Sodium Hypochlorite Irrigation Research Articles

Effectiveness of Activated Sodium Hypochlorite Irrigation by Shock Wave-Enhanced Emission Photoacoustic Streaming, Sonic and Ultrasonic Devices in Removing Enterococcus faecalis Biofilm From Root Canal System.

Aim: To compare shock wave-enhanced emission photoacoustic streaming (SWEEPS) with sonic- and ultrasonically activated irrigation systems in removing Enterococcus faecalis biofilm from the root canal system. Methodology: Fifty human single-canalled mandibular premolars were included in the study. After access cavity preparation, the root canals were prepared to a standardized size and taper. Then, the entire root surface was covered with two layers of resin, and the root apices were sealed before sterilization. All root canals were inoculated with E. faecalis biofilm, and the samples were incubated aerobically for 2 weeks at 37 °C. Biofilm formation was confirmed by scanning electron microscopy. All samples were randomly divided into five groups (n = 10 each) based on their irrigation activation method as A (no treatment or negative control), B (no irrigation or positive control), C (sonically activated irrigation (SAI)), D (ultrasonically activated irrigation (UAI)), and E (needle irrigation activated by an Er: YAG laser device using a SWEEPS quartz tip (SWEEPS)). Then, dentine chips were retrieved, vortexed, and diluted for colony-forming unit counts. Data were analysed using analysis of variance and post-hoc Tukey tests (α = 5%). Results: All methods could significantly reduce E. faecalis biofilm compared with control so that the UAI, SWEEPS, and SAI groups indicated a 23.54%, 14.89%, and 7.81% biofilm reduction, respectively. UAI demonstrated a significantly more effective reduction of E. faecalis biofilm than SAI (p = 0.004). Conclusions: All irrigation activation methods significantly reduced E. faecalis biofilm, with ultrasonic use being the most effective.

Unveiling the correlation between in vivo endodontic reciprocate instrumentation and crack formation

IntroductionDentinal microcracks have been supposedly associated with unrestorable vertical root fractures and consequently long-term treatment failure. This study aimed to investigate whether in vivo root canal instrumentation in mandibular incisors with vital pulps causes dentinal microcracks using two different irrigating solutions. MethodsFive patients with four vital mandibular incisors indicated for extraction were included. In vivo root canal preparation was performed using Reciproc R40 (tip #40 and taper 0.06). From these, two teeth were randomly assigned for root canal instrumentation irrigated with 5.25 % sodium hypochlorite irrigation (n = 10) or 2 % chlorhexidine gel with saline solution irrigation (n = 10). In sequence, all teeth were carefully extracted, stored in saline solution until microtomography (µCT) scan. Images were reconstructed and assessed for the presence or absence of dentinal microcracks where microcracks originating from the root canal lumen would be considered. All reconstructed samples were analysed dynamically and rendered in videos through the entire extension of the teeth, evaluating the axial cuts considering each third separately from the apex to the enamel-dentinal junction. Teeth were analysed using the DataViewer software at 100 % magnification without filters by three examiners blinded to the condition allocation. ResultsNo complete dentinal microcracks were observed after root canal instrumentation of mandibular incisors with vital pulps using Reciproc R40 regardless the irrigating solutions, 5.25 % sodium hypochlorite or 2 % chlorhexidine gel. ConclusionsIn vivo root canal instrumentation of mandibular incisors with vital pulps and bone/periodontal insertion does not cause dentinal microcracks and the irrigating solutions tested did not influence this occurrence. Microcrack evaluation must be performed in vivo conditions of dental tissue moist and periodontal support to avoid dryness dentinal alterations after extraction provoking false positive results. Clinical relevanceReciprocating instrumentation performed in vivo is safe and do not induce dentinal microcracks in mandibular incisors.

Comparative Evaluation of Accuracy of Two Apex Locators with Different Irrigants: An In-Vitro Study

Aim: The aim of this in-vitro study will be to evaluate and compare the accuracy of two apex locators in the presence of various irrigants. Methods and Material: The study will be conducted on 80 extracted straight, single-rooted permanent human teeth with mature apices. The teeth will be decoronated. Access cavity preparations will be done and working length will be established with 10 K file or 15 k-file into the canal until its tip emerged through the major apical foramen at ×10 magnification under a stereomicroscope. All the samples selected will be divided into four groups on the basis of irrigants used. Group 1 will be dry without irrigants, used as control, in Group 2 saline will be used as irrigant, in Group 3 sodium hypochlorite will be used as irrigant and in Group 4 chlorehexidine will be used as irrigant. Each group again will be subdivided into two groups on the basis of two different apex locators used (Root ZX Mini J. Morita) and CanalPro (Coltene). All the samples will be embedded in gelatin filled polyurethane bottles to simulate the periodontium. Statistical analysis used: Subsequently, the data will be statistically analysed using one-way analysis of variance (ANOVA) and paired t-test. Results: In this study, group 2 canal pro apex locator is accurate and sodium hypochlorite irrigant shows maximum variation. Conclusions: Canalpro showed accurate values than Root ZX and sodium hypochlorite showed more variations

Effects of the Irrigation Needle Design on Root Canal Disinfection and Cleaning

IntroductionThis ex vivo study evaluated the disinfecting and cleaning effects of root canal preparation using sodium hypochlorite irrigation with 3 different needle designs. MethodsMesial roots from extracted mandibular molars with Vertucci class II configuration were anatomically matched based on micro-computed tomography (micro-CT) analyses and distributed into 3 groups (n = 18/group). The canals were contaminated with a mixed bacterial culture for 30 days and then subjected to preparation using 2.5% sodium hypochlorite irrigation with open-ended flat needle (3 mm short of the working length - WL), closed-ended side-vented irrigation needle (1 mm short of the WL), or a closed-ended plastic needle with 2 lateral outlets (TruNatomy) (1 mm short of the WL). Bacteriological samples were taken from the canals before (S1) and after preparation (S2). After another micro-CT scan, the roots were sectioned and samples were also taken from the apical canal segment (S3). Bacterial reduction was assessed by quantitative real-time polymerase chain reaction. The amount of accumulated hard tissue debris was evaluated by micro-CT. ResultsA substantial reduction in bacterial counts was observed in all 3 groups when comparing S1 with S2 (99.95%, 98.93%, and 98.90% in the open-ended, closed-ended, and TruNatomy needle groups, respectively) (P < .01). No significant differences were observed between groups for bacterial reduction in the full and apical canal (P > .05). There were no intergroup differences in the amount of accumulated hard tissue debris either (P > .05). The open-ended needle group showed significantly more specimens with quantitative real-time polymerase chain reaction negative results for bacteria in S3 than TruNatomy (P < .05). ConclusionWhen used up to an appropriate insertion depth, the 3 needle types result in similar antibacterial and cleaning performance, provided variables such as needle size and irrigant type, volume and flow rate are controlled. Exclusive analysis of the apical segment, including the isthmus, revealed that the open-ended needle yielded more cases negative for bacteria.

Dens invaginatus Type II in an Immature Lateral Incisor With Apical Periodontitis Treated With Regenerative and Strategic Antimicrobial Procedures: A Case Report

Dens invaginatus is a developmental dental anomaly that can predispose the tooth to pulp and periradicular disease. Management of this condition can be challenging because of anatomic and microbiologic issues. This case report describes the regenerative endodontic treatment using a strategic antimicrobial protocol for management of an immature maxillary lateral incisor with type-II dens invaginatus associated with apical periodontitis in a 13-year-old patient. The tooth presented with a complex anatomy and was associated with an active sinus tract. Because the true root canal was not negotiable in its coronal part due to the presence of the dens invaginatus, the closed end of the invagination (pseudocanal) was perforated to permit access to the apical segment of the true root canal for cleaning and disinfection. Both the invagination and the true canal were treated using an antimicrobial regimen based on chemomechanical preparation with sodium hypochlorite irrigation, supplementary disinfection with passive ultrasonic irrigation and interappointment calcium hydroxide medication. After 2 exchanges of calcium hydroxide medication, the sinus tract did not disappear, then the antimicrobial protocol was changed to include an antibiotic solution for irrigation and antibiotic paste for intracanal medication. After signs and symptoms disappeared, regenerative endodontic treatment was performed by inducing blood clot formation within the root canal. The coronal canal segment including the invagination was filled with Biodentine. Follow-up including cone-beam computed tomography examination showed complete healing of the apical periodontitis lesion and mineralized tissue formation at the apical portion of the true root canal.

Does increase in temperature of sodium hypochlorite have enhanced antimicrobial efficacy and tissue dissolution property? - A systematic review and meta-regression.

The objective of this study was to analyze the available evidence on the performance of increase in temperature of sodium hypochlorite on its antimicrobial efficacy and tissue dissolution property. The study was conducted according to PRISMA guidelines, and a modified Joanna Briggs Institute (JBI) tool was used for quality assessment of the included studies. Two reviewers independently performed an electronic search in four databases along with the reference lists of the included articles. This systematic review included a total of 12 studies: antimicrobial efficacy (n = 6) and tissue dissolution property (n = 6). For the studies that were chosen, the overall risk of bias was moderate. Quantitative assessment through meta-regression was performed for tissue dissolution property. Low-concentration sodium hypochlorite irrigant (≤3%) shows a 0.13-unit times increase in tissue dissolution ability with a degree rise in temperature although not statistically significant. Due to inconsistency in the study parameters, results pertaining to the exclusive effect of increase in the temperature of sodium hypochlorite remain inconclusive.

Effectiveness of white tea-mediated silver nanoparticles as an intracanal irrigant against Enterococcus faecalis: An in vitro study.

The probability of a positive outcome of root canal therapy is substantially higher if the infection is eradicated successfully before the obturation of the root canal system. Irrigation is an essential aspect of root canal debridement, as it enables more thorough cleaning than is possible with root canal instrumentation alone. To overcome the side effects of chemical irrigants, there has been a search for herbal medicines as substitutes. The aim of the present study was to explore the antimicrobial efficacy of white tea-mediated silver nanoparticles (AgNPs) formulated as an intracanal irrigant against Enterococcus faecalis, and to compare it with the efficacy of chlorhexidine and sodium hypochlorite irrigants. The experimental groups were as follows: group I - white tea-mediated AgNPs; group II - 2% chlorhexidine; and group III - 2.5% sodium hypochlorite. The characterization of AgNPs was performed using ultraviolet-visible (UV-Vis) spectroscopy and transmission electron microscopy (TEM) analysis. Enterococcus faecalis was inoculated onto Mueller-Hinton agar plates. The disks impregnated with irrigants were placed on the inoculated plates and incubated aerobically at 37°C for 24 h. Then, the growth inhibition zones were measured. Statistical analysis was performed using the one-way analysis of variance (ANOVA) and the post hoc tests. A concentration of 50 μL of white tea-mediated AgNPs exhibited the greatest zone of inhibition (32 ±2 mm), followed by 2% chlorhexidine (25 ±1 mm) and 2.5% sodium hypochlorite (23 ±3 mm). White tea-mediated AgNPs showed promising results in the elimination of E. faecalis, being superior to chlorhexidine and sodium hypochlorite irrigants.

Normal Saline or Sodium Hypochlorite Irrigation for Vital Pulp Therapy? A Non-Inferiority Randomized Controlled Trial.

criteria were randomized to each irrigant, 65 in the NaOCl and 60 in the NSS groups. ProRoot® MTA was used as a pulp dressing material in both groups and teeth were followed for 12 months. The primary outcome was the success of VPT; requiring both clinical and radiographic success to be considered as success. The hypothesis was that the absolute difference of VPT success in the NSS group was not worse than that in the NaOCl group, by a margin of 5%. The secondary outcome was discoloration; percentages of discolorations between both groups were compared. Results: Using a per protocol analysis, the absolute difference of VPT success between the NSS and NaOCl groups was 2.08% (95% CI: -1.95, 6.1). Perceptible gray discolorations were 80% and 63% in NaOCl and NSS groups (difference -17%; 95% CI: -40.0, 6.2; p=0.15). Conclusions: For MTA-VPT procedure, irrigation with NSS was not worse than that with NaOCl. However, both irrigants caused discoloration. (EEJ-2023-05-065).

Comparing the EdgeFile X3, GenEndo, HeroGold, and ProTaper Gold Rotary Instruments Regarding the Effect of Different Concentrations and Temperature of NaOCl on Cyclic Fatigue Resistance.

This research was carried out with the objective of comparison between GenEndo, Protaper Gold, Hero Gold and EdgeFile X3 regarding the effect of different concentrations of NaOCl. About 720 study specimens were included in the study. They were divided into four groups. Each group consisted of 180 files. Group A: GenEndo, Group B: Protaper Gold, Group C: Hero Gold, Group D: EdgeFile X3. Each group of instruments were further subdivided into nine subgroups (n = 20 for each subgroup). Testing of the cyclic fatigue was carried out in artificial canals which were prepared inside the blocks of stainless steel. The stainless steel blocks with artificial canals were established in a receiver that was packed with experimental solutions like distilled water, 5.25% NaOCl and 2.5% NaOCl. The adjustment of temperature was done at 25, 37, and 60°C. The rotation of the instrument was carried out inside the artificial canal as per the instructions of the manufacturer. The instrument was rotated until it got fractured. The time taken by the instrument to fracture was recorded in seconds. The number of cycles to fracture (NCF) was analyzed with the help of the equation (NCF = time to fracture × rpm/60). Surfaces at the site of fracture were examined with the help of a scanning electron microscope (EVOLS10, ZEISS) at magnification (300x and 2000x). It was noticed that there was a statistically significant increase in cyclic fatigue when sodium chloride was used as an endodontic irrigant instead of distilled water. The increase in cyclic fatigue was also observed when 5.25% sodium chloride was used instead of 2.5% sodium hypochlorite. Cyclic fatigue increased on change in temperature from 25 to 37°C and from 37 to 60°C. The difference was statistically significant (p < 0.05). It was observed that resistance against cyclic fatigue on treatment with different irrigation solutions at different temperatures was in the order of GenEndo > Protaper Gold > Hero Gold > EdgeFile X3. The resistance against cyclic fatigue in new NiTi rotary files can be affected significantly by different concentrations of sodium hypochlorite irrigant solution and the GenEndo rotary endodontic instrument has the maximum resistance against cyclic fatigue. Irrigation of the root canal with irrigants, such as sodium hypochlorite (NaOCl) has been recommended strongly. NaOCl is used in the range of 0.5 and 6.5% concentration owing to its antimicrobial activity and tissue dissolution activities, particularly at higher temperatures. It has been postulated that fatigue of rotary endodontic instruments can be influenced by adjoining medium and their concentration.

Comparative assessment of antibacterial effect of two types of laser and their effect on morphology and mineral content of dentin

Background/aim Scientists have proven that the main cause of endodontic diseases and failures is the existence of micro-organisms in the root canals and inside the dentinal tubules. So the aim of the study was to compare the antibacterial effect of Erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser and diode laser 980 nm alone and in combination with 5.25% sodium hypochlorite (NaOCl) irrigant against Enterococcus faecalis biofilm and also compare their effect on the morphology and mineral content of root canal dentin by scanning electron microscope (SEM) and energy-dispersive X-ray spectroscopy (EDX) analysis. Materials and methods The specimens used in our study were fifty four extracted human single-rooted teeth. They were collected from the Dental Department of the Research Institute of Ophthalmology, Egypt. Mechanical preparation was done to all teeth after their crowns were removed. They were autoclaved, and after that, they were inoculated with Enterococcus faecalis for 30 days. Roots were divided into six groups (each=9) according to type of treatment. Group A: 5.25% NaOCl, group B: Er,Cr:YSGG laser, group C: 5.25% NaOCl and Er,Cr:YSGG laser, group D: diode laser 980 nm, group E: 5.25% NaOCl and diode laser 980 nm, in addition to control group: saline. Their antibacterial effect was assessed before and after treatment. Changes in the morphology and mineral content of root canal dentin were assessed by SEM and EDX. Statistical analysis was done. Results Group C had significantly the highest percentage of Enterococcus faecalis reduction (98.95%), followed by group E (98.04%), then group D (95.27%), then group A (94.65%), then group B (92.99%), while the control group had significantly the lowest percentage of Enterococcus faecalis reduction (0.22%). Regarding SEM results, group B and group D exhibited score 1 (88.9%), control group and group C score 3 (77.8%), group A score 4 (88.9%), and group E score 5 (88.9%). Regarding EDX results, group B was significantly the lowest in Ca/P ratio, while there was an insignificant difference between other groups. Conclusions Er,Cr:YSGG laser, and diode laser, when used without 5.25% NaOCl irrigant, produced less morphological changes to dentinal tubules, but when combined with 52.5% NaOCl irrigant, produced more antibacterial effect against Enterococcus faecalis. Lasers alone or combined with 5.25% NaOCl irrigant produced changes in the mineral content of root canal dentin.

Assessment of Penetrability for Different Endodontic Irrigation Activating Techniques Using Cone-Beam Computed Tomography and Periapical Digital Radiography—An In Vitro Study

The elimination of necrotic and inflamed pulp tissue, dentin debris, and microorganisms is essential for the success of endodontic treatment. However, the root canal’s complexity has led to incomplete cleaning and disinfection. This study aims to compare the efficacy of the penetrability of three different irrigation activating techniques to the apical third of the root canal. Sixty sound single-rooted human mandibular premolars are prepared with rotary instrumentation under continuous sodium hypochlorite irrigation. Three irrigation activation techniques are utilized: group 1 (n = 20), conventional needle irrigation (CN); group 2 (n = 20), side-vented endodontic needle irrigation (EN); and group 3 (n = 20), manual activation irrigation with gutta-percha cone (MA). The penetrability is assessed with the aid of a radiopaque irrigation solution using digital radiography in conjunction with cone-beam computed tomographic (CBCT) measurements. Data are analyzed using a statistical package for social sciences (SPSS), using multiple comparisons to compare the baseline and test values. One-way analysis of variance with post hoc analysis (Tukey honestly significant difference) is performed to detect the statistically significant differences between groups. Manual activation (MA) shows effective delivery of the irrigant into full WL, followed by endodontic needle (EN) and conventional (CN) methods of activation (p &lt; 0.001). The results of the present study show that maximum penetrability of the irrigant is observed with manual activation (MA) using a gutta cone in comparison with the conventional needle (CN).

Effect of Heated Sodium Hypochlorite Irrigant on Structural Changes and Microhardness of Radicular Dentin: An In Vitro Study.

This study is aimed to evaluate the combined effect of sodium hypochlorite at varied concentrations and temperatures on radicular dentin microhardness along with its surface structural changes using an FTIR spectrometer. Mandibular premolars were cleaned and shaped up to F3 Protaper gold rotary files, after which they were subjected to five experimental conditions - group I - neutral saline as negative control, group II - 3% NaOCl solution, group III - 5% NaOCl solution, group IV - 3% intracanal-heated NaOCl solution, and group V - 5% intracanal-heated NaOCl solution. Following this, the microhardness of radicular dentin at 100 µm and 300 µm from the canal lumen and Fourier-transform infrared (FTIR) spectroscopic analysis were performed. The results showed that intracanal-heated sodium hypochlorite group reduced root dentin microhardness at 300 µm than its nonheated counterpart. No difference in microhardness values was observed between 3% intracanal-heated and room-temperature sodium hypochlorite groups at 100 µm. Reduction in amide/phosphate ratio was noted in all the groups treated with sodium hypochlorite irrespective of temperature and concentration. Thus, considering that the level of alteration in physical and structural changes of root dentin with or without heating is insignificant, intracanal-heated low-concentration sodium hypochlorite solutions could be used as an alternative to high-concentration sodium hypochlorite. Intracanal-heated low-concentration sodium hypochlorite enables the clinicians to achieve maximum disinfection while keeping the structural and physical properties of the dentin similar to room-temperature sodium hypochlorite.

Assessment of Irrigant Agitation Devices in Simulated Closed and Open Root Canal Systems

IntroductionThe in vitro efficacy of irrigant activation devices has not been contrasted to their safety. This was attempted in this study using apically closed versus patent simulated root canal systems in epoxy resin models, with the latter featuring a simulated periapical lesion. MethodsAll 72 models had 2 joining canals connected by an isthmus, which was filled with dentin debris. The simulated periapical lesion was filled with colored gelatin in the 36 respective models. Canals were irrigated with 1.3% sodium hypochlorite. Samples were divided into 4 subgroups per system (n = 9): conventional irrigation, sonic low (EndoActivator; Dentsply Sirona, Charlotte, NC) and high frequency (EDDY; VDW, Munich, Germany), and ultrasonic agitation of the irrigant (always applying 3 cycles of 20 seconds). The total cleared surface areas (mm2) in the simulated isthmus and periapical lesion were compared between systems and devices using parametric tests (P < .05). ResultsThe cleaning of the isthmus was more effective in the apically open compared with the closed systems and was also significantly influenced by the agitation method (P < .001). In the closed systems, EDDY and ultrasonic agitation achieved the significantly (P < .05) best cleaning of the isthmus. In the open systems, ultrasonic agitation showed the single best result (P < .05). EDDY caused by far the highest and ultrasonic agitation the lowest dissolution of the gelatin in the simulated periapical lesion. ConclusionsUnder the conditions of this study, ultrasonic agitation of a previously administered sodium hypochlorite irrigant was more laterally targeted and thus safer and more effective than sonic agitation methods.

Microbiological evaluation of the disinfection of the root canal system using different irrigation protocol – An interventional study

ABSTRACT Aim: The focus of the present research is to analyze the potential role of irrigants along with the activation system in the disinfection of the root canal space. Methods: Ninety root canals were randomly divided into two experimental groups based on the irrigants: Group I (n = 45) – Sodium hypochlorite irrigant and Group II (n = 45) –Chlorhexidine irrigant. The two groups are further subdivided into three subgroups base on the activation devices, i.e., passive ultrasonic irrigation, endoactivator, and laser. The first sample as a baseline, and the second sample was collected after the disinfection procedure. All the samples were streaked in brain − heart infusion agar plate to analyze the bacterial colony growth. The confirmatory analysis for the presence of Enterococcus faecalis was done using gram staining, biochemical analysis, and polymerase chain reaction. The nonparametric analysis was done using Kruskal–Wallis, Mann–Whitney U, and Wilcoxon signed-rank test and P &lt; 0.05 was considered to be statistically significant. Results: The mean colony-forming unit was significantly reduced and there exhibited a statistically significant difference in pretreatment and posttreatment irrigated with sodium hypochlorite and chlorhexidine activated with passive ultrasonic activation with (P = 0.001), endoactivator with (P = 0.001), and laser with (P = 0.001). Conclusion: In consideration with advantage of the properties of both irrigants, the present study concludes a combined use with sodium hypochlorite during instrumentation followed by laser activation and a final rinse with chlorhexidine for a better eradication of the microbes from the root canal system thus preventing re-infection.

Advances in the Role of Sodium Hypochlorite Irrigant in Chemical Preparation of Root Canal Treatment.

Irrigation of root canal system is of great significance to the success of endodontic treatment, where sodium hypochlorite (NaOCl) is the most widely used irrigant in chemical preparation. NaOCl functions by eliminating bacterial biofilms and dissolving organic tissue, which may vary according to several factors such as the microbiology of root canal infection and the concentration of the irrigant. It has been proposed that the effectiveness of NaOCl could be enhanced via several methods, including heating the irrigant, applying in conjunction with certain reagents, or activating by agitation techniques. Despite its antibacterial and tissue-dissolving capacities, NaOCl should be used with caution to avoid detrimental effect due to its cytotoxicity and negative effect on dentin properties. In this narrative review, we discussed the factors that affect the properties of NaOCl, the methods to improve its efficacy, and the side effects that might occur in clinical practice.

Identifying The Superior Root Canal Irrigant Between Hydrogen Peroxide And Sodium Hypochlorite In Post Endodontic Pain Management

Place of Study: THQ Thal Hospital LayyahStudy Design: Randomized control trialDuration of Study: January 2022 to July 2022Methodology: 104 subjects were selected by non-probability non purposive sampling technique. Informed consent was taken from the patients and they were randomly allocated to 2 study groups i.e. Group A (Sodium Hypochlorite) and Group B (Hydrogen Peroxide). Mechanical preparation of root canals for the lower first molar was done in the first appointment. In Group A, a 2.5 % Sodium Hypochlorite (NaOCl) irrigant was used, while in Group B, a 3% Hydrogen Peroxide (H O ) irrigant was used. 2 The patients were followed up after 10 days. The frequency of endodontic pain on the follow-up visit was evaluated by Visual Analogue Scale (VAS). Statistical Package for Social Science (version 23.0) (SPSS) was used to analyze the data. The frequency of endodontic pain was compared between the study arms with a chi-square test.Results: A total of 104 participants were placed into 2 groups, 52 cases in each group. 56/104 (54.30%) were males while 48/104 (45.70%) were females. In Group “A” endodontic pain on 10-day follow-up visit was present in 18/52 (34.6%) patients, while in Group “B” endodontic pain on 10-day follow-up visits were present in 35/52 (68%) patients. By using the chi-square test it was observed that there was a significant association between groups and the presence of endodontic pain having p-value = 0.001Conclusion: Sodium Hypochlorite was much better than Hydrogen Peroxide in the management of endodontic pain in terms of incidence.

Effects of Calcium Hydroxide Paste in Different Vehicles on Bacterial Reduction during Treatment of Teeth with Apical Periodontitis

IntroductionThis clinical study evaluated the antibacterial effects of calcium hydroxide associated with different vehicles during the treatment of infected teeth with apical periodontitis. MethodsBacteriologic samples were taken from 90 necrotic root canals of teeth with apical periodontitis before (S1) and after preparation with a rotary nickel-titanium instrument system and 2.5% sodium hypochlorite irrigation (S2). The teeth were distributed in 3 groups according to the intracanal medication used, which consisted of a calcium hydroxide paste in glycerin, camphorated paramonochlorophenol/glycerin (CHPG), or 2% chlorhexidine for 1 week, and then another sample was taken (S3). The frequency of bacteria-positive cases and the reduction of bacterial counts were evaluated by quantitative real-time polymerase chain reaction. ResultsSubstantial intracanal bacterial reduction was observed after preparation in the 3 groups (P < .001). After calcium hydroxide paste in glycerin medication, the number of bacteria-positive cases decreased from 20/29 (69%) to 17/29 (59%); however, the mean bacterial counts increased 8.4% from S2 to S3. Medication with CHPG reduced the number of bacteria-positive cases from 17/29 (59%) to 15/29 (52%), with a significant mean S2–S3 reduction of 71% (P < .05). In the chlorhexidine group, the number of bacteria-positive cases decreased from 21/30 (70%) to 17/30 (57%) after medication, with a mean S2–S3 reduction of 55%, which, however, was not statistically significant (P > .05). Intergroup comparisons showed no significant differences (P > .05). ConclusionComparison between the 3 calcium hydroxide pastes showed no significant differences in antibacterial effectiveness in the main root canal. However, only the CHPG paste showed a significant reduction in bacterial counts when postpreparation and postmedication samples were compared.

Knowledge of Female Dental Students of KKU Regarding Pulp Revascularization Treatment

Aim: To assess the knowledge of female dental students of KKU about pulp revascularization procedure. Methods: A self-administered questionnaire was distributed to female students of 5th and 6th year and to dental interns. Collected data were analysed with descriptive statistics using SPSS (V19). Results: 137 contributors filled the proforma. Highest percentage of students (35%) considered pulp revascularization as the best treatment for immature necrotic permanent teeth in terms of tooth survival and 45.3% believed to have strongest tooth structure with this procedure as compared to other options. 68.6% of the participants had never attempted this procedure. 53.3% of the students were not sure about the outcome of the treatment. Only 31.4% of the students were aware of need of post and core as a contraindication forprocedure. 52.6% participants chose the option of little instrumentation with sodium hypochlorite irrigation for canal cleaning and 27.7% considered CaOH as a best intracanal medicament. According to majority of students (44.5%) continued root development with absence of signs and symptoms were the best indications of successful treatment. Conclusion: Majority of the students had the knowledge of regenerative endodontics as a viable treatment option for immature permanent teeth with necrotic pulps but were unaware of the details of the procedure and case selection criterion. Students should be given detailed clinical knowledge of this procedure so that in their future clinical practice they consider it among other options either for treatment or do case selection for referrals to specialists. Keywords: pulp revascularization; knowledge; dental students.

EVALUATION OF THE DENTINAL TUBULE PENETRATION OF AN ENDODONTIC BIOCERAMIC SEALER AFTER THREE FINAL IRRIGATION PROTOCOLS

Introduction: This study aimed to evaluate the dentinal tubule penetration of an endodontic bioceramic sealer, Sealer Plus BC, after three final irrigation protocols. Methods: Thirty distobuccal roots of maxillary molars were selected. Root canal preparation was performed up to an #40.06 instrument (X1 Blue) under 2.5% sodium hypochlorite irrigation. Specimens were randomly divided into three groups (n=10), according to the final irrigation protocol: G-NaOCl (2.5% sodium hypochlorite + PUI), G-SS (0.9% saline solution + PUI) and G-H20 (Deionized water + PUI). After final irrigation protocols, all specimens were irrigated with phosphate buffer solution. Root canal obturation was performed using the single cone technique and Sealer Plus BC, stained with a specific fluorophore. Specimens were transversely sectioned and each root third was evaluated in a confocal scanning laser microscopy. Images obtained were analyzed for sealer penetration in the dentinal tubules. Results: Dentinal tubule penetration of Sealer Plus BC was not observed in any root third, regardless of the final irrigation protocol investigated. Conclusions: Sealer Plus BC dentinal tubule penetration was not observed after none of the protocols tested. Dentinal tubule penetrability of Sealer Plus BC may be related to other factors rather than the final irrigation protocol.

Dentists' Knowledge, Practices, and Mishaps in Relation to Post Placement for Endodontically Treated Teeth

Background: When restoring teeth, the post and core method is often employed. Unfortunately, several reports of endodontically treated teeth failing after placement of this material exist. Objective: The purpose of this research is to determine whether or not dentists have a thorough understanding of the causes of post and core failure. The goal is to evaluate patient outcomes following post coronal restoration procedures, such as post space preparation, post placement, and post final coronal restoration. Methodology: The quantitative methodology has informed a cross-sectional study design. One hundred dentists were chosen at random to fill out the questionnaire, which was then examined statistically. Results: Sodium hypochlorite irrigation, rubber dams, mineral trioxide aggregate management, and follow-up were all mentioned in the findings. Further, it was demonstrated that factors such as tooth size, tooth type, repair time, and repair material all play a role in whether or not a restorative tooth fails. Conclusion: According to the results, the study population had varying degrees of understanding of the post- and core-restorative system. Guidelines should be established to improve restorative practices and expand understanding. Likewise, this aids in avoiding any accidents that could arise as a result of the same causes.