Root Canal Irrigation Research Articles

Sealing Ability of Bioceramic Sealer after Ultrasonic Activation of Different Root Canal Irrigating Solutions

Aim To evaluate and compare the sealing ability of bio ceramic root canal sealer after ultrasonic activation of root canal irrigation solutions 3% NaOCl , 40% Citric acid & Neem leaf extract .  Materials and Methods In this study, 42 mandibular premolar teeth with single roots and canals were divided into three groups for irrigation: 3% NaOCl, 40% citric acid, and Neem leaf extract. After access preparation and glide path creation with a #10 K-file (0.02 taper), the canals were instrumented using a crown-down technique to an ISO size of 30, with saline as the irrigant. Ultrasonically activated irrigation was used, followed by saline in all groups. The canals were obturated with Dentsply Gutta- percha and Bio C sealer, 1mm short of the working length, and sealed with temporary restorations. Teeth were incubated at 37°C for 3 days, and horizontal sections at 3mm from the apex were taken. Confocal laser scanning microscopy measured sealer penetration, and statistical analysis was conducted to compare results between groups.  Results The results suggest that 40% citric acid is the most effective irrigant for enhancing sealer penetration into dentinal tubules at the apical third, both in terms of percentage and depth of penetration, compared to 3% NaOCl and neem leaf extract. This indicates that citric acid may improve the sealing ability of root canal treatments more effectively than the other tested irrigants.  Conclusion The results suggest that 40% citric acid is the most effective irrigant for enhancing sealer penetration into dentinal tubules at the apical third, both in terms of percentage and depth of penetration, compared to 3% NaOCl and neem leaf extract. This indicates that citric acid may improve the sealing ability of root canal treatments more effectively than the other tested irrigants.

Antibiofilm efficacy of plant extracts as root canal irrigants in endodontics: a systematic literature review

Antibiofilm efficacy of plant extracts as root canal irrigants in endodontics: a systematic literature review

Impact of Tulsi extract on sealer penetration in dentinal tubules as compared to 17% EDTA as the final root canal irrigant (in vitro analysis)

Introduction: Penetration of endodontic sealers into dentinal tubules is essential for ensuring successful root canal treatment by creating a hermetic seal that prevents reinfection. Traditionally, 17% EDTA has been used as the final irrigant for smear layer removal. However, concerns regarding its limited antimicrobial properties and potential for dentin erosion have prompted the exploration of alternative solutions. This in vitro study compared the effectiveness of Tulsi extract with that of 17% EDTA in promoting sealer penetration within the dentinal tubules. Methodology: Thirty extracted single-rooted teeth were randomly divided into three groups: Group 1, 17% EDTA; Group 2, Tulsi extract; and Group 3, saline control. After preparation, the root canals were irrigated with their respective soluti ons, filled with gutta-percha, and sealed with a calcium hydroxide-based sealer. Sealer penetration was analyzed using scanning electron microscopy (SEM) at the 2 mm and 5 mm levels from the root apex. Results: The results showed no significant difference in sealer penetration at 2 mm among all the groups. However, at 5 mm, both EDTA and Tulsi groups exhibited significantly greater sealer penetration than the control group (p < 0.001). No significant difference was observed between the EDTA and Tulsi groups at 5 mm (p = 0.706). Conclusion: Tulsi extract demonstrated similar efficacy to 17% EDTA in facilitating sealer penetration, suggesting its potential as a biocompatible and antimicrobial alternative for root canal irrigation protocols. Further studies are warranted to explore its clinical applications and commercial viability.

The investigation of endodontic irrigants and polyhexanide-based solution action on smear layer

AIM. The effect of irrigants on the smear layer on the intracanalicular dentin surface is one of the important issues in endodontics. The objective of this article is to determine the effect of different concentrations of polyhexanide-based solutions and standard irrigants on the smear layer using scanning electron microscopy (SEM).MATERIALS AND METHODS. The present study was conducted on 42 extracted teeth (third molars, first and second premolars) with formed apices that had been extracted for orthodontic indications. The teeth were decoronated and samples were prepared. In order to create a smear layer, the lumen of the canals was instrumented with H-file #40 throughout. A simulation of root canal irrigation was conducted by immersing the specimens in a 5-ml container filled with the proper solution for 1 hour: group 1 – no treatment (n = 6); group 2 – saline (n = 6); group 3 – 2% chlorhexidine (n = 6); group 4 – 3% sodium hypochlorite (n = 6); group 5 – 17% EDTA; group 6 – polyhexanide 0.1% (n = 6); group 7 – polyhexanide 0.2% (n = 6). A ~30 nm thick platinum film was sputtered onto the surface of each sample using a magnetron deposition technique. SEM microphotos were acquired on a Vega3 TESCAN scanning electron microscope (SEM) with an SE secondary electron detector, which enables imaging with high topographic contrast. The initial detector (incamera) was employed for image acquisition, with an electron energy of 30 keV. Images were acquired at magnifications of x20 (overview image), x150, x250, x500, x1000, x2500, x7500 for each sample.RESULTS. The samples from groups 1 and 5 demonstrated the absence of a smear layer on the dentin surface and the absence of smear plugs in the dentinal tubules. Groups 2 and 3 are distinguished by the deposition of a pronounced amorphous smear layer and the obturation of all dentinal tubules. Groups 4, 6, and 7 are distinguished by the deposition of a smaller volume of smear layer on the dentin surface, as well as the presence of semi-open or completely open entrances to the dentinal tubules.CONCLUSION. The data obtained indicates that antiseptic compositions based on polyhexanide in concentrations of 0.1 and 0.2% do not have a pronounced effect on the smear layer. However, in visual evaluation of SEM micrographs, their effect is comparable to that of 3% sodium hypochlorite. In instances where enhanced dissolution of the smear layer and smear plugs from the tubules is necessary to facilitate decontamination of the wall dentin, the combination of antiseptics with chelate compounds, such as 17% EDTA, may be employed.

Antimicrobial evaluation of root canal irrigants of natural sources with and without gamma radiation activation (in vitro study)

ABSTRACT Aims: The present study aimed to evaluate the antibacterial effectiveness of newly formulated root canal irrigants derived from natural sources. In particular, this study investigated how these irrigants’ antimicrobial properties were affected by gamma radiation activation. Materials and Methods: Fifty-three single-rooted extracted human teeth with straight canals were selected, fully prepared, and sterilized. The roots were then infected with Escherichia coli, Enterococcus faecalis, and Candida albicans for 21 days at 37°C. Based on the irrigating solution utilized, the roots were divided into seven groups: Group I: chitosan irrigant, Group II: chitosan irrigant gamma irradiated, Group III: curcumin irrigant, Group IV: curcumin irrigant gamma irradiated, Group V: sodium hypochlorite (NaOCl) 5% irrigant, Group VI: positive control (infected roots without treatment), and Group VII: negative control (uncontaminated roots). After cleaning and shaping, microbiological sampling was performed. The samples were then transferred to sterile centrifuge tubes containing 1 mL of saline to determine the microbial growth. Colony-forming unit counts were employed for assessing the antimicrobial action. Statistical analysis was conducted to compare the percentage reduction in the microbial count from the initial count. Results: Group V and Group IV showed significantly higher values in microbial reduction than Group III and Group I. In addition, the results showed that Group II and Group III have significantly higher values than Group I. Conclusion: Natural irrigating solutions exposed to gamma radiation exhibited promising antimicrobial activity that is comparable to that of NaOCl and may be used as effective antimicrobial agents in endodontic treatment.

Synergistic bactericidal activity of chlorhexidine loaded on positively charged ionic liquid-protected silver nanoparticles as a root canal disinfectant against Enterococcus faecalis: An ex vivo study

The advancement of nanotechnology and the development of nanocomplexes offer promising solutions to address the limitations in biofilm management within endodontics. Current cleaning and disinfection methods often fail to completely eliminate bacterial biofilms from the complex anatomical structures of root canals, making the invention of new disinfectants or disinfection methods highly relevant. Previously, chlorhexidine-loaded positively charged ionic liquid-protected silver nanoparticles (CHX@AgNPs⁺) were introduced as an innovative root canal irrigation solution, demonstrating significant antibacterial efficacy against Enterococcus faecalis in vitro. This study aimed to further evaluate the antibiofilm activity of CHX@AgNPs⁺ in the root canals of extracted human teeth contaminated with E. faecalis biofilm. Fifty single-rooted human teeth with mature apices were randomly assigned to five experimental groups based on the irrigants used: CHX@AgNPs⁺, AgNPs⁺, 2.5 % NaOCl, 2 % CHX, and normal saline (n = 10 per group). The root canals were contaminated with E. faecalis, and biofilm formation was confirmed. Initial sampling (S1) was performed, followed by mechanical preparation of the root canals using ProTaper F3 files and irrigation with the respective test solutions. Post-instrumentation sampling (S2) was then conducted. The results demonstrated that CHX@AgNPs⁺ exhibited antibiofilm properties comparable to 2.5 % NaOCl, with no significant difference between them. Additionally, CHX@AgNPs⁺ significantly enhanced antimicrobial efficacy compared to CHX alone (P < 0.05), highlighting its potential as an effective root canal disinfectant.

Mustard Gel versus Chlorhexidine Gel as Root-Canal Medicament Against Enterococcus Faecalis: An in vitro Study.

To evaluate the efficacy of mustard gel versus chlorhexidine (CHX) gel in treating the most resistant Enterococcus faecalis (E. faecalis) bacteria as intra-canal medications. Randomised controlled trial (in vitro study). Place and Duration of the Study: Department of Operative Dentistry, de'Montmorency College of Dentistry, in collaboration with Lahore General Hospital, between March and October 2021. Forty single-rooted teeth, extracted and randomly allocated, were divided into two groups. Group 1 underwent treatment with CHX gel, while Group 2 was treated with Mustard gel. Subsequently, after disinfection, each tooth was horizontally divided into three equal parts. The middle section was standardised and inoculated with a controlled strain of E. faecalis. Intra-canal medicaments were administered for seven days. Bacterial colonies were quantified as colony forming units (CFU/mL) and subjected to analysis using Statistical Package for Social Sciences (SPSS) version 25. The median bacterial count observed was 1,550 (range 775 - 2,500) for Group 1, contrasting with 400 (range 200 - 775) for Group 2, indicating a significant difference in bacterial count between the groups (p <0.001). Mustard gel demonstrated significantly superior efficacy compared to chlorhexidine gel against E. faecalis in root canal procedures. Chlorhexidine, Enterococcus faecalis, Mustard, Root canal medicament, Antimicrobial drug-resistance, Root canal irrigants.

EFFECT OF INTRACANAL CRYOTHERAPY ON THE POST ENDODONTIC PAIN IN TEETH WITH SYMPTOMATIC APICAL PERIODONTITIS

Objectives: To compare the effect of cryotherapy, room temperature saline and no saline as final root canal irrigants on post-endodontic pain in patients with symptomatic apical periodontitis.Materials and Methods: An observational study was done at the Endodontics Department of Rehman College of Dentistry, Peshawar from August 2023 to January 2024. Ninety patients were selected via purposive sampling technique and underwent root canal treatment. After root canal preparation, patients were equally divided into three groups using the lottery method: Cryotherapy group, room temperature saline group and no saline group. Pain on percussion was recorded pre-operatively and 24hours post-operatively for every patient using the visual analogue scale. Wilcoxon Signed ranks test was used to assess the signifi cant difference between mean pre-endodontic and post-endodontic pain levels. Post hoc analysis was used to compare the significant difference (p value&lt;0.05) between each group. Results: At 24 hour post-operatively, the mean post-endodontic pain scores on visual analogue scale were 2.50± 1.253 for cryotherapy group, 2.70±2.261 for room temperature saline group and 3.63±1.938 for no saline group. The result shows that the post-endodontic pain reduces signifi cantly in all the three groups(p&lt;0.05). However, cryotherapy as the final irrigant was found to be significantly more eff ective in reducing the post-endodontic pain than no saline as the final irrigant (p value 0.029). No significant difference was found in between the cryotherapy group and the room temperature saline groups (p value 0.964).Conclusion: Cryotherapy as the final root canal irrigant is the most effective method of reducing post-endodontic pain as compared to when no saline was used as the final irrigant. Room temperature saline is also as useful as cryotherapy in reducing post-endodontic pain. The findings of the study will be helpful for the dentists to minimize post-endodontic pain.

Antimicrobial Efficacy of a Novel Herbal Endodontic Irrigant Against Enterococcus Faecalis in Root Canals of Permanent Teeth: An in Vitro Study

Background: A successful endodontic treatment is aimed at the sterilization of the entire pulp space. The use of extracts from Rhamnus prinoides as a novel irrigating material for root canal has not been studied . Hence, the antimicrobial efficacy of the alcoholic extract of Rhamnus prinoides as an irrigation material against E. faecalis was evaluated in comparison with the 2.5% sodium hypochlorite (NaOCL) solution used for root canals of permanent teeth. Methods: A total of 30 single-rooted human permanent teeth were thoroughly cleaned, shaped, and disinfected. Then, each tooth was subjected to a two-week infection with Enterococcus faecalis at 37 °C . Afterward, the samples were divided into three groups (10 teeth per group): 0.9% normal saline, 2.5% sodium hypochlorite, and 250 µg/ml Rhamnus prinoides. Paper points were used before and after irrigation to collect samples. Bacterial growth was evaluated after 24 h. Bacterial colonies were counted. The data were examined statistically via one-way analysis of variance, Dunnett’s T3 post hoc test, and Shapiro–Wilk test. The level of significance was set at p&lt;0.05. Results: The 2.5% sodium hypochlorite and 250 µg/ml Rhamnus prinoides demonstrated higher effectiveness against biofilm of Enterococcus faecalis than normal saline (p&lt;0.05). The percentage of antibacterial effectiveness were 94.094 ±3.342, 93.685 ±5.280, and 25.603 ±3.912. Conclusions: Rhamnus prinoides, when used as root canal irrigant solution, was effective the sodium hypochlorite against the E. faecalis biofilm.

Smear layer removal and antimicrobial efficacy of chitosan as a root canal irrigant: a systematic review of in-vitro studies

Smear layer removal and antimicrobial efficacy of chitosan as a root canal irrigant: a systematic review of in-vitro studies

Effect of Active Oxygen Fluid (Blue®m) as a Root Canal Irrigant Against Enterococcus Faecalis.

To evaluate the antimicrobial effect of a new active oxygen fluid (Blue®m) as a root canal irrigant against Enterococcus faecalis compared to sodium hypochlorite (NaOCl). Forty-five extracted single-canaled human teeth were selected, received root canal preparation, autoclaved, and contaminated with Enterococcus faecalis. The specimens were randomly allocated into three groups: Group (A) served as the negative control, receiving irrigation with saline (n &#61; 15); Group (B) was irrigated with 5.25% NaOCl (n &#61; 15); and Group (C) was irrigated with 10 mL of Blue®m (n &#61; 15). Microbial sampling from the root canals was performed before and after irrigation. The difference between the pre-irrigation and post-irrigation colony-forming units (CFU/mL) was calculated. The data was analysed using a one-way ANOVA followed by post-hoc Tukey tests. The significance level was set at 5%. Blue®m statistically significantly reduced the bacterial load compared to saline (p &#61; 0.009), but NaOCl was most effective, outperforming both (p 0.0001). Irrigation with Blue®m demonstrated antibacterial efficacy against Enterococcus faecalis, but it was not as effective as NaOCl.

ANTIBACTERIAL ACTIVITY OF PAPUYU FISH SCALE CHITOSAN (Anabas testudineus) AGAINST Staphylococcus aureus

Backgrounds: Pulp disease due to caries can be treated through endodontic treatment, which aims to eliminate bacteria in the root canal so microorganisms cannot multiply. Staphylococcus aureus is a resistant microorganism causing root canal treatment failure. Chlorhexidine as a gold standard cannot remove biofilm and other organic debris. Utilization of nature, chitosan of papuyu fish scales (Anabas testudineus) has antibacterial properties that can be an alternative root canal irrigation material. Purpose: Analyze the antibacterial activity of chitosan of papuyu fish scales against Staphylococcus aureus based on the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC). Methods: This research is a true experimental design with posttest only with control group design. The research groups were chitosan of Papuyu fish scales with concentrations of 25%, 50%, 75%, 100%, chlorhexidine gluconate 2% (positive control), and aquadest (negative control) with 6 repetitions. Results: The MIC value in the One-Way ANOVA test showed a significant difference (p&lt;0.05). Data analysis followed by Post Hoc Games-Howell test showed all treatment groups had significant differences between each other (p&lt;0.05). The MBC value in the Kruskal Wallis test shows that there is a significant difference (p&lt;0.05). Data analysis followed by MannWhitney test showed significant differences between each other (p&lt;0.05) except for the group of papuyu fish scale chitosan 25% concentration against papuyu fish scale chitosan 50% concentration, papuyu fish scale chitosan 100% concentration against chlorhexidine gluconate 2% (p&gt;0.05). Conclusion: There is a difference in the antibacterial activity of chitosan of Papuyu fish scales concentrations of 25%, 50%, 75%, 100%, chlorhexidine gluconate 2% (positive control) and aquadest (negative control) against Staphylococcus aureus bacteria.

A Comparative Evaluation of the Effect of Different Endodontic Irrigating Solutions on Microhardness of Root Canal Dentin: An in vitro Study.

During endodontic therapy, irrigation solutions applied in the root canal may affect the physicochemical properties of the dentinal wall, thereby changing its microhardness. This may adversely affect the sealing ability and adhesion of dental materials. Therefore, many studies have focused on the search for an ideal root canal irrigant that has a minimal effect on dentinal microhardness. This in vitro study was conducted to determine the changes in dentin microhardness after root canal irrigation with different endodontic irrigants. Ninety-five freshly extracted maxillary central incisor teeth with straight single canals were selected. These teeth were sectioned transversely at the level of the cementoenamel junction. The working length of each tooth was determined, and canal space was prepared by the HyFlex CM rotary file system. During instrumentation, normal saline was used for irrigation. Then, teeth were split longitudinally into two segments. According to the irrigating solution employed, samples were divided into five groups (n=19): normal saline (Group A), 3% sodium hypochlorite (Group B), 2% chlorhexidine (Group C), 5% calcium hypochlorite (Group D), and 0.2% nanochitosan (Group E).3 mL of the corresponding irrigating solution was administered for total15 minutes in each prepared sample. The Vickers micro-hardness tester was then used to assess micro-hardness. The data was analyzed using one-way analysis of variance (ANOVA). All tested irrigating solutions decreased the dentinal microhardness. Samples irrigated with 5% calcium hypochlorite demonstrated dentinal microhardness of 42.43±1.62, which is the lowest among all the tested groups, followed by nano chitosan, sodium hypochlorite, and chlorhexidine. Samples treated with control group (saline) demonstrated the maximum microhardness of dentin in the present study. Within the limitations of this research, it can be concluded that the tested novel irrigating solutions, 5% calcium hypochlorite and 0.2% nanochitosan, were more detrimental to radicular dentin microhardness when compared with conventional endodontic irrigants.

Root canal irrigants effect on the compressive strength and calcium ion release of Biodentine

Compressive strength and calcium ion release are integral properties of Biodentine for its enhanced efficiency. The present study evaluated the effects of Dual Rinse HEDP (DR HEDP), ethylenediaminetetraacetic acid (EDTA) and sodium hypochlorite (NaOCl) on the calcium ion release and compressive strength of Biodentine. Eighty Biodentine specimens were moulded and randomly divided into four groups (n = 20). Samples in group 1 were treated with 17 % EDTA; group 2 with DR HEDP; group 3 with 2.5 % NaOCl; and group 4 with distilled water. Samples were immersed in 10 mL of the test solutions for 1 min. The mean concentration of the calcium ion released was measured using atomic absorption spectrophotometry. The remaining 40 samples were tested for their compressive strength. Significant differences were determined among all the irrigants tested for calcium ion release and compressive strength. Samples treated with NaOCl had the lowest calcium ion release, while samples treated with 17 % EDTA had the largest calcium ions. No significant differences were measured between DR HEDP or distilled water. For compressive strength, samples treated with 2.5 % NaOCl had the lowest strength, while the highest values were obtained with distilled water. There was a significant difference between DR HEDP and EDTA, in which EDTA reduced the compressive strength significantly more than DR HEDP. DR HEDP had less detrimental effect on the calcium ion release and compressive strength of Biodentine.

Numerical investigation and optimization of innovative root canal irrigation needles with composite flow control structures.

Needle syringe irrigation is frequently used in root canal therapy, and the flow pattern during irrigation can be efficiently manipulated by means of passive flow control technique, resulting in expected irrigation performance improvement. Therefore, novel needles with composite flow control structures are numerically investigated and optimized in this study. Based on the 30G needle, six single/double side-vented needles with dimple and protrusion are proposed. Two flow rates in line with clinical applications, 5.3 and 8.6 m/s, are used in the analysis. Three performance parameters are investigated. The safety of the irrigation system is evaluated by the root canal apical pressure, whereas the irrigant extension and the flushing efficiency are evaluated by the extending depth and the effective cleaning area, respectively. The results demonstrate that the shear stress of the double-side-vented needle is higher while the irrigant extension is enhanced with a dimple structure. The performance of the double-side-vented needle with a dimple is superior to that of other designs, with up to 33% improvement in extending depth and a 22% increase in effective cleaning area over the prototype. New needles do not raise risk of irrigant extrusion. Furthermore, the effect of dimple depth and outlet angle are investigated. The needle with a dimple of 0.04 mm depth shows the highest extending depth within the confines of the investigation. The effective cleaning area is significantly influenced by the needle outlets, and the effective cleaning area expands with an increase in needle outlet angle, while the extending depth gradually declines.

In-vitro Antimicrobial Activity of Mtad, Photoactivated Disinfection Along with Chlorohexidine on Enterococcus faecalis, Staphylococcus aureus and Candida albicans

This study evaluated the antimicrobial activity of five root canal irrigants against MTCC of Enterococcus faecalis, Staphylococcus aureus, Candida albicans, in-vitro study of the inhibitory activity of PAD in conventional Endodontic Treatment (CET) and also combination of CET with PAD (CHX+PAD). All of these microorganisms were incubated in the presence of an Endodontic irrigant. Agar diffusion tests were performed and colony counts were tested using paper point to evaluate the inhibitory effect of the irrigants. The mean diameters of the inhibition zones for C. albican were 21mm 3% Naocl, 19mm CHX, 0.7PAD, 22mm CHX+PAD, 20mm Fluconazole, 18mm Doxycycline. The zone diameters of the inhibition zones of Enterococcus faecalis were 17mm 0.5% Naocl, 18mm CHX, 12mmPAD, 35mm MTAD, and 19mm PAD+CHX. The Zone Diameter of the inhibition zones of Staphylococcus aureus were 18mmCHX, 12mm PAD, 19mm PAD+CHX, 25mm MTAD, and 19mm 3% NaoCl. Together High inhibitory effect was detected for PAD+CHX and MTAD on all three pathogens. Candida showed more inhibition to all irrigants followed by Staphylococcus aureus and Enterococcus faecalis.

Breakthrough in the Development of Endodontic Irrigants.

The three main components of endodontic success are three-dimensional obturation, pulp space sterilization, and biomechanical preparation. Instrumentation techniques are insufficient to accomplish complete disinfection of the pulp space. It is essential to use additional tools, such as endodontic irrigants. This review article aims to provide a general overview of the different root canal irrigants and their clinical uses. Endodontic treatment focuses more on removing infectious material from the root canal system to facilitate the healing of an existing periapical lesion or to prevent the periradicular tissues from being infected. It is important to note that instrumentation alone can reach every part of the root canal wall. Therefore, the irrigation procedure is a crucial aspect of endodontic therapy. Irrigation requires the application of various irrigants, like sodium and chlorhexidine, to get rid of debris, bacteria, and tissue leftovers. The accomplishment of root canal treatments counts heavily on the thoroughness of irrigation, contributing to optimal canal shaping and disinfection. Modern root canal irrigation systems incorporate syringes, needles, and advanced delivery mechanisms, including sonic and ultrasonic devices. These inventions aim to enhance the mechanical action of irrigants, reaching intricate canal anatomy more efficiently. Understanding the dynamics of root canal irrigation and staying abreast of technological advancements are essential for clinicians to achieve improved treatment outcomes in endodontic procedures.

Cytotoxic Effect of Two Different Concentrations of Sodium Hypochlorite: An In-Vitro Study.

Introduction The endodontic treatment of primary teeth presents considerable complications due to their distinct anatomical properties. In order to achieve a successful endodontic treatment, certain factors must be assessed. These factors include a precise diagnosis, thorough cleaning, and a reliable disinfection protocol. Although sodium hypochlorite (NaOCl) has been effective as an irrigation agent in primary teeth, it is important to recognize that higher concentrations of NaOCl might possibly inflict toxic harm on the periapical environment if they penetrate the tooth's apical foramina. Since primary teeth are important, pediatric dentists must choose an appropriate NaOCl concentration for root canal irrigation, as higher concentrations can be toxic. Thus, the current investigation examined the cytotoxicity of two different NaOCl concentrations at various volumes. Methods To evaluate the cytotoxicity potential, a culture ofnauplii (brine shrimp) was prepared and subjected to testing. For the test, 5, 10, 20, and 40 µL of 1% and 3% NaOCl were added to the brine shrimp culture at different concentrations, and saline was used as a control. After a span of 24 hours, the total number of alive nauplii was duly noted. Results After 24 hours, nauplii showed no mortality in the control group. For 1% NaOCl, mortality ranged from 10% to 20% across volumes, with no significant differences (p = 0.193). In contrast, 3% NaOCl caused significantly higher mortality: 20% at 5 µL, 30% at 10 and 20 µL, and 60% at 40 µL (p = 0.007). Tukey's analysis revealed no significant differences for 1% NaOCl (p > 0.05) but significant differences for 3% NaOCl at 40 µL (p < 0.05). Conclusion Based on the results of the present study, it was observed that a 1% NaOCl solution exhibited a lower level of toxicity in comparison to a 3% NaOCl solution. These findings highlight the importance of using lower concentrations of NaOCl for endodontic irrigation in pediatric dentistry to reduce the risk of tissue damage and ensure safer outcomes for young patients.

Endodontic Treatment During Pregnancy: Knowledge of General Dental Practitioners and Interns in Zliten, Libya

This study was conducted to assess the knowledge of dental interns and general dentists about providing endodontic treatment to pregnant patients in Zliten-Libya. A descriptive, cross-sectional study was conducted using self-administered, closed ended questionnaire which was circulated among 127 dental interns and general dentists in Zliten-Libya. The questionnaire included demographical items and questions relative to the participant's knowledge regarding the endodontic treatment during pregnancy. The analysis of data was carried out using SPSS 26. 84% of survey participants indicated the second trimester as the safest period for endodontic treatment. 95% of respondents considered the need for a specific chair position among which 58% identified the correct one. 72% and 65% of respondents indicated the safety of local anaesthetics with vasoconstrictors and use of aspiration technique, respectively. 22% of respondents identified the toxicity of bupivacaine. 64% of respondents considered the safety of either root canal irrigants or intra-canal medicaments. The obturation materials were considered safe by 74% of respondents. 49% of respondents indicated the safety of radiographic examination among which 67% preferred RVG technique. 58% of respondents preferred acetaminophen for pain control. Dental interns and general dentists in Zliten exhibited a sufficient knowledge regarding the safety of endodontic treatment during pregnancy and required to improve their knowledge particularly regarding the safety of some local anaesthetics and radiographic examination during endodontic treatment.

The effects of aperture position and length in side-vented needles on root canal irrigation: A computational fluid dynamics study

IntroductionRoot canal irrigation is crucial for infection control during root canal treatment. Side-vented needles for positive pressure irrigation are commonly used in clinical practice. However, variations in needle design among manufacturers can impact the fluid dynamics of irrigation. This study aims to use computational fluid dynamics to explore the flow characteristics of different needle aperture lengths and positions, and their effects on the effectiveness and safety of irrigation, using a validated passive scalar transport numerical model. MethodsThe validation of the CFD irrigant model was achieved by comparing it with an in vitro irrigation experiment model. The CFD model used scalar concentration, while the in vitro experiment model used red dye tracing. Using a standard 30G side-vented needle as a reference, virtual needle models featuring four aperture lengths and three positions were created. These virtual irrigation needles were then placed in two root canal geometries for CFD simulation to evaluate fluid exchange capabilities and related fluid dynamic parameters. ResultsThe results of the CFD simulation, using a scalar transport model, closely matched the in vitro tracer tests for irrigation experiments across seven root canal geometries. The CFD analysis indicated that positioning the aperture lower increased the irrigant exchange distance. Notably, decreasing the aperture length to 0.25x, and positioning it at the lower end of the needle significantly increased exchange distance and shear stress, while reducing apical pressure. ConclusionsThese results indicate that the position and length of the aperture affect the exchange distance of irrigant flow, wall shear stress, and apical pressure. The CFD validation model for scalar transport, based on a steady state, can function as a valuable tool for optimizing the side-vented needle in research. Further research on the design of side-vented needles will enhance the understanding of flow characteristics beneficial for irrigation efficiency in clinical practice.