Final Irrigation Research Articles

Postendodontic Pain Using Single File System with Different Irrigation Protocols in Single-visit Root Canal Treatment: A Randomized Control Trial.

To evaluate the intensity of postendodontic pain (PEP) using final irrigation with side-vented needle (SV), EndoActivator (EA), and Ultra X (UX) in single-visit endodontics (SVE) with F-One rotary files. A total 150 patients indicated for endodontic treatment were selected. Single-visit endodontics treatment was performed under local anesthesia. For the final irrigation protocol, they were divided into three groups: group I (SV), group II (EA), and group III (UX). The severity of PEP was assessed using visual analogue scale (VAS) score after 6, 12, 24, and 48 hours. Analgesics taken by patients, for pain, were also recorded. Finally, the data were tabulated and statistically analyzed using SPSS 20.0 software at a level of significance being 0.05. Postendodontic pain was less in group III (UX) and group II (EA) compared with group I (SV) at 6 and 12 hours, which is statistically significant (p < 0.05). There was no statistically significant difference found after 24 hours and 48 hours. The intensity of PEP was minimum in patients treated with EndoActivator and ultrasonic along with single rotary file systems. The incidence of analgesic intake was similar in all three groups. How to cite this article: Kathiria NV, Attur K, Bagda KM, et al. Postendodontic Pain Using Single File System with Different Irrigation Protocols in Single-visit Root Canal Treatment: A Randomized Control Trial. J Contemp Dent Pract 2024;25(2):180-185.

Comparation of the effectiveness of conventional needle irrigation and photon-induced photoacoustic streaming with sodium hypochorite in the treatment of teeth with apical periodontitis: a randomized clinical trial

Photon-initiated photoacoustic streaming (PIPS) with an Er: YAG laser has been introduced in root canal treatment to improve irrigation and facilitate the removal of bacteria in the root canal system. This study aimed to compare the antibacterial effectiveness of two different root canal irrigation techniques, conventional needle irrigation (CNI) and PIPS, using 1% sodium hypochlorite (NaOCl), in the treatment of teeth with apical periodontitis. Sixty patients with a total of sixty teeth affected by apical periodontitis were included in this study. The teeth underwent root canal therapy, and after mechanical instrumentation, they were randomly assigned to two groups (n = 30) based on the final irrigation protocol: CNI or PIPS with 1% NaOCl. Bacterial suspensions in the root canals were evaluated using Adenosine 5’-triphosphate (ATP) assay kit after mechanical instrumentation and after final irrigation. Then, a follow-up was conducted after 7 days. The results revealed that final irrigation significantly reduced ATP values in both the CNI and PIPS groups (P < 0.001). The ATP values after final irrigation was greater in the CNI group compared to the PIPS group (P < 0.001). After a 7-day follow-up, percussion tenderness and fistula were significantly resolved in both groups (P < 0.05). A multivariate linear regression model was used to identify the factors that influence post irrigation ATP values. The analysis demonstrated that pre-operative percussion tenderness (P = 0.006), the presence of a fistula (P < 0.001) and the method used in the final irrigation (P < 0.001) had a significant impact on the ATP value after final irrigation. These results indicate that employing PIPS with 1% NaOCl as the final irrigation protocol exhibited superior antibacterial effectiveness and has the potential to enhance clinical outcomes in the treatment of teeth afflicted with apical periodontitis.

Root canal dentin wear during final irrigation in endodontic retreatment with passive ultrasonic irrigation and easy clean instruments.

Complementary procedures have been proposed to improve the endodontic retreatments. The aim of this study was to evaluate, by microcomputed tomography (micro-CT), the dentin wear caused by passive ultrasonic irrigation (PUI) and easy clean (EC) instruments, when used for the final removal of filling material during endodontic retreatment. Thirty-six mesial roots of the lower first molars were divided into four groups (n = 9), according to the final irrigation and sealer: PUI/AH Plus, EC/AH Plus, PUI/Total Fill (TF), and EC/TF. Canal volume was evaluated, both before and after the final irrigation, by micro-CT analysis. The Kruskal-Wallis test was used to compare the volumes among groups and the paired Wilcoxon test was used to compare the volume values before and after the final irrigation within each group. Both complementary cleaning procedures promoted dentin wear that was observed only when the volume was analyzed for each third of the root canal. In the apical third, both instruments showed significant wear, where the use of the EC instrument resulted in greater wear than the PUI, in teeth filled with both AH Plus and TF BC Sealers (P < 0.05). Both complementary cleaning procedures promoted dentin wear and must be used cautiously.

Comparative Analysis of AH Plus Bond Strength to Root Canal Dentin and Adhesive Interface Quality after Calcium Hydroxide Removal using Different Irrigation Protocols

IntroductionTo evaluate the push-out bond strength (POBS) of AH Plus sealer to root dentin and the adhesive interface quality after calcium hydroxide (Ca(OH)2) intracanal dressing removal with different final irrigation protocols. MethodAfter root canal instrumentation and irrigation, 40 root canals were filled with Ca(OH)2 and sealed. After 14 days, the specimens were randomly distributed according to the irrigation protocols for Ca(OH)2 removal (n = 10): GH2O (control) - distilled water; GNaOCl - 1% NaOCl; GEDTA - 17% EDTA; GEDTA + NaOCl - 17% EDTA + 1% NaOCl. The root canals were filled with AH Plus sealer and gutta-percha. After 7 days, the roots were sectioned into dentin slices and submitted to POBS test and analysis of the adhesive interface under scanning electron microscope. The POBS data were statistically evaluated (analysis of variance and Tukey test). The Kruskal-Wallis and Mann-Whitney tests were used to analyze the adhesive interface (α = 0.05). ResultsGH2O, GNaOCl, and GEDTA + NaOCl had similar POBS values, with higher values on the apical third, in comparison with other thirds (P < .05). A homogeneous and free-of-gaps adhesive interface was observed for GH2O, GNaOCl, and GEDTA + NaOCl, with difference between GH2O and GEDTA (P < .05). GH2O and GEDTA + NaOCl presented higher sealer tags formation (P < .05). ConclusionThe final rinse with EDTA for Ca(OH)2 dressing removal had a negative effect on the POBS of the filling material to root dentin. The use of EDTA followed by NaOCl had results similar to the distilled water, providing uniform and free-of-gaps adhesive interface, and a higher number of sealer tags.

Debris and Smear Layer Removal in Curved Root Canals: A Comparative Study of Ultrasonic and Sonic Irrigant Activation Techniques.

The aim of this study was to compare the cleaning efficacy of three irrigant activation devices with a control of non-activated syringe and needle irrigation in curved root canals. Sixty human curved roots were endodontically prepared and divided into four groups (n = 15) with similar root curvature distributions. Final irrigation using 4% NaOCl was performed with a syringe and needle (30-G) alone, or with Eddy sonic powered irrigation system (polymeric tip #0.25/0.06), Endosonic ultrasonic activation (polymeric tip #0.25/0.03), or Irrisafe ultrasonic activation (stainless-steel tip, #0.25/0.00). SEM was used to evaluate cleaning efficacy, employing five-score systems for debris and smear layer. While no significant difference in debris removal was observed between Endosonic or Irrisafe activation and non-activated irrigation, Eddy sonic powered irrigation system significantly improved debris removal in the apical third of curved root canals. Smear layer removal was effective in coronal and mid-root sections for all groups but less so in the apical third. Thus, Eddy sonic powered irrigation system demonstrated higher efficacy in removing debris from the apical third of curved root canals compared with non-activated syringe and needle irrigation. However, all three irrigant activation systems exhibited no difference from the non-activated control in smear layer removal.

Final irrigation with bioglass solution in regenerative endodontic procedure induces tissue formation inside the root canals, collagen maturation, proliferation cell and presence of osteocalcin.

To evaluate the influence of an experimental solution of cobalt-doped F18 bioactive glass (F18Co) on tissue repair following regenerative endodontic procedure (REP) in rat molars. The F18Co solution was prepared at a ratio of 1:5 F18Co powder to distilled water. The right or left upper first molars of 12 Wistar rats were used, where the pulps were exposed, removed, and irrigated with 2.5% sodium hypochlorite (NaOCl), followed by 17% ethylenediaminetetraacetic acid (EDTA) (5 min each). Subsequently, the molars were divided into two groups (n = 6): REP-SS and REP-F18Co, where they received a final irrigation (5 min) with saline solution (SS) or F18Co solution, respectively. Then, intracanal bleeding was induced, and the tooth was sealed. Untreated molars were used as controls (n = 3). At 21 days, the rats were euthanized, and the specimens were processed for analysis of mineralized tissue and soft tissue formation inside the root canal using haematoxylin-eosin. The presence and maturation of collagen were evaluated by Masson's trichrome and picrosirius red staining. Immunolabelling analyses of proliferating cell nuclear antigen (PCNA) and osteocalcin (OCN) were performed. The data were submitted to the Mann-Whitney U-test (p < .05). There was a similar formation of mineralized tissue in thickness and length in REP-SS and REP-F18Co groups (p > .05). Regarding the presence of newly formed soft tissue, most specimens of the REP-F18Co had tissue formation up to the cervical third of the canal, whilst the REP-SS specimens showed formation up to the middle third (p < .05), and there was higher maturation of collagen in REP-F18Co (p < .05). The number of PCNA-positive cells found in the apical third of the root canal was significantly higher in the F18Co group, as well as the OCN immunolabelling, which was severe in most specimens of REP-F18Co, and low in most specimens of REP-SS. The final irrigation with F18Co bioactive glass solution in REP did not influence mineralized tissue formation but induced soft tissue formation inside the root canals, with higher collagen maturation, and an increase in PCNA-positive cells and OCN immunolabelling.

Comparative evaluation of the effect of ultrasonic and rotary agitation of herbal irrigating solutions on smear layer: A SEM study.

Instrumentation and irrigation balance helps in effective removal of endodontic microbes housing inside the smear layer. This study aimed to (1) evaluate whether activation of the irrigating solutions with two different systems during the final irrigation step can lead to smear layer formation in the middle and apical third of the root canal and (2) evaluate and compare the smear layer removal ability of the aqueous extracts of Emblica officinalis and Morinda citrifolia. A total of 72 single-rooted teeth were prepared up to F4 ProTaper. The specimens were assigned into eight groups of nine teeth each, according to the final irrigant and activation techniques. Further, the teeth were evaluated under SEM for endodontic smear layer at the middle and apical third. Inferential statistics included Pearson's Chi-square. Level of significance was set at 0.05 at 95% confidence level. Ultrasonic activation system showed significant (P = 0.000) amount of smear layer compared to XP-Endo Finisher file. A significant difference (P = 0.00) in the smear layer removal was observed when 6% M. citrifolia was activated with XP-Endo Finisher file both in the middle and apical third. Within the limitations of this in vitro study, it can be concluded that smear layer formation was noted with ultrasonic and XP-Endo Finisher file when saline was used as an irrigant. 6% M. citrifolia when activated with XP-Endo Finisher file showed best results among all other experimental groups.

Microscopic Evaluation of Dentinal Defects after Root Canal Preparation with Different Hand and Nickel-Titanium Files; An In Vitro Study

ABSTRACT Background: Effective endodontic instrumentation aims to remove microorganisms, debris, and tissue from the root canal while maintaining dentinal integrity. This study compares dentinal defect incidence following canal preparation with different hand files, nickel-titanium rotary files, and reciprocating files Materials and Methods: Eighty single-rooted mandibular premolars with mature apices were collected. Four groups (n = 20) were established based on canal patency establishment, canal preparation technique, irrigation solution, and final irrigation. After root sectioning at 3 mm, 6 mm, and 9 mm from the apex, slices were examined under a stereomicroscope, and dentinal defects were recorded. A second examiner reviewed the images. Results: The results showed significant difference of P = 0.031 among Hand files vs. Rotary ProTaper files: In Hand files vs. Reciprocating WaveOne files significant difference was P = 0.048, and for rotary ProTaper files vs. Reciprocating WaveOne files: No significant difference (P = 0.643). Dentinal defect counts were similar at 3 mm, 6 mm, and 9 mm. Statistically significant variation was observed between hand files and rotary files, as well as hand files and reciprocating files Conclusion: Both rotary and reciprocating files showed a statistically significant increase in dentinal defect incidence compared to hand files. However, clinical implications should be considered cautiously. Instrumentation technique selection should be based on clinical context, operator experience, and patient factors. Further clinical studies are needed for validation.

Final Irrigant Temoporfin, Femtosecond Laser, and Chitosan Nanoparticles on Extrusion Bond Strength of Glass Fiber Post, Microhardness, and Modulus of Elasticity of Canal Dentin

Final root canal disinfectants Temoporfin, Femtosecond (FS) laser, and Chitosan nanoparticles (NPs) on marten hardness (MH), modulus of elasticity (EIT), and push-out bond strength (PBS) of glass fiber reinforced post (GFRP) to the root dentin. Sixty caries-free single-rooted human premolars were decoronated and a root canal was performed followed by post space. The specimens were then arbitrarily allocated into groups according to the final disinfectant used. Group 1: 17% EDTA, Group 2: Temoporfin, Group 3: FS laser and Group 4: Chitosan NPs. Evaluation of mechanical properties (MH and EIT) was performed on five samples from each group. Ten samples from each group were bonded with GFRP and sectioned. A universal testing machine and stereomicroscope were used to analyze the PBS and failure mode. Means and standard deviations (SD) of MH, EiT, and PBS were assessed using ANOVA and post hoc Tukey. The highest values of MH and EiT were revealed by 5.25% NaOCl+Chitosan NP samples. The lowest scores of MH and EiT were presented by samples irrigated with 5.25% NaOCl+17% EDTA. The coronal section of samples treated with 5.25% NaOCl+Chitosan NPs showed the highest EBS. Chitosan NPs and FS laser have proved to be valuable alternatives to EDTA as both improved PBS without deteriorating the MH and EiT.

Effect of final irrigation protocols with chitosan nanoparticle and genipin on dentine against collagenase degradation: An ex-vivo study.

Endodontic irrigants may affect the mechanical and chemical properties of dentine. This study evaluated the effects of various final irrigation protocols including the use of chitosan nanoparticle (CSnp) and cross-linking with genipin on the (1) mechanical and (2) chemical properties of dentine against enzymatic degradation. CSnp was synthesized and characterized considering physiochemical parameters and stability. The root canals of 90 single-rooted teeth were prepared and irrigated with NaOCl. Dentine discs were obtained and divided into groups according to the following irrigation protocols: Group NaOCl+EDTA, Group NaOCl+CSnp, Group NaOCl+EDTA+CSnp, Group NaOCl+CSnp+Genipin, Group NaOCl+EDTA+CSnp+Genipin and Group distilled water. (1) Mechanical changes were determined by microhardness analysis using Vickers-tester. (2) Chemical changes were determined by evaluating molecular and elemental compositions of dentine using Fourier transform infrared spectroscopy (FTIR) analysis and scanning electron microscope (SEM)/energy dispersive X-ray spectroscopy (EDS) analysis, respectively. All analyses were repeated after the discs were kept in collagenase for 24 h. Data were analysed with repeated measures analysis of variance and Bonferroni correction for microhardness analysis, and Kruskal-Wallis and Wilcoxon tests for FTIR and SEM/EDS analyses (p = .05). (1) Collagenase application did not have a negative effect on microhardness only in Group NaOCl+EDTA+CSnp+Genipin when compared with the post-irrigation values (p > .05). Post-collagenase microhardness of Group NaOCl+EDTA+CSnp and Group NaOCl+CSnp+Genipin was similar to the initial microhardness (p > .05). (2) After collagenase, Amide III/ ratio presented no change in Group NaOCl+EDTA+CSnp, Group NaOCl+CSnp+Genipin and Group NaOCl+EDTA+CSnp+Genipin (p > .05), while decreased in other groups (p < .05). Collagenase did not affect / ratio in the groups (p > .05). There were no changes in the groups in terms of elemental level before and after collagenase application (p > .05). CSnp and genipin positively affected the microhardness and molecular composition of dentine. This effect was more pronounced when CSnp was used after EDTA.

Efficacy of Different Irrigation Activation Techniques on Dentinal Tubule Penetration of the Novel AH-Plus Bioceramic Sealer

This study aimed to assess the penetration of AH-Plus (AHP) and AH-Plus Bioceramic (AHPB) sealers into dentinal tubules subsequent to different irrigation activation protocols. One hundred fifty teeth were divided into five groups according to the final irrigation protocol: conventional syringe irrigation (CSI), EndoActivator (EA), passive ultrasonic irrigation (PUI), Er,Cr:YSGG laser, and SWEEPS. Then, the teeth were divided into two subgroups (n = 15) according to the canal sealer type. The maximum penetration depth (MPD) point and percentage of the sealer were evaluated using confocal laser scanning microscopy. Then, the data were statistically analyzed. The highest MPD values were observed in the SWEEPS groups, while the lowest value was in the CSI groups. Considering the effect of the sealer type and irrigation protocol interaction, there was a significant difference between the Er,Cr:YSGG laser, and EA groups for the AHPB sealer (p &lt; 0.05), while it was insignificant for the AHP sealer (p &gt; 0.05). The AHP and AHPB sealers statistically presented similar penetration properties. Laser-activated irrigation presented a higher sealer penetration compared to the other techniques.

Can Heated Distilled Water Effectively Prevent Precipitate Formation between NaOCl and CHX?

The present study aimed to investigate the capacity of different irrigation protocols using heated distilled water at 65°C (HDW), in preventing the formation of the brown-orange precipitate observed after the interaction between sodium hypochlorite (NaOCl) and chlorhexidine (CHX). Forty human canines were selected, prepared, and cleaved in two halves. Images of delimited areas in each root canal thirds were obtained through a stereomicroscope (16x and 40x). After reassembly, the teeth were distributed into four groups (n = 10) according to the final irrigation protocol: G1 (no HDW): EDTA + NaOCl + CHX with conventional irrigation (CI); G2 (HDW + CI): EDTA with passive ultrasonic irrigation (PUI) + NaOCl (PUI) + HDW (CI) + CHX (PUI); G3 (HDW + PUI): EDTA + NaOCl + HDW + CHX with PUI; G4 (HDW + CUI): EDTA (PUI) + NaOCl (PUI) + HDW with continuous ultrasonic irrigation (CUI) + CHX (PUI). After irrigation, the teeth were re-separated and images of the same delimited areas were obtained again. Scores were assigned according to the amount of precipitate observed, comparing the initial and final images. The data were submitted to Kruskal-Wallis, Dunn and Friedman statistical tests (α = 5%). G1(no HDW) showed the highest scores in the analysis between groups (p < 0.001), with a greater amount of precipitate in the cervical and medium thirds (p < 0.001). The thirds of the other experimental groups did not differ from each other (p > 0.05). The intermediate irrigation with heated distilled water at 65°C prevented the formation of brown-orange precipitate, regardless of the use of ultrasonic activation (PUI or CUI).

Effect of crosslinking/antioxidant agents as final irrigant on the fracture resistance of endodontically treated root after radiotherapy.

To investigate the effects of Epigallocatechin gallate (EGCG) and curcumin, as a final irrigant on the fracture resistance of irradiated root that obturated with an epoxy resin sealer. Eighty mandibular premolars were randomly divided into non-irradiated (NIR) and irradiated (IR) groups. The teeth were irradiated at 2 Gy per fraction, 5 times a week for a total dose of 60 Gy over 6 weeks. All specimens were decoronated, remaining 13±1 mm root length. Two groups were subdivided into four groups (n = 10): 1) non-instrumented; the intact root served as control. The other roots were instrumented with a pro-taper NiTi rotary system. The final irrigation used was 17% EDTA, followed by three irrigation solution groups; 2) 2.5% NaOCl, 3) 0.02% EGCG, and 4) 0.1% curcumin. Root canals were filled with gutta-percha and AH plus. All specimens were embedded in self-curing acrylic resin and loaded vertically at 1 mm/min until fracture occurred. Also, sealer penetration was assessed by confocal laser scanning microscopy (CLSM). The data were evaluated statistically using two-way ANOVA and Tukey test (α = 0.05). In irradiated roots, fracture resistance of EGCG and curcumin groups did not differ from non-instrumented roots, but they were higher than the NaOCl group (P = 0.006). However, NaOCl, EGCG, and curcumin in irradiated roots had comparable strength that was higher than in the non-instrumented group (p<0.001). Difference between irradiated and non-irradiated roots was observed only for NaOCl and non-instrumented groups (P≤0.004). In irradiated roots, a higher sealer penetration was observed in EGCG and curcumin groups compared to NaOCl. EGCG and curcumin could be promising final irrigants to reverse the adverse effect of radiotherapy on the strength of irradiated roots obturated with AH Plus sealer.

Glycolic acid and ultrasonic activation: Effects on smear layer removal, dentin penetration, dentin structure and bond strength of the root dentin filling material.

Glycolic acid (GA) has been tested as enamel and dentin etchant, and final irrigant for smear layer removal. This study evaluated the effects of GA and ultrasonic activation (US) on smear layer removal, dentin penetration, dentin structure and bond strength of the root dentin filling material. The root canals of 210 teeth were distributed into four test groups: smear layer removal (N=50), dentin penetration (N=50), dentin structure (N=10) and bond strength (N=100). In all tests, specimens were subdivided into five groups, according to the final irrigation protocols: G1:distilled water(DW)+US; G2:17% EDTA; G3:17% GA; G4:17% EDTA+US; G5:17% GA+US. Scanning electronic microscopy, confocal laser scanning microscopy, transmission electronic microscopy and the push-out test were performed to evaluate smear layer removal, dentin penetration, dentin structure and bond strength, respectively. Statistical analysis was performed for each evaluation (α=5%). Groups 4 (EDTA+US) and 5 (GA+US) were the most effective on smear layer removal, with no statistical differences from each other (p>0.05). The maximum penetration depth into dentinal tubules was observed for group 5(GA+US), being statistically different from all other groups (pp<0.05). Group 5(GA+US) showed the largest collagen dispersion area, being statistically different from groups 1(DW+US), 2(EDTA) and 3(GA) (pp<0.05), and similar to group 4(EDTA+US) (p>0.05). The highest BS values for filling and restorative material were observed for all experimental groups, being statistically different from control group (pp<0.05), with higher predominance of cohesive failure. The association of GA and US promotes better smear layer removal, dentin penetration and collagen dispersion, with no influence on bond strength of the root dentin filling/restorative material. Key words:EDTA, final irrigation, glycolic acid, ultrasonic activation.

The effect of final irrigation with different solutions on smear layer removal and dentin erosion: A scanning electron microscope study.

This study aimed to compare the effectiveness of initial irrigation with sodium hypochlorite (NaOCl) and final irrigation with QMix, 40% citric acid, and 17% ethylenediaminetetraacetic acid (EDTA) on smear layer removal and dentin erosion. Forty extracted human mandibular premolar teeth were randomly divided into four groups (n = 10) according to the type of final irrigants used: 17% EDTA, QMix, citric acid, and control (normal saline). Canals were mechanically prepared using ProTaper Next instruments to an apical size of X3. Subsequently, the roots were sectioned in a buccolingual direction. Scanning electron microscopy (SEM) was used to assess the presence of the smear layer and the amount of dentin erosion in the coronal, middle, and apical thirds of the root canals. In regards to smear layer removal, there was a significant difference between the control group and the other tested groups. Moreover, it was significantly higher in the coronal and middle thirds than in the apical third. However, there were no significant differences between the groups of EDTA, QMix, and citric acid. Concerning dentin erosion, citric acid produced significantly more dentin erosion than the other tested groups. Final irrigation with solutions had a higher ability to remove the smear layer in the coronal and middle thirds compared to the apical third. Of all the solutions tested, 40% citric acid had the most pronounced impact on dentin erosion, followed by 17% EDTA and QMix.

Comparative Evaluation of the Effect of Different Chelating Agents on Mineral Content and Erosion of Radicular Dentine: A FESEM-EDS Analysis.

Irrigating solutions play an important role in the debridement and disinfection of the root canal space, and thus, it is crucial to comprehend their effects on the composition and surface structure of radicular dentine. This study evaluated and compared the effects of 17% ethylenediaminetetraacetic acid (EDTA), 9% 1-hydroxyethylidene-1,1-bisphosphonate (HEBP) and 0.2% chitosan on the mineral content and erosion of radicular dentine when used as a final rinse. Sixty extracted human mandibular premolar teeth were decoronated and instrumented to ProTaper size F2. After final instrumentation, the samples were randomly divided into 4 groups (n=15) according to the type of final irrigant used: Normal saline (control), 17% EDTA, 9% HEBP and 0.2% chitosan. Field emission scanning electron microscopy was used to assess the erosion of radicular dentine, and energy dispersive X- ray spectroscopy was used to quantify the radicular dentine mineral composition at the coronal, middle and apical levels of all the prepared samples after final irrigation. The one-way analysis of variance was used for intra-group and inter-group comparisons of means, the Kruskal Wallis test for intra-group and inter-group comparisons of medians and Tukey's post hoc test for pairwise comparisons. There was no significant difference in the levels of calcium (Ca), phosphorus (P) and Ca/P ratio after final rinse with 17% EDTA, 9% HEBP and 0.2% chitosan at all three root levels (p>0.05); except at the coronal level, where 0.2% chitosan caused significantly less alteration in Ca levels and Ca/P ratio than 17% EDTA and 9% HEBP respectively (p<0.05). 17% EDTA, 9% HEBP and 0.2% chitosan caused no erosion at the middle and apical levels. Meanwhile, 17% EDTA and 9% HEBP caused moderate erosion at the coronal level. Alternatives to 17% EDTA during final irrigation can be 9% HEBP and 0.2% chitosan. (EEJ-2023-06-078).

Application of Sanitation Safety Planning in the Usage of Wastewater for Agriculture in Bangalore Urban District, India.

Due to water scarcity, wastewater is used in agriculture in peri-urban areas. We aimed to assess the hazards associated with wastewater farming and develop an incremental improvement plan for the sanitation system of wastewater use for agriculture using Sanitation Safety Planning (SSP) in Bangalore urban district, India. Interviews and observations were conducted among 100 farmers in the Mugalur Gram Panchayat area. Direct ingestion and ingestion after contact with wastewater due to inadequate hand hygiene are the routes of contact with wastewater. The control measures followed in the community are the cultivation of crops, which do not have direct contact with wastewater, furrow and drip irrigation, and restricted irrigation. Methods to mitigate the hazards are the provision of interval between final irrigation and consumption,washing of produce with freshwater before transportation to market, and hygienic cooking. Occupational hazards and risks associated with wastewater farming can be mitigated through the adoption of locally acceptable preventive measures.

Effect of Final Irrigation Solutions on Mechanical Properties of Root Canal Dentine Running title: Final Irrigation on Mechanical Properties

Effect of Final Irrigation Solutions on Mechanical Properties of Root Canal Dentine Running title: Final Irrigation on Mechanical Properties

Comparative evaluation of effect of intracanal cryotherapy and corticosteroid solution on post endodontic pain in single visit root canal treatment.

Post-operative pain after endodontic treatment is a common occurrence, and its prevalence is mostly high immediately after treatment, decreasing in one day and reportedly reaching minimal levels 7 days after treatment. This research focuses on the final flushing of the root canal with different irrigating solutions to reduce its occurrence. Aim: To compare and evaluate the effect of delivering three intracanal irrigants - saline at room temperature, saline at 2.5oC, and intracanal dexamethasone as final irrigant on postoperative pain after a single visit endodontics. This randomized double-blinded parallel clinical trial was conducted on patients requiring a single appointment root canal treatment, with a pain level of 4 or higher on the visual analogue scale (VAS). According to the final irrigating solution, all patients were randomly allocated into three groups of 15 each: 0.9% physiological saline (Group 1), 2.5oC cold saline (Group 2), and 2ml Dexamethasone (Group 3). Patients were instructed to complete VAS to determine their post-operative scores at 6hrs, 12hrs, and 24hrs following the treatment. In all groups, mean VAS scores decreased significantly from baseline to 6hr and 12hr, with lower scores at 24 hours. Post-hoc analysis revealed no significant distinction in the mean VAS scores between 12 hours to 24 hours. Lower pain scores are observed in the dexamethasone group, followed by cryotherapy which performed better than saline at room temperature. Final flushing with dexamethasone solution and cryotherapy is effective, safe, and a well-tolerated strategy to minimize postoperative pain after single visit endodontics. Key words:Intracanal cryotherapy, Cold saline, Dexamethasone, Postoperative pain, Visual analogue scale.

An in vitro study on the influence of laser-activated irrigation on infiltration and leakage of a dual curing-resin cement as an endodontic sealer.

The study aims to investigate the effects of laser-activated irrigation on infiltration and microleakage of a dual-curing resin cement applied as a root canal sealer. Thirty-eight extracted upper molars were attributed to four experimental groups. Roots were mechanically enlarged and disinfected (NaOCl). Control samples (n = 11) were irrigated with conventional needles and three different lasers were used to activate the irrigant in the other groups (n = 9): 2.94 µm Er:YAG laser, 9,300 µm CO2 laser and 808 nm diode laser with a modified black coated laser tip. Final irrigation was performed in each group with ethylenediaminetetraacetic acid (EDTA), sodium hypochlorite (NaOCl) and sodium chloride (NaCl) activated with lasers and in the control without activation.Dentin tubules were then labeled with a red fluorophore (Rhodamine B) and the root canals were sealed with a dual-curing resin cement (Paracore). The cement fixed the dye on the sealed and infiltrated dentin parts. To remove the Rhodamine not fixed by the cement, roots were then sectioned horizontally and immersed in hydrogen peroxide (H2O2). The empty dentin tubules spaces were then labeled with a green fluorophore (Fluorescein) allowing the visualization of infiltration and microleakage by confocal microscopy. Percentages of infiltration were significantly higher in the middle root third of the control and Er:YAG laser-activated samples compared to CO2 or diode laser groups. Microleakage was present in all experimental groups but significantly less after CO2 laser activation. Laser-activated irrigation impacted resin cement infiltration and microleakage dependent on the applied wavelength. Er:YAG laser activation led to higher values of infiltration and microleakage compared to CO2 and diode lasers.