Internal Resorption Cavities Research Articles

Medicaments removal with different techniques from internal resorption cavities

Medicaments removal with different techniques from internal resorption cavities

Evaluation of different irrigation activation techniques for the removal of various medicaments from a simulated internal resorption cavity: an in vitro study.

This study aimed to assess the efficacy of different activation techniques in removing calcium hydroxide (Ultracal XS), Ledermix, and Bio-C Temp from simulated internal root resorption (IRR) cavities. 108 single-rooted maxillary incisors were prepared using Reciproc R50 files. Simulated IRR cavities, 2mm in diameter and located 8mm from the apex, were created. Ultracal XS, Ledermix, and Bio-C Temp were applied to the samples, grouped by irrigation activation techniques: Standard Needle Irrigation (SNI), EDDY, Passive Ultrasonic Irrigation (PUI), and XP-endo Finisher (XPF). Medicament removal efficacy was evaluated using a standardized scoring system. Statistical analysis was performed using the Kruskal-Wallis test. XPF and PUI were more effective than SNI in medicament removal across the groups, with no significant difference. EDDY showed no significant difference than other groups. Ledermix was more effectively removed in all activation groups compared to Bio-C Temp. The XPF was superior in removing Ultracal XS compared to Bio-C Temp. However, none of the groups achieved complete medicament removal. XPF and PUI techniques enhance medicament removal efficacy. Bio-C Temp was more difficult to remove from the IRR cavities than other medicaments. Bio-C Temp could be removed from the canals less effectively compared to calcium hydroxide and Ledermix. Among the tested irrigation activation methods, XPF and PUI were found to be more effective at removing the tested medicaments.

Evaluation of the efficacy of different irrigation activation techniques in removing of calcium hydroxide on teeth with the simulated internal root resorption cavity: a confocal laser scanning microscope analysis.

The aim of this study is to evaluate the effect of different irrigation activation methods on root canal sealer penetration in teeth with simulated internal root resorption (IRR) and calcium hydroxide (CH) applied using a confocal laser scanning microscope (CLSM). 60 incisors with a single root and a single canal were included in the study. IRR cavities were created in the middle third of the root canal, and CH was placed. The samples were randomly divided into 4 groups (n = 15) according to the irrigation activation method to be tested: standard needle irrigation (SNI), sonic activation (EDDY), photon-induced photoacoustic flow (PIPS), and shock wave enhanced emission photoacoustic flow (SWEEPS). After irrigation activation applications, the root canals were obturated. Sections of 1.0 ± 0.1mm were taken from the apical, middle, and coronal regions of each sample. The penetration area (µm2) and maximum penetration depth (µm) of the root canal sealer were examined by CLSM and analyzed using ImageJ software. Statistical analysis was performed with a one-way ANOVA and post-hoc Tukey test at the P < 0.05 significance level. Among all irrigation activation methods tested, both the penetration area and maximum penetration depth of the root canal sealer were greater in the coronal region than in the apical region (p < 0.05). In the IRR region, there was no difference in terms of maximum penetration depth between PIPS and SWEEPS (p > 0.05), it was highest in SWEEPS (p < 0.05). PIPS and SWEEPS were better than other irrigation activation methods in the penetration of root canal sealer in the resorption areas of teeth with IRR.

The ability of three different protocols in removing Bioceramic- and Resin-Based sealers from simulated internal resorption cavities: an in vitro study

The ability of three different protocols in removing Bioceramic- and Resin-Based sealers from simulated internal resorption cavities: an in vitro study

Comparative Effectiveness of Different Er:YAG Laser-Activated Irrigation Systems on Removing Calcium Hydroxide from Simulated Internal Root Resorption Cavities at Different Root Levels.

Objective: To investigate the effectiveness of Er:YAG laser-activated irrigation (LAI) with a short pulse duration for removing calcium hydroxide (CH) from simulated internal root resorption (IRR) cavities at three root levels. Background: Pulse duration is an important parameter during LAI, which ensures the efficiency of irradiation and the corresponding activation process. Short pulses in the range of a few microseconds enable rapid expansion and successive implosion of irrigants, resulting in distinct fluid movement. There have been few reports on CH removal efficacy from IRR cavities of different LAI systems, including those using short pulse duration. Methods: IRR cavities (1.6 mm diameter) were created at the apical, middle, and coronal root levels in 60 mandibular premolars and filled with a radiopaque CH paste. Samples were assigned to the following irrigation groups (n = 12, each): (1) LAI(P)-F, a prototype laser device that operates with short pulse duration (Morita Manufacturing) with a flat tip; (2) LAI(EA)-F, the ErwinAdverl laser device (Morita Manufacturing) with a flat tip; (3) LAI(EA)-T, the ErwinAdverl laser device with a tapered tip; (4) PIPS-T, the Lightwalker laser device (Fotona) with a tapered tip; and (5) SI, the syringe irrigation group. The laser tips were fixed at the canal entrance. The remaining CH volume and surface area were assessed in IRR cavities using micro-computed tomography and scanning electron microscopy, respectively. Data were statistically analyzed utilizing one-way analysis of variance and Tukey's test at 5% significance level. Results: The LAI(P)-F and PIPS-T groups exhibited the highest CH removal rates at three different levels (p < 0.05). The LAI(EA)-F group had a significantly better efficacy of CH removal compared with the LAI(EA)-T group at the middle level (p < 0.05). Conclusion: The LAI(P)-F and PIPS-T groups demonstrated superior efficiency in removing CH from simulated IRR cavities.

Three-Dimensional Measurement of Obturation Quality of Bioceramic Materials in Filling Artificial Internal Root Resorption Cavities Using Different Obturation Techniques: An In Vitro Comparative Study

IntroductionPathologic conditions such as internal root resorption (IRR) may complicate root canal filling. This study aimed to evaluate and compare the obturation quality by measuring the percentage of obturation volume (POV) in root canals with artificial IRR obturated with different materials and techniques using cone beam computed tomography (CBCT). MethodsForty single canal extracted mandibular premolars were decoronated to standardize their length to 14 mm. Following instrumentation, the roots were cut horizontally, and artificial IRR cavities were made at the level of 7 mm from the apex. The root halves were joined using cyanoacrylate adhesive. The samples were randomly assigned to 4 groups (n = 10), and the canals were filled as follows: single-cone technique (SC), bulk-fill Bio-C Sealer (BF), and Bio-C Repair for the coronal and middle third (BCR) + cold lateral condensation technique (CLC) for the apical third and continuous wave compaction technique (CWC). The pre- and postobturation volumes and the POV were measured in the total canal and for the apical, middle, and coronal thirds separately using CBCT and Mimics Medical software. The results were analyzed statistically using one-way ANOVA and Tukey HSD test, and statistical significance was set at P < .05. ResultsBF group resulted in significantly lower total, coronal, middle and apical POV values compared to SC, BCR + CLC, and CWC groups (P < .05), respectively. Also, at the apical third, the BCR + CLC group showed significantly lower POV than the SC and CWC groups (P < .05), respectively. The intra-group comparison showed that BF and BCR + CLC groups had a significantly lower POV in the apical third compared to the middle third (P < .05). Conversely, the CWC group had a significantly higher apical POV than the middle third (P < .05). ConclusionsThe maximum POV was obtained using the CWC technique, Bio-C Repair, and SC technique with Bio-C Sealer, making their application in IRR more preferable than the BF Bio-C Sealer.

Reinforcement of Teeth Having Reenacted Perforating Internal Resorption Cavities After Repair Using Different Calcium Silicate-based Cements and Backfilling Materials: An In vitro Study

ABSTRACT To evaluate the fracture resistance (FR) of the teeth having reenacted perforating internal resorption cavities repaired by distinctive calcium silicate-based cements (CSCs) specifically: Endocem MTA, Biodentine, NeoMTA Plus, and backfilling materials. Ninety-six freshly extracted human mandibular premolar teeth were selected. Twelve roots were used as the negative control group. Rotary files were used to complete the final irrigation and root canal preparation on the remaining teeth. Following that, burs were used to make standardized internal resorption chambers in the middle part of the roots. Twelve of these samples were used as positive control samples. The remaining 72 root canals were obturated in the apical 4 mm using a single-cone approach, and they were separated into 6 groups based on the CSCs used to fill voids and the materials used as backfilling. Group 1: Endocem MTA (resorption) + Endocem MTA (coronal), Group 2: Endocem MTA (resorption) + Gutta-percha/sealer (coronal), Group 3: Biodentine (resorption) + Biodentine (coronal), Group 4: Biodentine (resorption) + Gutta-percha/sealer (coronal), Group 5: NeoMTA Plus (resorption) + NeoMTA Plus (coronal), and Group 6: NeoMTA Plus (resorption) + Gutta-percha/sealer (coronal). Specimens were inserted in acrylic resin and then subjected to fracture testing. Fracture strength tests were performed using a Universal Testing Machine. The force was employed vertically with a consistent speed of 1 mm/minute. The results were analyzed with Variance and Bonferrini tests at P &lt; 0.005. The mean force of fracture values were 447.00, 201.25, 318.75, 187.50, 596.58, 258.75, 347.50, and 298.75 N for Group 1, 2, 3, 4, 5, 6, 7, and 8, respectively. “There was a significant difference (P &lt; 0.001) between the experimental groups and the control group”. Group 5 showed the highest FR as compared to other groups. Backfilling with CSCs appears to be a better material than a gutta-percha/sealer combination. Neo MTA plus furthermore appeared the highest fracture-resistant material, while Biodentine + Gutta percha/sealer showed the least FR.

Evaluation of Filling Quality of Obturation Techniques in Internal Resorption Cavities Created with a Novel Methodology

Evaluation of Filling Quality of Obturation Techniques in Internal Resorption Cavities Created with a Novel Methodology

Pulp tissue dissolution capacities of different irrigation agitation techniques in artificial internal resorption cavities.

The aim of this in vitro study was to compare the organic tissue dissolution capacities of 3 different irrigation agitation techniques (IATs) in artificial internal root resorption cavities (IRCs). Ninety freshly extracted maxillary human incisors were selected. After decoronation procedure, the roots were split longitudinally, and a standard IRC were prepared in the canals on each half of the roots. Then, the bovine pulp samples (~2,3 mg) were previously weighed and placed into the cavities. The root fragments were reassembled and cemented to create a circular IRC within the canal. Teeth samples were randomly divided into 6 groups (n=15); sodium chlorur (NaCl) and sonic irrigation (SI), sodium hypochlorite (NaOCl) and SI, NaCl and passive ultrasonic irrigation (PUI), NaOCl and PUI, NaCl and laser activated irrigation (LAI), NaOCl and LAI. After that, the teeth were decemented and the tissue samples inside the cavities were weighed again. The percentage of weight loss was calculated and statistically analyzed. SI has significantly more successful results than PUI and LAI in groups which the irrigant was NaCl. There was also a significant difference between LAI and PUI in groups which the irrigant was NaOCl (Group 6 ˃ Group 4, p=0.003). There was no significant difference between LAI and SI with NaOCl. Complete dissolution of bovine pulp tissue from IRCs was not achieved by any tested techniques. However, the LAI with NaOCl was more effective than other IATs. In addition, there is no significant difference between the LAI and SI with NaOCl.

Efficacy of laser-activated irrigation with the SWEEPS modality in removing calcium hydroxide from simulated internal resorption cavities

Aim: To compare the efficacy of shockwave-enhanced emission photoacoustic streaming (SWEEPS), sonic activation with EDDY, and passive ultrasonic irrigation (PUI) in the removal of calcium hydroxide medicaments from artificial internal resorption cavities. Methodology: Ninety mandibular premolars with single oval canals were prepared to size 50/0.04 and split longitudinally. Standardized cavities were prepared in the apical third of the root canal and filled with calcium hydroxide. The root halves were reassembled and divided into three groups (n = 30) according to the removal methods used. The amount of residual calcium hydroxide was evaluated using a four-grade scoring system. The differences between the groups were analyzed using the Kruskal–Wallis H test (p &lt; 0.05). Results: SWEEPS removed significantly more calcium hydroxide than PUI (p &lt; 0.003) and EDDY (p &lt; 0.035). There was no significant difference between the EDDY and PUI groups (p = 1.000). Conclusion: None of the systems tested were able to completely remove the calcium hydroxide paste from the simulated internal resorption cavities; however, SWEEPS removed more calcium hydroxide than the EDDY and PUI techniques. How to cite this article: Erkan E, Aydın RN, Falakaloğlu S, Yeniçeri Özata M, Gündoğar M. Efficacy of laser-activated irrigation with the SWEEPS modality in removing calcium hydroxide from simulated internal resorption cavities. Int Dent Res 2023;13(2):48-53. https://doi.org/10.5577/idr.2023.vol13.no2.1 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Efficacy of Chitosan Scaffolded Calcium Silicate-based Cements for Treating Internal Resorption Defects with Perforation: In Vitro Study.

The present study aimed to evaluate the efficacy of chitosan scaffold combined with calcium silicate cements in the management of internal resorption with perforation. Internal resorption cavities were simulated in 20 human permanent maxillary incisors that were then divided into two groups: group I - biodentine and group II - chitosan scaffold combined with biodentine. The samples were evaluated for the mineralization activity at the end of the 7th day and 14th day using scanning electron microscopy-energy dispersive X-ray (SEM-EDX) analysis. The data were recorded, tabulated, and then statistically analyzed. From the SEM-EDX analysis, the mean score of calcium and phosphorus ion uptake by the material was obtained. Statistical analysis by nonparametric Mann-Whitney test showed that there was statistically significant difference in calcium ion uptake at the end of the 7th day (p = 0.016) and at the end of 14th day (p = 0.043) between the group biodentine and group chitosan scaffold combined with biodentine (p < 0.05). In this present study, the use of chitosan scaffolds combined with biodentine showed a statistically significant difference in the mineralization activity when compared with pure biodentine. These scaffolded biomaterials exhibited greater potential for mineralization in vitro which can be efficiently used for the management of teeth with internal resorption with perforation. Further clinical trials are required for the understanding of their behavior in real-world scenarios. Calcium silicate cements have often exhibited defective hard tissue barrier formation and hence there is a pressing need to search for newer biomaterials that can overcome these shortcomings. Scaffolded biomaterials provide a controlled microcellular environment for bioactivity, and they were found to be efficient in the remineralization of tooth structure. The present study findings indicate that these chitosan scaffolds can be efficiently used in combination with calcium silicate cements for the management of internal resorption with perforation to enhance the treatment outcome.

Mechanical activation with Easy Clean device enhanced organic tissue removal from simulated internal root resorption in a laboratory evaluation

BackgroundConsidering the irregular shape of the root canal, removing inflamed pulp and granulation tissue completely from internal resorption cavities during chemomechanical preparation can be challenging. This study aimed to evaluate the effectiveness of passive ultrasonic irrigation (PUI) compared to mechanical activation with Easy Clean in the removal of organic tissue from simulated areas of internal root resorption.MethodsThe root canals of 72 extracted single-rooted teeth with oval canals were instrumented with Reciproc R25 instruments. After root canal preparations, the specimens were split longitudinally, and semicircular cavities were prepared using a round bur on each half of the roots. Samples obtained from bovine muscle tissue were weighed and adapted into semicircular cavities. The roots were reassembled and joined, and the teeth were divided into six groups (n = 12) according to the irrigation protocol: Sodium hypochlorite (NaOCl) without activation; NaOCl + PUI; NaOCl + Easy Clean; distilled water without activation; distilled water + PUI; and distilled water + Easy Clean. After irrigation protocols, the teeth were disassembled, and the remaining organic tissue was weighed. Data were analyzed by two-way ANOVA and Tukey’s post hoc test (p < 0.05).ResultsNone of the experimental protocols totally removed the bovine tissue from simulated cavities. Tissue weight reduction was significantly affected by the activation method (p < 0.05) and by irrigation solution (p < 0.05). Groups with NaOCl irrigation presented higher tissue weight loss when compared to distilled water, for all irrigation methods (p < 0.05). The use of Easy Clean resulted in the greatest tissue weight loss (42.0%—Distilled water/45.5%- NaOCl) compared to those of PUI (33.3%—Distilled water/37.7%- NaOCl) and no activation (33.4%—Distilled water/38.8%- NaOCl) (p < 0.05). However, no differences were observed between PUI and no activation groups (p > 0.05).ConclusionsMechanical activation with Easy Clean enhanced organic tissue removal from simulated internal resorption more effectively than PUI. Easy Clean for agitation of the irrigating solution is effective in removing simulated organic tissues from artificial internal resorption cavities, being an alternative to the use of PUI.

Effect of Different Obturation Techniques on Sealer Penetration in Teeth with Artificial Internal Root Resorption: a Confocal Laser Microscope Analysis.

To investigate the efficacy of different obturation techniques on sealer penetration in teeth with internal root resorption using confocal laser microscopy. An artificial internal resorption cavity (3 mm deep and 1.2 mm in diameter) was formed in the round-shaped root canals of 45 single-rooted teeth at a distance of 7 mm from the apex, then roots were instrumented (size 40/.06). The samples were divided into three groups (n = 15) according to the obturation technique: lateral compaction (LC), warm vertical compaction (WVC) and carrier-based (CB). In the resorption regions, the sealer penetration depth in the CB and LC groups was significantly higher than that in the WVC group (P < 0.05). Within the limitations of this study, the penetration depth of the sealer in the resorption region was higher in the CB and LC groups as compared to that in the WVC group.

Evaluation of reinforcement effect of capillary condensation technique in teeth with simulated internal resorption cavity: An in vitro study

Aim: To evaluate the reinforcement effect of capillary condensation technique in teeth with simulated internal resorption cavity. Materials and Methods: G*Power software (effect size d = 0.59) was used to calculate the sample size. Thirty-six mandibular premolars with a single canal were decoronated at the cementoenamel junction to standardize 12 mm length of the root. Biomechanical preparation was done with ProTaper Universal rotary up to F4. #08 size round bur was used to prepare an internal resorption cavity of uniform diameter in the middle third of the root. Random sample allocation was done into experimental and control groups: Group I, positive control Group – noninstrumented teeth; Group II, negative control Group – teeth with biomechanical preparation but without obturation; Group III, teeth with a bioceramic sealer (EndoSequence BC Sealer, Brasseler, USA) application with conventional technique and hybrid technique of obturation; and Group IV, capillary condensation technique of bioceramic sealer along with master cone gutta-percha. The samples were subjected to evaluation of fracture resistance using a universal testing machine (Instron-3369). Statistical Analysis: Statistical analysis of the data was done using one-way ANOVA and Tukey’s HSD tests with P < 0.05. Results: The positive control group demonstrated the highest fracture resistance with a mean of 574.44 Newton (N), whereas the negative control group demonstrated fracture resistance with a mean of 162.22 N. The capillary condensation technique group demonstrated fracture resistance with a mean of 202.22 N, followed by the hybrid technique group with a mean of 172.22 N. Conclusion: The results were statistically similar between hybrid technique and capillary condensation technique. However, capillary condensation technique showed higher values compared to hybrid technique.

In vitro evaluation of the quality of obturation with capillary condensation technique and hybrid technique in teeth with simulated internal resorption cavity: A cone-beam computed tomography study

ABSTRACT Aim: The quality of obturation with recent capillary condensation technique and hybrid technique in teeth with artificial internal resorption cavity needs to be evaluated. Methods: Calculation of sample size was done with G*Power software (version 3.1.9.4) (effect size d = 1.46). Eighteen single-canal mandibular premolars were decoronated at the cementoenamel junction for standardization of specimen length as 12 mm. Biomechanical preparation was done with ProTaper Universal rotary file up to F4. Internal resorption cavity was prepared with #08 size round bur 6 mm from the apex. Samples were distributed randomly into two groups. Group I: teeth with bioceramic sealer (EndoSequence BC Sealer, Brasseler, USA) application using conventional technique and hybrid technique of obturation. Group II: capillary condensation technique of bioceramic sealer (EndoSequence BC Sealer, Brasseler USA) using single-cone gutta-percha obturation. The voids in three segments of the root canal were measured with cone-beam computed tomography using “OnDemand3D App” software. Data were statistically analyzed by one-way analysis of variance (ANOVA) and multiple comparisons of Tukey honestly significant difference tests with P &lt; 0.05. Results: The mean area of the void was 0.3963 ± 0.3299 mm2 for Group I and 0.4022 ± 0.4101 mm2 for Group II. There was a difference in the number of voids present in different sections of the root within a group with significance but not between the groups. Conclusion: Capillary condensation technique with single-cone obturation is comparable to conventional sealer application and hybrid technique of obturation for filling internal resorption cavity.

Elimination of Calcium Hydroxide from Simulated Internal Resorption Cavities Using EDDY

Elimination of Calcium Hydroxide from Simulated Internal Resorption Cavities Using EDDY

Irrigant flow characteristics in the root canal with internal root resorption: a computational fluid dynamics evaluation.

Irrigation dynamics of syringe irrigation with different needle designs (side-vented, double side-vented, notched) and ultrasonic irrigation in the root canal with internal root resorption were evaluated using a computational fluid dynamics model. A micro-CT scanned mandibular premolar was used for modeling internal root resorption. The needles and the ultrasonic tip were positioned at 2, 4, and 5mm from the working length. The insertion depth and the irrigation model were found influential on the shear stress and the irrigant extension. The extension of the irrigant increased toward 2-5mm from the working length. Ultrasonic irrigation revealed the highest shear stress values regardless of the insertion depth. The shear stress distribution on the resorption cavity walls gradually increased when the needles were positioned coronally. The residence time of the irrigant in the canal was affected by the needle position relative to the internal root resorption cavity and the needle type.

Comparative evaluation of efficacy of XP Endo Finisher, sonic, and ultrasonic irrigation in removal of calcium hydroxide and subsequent adaptation of gutta percha in simulated internal resorption cavity - An in vitro study

Comparative evaluation of efficacy of XP Endo Finisher, sonic, and ultrasonic irrigation in removal of calcium hydroxide and subsequent adaptation of gutta percha in simulated internal resorption cavity - An in vitro study

Assessment of heat transfer to periodontal tissues and stress distribution in a tooth with simulated internal resorption cavities at different root levels using two thermoplasticized obturation systems – A finite element analysis study

Assessment of heat transfer to periodontal tissues and stress distribution in a tooth with simulated internal resorption cavities at different root levels using two thermoplasticized obturation systems – A finite element analysis study

Comparative evaluation of efficacy of different irrigation devices in removal of calcium hydroxide in teeth with simulated internal resorption cavities - An in vitro study.

The aim of this in vitro study was to compare the efficacy of newly developed irrigation systems, i.e., XP-endo Finisher file (XP-endo), EndoActivator (EA), and Endo-Irrigator Plus (EI) with gold standard passive ultrasonic irrigation (PUI) tip and in removal of calcium hydroxide (CH) from single-rooted teeth with artificial simulated internal resorption cavities. One hundred and twenty single-rooted mandibular premolars were decoronated and prepared using the ProTaper Gold system up to F5. Samples were buccolingually sectioned and resorption cavities were prepared. Twenty specimens were served as Group 1 - negative control. In the remaining specimens, CH was delivered and root halves were brought together. Twenty specimens were served as Group 2 - positive control. The remaining specimens were randomly divided into four experimental groups (n = 20), where NaOCl and EDTA were activated using PUI, XP-endo, EA, and EI for 1 min. The remnants of CH were scored and analyzed by employing Kruskal-Wallis H- and Mann-Whitney U-tests. PUI and XP-endo removed more CH than other devices (P < 0.05), showing no significant difference between them. None of the tested systems were able to remove CH completely from resorption cavities. PUI and XP-endo were superior to other tested devices.