Endodontic Space Research Articles

A clinical dilemma: Performing or avoiding root instrumentation in the treatment of the acute phase of endodontic‐periodontal lesions? A case report

AbstractBackgroundThis study presents the diagnois, management, and tissue response to an acute periodontal lesion with deep pocketing affecting a maxillary central incisor in a young patient devoid of caries or a history of periodontitis.MethodsClinical and radiographic examinations facilitated the diagnosis of the pathology as an endoperiodontal lesion (EPL) with root damage, exhibiting supracrestal invasive root resorption. Orthograde endodontic therapy was employed to decontaminate and seal the endodontic space. The resorptive site was treated through the endodontic access, debrided, and sealed. No periodontal therapy (surgical or nonsurgical) was performed. No mechanical instrumentation was performed within the pocketed root surface.ResultsAt 6‐month and 1‐year follow‐ups after endodontic therapy the periodontium displayed a physiologically healthy condition without pus or inflammation, exhibiting a circumferential probing depth of 2 mm, and absence of tooth mobility. These favorable outcomes persisted throughout a 4‐year follow‐up period.ConclusionsThe spontaneous healing of pocketing and abscess occurred without mechanical root instrumentation following endodontic therapy and treatment of external invasive root resorption in an EPL.Key Points Accurate diagnosis and identification of relevant etiologic factors are pivotal for effectively managing endodontic‐periodontal lesions. Once a diagnosis is established, the therapy focuses on eliminating the primary cause, followed by a subsequent diagnostic phase after healing. The definitive understanding of the diagnosis and etiology of endodontic‐periodontal lesions often becomes clear in retrospect, based on the outcomes of the therapy. When probing acute periodontal lesions, deep probing depths may occur without permanent loss of periodontal attachment. If the acute lesion was not induced by a periodontal cause and if no periodontal etiology arises secondarily, resolving the primary cause of the endoperiodontal lesion can lead to the spontaneous resolution of the pocketing. This results in spontaneous healing of periodontium without the need for intentional periodontal therapy. A clinical dilemma arises when considering periodontal treatment during the acute inflammatory phase of endo‐periodontal pathology. It is advisable to refrain from mechanical root instrumentation particularly if a clear periodontal cause is not apparent, to prevent from iatrogenic damage to periodontal fibers and the potential risk of gingival recessions. However, this does not imply avoiding periodontal therapy entirely for every case. Rather, it is recommended to delay the decision on root instrumentation until a new diagnostic phase is conducted following the healing of the endodontic etiology.

Cyclic Fatigue of Different Ni-Ti Endodontic Rotary File Alloys: A Comprehensive Review.

Modern endodontics aims to decrease the bacterial load from the complex endodontic space. Over the years, improvements in the operative phases have led to a considerable increase in the success rate of endodontic treatments. The shaping phase has seen the development of new techniques supported by technological innovations that have led to higher treatment predictability. Endodontic instruments have experienced a series of changes that have led to modifications in their design, surface treatments, and heat treatments. The clinical use of rotating nickel-titanium instruments has become widespread and consolidated, a success due primarily to the alloy's mechanical characteristics, which are superior to steel ones, but also to innovations in instrument design. The advent of the Ni-Ti alloy has kept the concepts and requirements of shaping the same but has modified its implementation in endodontics. The following review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) protocol. The research question focused on Ni-Ti endodontic instruments whose cyclic fatigue was evaluated by analyzing cyclic fatigue strength and the incidence of fracture. At the end of the research, 10 systematic reviews and 1 randomized controlled trial were included in this comprehensive review. The most frequently analysed alloys were M-wire, conventional Ni-Ti, and CM-wire. In seven articles, instruments made of M-wire alloy were used; in eight articles, instruments made of conventional Ni-Ti; and in seven articles, instruments made of CM-wire alloy. The technological evolution of Ni-Ti alloys has led to the development of increasingly high-performance endodontic files that are resistant to cyclic fatigue during clinical practice and have greater resistance to sterilisation practices, making treatment easier and more predictable over time. In particular, heat-treated nickel-titanium root canal instruments present greater resistance to cyclic fatigue than untreated ones and those used with reciprocating kinematics concerning continuous rotation.

Dentinal tubule penetration following ultrasonic, sonic, and single-cone technique of a biosealer: An ex vivo study.

The endodontic space is complex, and using a single-cone obturation technique fails to ensure a complete filling. This study aimed to investigate the effect of ultrasonic activation, sonic activation, and single-cone technique of a biosealer on its dentinal tubular penetration. In the experiment, single-root mandibular premolars were randomly assigned to three groups (n = 20): group A, ultrasonic activation; Group B, sonic activation; and Group C, single-cone technique. Penetration of the fluorescently labeled biosealer was investigated using a confocal laser scanning microscope. The data were statistically analyzed using Kruskal-Wallis and Mann-Whitney tests (P = 0.05). The highest penetration of biosealer was observed in Group A, followed by Group B (P < 0.05). Dentinal tubule penetration of biosealer was significantly improved by ultrasonic and sonic activation techniques.

Evaluation the Quality Three Different Obturation Technique Using Multi-Slice Computed Tomography: An In-Vitro Study

After endodontic space has been completely cleaned, shaped and disinfected, a three-dimensional obturation of this space will be the ultimate objectiv e of endodontic therapy. With a durable three dimensional obturation any communication with the periodontium will be eliminated and prevented. The aim of this study was to use multi-slice CT scanning to determine: (i) number of voids (ii) diameter or length of voids and (iii) presence of voids at material/tissue interfaces in root canals obturated with: (a) E &amp; Q Master (b) Lateral Condensation, and (c) Soft Core system. Thirty freshly extracted human mandibular premolar teeth were used in this study. After pr eparation of the root canals, the teeth were divided into three groups with 10 teeth in each groups. G1 obturated with E&amp;Q master, G2 obturated with Lateral Condensation, and G3 was obturated with Soft Core. GuttaFlow was used as sealer for all groups. After obturation all the specimen were analyzed with multi-slice CT, the data obtained was statistically analyzed us ing ANOVA test followed by Duncan's multiple range test ,a val ue of p&lt; 0.05 was considered statistically significant.Voids are obs erved in all groups, Neither technique was free of voids or p erfectly smooth. Overall, the canals that obturated with E&amp;Q mas ter showed the lowest number of voids (3.0), whereas those ob turated with lateral condensation showed the highest number (3.9) and the differences was statistically significant. The canals t hat obturated with Soft core showed the highest mean of voids diameter ( 0.77 mm) , whereas those obturated with E&amp;Q m aster and lateral condensation had the lowest mean (0.62 mm and 0.61 mm) respectively, and the differences were statisti cally significant. The percentage of outer voids was higher for a ll techniques than the inner voids. The presence of inner voids was the highest in canals that obturated with soft core system (9.230%). Conclusion: E&amp;Q master of obturation show the low est number of voids. Obturation with Soft core show the highest m ean of voids diameter. In all obturation techniques, the outer voi ds was higher than inner voids.

An Alternative Method of Management of a Separated Endodontic File Beyond the Apex - A Case Report

Endodontic instrument fracture is a prevalent challenge in root canal therapy, often leading to treatment complications and increased procedural difficulty. This case report presents an alternative way of treating an endodontic file separated in the apical third of the mesio-buccal canal of a lower molar. Due to the strategic importance of the tooth, the considerable apical curvature and patient’s requirements, the clinicians opted for deliberate extrusion of the broken fragment into the periodical tissues, thus hermetically sealing the endodontic space. This approach has the potential to offer a less traumatic treatment option under certain conditions. Keywords: separated, file, fracture, management, alternative

Evaluimi i dy teknikave të obturimit të kanalit të rrënjës së dhëmbit me ndihmën e mikro-tomografisë së kompjuterizuar – studim in vitro

The main goal of endodontic therapy is the three-dimen- sional obturation of the endodontic space. Tendencies for ideal root canal preparation and its disinfection are com- promised if the canal is not completely obturated. The pur- pose of this study is to determine the percentage of the vol- ume of the spaces in the root canal of the tooth. obturated with different materials by microcomputer-tomography. In this study, 40 extracted frontal teeth were included. The teeth were divided into two groups according to the mate- rial used for obturation. The teeth after root canal prepara- tion according to the standard technique were obturated with Gutta-Flow and Thermafill. The teeth were analyzed by micro-CT. Statistical analysis showed that root canals obturated with GuttaFlow showed a higher percentage of gaps inside the obturation material, while root canals ob- turated with Thermafill have a higher percentage of spaces between the obturation material and the root canal wall.

Maintain Access Strip Technique (MAST) crown: a novel technique to stabilize anterior teeth while maintaining pulp canal access

The management of an anterior tooth that has undergone breakdown, either due to trauma or failure of previous restorations, poses a challenge for clinicians to restore in situations where endodontic treatment is also necessary. The novel technique described in this Technique Tip: Maintain Access Strip Technique (MAST) crown, allows clinicians to effectively restore function and aesthetic form to an anterior tooth, while maintaining ease of access to the pulpal anatomy for future endodontic treatment. The approach uses clear strip crowns to reproduce coronal structure and anatomy with gutta percha cones for canal projection to maintain a path to the endodontic space. CPD/Clinical Relevance: The MAST crown technique facilitates stabilization of traumatized or broken teeth and maintain ease of access to the root canal.

Smear Layer and Debris Removal from Root Canals Comparing Traditional Syringe Irrigation and 3D Cleaning: An Ex Vivo Study.

Background: Endodontic treatment objectives comprise eliminating or decreasing bacterial load inside the complex endodontic space. Removing the smear layer and debris becomes mandatory to achieve good three-dimensional (3D) cleaning. Aim: This study assesses the difference in smear layer removal using the 3D cleaning technique and traditional syringe needle irrigation. The 3D cleaning technique includes the ultrasonic activation of intracanal-heated NaOCl. Materials and Methods: Our current study used single-rooted human mandibular premolar teeth to test the earlier-mentioned technique (n = 30). Initially, an endodontic access cavity was performed. Consequently, specimens were randomly distributed into three study groups according to irrigation protocol. The groups were Group 1, where the traditional syringe needle irrigation system was applied; Group 2, where the 3D cleaning technique was performed; and Group 3, in which teeth remained uncleaned as it was regarded as the control group. Once the experiment was completed, the teeth were decoronated at the cementoenamel junction (CEJ) and examined using scanning electron microscopy (SEM). Debris and smear layers were viewed in 1000× magnification and scored. Results: Statistical analysis was performed with a standard statistical software package (SPSS, version 28.0; SPSS IBM, Armonk, NY, USA). Data were analyzed with a nonparametric analysis of variance (Kruskal−Wallis ANOVA) among the groups tested and among the thirds of the canals. The level of significance was set at p < 0.05. A statistically significant (p < 0.05) lower mean smear layer and debris score was observed in both study groups compared to the control group. Group 2 showed better results compared to Group 1. Conclusions: The present study concluded that the 3D cleaning technique is an effective irrigation method for removing debris and smear layers. Future research, such as CLSM (Confocal Laser Scanning Microscopy) and Histological study, should be employed to confirm this study’s conclusion.

Formiranje instrumentacione putanje ručnim i mašinskim instrumentima u povijenim kanalima - in vitro studija

Introduction: Preparation of glide path is an important precondition for the safe use of rotary NiTi instruments during endodontic treatment. Aim: The aim of this study was to examine the duration of glide path preparation as well as all the changes in canal morphology and canal diameter after the use of hand K-files and NiTi rotary PathFiles. Material and methods: This research was performed on a total of twenty Endo Training Blocks (Dentsply, Maillefer, Switzerland). The glide path was prepared using hand stainless steel K-files ISO #10-15-20 (Dentsply, Sirona, USA) (n = 10) and NiTi rotary PathFiles ISO #13, #16 and #19 (Dentsply, Sirona, Switzerland) (n = 10). The time required to establish the glide path was measured with an iPhone stopwatch (Apple Inc. Cupertino, California). The images of the apical segment of canals before and after glide path preparation were taken under the stereomicroscope (Boeco BSZ-405, Germany), and then images were analyzed and processed with Scopeimage 9.0 (Teleskop, Austria). Statistical analysis was performed with the Mann-Whitney test at the level of significance 5% (a = 0.05). Results: A statistically significant difference was observed in terms of the time required for glide path preparation. The mean total time for glide path preparation was significantly longer with K-files (382 ± 62 s) than with PathFile (200 ± 11 s) (p &lt; 0.05). A statistically significant difference in terms of changing the morphology of the apical part of the canal (p &gt; 0.05) was not observed. The difference in the diameter of the root canal was at the limit of statistical significance (p ≈ 0.05). Conclusion: Instrumentation with NiTi rotary PathFiles reduces the time required for glide path preparation. Preparing endodontic space for rotary instrumentation with hand K-Files and rotary PathFiles leads to similar changes in the morphology of the apical segment. A slightly larger diameter of the root canal was measured after preparation with the hand K-files.

Analogy between the oral microbial flora found at the level of carious lesions, endodontic spaces and prosthetic components

Nowadays, eating habits and lifestyles are moving towards a diet high in sugars and carbohydrates, which is extremely harmful to both oral integrity and systemic health. The aim of the study was to identify the variations between the bacterial plaque formed in carious lesions, infected root canals and prosthetic components, in comparison with commensal oral microflora. The study was carried out on a group of 21 patients aged between 7 and 84 years, 13 women and 8 men, with various oral diseases, which were diagnosed during the specialized examination. The preparation of the medical record, the signing of the informed consent, the anamnesis and the consultation were carried out in the private dental office where the patients presented for a personalized treatment plan, and the examination of the pathological products and the interpretation of the results obtained in the Microbiology Discipline, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania. The study carried out on the preparations taken from patients with carious lesions reveals the presence of numerous G+ cocci arranged in short chains (23%), frequent G+ cocci in diplo, thin G+ bacilli with rounded ends and G+ cocci in diplo, arranged in small piles (15 %), and values lower than 8% are represented by G+ in diplo cocci, lanceolate, rare G+ in diplo cocci, very rare fusiform bacilli and dentinal fragments. The study carried out on the preparations taken from the endodontic space showed a remarkable percentage of epithelial cells and leukocytes (28%), rare fusiform bacilli, very small fragments of epithelial tissue, thin G+ bacilli with rounded ends, G+ cocci in diplo and in small piles and buns arranged in short chains (5-6%). The study carried out on the preparations taken from the level of prosthetic components, recorded a relatively high number of epithelial cells (19%), G+ cocci arranged in diplo, lanceolate and in small piles (13%), thin G+ bacilli, with rounded ends (10 %), cocci in short chains (10%) and rare polymorphonuclear leukocytes (10%), while at the opposite pole, squamous epithelial cells, fusobacteria and pleomorphic forms (3%) are found.

Two-Year Healing Success Rates after Endodontic Treatment Using 3D Cleaning Technique: A Prospective Multicenter Clinical Study.

Background: Various irrigation techniques for cleansing the endodontic space have been proposed, and internal heating combined with ultrasonic activation (3D cleaning technique) is considered an effective technique. This prospective multicenter clinical study aims to evaluate healing rates for teeth after root canal treatment utilizing the 3D cleaning technique and to report predictive values for success. Material and Methods: Ninety patients referred for a root canal treatment were included. All enrolled patients were treated with the 3D cleaning protocol. Four endodontists performed the clinical procedures and follow-up evaluations. Preoperative, postoperative and follow-up data were gathered from the consented patients. Each patient was assessed for any clinical signs or symptoms. Afterwards, two trained, blinded, and independent evaluators scored the subject’s periapical radiographs. This score was made by checking for the presence or absence of apical periodontitis using the periapical index (PAI). Then, the teeth were classified as healing or healed and were considered a success based on a cumulative success rate of healing. Statistical analysis was performed using the Fisher’s exact test, Pearson correlation, and logistic regression analyses of the preoperative prognostic factors at a 0.05 significance level. Results: 90 patients were evaluated at two years with a follow-up rate of 97.7%. The cumulative success rate of healing was 95.4%. Eight predicting aspects were identified by employing bivariate analyses. Then, using logistic analyses, the two prognostic significant variables directly correlated to healing were the preoperative presence of periapical index (p value = 0.016). Conclusions: In this two-year clinical study, the cumulative success rate of healing was 95.4% when patients were treated with the 3D cleaning protocol.

Role of Herbs in Endodontics: An Update

Treatment involving Endodontics and root canal therapy comprises of extirpation of infected pulpal tissue along with a variety of microbial organisms from root canal spaces for prevention of any increase in infection of peri- radicular soft tissues while at the same time allowing the healing of surrounding tissues. Performing root canal therapy includes the usage of different chemical-based irrigating medications for disinfecting root canal or endodontic space. The most commonly used chemical irrigating agents are sodium hypochlorite, chlorhexidine, or EDTA. Irrigation is a repeatedly used process that is performed for reducing the total bacterial count within any root canal(s). To accomplish good irrigation, large assortments of irrigating medications are commercially available as of this day. However, these agents or drugs may prove to be toxic, have various safety concerns, and may exhibit various side effects. Due to this reason, different alternatives of herbal derivation are used as endodontic or root canal irrigants as these have distinctly high safety profiles and are less cytotoxic. Herbal irrigating products are largely popular as a result of ease of availability, greater cost-effectiveness, and increase in shelf life as well as low degree of toxicity. In recent years, an increase in the trend for seeking natural-based remedies in all types of treatment protocols in dentistry is being explored. This branch of herbal medications is known as ‘ethnopharmacology’ or ‘phytotherapy’. Hence, the current review paper aims at an overview of various plant-derived endodontic irrigating agents along with their effectiveness in irrigating root canals during endodontic therapy.

NON-SURGICAL MANAGEMENT OF FLOOR PERFORATION OF MAXILLARY FIRST MOLAR USING MTA: A CASE REPORT

In endodontic practice one of the most common iatrogenic errors is furcation perforation. The purpose of treating furcal perforation is to seal the articial communication between the endodontic space and the periradicular tissue to prevent alveolar bone resorption and damage to the periodontal ligament. Endodontic repair material should seal the pathways of communication between the root canal system and its surrounding tissues. In addition, it should be nontoxic, noncarcinogenic, nongenotoxic, biocompatible, insoluble in tissue uids, and dimensionally stable. Because existing materials did not have these ''ideal'' characteristics, mineral trioxide aggregate (MTA) was developed and recommended for pulp capping, pulpotomy, apical barrier formation in teeth with necrotic pulps and open apex, repair of root perforations, rootend lling, and root canal lling.

Root-end resection with or without retrograde obturation after orthograde filling with two techniques: A micro-CT study.

To evaluate the filling ability of two orthograde obturation techniques followed by the apical resection with or without retrograde obturation through micro-computed tomography (CT). Thirty-two single-rooted permanent teeth were prepared and randomised into four groups (n=8) according to the orthograde obturation technique (single cone technique [SCT] and mineral trioxide aggregate placement) combined or not with retrograde obturation. The volume of voids (VoV) within the entire endodontic space, the apical 3 mm, and 1 mm after root resection was calculated by micro-CT. Statistical analysis showed no significant difference among the groups regarding the total VoV in all root canals, as well as within the apical 1 mm after root resection. The SCT and apical resection without retrograde filling showed significantly better results in terms of VoV at the apical 3 mm after root resection. Within the study limitations, SCT associated with apical resection without retrograde preparation exhibited a similar or less amount of voids than the other groups.

Endodontic Treatment of a Molar with Peculiar Anatomy: Case Study with CBCT and 3D Printed Model

The aim of the study was to achieve the endodontic treatment of a second maxillary molar with abnormal anatomy through cone-beam computed tomography (CBCT) analysis and three-dimensional (3D) printing. A patient arrived referring recurrent abscesses, spontaneous pain, and the difficulty to eat properly; a diagnosis of tooth necrosis was made. The periapical X-ray showed an abnormal anatomy of the tooth. The preoperative analysis of the tooth morphology was performed through CBCT analysis. The 3D scans were reconstructed through a dedicated software application (Mimics) to visualize the abnormal anatomy and detect the root canal morphology. Moreover, a 3D printed model was created to plan the clinical stage. Canal shaping was achieved with ProGlider and ProTaper Next techniques, and the root canal filling was performed with a carrier-based technique. The limits of this case were the low definition of the CBCT owned by the patient and the difficulties during the scouting of the canals due to the abnormal endodontic space complicated by narrow and flat canals. The software reconstruction allowed a 3D high-definition preclinical analysis of the tooth anatomy. Both digital analysis and printed models based on CBCT scans seemed fundamental to preclinically understand the abnormal endodontic anatomy.

Interfacial Biomaterial-Dentin Bacterial Biofilm Proliferation and Viability Is Affected by the Material, Aging Media and Period.

Biomaterial–dentin interfaces undergo degradation over time, allowing salivary, tissue fluid, and bacterial movement between the root filling or restoration and dentin. This study aims to investigate the effect of aging in simulated human salivary/bacterial/blood esterases (SHSE) on proliferation and viability of Enterococcus faecalis biofilm within the dentin interface with four materials used to fill/restore the endodontic space. Root canals of human anterior teeth were prepared and filled with gutta-percha and one of the following: self-cured resin composite (BisfilTM 2B, Bisco, Schaumburg, IL, USA) with either self-etch (SE) (EasyBond) or total-etch (TE) (ScotchbondTM, 3M, Saint Paul, MN, USA) methacrylate-based adhesives, epoxy-resin sealer (AH Plus®, Dentsply Sirona, York, PA, USA), or bioceramic sealer (EndoSequence® BC Sealer™, Brasseler USA, Savannah, GA, USA). Specimens were aged in SHSE or phosphate-buffered saline (PBS) for up to 360 days, followed by cultivation of steady-state E. faecalis biofilm. Depth and viability of interfacial bacterial biofilm proliferation were assessed by confocal laser scanning microscopy and live/dead staining. Data were analyzed using three-way ANOVA and Scheffe’s post hoc analyses. Initial depths of biofilm proliferation were similar among material groups (p > 0.05). All groups showed significantly deeper biofilm proliferation with increased aging period (p < 0.05). SHSE aging increased interfacial biofilm depth for TE, SE and BC (p < 0.05) but not AH. For unaged interfaces, BC exhibited the lowest ratio of live bacteria, followed by AH, TE, and SE (p < 0.05). Interfacial bacterial biofilm proliferation and viability were dependent on the biomaterial, aging media, and period.

Root Canal Cleaning after Different Irrigation Techniques: An Ex Vivo Analysis.

Background and Objectives: The endodontic space is a complex area on both micro and macro levels; therefore, traditional irrigation techniques may not guarantee a complete cleaning of such a complicated tridimensional system. The presented ex vivo study aimed to evaluate root canal cleanliness, obtained through an equal volume of traditionally applied sodium hypochlorite (NaOCl), compared to ultrasonically activated NaOCl and ultrasonically activated NaOCl that had undergone intracanal heating NaOCl. Materials and Methods: A total of 60 freshly extracted human mandibular premolars underwent root sample length standardization (18 mm), root canal preparation and, based on the irrigation method employed, were randomly and equally assigned to three study groups, composed of root samples treated with ultrasonically activated NaOCl, ultrasonically activated NaOCl that had undergone intracanal heating and traditionally applied NaOCl. The root specimens were subsequently fixated with 4% buffered formalin solution and decalcified in Morse liquid. A total often 6-micron-thick serial cross-sections were obtained, dyed using hematoxylin and eosin and examined through an optical microscope at 40×, 100×, and 200×. Results: Ultrasonically activated NaOCl that had undergone intracanal heating showed a significantly smaller amount of debris compared to ultrasonically activated and traditionally applied NaOCl groups (p value < 0.05). Conclusions: Root canal cleanliness saw significant enhancements by ultrasonically activated NaOCl that had undergone intracanal heating.

Un caz de acutizare în cazul retratamentului endodontic al unui premolar superior

A flare-up is an acute exacerbation after the initiation or following the root canal treatment. In some cases, the patient may develop a flare-up due to the penetration or development of the microorganisms into the endodontic space. The main symptom felt by the patient is the pain caused by the clinical manifestation of complex pathologic changes occurred at a cellular level. This article discusses the predisposing conditions represented by insufficient instrumentation and by pushing the remnants out to the root canals, factors that lead to an exacerbation during the root canal retreatment.

Effect of Herbal and Chemical Solution in Tissue Dissolution by using Conventional Irrigation and Sonic Irrigation System.

Introduction:An essential part of root canal cleaning is irrigating the system to remove any remaining debris and tissue remains. The purpose of root canal therapy is to shape and clean the endodontic space, reduce the bacterial burden, and remove the pulp tissue. In this research, several irrigation solutions with and without sonic irrigation were evaluated to see how quickly tissue dissolves.Method:A tissue sample was taken from a cow (68 ± 3 mg) with no statistically significant difference between groups. All five test tubes in each group were immersed in irrigant, and each group contained one subgroup with five test tubes. Separate weights were recorded for every irrigant that had been passed through the filter paper. Thus, the quantity of pulp dissolved by different irrigating solutions was quantified using a filtering technique.Results:It was revealed that there was a substantial difference between the groups. Sonic and non-sonic irrigation of sodium hypochlorite resulted in a substantial difference in tissue disintegration.Conclusion:This research found that sodium hypochlorite was more effective than EDTA and saline in dissolving pulp. Despite several studies claiming that neem has potent antibacterial activities, tissue dissolution has not been shown in experiments using this herb.

Retreatability of calcium silicate-based root canal sealer using reciprocating instrumentation with different irrigation activation techniques in single-rooted canals.

This study analysed the bioceramic sealer cleaning ability of two chemo-mechanical systems in intact and restored teeth. Thirty-two single-rooted teeth were used, and half of them restored with a pre-endodontic composite restoration (PCR). All samples were instrumented with a size 40 Reciproc Blue file and filled with BioRoot RCS. Canals were retreated using the R40 and then R50 Reciproc Blue. The samples were divided into four experimental groups (n = 8): intact teeth/passive ultrasonic irrigation (PUI) (G1), intact teeth/shock wave-enhanced emission photoacoustic streaming (SWEEPS) (G2), PCR/PUI (G3) and PCR/SWEEPS (G4). The samples were scanned by micro-CT before and after retreatment, and the volume of remaining filling material was evaluated. The minor percentage of residues were observed in G2, with a volume of 0.447 ± 0.356% of the endodontic space (P < 0.001). The Reciproc/SWEEPS technique showed the better performance in intact teeth compared with PUI technique. Pre-endodontic restoration did not significantly affect the effectiveness of sealer removal.