Root Canal Irrigation Research Articles

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.

Effect of Saga Leaf Extract (Abrus precatorius Linn) in Inhibiting Enterococcus faecalis Bacteria Growth as an Alternative Root Canal Irrigation Material

Abstract Objective This study aims to examine the antibacterial effect of saga leaf extract on Enterococcus faecalis bacteria, which causes root canal treatment failure. Materials and Methods This research was conducted using a laboratory experimental method with saga leaf extract at 3.125, 6.25, 12.5, 25, 50, and 100% concentrations. Two percent chlorhexidine acts as the positive control, and 100% dimethyl sulfoxide as the negative control. The diameter of the inhibition zones was measured using the well diffusion test method. Statistical Analysis Data from the measurement of inhibition zone diameter were obtained and tested statistically using the normality test (Shapiro–Wilk), homogeneity test (Levene), parametric test (one-way analysis of variance), and further test (post hoc test). Results The largest inhibition zone diameter observed in this study was 9.46 mm at 100% concentration; however, it was not bigger than the positive control, which was measured at 16.55 mm. The research data were analyzed based on the classification of Davis and Stout inhibition zones. Conclusion This study concludes that saga leaf extract has an antibacterial effect on the growth of E. faecalis bacteria.

Antibacterial Activity of Ethanolic Extract of Torch Ginger (Etlingera elatior) Towards Enterococcus faecalis: A Preliminary Research to the Alternative of Root Canal Irrigant of Primary Teeth

Enterococcus faecalis is a notable pathogen found in the root canals of primary teeth with endodontic infections, often resistant to conventional root canal irrigation solutions, leading to treatment failure. Torch ginger or kecombrang (Etlingera elatior), a spice plant, is reported to contain bioactive compounds with antibacterial properties. This study investigates the antibacterial efficacy of ethanolic extract of torch ginger against Enterococcus faecalis, evaluating its potential as an alternative irrigant based on minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and effective concentration. Samples included Enterococcus faecalis ATCC® 29212™ and 70% ethanol extract of torch ginger, tested in eight concentrations (80%, 75%, 65%, 50%, 25%, 12.5%, 6.25%, and 3.125%) obtained through maceration, alongside two control groups (NaOCl and saline). The Kirby-Bauer disc diffusion method was employed to determine MIC, while the streaking method from MIC testing identified MBC. Data analysis for MIC and MBC values was conducted using the One-Way ANOVA parametric test (p < 0.05). Torch ginger extract demonstrated antibacterial activity against Enterococcus faecalis, with inhibition observed at a minimum concentration of 3.125% with average inhibition zone diameter of 9.63 ± 0.25 mm and reaching up to 80% concentration with average inhibition zone diameter of 15.03 ± 0.21 mm. The MIC was established at 3.125%, and the MBC among the tested concentrations was 80%. The study concludes that the ethanolic extract of torch ginger shows significant antibacterial activity against Enterococcus faecalis. An 80% concentration is identified as the most effective for inhibiting and killing the pathogen, suggesting its potential as an alternative root canal irrigant of primary teeth.

Amelioration in the sodium hypochlorite as root canal irrigant – A review

Amelioration in the sodium hypochlorite as root canal irrigant – A review

Assessment of Smear Layer Removal and Push-Out Bond Strength Efficacy of Traditional and Herbal Root Canal Irrigants Across Different Root Levels: An In Vitro Study.

Endodontic therapy requires meticulous root canal debridement, pathogen elimination, and effective obturation to prevent microbial intrusion. The presence of the smear layer hinders sealer penetration, compromising sealing effectiveness. Sodium hypochlorite and chlorhexidine are esteemed endodontic irrigants. Herbal extracts like neem and tulsi, with antimicrobial and anti-inflammatory properties, show promise for root canal irrigation. The study aimed to evaluate the efficacy of various irrigants in removing the smear layer and enhancing push-out bond strength at different root canal levels. One hundred mandibular premolars with single canals were collected, and 50 samples each were used for the smear layer and push-out bond strength analysis. Neem and tulsi extracts were prepared for irrigation. Teeth were decoronated, and up to 30 (6%) canals were prepared and were randomly divided into five groups based on irrigants used. A smear layer examination was conducted after longitudinally sectioning the tooth and sections were observed in a scanning electron microscope (SEM). Obturation was done in the remaining samples, and the push-out bond strength was assessed using a universal test machine. Sodium hypochlorite showed the highest smear layer removal efficacy followed by chlorhexidine, neem, tulsi leaves with rose water extract, and normal saline. Chlorhexidine exhibited the highest push-out bond strength, with the coronal third presenting the strongest values, followed by neem, tulsi with rose water, normal saline, and sodium hypochlorite. The study underscores the potential of herbal irrigants in endodontic therapy, indicating promising results while emphasizing the necessity for further clinical trials to validate their efficacy and other properties.

Prevalence and Classification of C-Shaped Canal and Radix in Mandibular Molars Using Cone-Beam Computed Tomography on Mexican Population.

The diverse morphological configurations in teeth present clinical challenges in root canal treatment, complicating instrumentation and irrigation processes, which can lead to treatment failure. Understanding anatomical variations, such as C-shaped canals and radix entomolaris, enhances clinical skills and improves long-term endodontic treatment success rates. Cone-beam computed tomography (CBCT) offers superior diagnostic capabilities over conventional radiography, enabling the pre-operative detection of root configurations and canal numbers, facilitating personalized endodontic treatments. A total of 2173 teeth of a Mexican population, including 1057 first mandibular molars and 1116 s mandibular molars, were studied using only CBCT to identify C-shaped canals and radix configurations of patients who were treated from 2018 to 2023 at the Department of Radiology at the Faculty of Dentistry, Juarez University of the State of Durango, Mexico. C-shaped canals were identified in 160 teeth, with a prevalence of 0.2% in first mandibular molars and 14.1% in second mandibular molars. The highest frequency was in the left second mandibular molar (3.7) at 14.8%. Gender differences were significant, with higher prevalence in females (27.3%) compared to males (13.3%). The most common C-shaped canal configuration was type C2 (39.3%). Radix entomolaris was found in 52 teeth, with a prevalence of 3.4% in first mandibular molars and 1.4% in second mandibular molars. This research on a Mexican population using cone-beam computed tomography (CBCT) highlights significant findings in the prevalence and types of C-shaped canals and radix entomolaris in mandibular molars for this population. The left second mandibular molar (3.7) showed the highest prevalence at 14.8%, followed closely by the right second mandibular molar (4.7) at 13.5%, with a significant difference (p < 0.001). We found a significant difference in the prevalence of C-shaped canals between genders (p = 0.004, OR 1.78). Additionally, radix entomolaris (p < 0.001) was more frequently identified in first mandibular molars to a significant degree. These insights underscore the importance of CBCT in diagnosing complex root anatomies, which can greatly enhance the success rates of endodontic procedures by allowing for more tailored and precise treatments for this population.

A comparative analysis of the antimicrobial efficacy of different concentrations of silver nanoparticles and chlorhexidine against Enterococcus faecalis - In vitro study

Introduction: Root canal irrigants combat endodontic microbial flora, effectively targeting resilient microbes like Enterococcus faecalis, which persist despite treatment. Chlorhexidine (CHX), as an irrigant, boasts broad-spectrum antibacterial activity, notable substantivity in dentine, and favorable biocompatibility. In the realm of nanotechnology, the use of silver nanoparticle (AgNP) solutions appears promising, given their strong antibacterial and antimicrobial properties. Objective: The objective of the study was to compare the antimicrobial effectiveness of varying concentrations (1%, 0.75%, and 0.5%) of AgNPs and 2% CHX against E. faecalis. Materials and Methods: Four irrigant solutions, including 1%, 0.75%, and 0.5% AgNPs and 2% CHX with gentamicin as the control, will be assessed. The ATCC 29212 strain of E. faecalis will be cultivated at 37°C on brain–heart infusion Broth plates. After 48 h, the bacterial population will be quantified by counting colony-forming units on agar plates. Each irrigant will be applied to the plates, and the resulting bacterial inhibition zone will be measured. Results: Our study demonstrates the antimicrobial effects of 1%, 0.75%, and 0.5% AgNPs and 2% CHX against E. faecalis. While 2% CHX exhibited superior activity, AgNPs at various concentrations also displayed inhibitory effects against E. faecalis. Conclusion: In conclusion, this study highlights the antimicrobial properties of 1%, 0.75%, and 0.5% AgNPs and 2% CHX against E. faecalis. The results indicate that 2% CHX exhibits superior activity, while AgNPs at various concentrations also demonstrate inhibitory zones against E. faecalis.

Comparative evaluation of minimal inhibitory concentration and minimal bactericidal concentration of various herbal irrigants against Enterococcus faecalis.

The purpose of this article is to evaluate the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of Herbal Irrigants. The aim of the study was to evaluate MIC and MBC of herbal extracts of Azadirachta indica, Curcuma longa, and Green Tea Against Enterococcus faecalis. The MIC and MBC of extracts of A . indica (neem), C. longa (turmeric), and Green Tea were evaluated to establish them as standard root canal irrigants against E. faecalis using agar well diffusion method. The collected data were statistically analyzed using the Statistical Package for the Social Sciences (SPSS) software. The present study found that green tea exhibited the most substantial antimicrobial activity among the tested herbal extracts, which was comparable to chlorhexidine. Although A. indica and C. longa required higher concentrations for effectiveness, their antimicrobial properties were also apparent. Within the constraints of this study, it can be concluded that green tea could be considered a promising alternative to chlorhexidine in treating endodontic infections due to its substantial antimicrobial activity against E. faecalis at lower concentrations.

Antibiofilm activity of sodium hypochlorite against enterococcus faecalis using four irrigant activation protocols.

The aim of the study was to compare the activity of sodium hypochlorite (NaOCl) against Enterococcus faecalis when used with four different irrigation protocols. Sixty-five single-rooted mandibular premolars with closed apex were prepared till size 35/0.04. The specimens were sterilized and infected with E. faecalis colonies that were cultured separately. The canals were randomly divided into four experimental groups based on irrigation activation protocol, with each group having 15 specimens each - Group 1: control, Group 2: manual dynamic agitation (MDA), Group 3: passive ultrasonic irrigation (PUI), Group 4: intracanal heating (ICH), and Group 5: passive ultrasonic irrigation followed by ICH (PUI ICH). The dentinal shavings were collected and sampled before (S1) and after (S2) the different irrigation techniques were performed. The colony-forming units were counted, and the bacterial reduction was calculated for each group. A significant reduction in the number of E. faecalis colonies was observed for all the experimental groups (P < 0.001). The groups with ICH of NaOCl showed a considerable reduction in bacterial colonies than other groups (P < 0.001), with Group 5 that combined ultrasonics with ICH showed the highest reduction. ICH of NaOCl may be used as an adjunct to root canal irrigation to reduce the bacterial concentration from root canal spaces.

Effects of Final Root Canal Irrigants in Conventional and Regenerative Endodontic Treatments: A Systematic Review

Background: The effectiveness of final root canal irrigants is crucial for successful conventional and regenerative endodontic treatments. This study aimed to systematically review the impact of final irrigants on dentin, disinfection, and regenerative potential in endodontic therapies. Methods: MEDLINE, Cochrane Library, and Web of Science databases were electronically searched for articles on final irrigants in conventional and regenerative endodontics, evaluating effects on dentin, smear layer, fracture resistance, stem cells, growth factors, and antimicrobial properties. The risk of bias was assessed using the Systematic Review Centre for Laboratory Animal Experimentation risk of bias tool. Results: Overall, 25 eligible studies were included in this review after screening 2842 articles. Commonly assessed irrigants included ethylenediaminetetraacetic acid (EDTA) (21 studies), sodium hypochlorite (NaOCl; 12 studies), and citric acid (6 studies). EDTA could enhance growth factors but could weaken dentin. NaOCl affected dentin despite its antimicrobial benefits. Nanoparticles, chitosan, peracetic acid (PAA), and citric acid showed potential benefits. A meta-analysis was not performed due to methodological heterogeneity. Conclusion: In general, optimized irrigation strategies balancing disinfection, biocompatibility, and regenerative potential are necessary. More research is required to develop improved irrigation protocols. Registration: PROSPERO CRD42023420406.

In Vitro Methods for Assessing the Antibacterial and Antibiofilm Properties of Essential Oils as Potential Root Canal Irrigants-A Simplified Description of the Technical Steps.

Essential oils have gained in significance due to their various biological activities, and there is a growing demand for them in many industries. The present article focuses on the technical steps for an in vitro evaluation of the antibacterial and antibiofilm activities of essential oils for potential use as root canal irrigant in dentistry. The bioactivities of the essential oil were investigated through in vitro assays. The gram-positive bacterium Enterococcus faecalis was used as a micro-organism model. The antibacterial activity of the essential oil was assessed using the microdilution method, and resazurin staining to determine the minimal inhibition concentrations (MICs) and the minimal bactericidal concentrations (MBCs). The antibiofilm effect was evaluated spectrophotometrically at 570 nm using the microplate cultivation technique and crystal violet staining. This article features a detailed in vitro protocol to facilitate the preparation of the essential oil samples, the bacterial suspension, and the methods used for assessment of the antibiofilm and antibacterial activities of the essential oil. The advantages of these approaches are presented in relation to the limits linked to the choice of the bacteria and the essential oil.

A Comparative Evaluation of Contact Angle and Depth of Penetration of Sodium Hypochlorite With Various Surfactants: An In Vitro Study.

Sodium hypochlorite (NaOCl) is regarded as the most frequently used root canal irrigant. Its high surface tension prevents its penetration into complex canal anatomies. The present study assesses the contact angle and penetration depth of 2.5% NaOCl with 0.2% cetrimide and propylene glycol. Sixty recently extractedmandibular premolars with a single root were obtained. Thirty were sectioned longitudinally, and the remaining 30 teeth were sectioned transversely. Acrylic blocks were used to mount the parts, and 5 µL of each of the following solutions was placed on the dentin surface: Group 1: 2.5% NaOCl (control), Group 2: 0.2% cetrimide + 2.5% NaOCl, and Group 3: propylene glycol + 2.5% NaOCl. Following this, contact angle analysis was made using a contact angle goniometer. We prepared and instrumented access cavities in 30 teeth to work up to the size of the ProTaper Gold F2 (Dentsply Tulsa Dental Specialties, Tulsa, OK). Samples were allocated to the three groups, and irrigation was done accordingly. They were sectioned at the coronal, middle, and apical thirds and then subjected to confocal laser scanning microscopy. The data were analyzed using a one-way ANOVA and a Tukey multiple comparison test. Group 2 had the least contact angle (35.20°) and the highest depth of penetration (DOP; 752.409 µm) when compared to Groups 1 and 3. The DOP decreased significantly from the coronal, middle, and apical thirds. No discernible variation in the contact angle was found between the radicular and coronal portions. 0.2% cetrimide improved the efficiency of 2.5% NaOCl as an irrigant by lowering its contact angle and increasing its DOP.

Association between the irrigation-agitation techniques and Periapical Healing of large periapical lesions: a Randomized Controlled Trial

ObjectivesThe aim of this study was to evaluate the effects of manual dynamic activation (MDA), passive ultrasonic irrigation (PUI), and laser-activated irrigation (shock wave-enhanced emission photoacoustic streaming (SWEEPS)) on the periapical healing of large periapical lesions following nonsurgical root canal treatment.Materials and methodsA total of fifty-six systemically healthy patients with a mandibular single-rooted tooth with periapical lesions of endodontic origin and a periapical index score of 3 or higher were included in the study. Before the treatment procedures, lesion volumes were determined volumetrically using cone–beam computed tomography (CBCT). Patients were randomized into treatment (MDA, PUI, SWEEPS) and control groups (n = 14). Root canal treatment and irrigation procedures were performed by a calibrated postgraduate operator and completed at one visit. For routine follow-up, clinical and radiographic evaluations were performed by a blinded evaluator using periapical (PA) radiographs according to Molven’s criteria at 3, 6, and 9 months. At 12 months, lesion volumes were quantified volumetrically using CBCT (ITK-SNAP). The data were statistically analyzed with the Wilcoxon test. The significance level was set at p < 0.05.ResultsIn all groups, the mean lesion volume after treatment was significantly smaller than the mean volume before treatment (p = 0.001). Among the 56 teeth, 11 teeth were ‘totally healed’, and 39 teeth were ‘reduced’ on PA radiographs. No ‘enlargement’ was detected in any group. On CBCT, the lesion volume decreased in the following order: LAI-SWEEPS (86.9%) > PUI (85.4%) > MDA (80.4%) > control (74.5%), with no statistically significant difference (p > 0.05).ConclusionsDespite the limitations of the present study, although a greater percentage of healing was observed in the LAI-SWEEPS and PUI groups, irrigation procedures had no statistically significant effect on the healing of periapical lesions with a single root canal at the 12-month follow-up. On the other hand, the outcome may change in multirooted teeth with curved and complex root canal systems.Clinical relevanceIn the short term and in single-canal teeth, advanced irrigation agitation methods such as laser and ultrasonic did not make a difference in healing other than manual irrigation agitation.

Assessment of Smear Layer Removal and Penetration Depth of Root Canal Irrigant Using Different Irrigation Activation Systems: A Comparative Study.

The aim of the current study was to evaluate the penetration depth and smear layer removal of root canal irrigant using various irrigation activation techniques. In this investigation, sixty single-rooted premolars extracted for orthodontic purposes were chosen. Diamond burs were used to create an access cavity, and #10 K-file was used to determine the patency. About sixty samples were divided into the following three groups (20 samples in each group), group I: Irrigation with conventional needle, group II: Activation of EndoVac system, group III: Passive ultrasonic irrigation (PUI). The efficacy of the smear layer was assessed using a scanning electron microscopy at a ×2000 magnification. One-way ANOVA was used to record and analyze the data. All statistical analyses were performed with a significance level of p < 0.05. At coronal third, the maximum smear layer was removed in group II (1.26 ± 0.02) followed by group III (1.84 ± 0.16) and group I (2.89 ± 0.21). At middle third, smear layer removal was maximum in group I (1.18 ± 0.10) followed by group III (1.72 ± 0.09) and group I (2.66 ± 0.18). At apical third, the more smear layer was removed in group II (1.02 ± 0.01) followed by group III (1.58 ± 0.08) and group I (2.38 ± 0.06). There was a highly significant difference found between the three different irrigation systems at all three levels (p < 0.001). In conclusion, every irrigation device that was evaluated was successful in removing the smear layer from the root canal. However, the EndoVac system group removed a greater amount of smear layer compared with PUI and conventional needle group. With the goal of promoting cleaning that is beyond the ability of mechanical devices, irrigation is a crucial part of root canal therapy. If an efficient irrigation delivery system is used, the irrigants can reach the working length (WL). This type of distribution system needs to provide a suitable amount of irrigants up to the WL, as well as have enough flow and be effective at debriding the entire canal system. How to cite this article: Pujari MD, Das M, Das A, et al. Assessment of Smear Layer Removal and Penetration Depth of Root Canal Irrigant Using Different Irrigation Activation Systems: A Comparative Study. J Contemp Dent Pract 2024;25(4):331-334.

Antimicrobial Efficacy of Saline, Chlorhexidine, and Zataria Multiflora and Mentha Piperita Essential Oils in Root Canal Irrigation of Primary Molars.

Objectives: This study aimed to compare the antimicrobial efficacy of saline, 0.5% and 2% Zataria multiflora (Z. multiflora) essential oil, 0.5% and 2% Mentha piperita (M. piperita) essential oil, and 0.2% chlorhexidine (CHX) as root canal irrigants for primary molar teeth. Materials and Methods: A total of 64 primary molars were used in this in vitro study. The teeth were randomly assigned to six groups (N=10). The root canals were prepared up to file #35, and all teeth were sterilized before contamination with Enterococcus faecalis (E. faecalis; ATCC 29212) suspension. After 48 hours of incubation, the root canals in each group were irrigated with the respective irrigants. Sterile paper points were then used to collect microbial samples from the root canals. A colony counter was used to count the number of colony-forming units (CFUs). Data were analyzed by SPSS version 20 (alpha=0.05). Results: The colony count was significantly different among the groups (P<0.001), and 2% M. piperita (P=0.009), 0.5% Z. multiflora (P=0.021), and 0.2% CHX (P=0.002) were significantly more effective than saline in elimination of E. faecalis. The ascending order of microbial count after irrigation was as follows: saline > 0.5% M. piperita > 0.2% CHX > 2% M. piperita > 0.5% Z. multiflora. Conclusion: The current study showed the optimal antibacterial activity of 0.5% Z. multiflora essential oil and 2% M. piperita essential oil against E. faecalis, and indicated their possible efficacy for use as an irrigant for root canal irrigation of primary molars.

Comparative Evaluation of Microbial Reduction Using Silver Diamine Fluoride, Azadirachta indica (Neem) and Sodium Hypochlorite as Root Canal Irrigants after Biomechanical Preparation in Uniradicular Canals: An In Vivo Study.

It is difficult to completely eradicate microorganisms from the infected root canal system. Intracanal irrigants seem necessary for eradication of infected tissues and microorganisms in addition to mechanical debridement. Continuous use of chemical antimicrobial agents leads to serious side effects. Therefore, the need arises for alternative agents to overcome the disadvantages of their chemical counterparts. To evaluate and compare the antimicrobial efficacy of three endodontic irrigants against clinically isolated bacteria found in root canals containing necrotic pulp. Preirrigation sample were collected using sterile paper points and sent for microbial count. Chemomechanical preparation was performed, and the root canals were irrigated with 5 mL of test samples. After 3 days, the patient was recalled, and a postirrigation sample was collected and sent for microbial count. Both 3.8% silver diamine fluoride (SDF) and 3% sodium hypochlorite (NaOCl) showed a superior capacity to sterilize the root canals compared to the neem group. The use of SDF as an endodontic irrigant is feasible as it effectively removes the microbes present in the canal. Silver diamine fluoride has not been shown to be cytotoxic or carcinogenic, unlike NaOCl, suggesting it could be used as a potential endodontic irrigant. However, few studies have evaluated the antimicrobial efficacy of SDF as an endodontic irrigant. Raj S, Sharma A, Dhinsa K, et al. Comparative Evaluation of Microbial Reduction Using Silver Diamine Fluoride, Azadirachta indica (Neem) and Sodium Hypochlorite as Root Canal Irrigants after Biomechanical Preparation in Uniradicular Canals: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(6):625-629.

The ability of working length determination of the electronic apex locator Propex Pixi in the presence of various irrigants - an in vitro study

Background: To achive success in endodontic treatment, the clinicians have to completely control the depth of penetration of instruments inside the root canal called the working length. Determining the working length by using electronic apex loactors have been increasingly popular and gradually become an indispensable tool in endodontics. The purposes of this study was to compare the working length determined by Propex Pixi with the actual canal length as well as evaluate the effect of various intracanal irrigants on the accuracy of Propex Pixi. Materials and method: 45 human incisors extracted for periodontal reasons were selected for this in vitro study. Standard access preprations were prepared, then digital Caliper was used to meassure the actual root canal length. Teeth were imbedded in alginate model. The working length was determined by using the Propex Pixi in the presence of different irrigant solutions: distilled water, 2.5% NaOCl and 2% Chlorhexidine. The working length meassurements obtained with Propex Pixi were compaired with the actual root canal length and then evaluating the effect of irrigation solutions on the accuracy of Propex Pixi. Results: There was no significant differences between the actual canal length and the WL determined by Propex Pixi (p &gt; 0.05). Root canal irrigants has no effect on the accuracy of Propex Pixi. Conclusion: There was no significant differences between actual root canal length with the measurements obtained by Propex Pixi. The accuracy of Propex Pixi was not affected by the irrigants used. Key words: working length, electronic apex locator, Propex Pixi.

Assessment of Antimicrobial Efficacy of Triphala, Neem, and Chlorhexidine Root Canal Irrigants.

Complete eradication of microorganisms from the root canal and three-dimensional obturation of the canal space are necessary for a successful root canal therapy. In root canal failures, Enterococcus faecalis is the most often detected bacterium. Microorganisms can be eliminated with the aid of chemical irrigation. The current research was conducted to evaluate the antimicrobial effect of triphala, neem, and chlorhexidine root canal irrigants. Mueller-Hinton agar plates were inoculated with the E. faecalis (ATCC) bacterial culture after it had been cultured overnight in brain heart infusion (BHI) broth. Agar well diffusion was used to measure antibacterial inhibition. After being introduced to their appropriate wells in agar plates, the three research irrigants were incubated for 24 hours at 37°C. Every well's bacterial inhibition zone was noted. After tabulating the results, statistical analysis was done. When triphala and A. indica extract (neem) were added to chlorhexidine, the highest inhibitory zone against E. faecalis was observed. The herbal remedy triphala and the extract from A. indica exhibited an inhibitory zone when tested against E. faecalis. As a result, these irrigants might be utilized as a substitute for root canal irrigants.

Effect of different root canal irrigants on surface roughness and microhardness of Biodentine combined with triple antibiotic paste: An in vitro study

Background: Biodentine is widely used for endodontic applications; recently, it has been incorporated with triple antibiotic paste (TAP). The effect of endodontic irrigants on the physical characteristics of this new combination needs to be studied. Aims: The aim of the study was to evaluate the surface roughness and microhardness of Biodentine incorporated with TAP subjected to various endodontic irrigants. Materials and Methods: Hundred cylindrical discs (6 mm × 3 mm) were prepared by mixing the Biodentine with TAP (3:1). The specimens were subjected to different irrigating solutions for 5 min in 5 groups (n = 20): Group 1: distilled water (control), Group 2: 2.5% sodium hypochlorite, Group 3: 17% ethylenediaminetetraacetic acid, Group 4: 2% chlorhexidine (CHX), and Group 5: 2% chitosan nanoparticles (CSNs). Half of the specimens in each group were subjected to surface roughness (n = 10) and another half to microhardness (n = 10). Surface roughness was measured using a surface roughness tester, and digital Vickers microhardness testing was performed on each specimen. Statistical Analysis: One-way ANOVA and post hoc Tukey’s tests (P ≤ 0.05) were used. Results: The highest microhardness was found with 2% CSN, whereas 2% CSN and 2% CHX had a minimal effect on the surface roughness of Biodentine incorporated with TAP (P ≤ 0.05). Conclusion: The root canal irrigant 2% CSN exhibited the highest microhardness and least surface roughness of modified Biodentine with TAP.