium hypochlorite for root canal irrigation during and after instrumentation. The use of irrigants aids in the removal of the smear layer from the root canals, thereby increasing the success rate of endodontic therapy. This study supports the hypothesis that a thorough use of root canal irrigants can efficiently remove the smear layer which is the key for successful root canal treatment. The present study helps in choosing an appropriate irrigant that can ensure complete root canal debridement from all thirds, especially from the apical third of the root canal. How to cite this article: Mankeliya S, Singhal RK, Gupta A, et al. A Comparative Evaluation of Smear Layer Removal by Using Four Different Irrigation Solutions like Root Canal Irrigants: An In Vitro SEM Study. J Contemp Dent Pract 2021;22(5):527-531.

Fluorescence characteristics of E. faecalis in dentine following treatment with oxidizing endodontic irrigants

IntroductionThis study aimed to assess changes in the fluorescence characteristics of Enterococcus faecalis in human dentine over a period of 24 h following treatment with endodontic irrigants. MethodSterilised, non-functional extracted third molars were embedded in acrylic resin and uniformly sectioned into 2 mm thick dentine sections. After the removal of smear layer, the dentine sections were inoculated with E. faecalis and cultured for 7 days. The infected dentine sections were subsequently treated with different concentrations of sodium hypochlorite (NaOCl) and hydrogen peroxide (H2O2). Bacterial fluorescence readings were assessed at different time points using a calibrated laser device. All data were assessed for normality (Kolmogorov Smirnoff test) and analysed using ANOVA with Bonferroni post-hoc tests. ResultsFluorescence readings were quenched when E. faecalis infected human dentine sections were treated with oxidizing irrigants in vitro. Throughout a 24-hour period, fluorescence recovered in part but did not return to baseline level. ConclusionThe fluorescence quenching effect of these oxidizing agents needs to be considered when using laser fluorescence in assessing the quality of root canal debridement or disinfection.

Can the Root End Resective Surgery of Two Different Angles Affect the Apical Microleakage of the Retrofilling Material (In Vitro Study)

Introduction: Endodontic surgery become essential to save teeth when the endodontic treatments are failed.It promote root canal debridement and insertion of retrograde filling to make sure tight sealing apically.Aim: Compare the influences of two different resection angles (0 and 30 degree bevel angle to the long axisof the tooth) on the apical micro leakage by utilizing dye penetration technique.Methods: 80 single rooted permanent teeth were amputated 3 mm from the apex at two different resectionangles. Retrograde cavities were prepared and filled with Well-ROOT PT® and MTA BIOREP®. Allspecimens were immersed in 2% methylene blue dye for 24 hours. The specimens were cut longitudinallyby microtome and photographed digitally using stereomicroscope. With the use of Kinovea program dyepenetration area was measured. Two WAY Analysis of Variance (Two Way ANOVA) were used to analyzethe result statistically at P&lt;0.05.Results: No group exhibited complete sealing of root-end zones. The group of MTA BIOREP® demonstratedstatistical significant differences with 0 degree angle which showed less leakage.Conclusion: MTA BIOREP® retro filling material with 0 degree angle of resection were significantlysuperior regarding apical microleakage compared with Well-ROOT PT®.

Efficacy of Handpiece Mounted Continuous Irrigation System for the Removal of Residual Pulpal Debris During Root Canal Preparation.

Objective The removal of residual pulpal debris (RPD) from the root canal walls, especially in necrotic teeth is important for successful endodontic outcome. The aim of this study was to evaluate the RPD removal efficacy of handpiece mounted continuous irrigation with simultaneous root canal preparation from the apical third of root canals as compared to conventional syringe irrigation (SI). Materials and Methods Ninety extracted teeth were randomly divided into three groups: SI; handpiece mounted continuous irrigation (CI); and both syringe and continuous irrigation (CI+SI). After root canal preparation, roots were sectioned at 1 (a), 3 (b) and 5 (c) mm from apex and prepared for Hematoxylin-Eosin staining. Sections were microscopically examined for presence of RPD. Statistical Analysis Intergroup difference in average percentage of RPD at different root levels was calculated by using analysis of variance test (ANOVA). Tuckey test was used for pairwise comparison. Results ANOVA showed significant difference between all three groups ( p < 0.05). SI group showed a significantly higher percentage of RPD as compared with CI and CI+ SI groups at all root levels ( p < 0.01). At root level a, CI showed a significantly higher percentage of RPD as compared with CI+SI ( p < 0.01). Conclusion Handpiece mounted CI during rotary instrumentation showed a significant reduction in RPD as compared with conventional syringe irrigation. This technique was found to be an effective method for an enhanced root canal debridement.

Graphene – Scope in Conservative Dentistry and Endodontics

Graphene, a member of the carbon family, is the strongest, stiffest, and thinnest known material, with a thickness of 10 nm. It has emerged as engineered nanomaterials and nanomedicines in dentistry with promising results. Usually produced employing Hummers method, graphene possesses excellent physiomechanical properties, electrical conductivity, stability, biocompatibility, and biodegradability. Owing to their interactions with dental pulp stem cells, they have been functionalized with many scaffolds in regenerative dentistry, to upregulate the odontogenic and osteogenic genes. This emerging science of graphene-based materials has also been used for the debridement of root canals. Their unique property of antibiofilm and antiadhesiveness has been used to prevent dental caries and erosions. In addition, they have been incorporated into various biomaterials to enhance their original properties, like in glass ionomers, biodentine, and in bleaching agents like hydrogen peroxide. Depending on their concentration and time of exposure to the substrate, graphene and their derivatives can be effective antibacterial agents. This updated review provides useful information on the promising introduction of graphene in the field of conservative dentistry and endodontics.

Flowable Urethane Dimethacrylate-Based Filler for Root Canal Obturation in Primary Molars: A Pilot SEM and microCT Assessment.

Pulpectomy in deciduous teeth involves endodontic access opening, root canal debridement and obturation with an appropriate filling material. EndoREZ (ER) is the urethane dimethacrylate-based filler, which can be used for root canal obturation in permanent and primary teeth. This observation aimed to evaluate the behavior of the ER as a filler in root canals of two primary molars after the physiological resorption process using the scanning electron microscopy (SEM) and micro-computed tomography (µCT) in second lower molars after their natural exfoliation. The SEM analysis revealed a non-uniform, porous and lacunary structure of ER, visually similar to the resorbed surface of the dentine. The µCT observations demonstrated the differences in the resorption level of the root and material surfaces. The preliminary observations suggest that ER is resorbed faster than root tissues and can therefore be a suitable material for the root canal filling in primary teeth. However, more investigations are needed to support these preliminary findings.