Endodontic Solutions Research Articles

Evaluation Of the Antibacterial Effect of MTAD And Vanillin Against Root Canal Bacteria Running Title: MTAD And Vanillin Against Root Canal Bacteria

Objective: Comparison of the effectiveness of Bio pure MTAD (mixture of Doxycycline, citric acid and a detergent) versus vanillin(V) as an endodontic aqueous solutions for tested canals infected with E. faecalis and S. Mutans. Materials and methods : Fourty human extracted lower bicusped teeth (single-rooted) unit at the cementoenamel junction (CEJ) were decoronated. Thereafter, the teeth were prepared with Protper NiTi rotary files till (F3 [30/.06). Then samples are often divided into “2” main groups (18/each), infected by bacteria and incubated in brain heart infusion (BHI) for forty-eight hours at “37°C”. Then the teeth were sub-divided into three groups(N=6) according to the irrigation protocol (MTAD, V, and Distilled water”DW”, which was the control group ”Gp.”).-ve control(N=4). Dentin chips were removed from the canals by sterile low-speed handpiece spherical bur, transfered to BHI, then cultured to count the growing colonies which were recorded as colony forming unit (CFU).Results : Siginficant differences were found in the bactericidal efficacy of (Bio pure MTAD, V and DW) irrigations. Conclusion:Bio pure MTAD had the maximum antibacterial efficacy on E.faecalis and S. mutans as compared to vanillin and DW. Significance and impact of the study: Understanding the mode of action of natural antimicrobials(V) on endodontic therapy may facilitate their application as natural endodontic solutions, particularly for their potential use in endodontic irrigation protocol employing multiple hurdles.Additionally compared these natural compound with artificial one like MTAD and so on.

The importance of surface tension in endodontic irrigation: A review study

The surface tension of irrigants determines their ability to penetrate dentinal tubules and access the apical third of root canals. It is defined as an affinity for a liquid's surface area to decline in the case of surface tension between molecules. Irrigating the canal wall is vital for dissolving organic tissues and disinfecting dentin and its tubules in root canal preparation. Even with super elastic rotary preparation, untouched spaces are a typical issue during root canal instrumentation. As a result, the antimicrobial activity and solvent action in these areas is essential to the disinfection of root canals. The ability to diagnose irrigants quickly and treat them successfully depends on a thorough discernment of their surface tension. In this study, surface tension involved in endodontic solutions was examined for etiological factors, features, and possible consequences. The relevant studies were found by searching online databases. We identified 30 articles using the hand search method and summarized the critical factors of each study. It was found that low surface tension agents would penetrate tubules more acceptable and that surface tensions estimated at various temperatures and concentrations affected canal cleaning.

A Multi-Criteria Approach for Comparison of Ginger Extract and Conventional Irrigants in Root Canal Treatment.

BackgroundConsidering the importance of irrigation in dental root canal treatment, there is an urgent need to find a risk-free bioactive and antibacterial endodontic solution. Enterococcus faecalis, an anaerobic gram-positive coccus, has been identified as the main reason for endodontic infections. Several studies have been conducted on E. faecalis and periapical infection. Nowadays, plants used in traditional medicine play a role that is widely appreciated by researchers. One of these herbs is ginger which shows an acceptable antimicrobial effect on E. faecalis. Due to the highly crucial role that irrigation plays in the success of endodontic treatment, a comprehensive survey based on several criteria, namely, scientific, technical, and empirical, is required to address the goal of determining the best endodontic solution.MethodologyThe most important criteria are antibacterial activity, risks and hazards, cost, and availability. In this study, the analytical network process (ANP), which is a multi-criteria decision-making method, was applied to determine the best endodontic irrigant.ResultsSeveral alternatives were investigated using the ANP. In this study, 5.25% sodium hypochlorite (NaOCl) and 2% chlorhexidine were at the top of the list. According to the sensitivity analysis, 10% ethanolic ginger extract showed comparable results to 2.5% NaOCl.ConclusionsTo carefully prioritize endodontic irrigants a wide range of standards and criteria should be considered. Considering the low risk, great wettability, and active compounds of ginger extract, it can be a promising viable risk-free solution for root canal treatments.

An Evaluation on the use of Photon-Induced Photoacoustic Streaming in Root Canal Treatment

Introduction: The main purpose of endodontic treatment is to retain the involved teeth in the oral cavity for as long as possible by the prevention and elimination of infection in the root canal system. Irrigation of the root canal after instrumentation is a fundamental component of endodontic treatment success. It is mainly aimed to achieve debridement, smear layer removal, and disinfection of the entire root canal system. Recently, Photon Induced Photoacoustic Streaming (PIPS), which is an activation technique based on the using of Er:YAG (2.940nm) laser equipped with PIPS tip at sub-ablative energy levels, has been used to achieve this goal. Objective: Evaluate the ability of PIPS technique in removing smear layer and remnants. Material and Method: Review and summarize studies evaluated the effect of PIPS in root canal treatment. Results: Several in-vitro studies has been evaluated the evidence to support the benefit of PIPS technique over the traditional and other laser agitation techniques as an efficient method regarding removal of smear layer, remnants disinfection of root canal system and its benefits in other procedures. Conclusion: Photon induced photoacoustic streaming in in-vitro studies seems to show better smear layer removal at coronal and middle thirds of root canal but not at the apical third, it has no superior effects compared with the other activation technique of endodontic solution

Sport and Dental Traumatology: Surgical Solutions and Prevention.

Trauma is a worldwide cause of millions of deaths and severe injuries every year, all over the world. Despite the limited extension of the oral region compared to the whole body, dental and oral injuries account for a fairly high percentage of all body traumas. Among head and neck traumas, dental and facial injuries are highly correlated to sport activities, and their management can be a real challenge for practitioners of any specialty. In case of trauma directed to periodontal structures, restorative and endodontic solutions may not be sufficient to achieve a definitive and long-lasting treatment. This article aims to illustrate surgical options and appliances to prevent dental injuries that may be available to the clinicians treating dental trauma involving oral soft and hard tissues.

A complete range of endodontic solutions

A complete range of endodontic solutions

Can Endodontic Irrigating Solutions Influence the Bond Strength of Adhesives to Coronal Dental Substrates? A Systematic Review and Meta-Analysis of In Vitro Studies.

To systematically review the literature to analyze the influence of endodontic irrigating solutions on the bond strength of adhesives to coronal enamel or dentin. The PubMed/MEDLINE, Web of Science and Scopus electronic databases were used to select laboratory studies related to the research question, without publication year or language limits. From 2461 potentially eligible studies, 2451 were selected for full-text analysis, and 97 were included in the systematic review. Two authors independently selected the studies, extracted the data, and assessed the risk of bias. Pooling bond strength data were calculated using RevMan5.1 with random effects model (α = 0.05), comparing control (no endodontic irrigating solution) and experimental groups (one or more endodontic solutions). No significant difference was found between the control and experimental groups (p = 0.12) in the overall meta-analysis and in the meta-analysis excluding chlorhexidine (p = 0.06). High heterogeneity was found in the meta-analyses. Most included studies in the systematic review were scored as having a high risk of bias. The different endodontic irrigating solutions evaluated showed no negative influence on the bond strength of dental adhesives to coronal dental substrates.

Cytotoxic evaluation of two chlorine-releasing irrigating solutions on cultured human periodontal ligament fibroblasts

Objective: Endodontic irrigants solutions with anti-bacterial activity have been used in treatment of teeth with infected root canals; however, these solutions can irritate periapical tissues. The objective of this study was to evaluate the cytotoxicity of two chlorine-releasing irrigating solutions on cultured human periodontal ligament fibroblasts. Materials and Methods: Periodontal ligament fibroblasts cells were cultured from orthodontically extracted premolars. The passage number between 3-6 was taken for further experiments. 2.5% sodium hypochlorite and 0.6% sodium dichloroisocyanuarate are the irrigating solution used for testing their cytotoxicity. The viability of cells after treating with irrigating solutions was evaluated by trypan blue dye exclusion. Results: Results showed that 0.6% NaDCC solution was less cytotoxic on cultured human periodontal ligament fibroblasts compared with 2.5% NaOCl at 2 min, 30 min, and 1 hr. Conclusion: This study suggested that sodium dichloroisocyanuarate is less cytotoxic than 2.5% NaOCl, suggesting its potential for use as root canal irrigant.

Evaluation of two compact electronic apex locators in the presence of different endodontic solutions

The purpose of this study was to evaluate the accuracy of two compact electronic apex locators, the Root ZX mini and the Mini Apex Locator, in the presence of different endodontic solutions and to compare their performance to the Root ZX electronic apex locator. The sample consisted of 60 extracted single-rooted human teeth. Manufacturers’ recommendations were followed to operate each electronic apex locator to determine electronic length in the presence of 5.25% Sodium Hypochlorite, 2.625% Sodium Hypochlorite, 1.0% Sodium Hypochlorite, 0.9% NaCl, 2% lidocaine with 1:80,000 Epinephrine, and 2% Chlorhexidine. The difference between the electronic (EL) and actual length (AL) was calculated. In addition, EL measurements were classified into three categories: “correct” (AL±0.5mm), “long” (>0.5mm from AL), “short” (<−0.5mm from AL). There were no statistically significant differences in the accuracy of each of the three apex locators in the presence of the six endodontic solutions used in this study. The Root ZX mini and the Mini Apex Locator had similar accuracy to the Root ZX in the presence of each endodontic solution. It is concluded that the Root ZX mini and Mini Apex Locator have similar accuracy to the Root ZX and that the function of the three apex locators was not affected by the type of endodontic solution used.

Antimicrobial effect of endodontic solutions used as final irrigants on a dentine biofilm model

To evaluate the residual biovolume of live bacterial cells, the mean biofilm thickness and the substratum coverage found in mixed biofilms treated with different endodontic irrigant solutions. Twenty-five bovine dentine specimens were infected intraorally using a removable orthodontic device. Five samples were used for each irrigant solution: 2% chlorhexidine, 1% sodium hypochlorite (NaOCl), 10% citric acid, 17% EDTA and distilled water. The solutions were used for 5 min. The samples were stained using the Live/Dead technique and evaluated using a confocal microscope. Differences in the amount of total biovolume (μm(3)), number of surviving cells (μm(3)), mean biofilm thickness (μm) and substratum coverage (%) of the treated biofilms were determined using nonparametric statistical tests (P < 0.05). Similar values of biovolume total, biovolume of live subpopulations and substratum coverage were found in 2% chlorhexidine, 10% citric acid, 17% EDTA and distilled water-treated biofilms (P > 0.05). The lower values of the studied parameters were found in 1% NaOCl-treated dentine (P < 0.05) with the exception of the mean biofilm height criteria that did not reveal significant differences amongst the irrigant solutions (P > 0.05). One per cent sodium hypochlorite was the only irrigant that had a significant effect on biofilm viability and architecture.

In vitro evaluation of effect of various endodontic solutions on selected physical properties of white mineral trioxide aggregate

During endodontic therapy various irrigating solutions at different concentrations and duration are used. These chemical solutions may affect the setting reaction of mineral trioxide aggregate (MTA). The aim of this study was to evaluate the effect of sodium hypochlorite (NaOCl) (5.25%), chlorhexidine gluconate (CHX) (2%), ethylenediaminetetraacetic acid (EDTA) solution (17%) and BioPure MTAD on surface micro-hardness and flexural strength of white MTA. Twenty-five disk-shaped and 25 bar-shaped specimens were divided into five groups and were stored under distilled water, NaOCl (5.25%), chlorhexidine CHX (2%), EDTA solution (17%) and BioPure MTAD for 7 days. The micro-hardness of disk specimens was measured while the flexural strength was tested on bar specimens. EDTA and BioPure MTAD significantly reduced the hardness and flexural strength as compared with other groups. Under distilled water strength remained high; therefore, a final flush with distilled water before placement of MTA is advocated, especially if decalcifying agents are used during the clinical procedure.

Bespoke endodontic solution

Bespoke endodontic solution

Effect of various endodontic solutions on punch out strength of Resilon under cyclic loading

Background:Before obturation, various endodontic solutions are used as a final rinse. These solutions might affect the bond strength of Resilon-Epiphany system. The aim of this study was to evaluate the effect of NaOCl (5.25%), chlorhexidine CHX (2%), EDTA solution (17%), and BioPure MTAD on push out bond strength of Resilon-Epiphany system.Materials and Methods:Seventy-five human premolar roots were prepared and divided on the basis of final endodontic solution rinse. The canals were obturated with Resilon-Epiphany system. All samples were restored using a fiber post system and indirect composite crown. The samples received 150 000 cycles of mechanical loading. Push out bond strength was performed in the apical third of root having Resilon obturation.Results and Conclusions:Different endodontic solutions tested, did not affected the push out bond strength of Resilon-Epiphany obturation system.

SEM Evaluation of the Root Canal Walls after Treatment with Tetraclean

In this ex vivo study, the surface cleanliness of root canal walls after shaping with Ni-Ti instruments and irrigating with different endodontic solutions was evaluated by SEM. 50 single-rooted teeth were divided into 5 groups. All root canals were shaped with Revo-S™ (MICRO-MEGA®, Besancon, France) rotary Ni-Ti instruments and irrigated with NaOCl, varying the final rinse: NaOCl, Tetraclean, 17% EDTA, Cloreximid, Tetraclean liquid not mixed with powder. Specimens were fractured longitudinally and prepared for SEM analysis in order to evaluate the presence/absence of smear layer and the presence/absence of open tubules at the coronal, middle, and apical third of each canal, using a 3-step scale for scores. Numeric data were analyzed using Kruskall-Wallis test and Mann-Whitney U test and significance was predetermined at p<0.05. This study showed significant differences between the various groups. The 5.25% NaOCl + Tetraclean and 5.25% NaOCl + 17% E.D.T.A. groups had significantly lower scores than other groups (p<0.001), with no significant difference between them. Final rinse with Tetraclean is effective in removing the smear layer, leaving a high number of opened dentin tubules.

Safe dispensers for endodontic solutions

Safe dispensers for endodontic solutions

Endodontic solutions

Endodontic solutions

Endodontic management of an impacted premolar

This report demonstrates a simple endodontic solution to an interdisciplinary case of a patient with multiple gene deficiencies. An adolescent patient presented with an impacted premolar that could not be extracted due to high-risk conditions. A suspicious degree of radiolucency around the crown was clinically diagnosed as dentigerous cyst. The treatment dilemma and implementation are discussed. This case report offers a different treatment option for impacted teeth when significant differential diagnosis of a pericoronal lesion dictates treatment.

The Effect of Endodontic Solutions on Resorcinol-Formalin Paste in Teeth

This study determined if any of six endodontic solutions would have a softening effect on resorcinol-formalin paste in extracted teeth, and if there were any differences in the solvent action between these solutions. Forty-nine single-rooted extracted teeth were decoronated 2 mm coronal to the CEJ, and the roots sectioned apically to a standard length of 15 mm. Canals were prepared to a 12 mm WL and a uniform size with a #7 Parapost drill. Teeth were then mounted in a cylinder ring with acrylic. The resorcinol-formalin mixture was placed into the canals and was allowed to set for 60 days in a humidor. The solutions tested were 0.9% sodium chloride, 5.25% sodium hypochlorite, chloroform, Endosolv R (Endosolv R), 3% hydrogen peroxide, and 70% isopropyl alcohol. Seven samples per solution were tested and seven samples using water served as controls. One drop of the solution was placed over the set mixture in the canal, and the depth of penetration of a 1.5-mm probe was measured at 2, 5, 10, and 20 min using a dial micrometer gauge. A repeated-measures ANOVA showed a difference in penetration between the solutions at 10 min (p = 0.04) and at 20 min (p = 0.0004). At 20 min, Endosolv R, had significantly greater penetration than 5.25% sodium hypochlorite (p = 0.0033) and chloroform (p = 0.0018); however, it was not significantly better than the control (p = 0.0812). Although Endosolv R, had statistically superior probe penetration at 20 min, the softening effect could not be detected clinically at this time.

The Effect of Endodontic Solutions on Resorcinol-Formalin Paste

This study determined if any of four endodontic solutions would have a softening effect on resorcinol-formalin paste and if there were any differences in the solvent action between these solutions. Resorcinol, formalin, and zinc oxide were mixed and allowed to set for 30 days. The solutions tested were 0.9% sodium chloride, 5.25% sodium hypochlorite, chloroform, and Endosolv R. Seven samples per solution were tested and an additional seven samples served as controls. Each sample was saturated with one of the solutions and the depth of penetration was tested at 1, 2, 5, 10, and 20 min using a dial strain gauge. At 2 min, sodium hypochlorite and sodium chloride had significantly greater penetration than the other groups (p < 0.0010). Sodium hypochlorite was superior to all other groups after 5 min. This study showed that both sodium chloride and sodium hypochlorite exhibited a significant softening effect within 2 min.

Cytotoxicity of some solutions used for root canal treatment assessed with human fibroblasts and lymphoblasts.

The cytotoxicity of seven solutions used in root canal therapy was tested in human fibroblast and lymphoblast cultures. The amount of cell damage was assessed by measuring the release of 51Cr from labeled cells into the medium. The solutions, when applied at therapeutic concentrations, displayed high toxicity in vitro and differences in cytotoxicity were seen between different solutions. Generally, lymphoblasts were found to be more sensitive than fibroblasts. The cytotoxic profiles of the two cell types resembled each other except when 5% sodium hypochlorite or 0.2% Hibitane was used. When the criterion of total cell lysis was 50% 51Cr release, the toxic concentrations of the solutions tested ranged between 1:25 and 1:900 (v/v) for fibroblasts. For lymphoblasts the corresponding concentration range was between 1:40 and 1:750. Despite technical simplicity and good reproducibility the 51Cr release method proved unreliable for testing the cytotoxicity of endodontic solutions. Because the methodological errors cannot be foreseen the 51Cr release method requires supporting evidence from other methods.