ABSTRACT
RESUMEN: La irrigación del sistema de conductos radiculares con soluciones antibacterianas es considerada una parte esencial de la preparación químico-mecánica. Varios factores influyen en la eficacia de la irrigación del conducto radicular, incluyendo tamaño de la preparación apical y ensanchamiento, distancia de penetración de la aguja con respecto al ápice, flujo y volumen de sustancia de irrigante, dimensión de las agujas y la presencia de curvatura del conducto radicular. El tamaño de la preparación apical y la conicidad afectan el recambio del irrigante, el esfuerzo de corte en las paredes del conducto radicular y la presión en el foramen apical. La colocación de la punta de la aguja más cerca del ápice, permite un recambio de la solución más eficiente, resultando una mejor limpieza y desinfección del conducto radicular. La velocidad del irrigante, al lado de la aguja, en las paredes del conducto opuestas y frente a la salida de la aguja es dependiente del diseño de la aguja. El patrón de flujo y recambio del irrigante de las agujas con extremo abierto es diferente al de las agujas cerradas y las que logran mejor recambio de irrigante en la parte apical del conducto radicular también conducen a un aumento de la presión media en el foramen apical, lo que indica un mayor riesgo de extrusión del irrigante hacia el tejido periapical. El objetivo de esta revisión a la literatura, es evaluar los diferentes diseños de agujas y su influencia en la irrigación del sistema de conductos radiculares.
ABSTRACT: Root canal irrigation with antibacterial solutions is considered an essential part of the chemical-mechanical preparation. Several factors influence the efficacy of root canal irrigation, including apical preparation size and taper, needle penetration distance from the apex, flow and volume of irrigant substance, dimension of the needles and the presence of curvature of the root canal. The apical preparation size and the taper affect irrigant replacement, shear stress on the root canal walls, and pressure on the apical foramen. Placing the tip of the needle closer to the apex, allows more efficient solution exchange, resulting in better cleaning and disinfection of the root canal. The velocity of the irrigant, next to the needle, on the opposite canal walls and in front of the needle outlet is dependent on the design of the needle. The flow and irrigant replacement pattern of open ended needles is different from needles with closed tip. The needles that achieve better irrigant exchange in the apical part of the root canal also lead to an increase in mean pressure in the apical foramen which indicates a greater risk of extrusion of the irrigant into the periapical tissue. The objective of this literature review is to evaluate the different needle designs and their influence on the root canal system irrigation.
ABSTRACT
Objective@#To compare the efficacy of different methods in the removal of calcium hydroxide from root canals and to provide a reference for clinical treatment. @*Methods@# A total of 160 extracted single-rooted mandibular premolars were instrumented up to ProTaper Universal F4. The roots were split longitudinally, and standardized groove and depression models were prepared and filled with calcium hydroxide. The samples were randomly divided into 4 groups (n=40) according to different irrigation methods: syringe needle irrigation, passive ultrasonic irrigation, XP-endo finisher (XPF) irrigation, and M3-Max irrigation. Each group was then divided into 2 subgroups (n=20) according to the irrigation protocol: NaOCl and NaOCl+EDTA. Photos of grooves and depressions were taken under a microscope after irrigation, and the residual calcium hydroxide was scored to compare the removal effects of different irritation methods and solutions.@*Results@#In the groove and depression model, when sodium hypochlorite is used as the irrigation fluid, ultrasound irrigation, XPF and M3-Max are better than syringe needle irrigation in removing calcium hydroxide (P < 0.05); when sodium hypochlorite combined with EDTA flushing, the effect of removing calcium hydroxide with ultrasound irrigation, XPF and M3-Max is better than that of syringe needle irrigation (P < 0.05); but there is no statistically significant difference between ultrasound, XPF and M3-Max (P > 0.05); when compared with the use of sodium hypochlorite, the combined use of EDTA irrigation could enhance the effect of ultrasonic irrigation, XPF and M3 Max on the removal of calcium hydroxide (P < 0.05), but there was no significant improvement in the syringe needle irrigation group (P > 0.05). @*Conclusion @#Sodium hypochlorite combined with EDTA can enhance the effect of ultrasonic irrigation, XPF and M3 Max on the removal of calcium hydroxide, and there is no significant difference among these approaches, which are more effective than syringe needle irrigation.
ABSTRACT
Septic arthritis of the hip is rarely caused by Mycoplasma hominis. It rarely develops in a patient during the postpartum period. However, delayed treatment of septic arthritis of the hip may lead to serious sequelae; therefore, it is important for clinicians not to overlook patients with the disease. This case illustrates the clinical steps in diagnosis and treatment of M. hominis septic arthritis of the hip.