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

AIM: 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. MATERIALS AND METHODS: 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. RESULTS: 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). CONCLUSION: 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. CLINICAL SIGNIFICANCE: 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.

Effect of continuous vs sequential chelation on the mechanical properties of root dentin: An ex vivo study.

OBJECTIVES: To evaluate the mechanical properties of root canal dentin treated with sodium hypochlorite (NaOCl) in combination with hydroxyethylidene diphosphonic acid (HEDP) or ethylenediaminetetraacetic acid (EDTA). METHODS: For testing fracture resistance, 45 single-rooted teeth were instrumented and irrigated with NaOCl/HEDP, NaOCl/EDTA, or distilled water. Fifteen untreated teeth served as control. After obturation, specimens from the experimental groups were thermocycled, dynamically-loaded, and then statically-loaded in a universal testing machine until failure. For flexural strength analysis, 15 teeth were instrumented and irrigated with NaOCl/HEDP or NaOCl/EDTA. Root segments were sectioned into dentin bars and tested for flexural strength using a universal testing machine. For microhardness evaluation, 20 teeth were instrumented and irrigated with NaOCl/HEDP or NaOCl/EDTA. Dentin disks from the coronal-third of each root segment were prepared, one before and one after irrigation, for microhardness testing with a Knoop hardness tester. RESULTS: The highest fracture resistance was recorded in the untreated group, and the lowest in the EDTA group. Although the HEDP group had higher fracture resistance than the EDTA group, the distilled water group demonstrated even greater fracture resistance than the HEDP group. Specimens treated with HEDP had significantly higher flexural strength and microhardness values when compared with those treated with EDTA. CONCLUSION: The fracture resistance, flexural strength, and microhardness of root canal dentin were higher when root canals were irrigated with NaOCl/HEDP, when compared with NaOCl/EDTA. CLINICAL SIGNIFICANCE: Irrigating root canals with NaOCl combined with HEDP significantly improves the mechanical integrity of root canal dentin compared to the use of NaOCl with EDTA.

Comparative clinical outcomes of irrigation techniques in burr-hole craniostomy for chronic subdural hemorrhage: a multicenter cohort study.

BACKGROUND: Chronic Subdural Hemorrhage(cSDH) is often treated with surgical blood drainage, but concerns about recurrence and outcomes persist. Surgical techniques, including irrigation, vary. This study compares the outcomes of irrigation in cSDH surgery. MATERIALS AND METHODS: From September 2020 to September 2022, 92 cSDH patients underwent surgery. Two different irrigation methods were used: extensive irrigation (IG) and non-irrigation (NIG). Method of irrigation was selected by each surgeon's preference. Parameters measured included volume of hematoma changes, midline shifting, complications, and basic demographics. Recurrence was defined as symptomatic or hematoma expansion more than double the volume before surgery. Factors predicting recurrence and irrigation method impact were analyzed. RESULTS: Eleven patients were excluded because of bilateral or related to other disease. We analyzed 81 patients (44 NIG, 37 IG). Recurrence occurred in 6 IG cases (16.2%) and 1 NIG case (2.3%). Irrigation method significantly affected recurrence (P = 0.043). Age, gender, medication, medical history, and preoperative measurements had no major impact on recurrence. NIG had unexpected cases of intracerebral hemorrhage. CONCLUSION: Extensive irrigation may increase recurrence in cSDH drainage. Non-irrigation drainage had fewer recurrences, but unexpected complications arose. Careful drainage in non-irrigated cases is crucial.

Outcomes of early versus late irrigation and debridement of pediatric open long bone fractures.

BACKGROUND: Open long bone fractures are a major concern for pediatric patients due to the risk of surgical site infection (SSI). Early studies have recommended irrigation and debridement of open fractures within 6 hours-8 hours for the prevention of SSI. According to the American College of Surgeons (ACS) Best Practice Guidelines, in 2015, irrigation and debridement should be done within 24 hours. AIM: To identify whether early irrigation and debridement, within 8 hours, vs late, between 8 hours and 24 hours, for pediatric open long bone fractures impacts rate of SSI. METHODS: Using retrospective data review from the National Trauma Data Bank, Trauma Quality Improvement Project (TQIP) of 2019. TQIP database is own by the ACS and it is the largest database for trauma quality program in the world. Propensity matching analysis was performed for the study. RESULTS: There were 390 pediatric patients with open long bone fractures who were included in the study. After completing propensity score matching, we had 176 patients in each category, irrigation and debridement within 8 hours and irrigation and debridement between 8 hours and 24 hours. We found no significant differences between each group for the rate of deep SSI which was 0.6% for patients who received surgical irrigation and debridement within 8 hours and 1.1% for those who received it after 8 hours [adjusted odd ratio (AOR): 0.5, 95%CI: 0.268-30.909, P > 0.99]. For the secondary outcomes studied, in terms of length of hospital stay, patients who received irrigation and debridement within 8 hours stayed for an average of 3.5 days, and those who received it after 8 hours stayed for an average of 3 days, with no significant difference found, and there were also no significant differences found between the discharge dispositions of the patients. CONCLUSION: Our findings support the recommendation for managing open long bone fractures from the ACS: Complete surgical irrigation and debridement within 24 hours.

Effect of the Irrigation Agitation Technique on Postoperative Pain in Teeth With Symptomatic Irreversible Pulpitis.

Introduction Irrigation of the root canal system is a vital step in endodontic treatment aimed at disinfecting the canal. The efficacy of irrigation can be improved by various irrigation agitation methods. One such novel method of interest is the manual dynamic agitation (MDA) technique. However, the effect of MDA on postoperative pain as compared to needle irrigation (NI) with sodium hypochlorite has been scarcely explored. This study aimed to compare the effects of NI and MDA techniques on postoperative pain in teeth with symptomatic irreversible pulpitis. Materials and methods This quasi-experimental study was conducted at the Department of Operative and Paediatric Dentistry, Fauji Foundation Dental Hospital, over four months after gaining ethical approval. One hundred and sixty-eight participants diagnosed with symptomatic irreversible pulpitis were enrolled in the study through the purposive sampling technique. The participants were divided into two groups based on the irrigation technique used: Group A (NI) and Group B (MDA). Postoperative pain was recorded after six hours, 24 hours, 48 hours, and seven days using the 0-100mm visual analog scale (VAS). The VAS scores were compared using an independent sample t-test. Results Out of 168 participants, 48.2% were in Group A and 51.2% in Group B. The study found that VAS pain scores for Group B (MDA) were significantly lower at six hours, 24 hours, 48 hours, and seven days as compared to Group A (NI), with a p-value less than 0.001. Conclusion This study shows that the MDA technique leads to decreased postoperative pain both immediately after endodontic treatment and a week later as compared to the NI technique. Hence, the use of MDA can aid in controlling postendodontic pain and, therefore, ensure smoother recovery and increased patient satisfaction.

Transanal irrigation: best practice in the community.

Chronic constipation, which is common and often difficult to treat, has numerous origins, including neurological and other conditions, and adverse reactions to drugs, especially opioids. Chronic functional constipation lacks a clear underlying cause. Increasing evidence suggests that transanal irrigation (TAI) aids faecal evacuation and is well tolerated in many people with bowel dysfunction who do not adequately respond to first-line treatments. Recent papers offer insights that help nurses and other healthcare professionals implement best practice in the community, including discussing any need for assistance before starting TAI, agreeing the most appropriate device with patients and optimising the irrigation protocol. Training, careful follow-up and ongoing supervision improve adherence and success. Further studies are needed, however, and patients who do not respond adequately or are unable to tolerate TAI should be referred to a specialist service.

Irrigation method matters: Contamination and die-off rates of Escherichia coli on dry bulb onions after overhead and drip irrigation in Washington State (2022-2023).

Two U.S. outbreaks of salmonellosis in 2020 and 2021 were epidemiologically linked to red onions. The 2020 outbreak investigation implicated production agricultural water as a likely contamination source. Field trials were designed to investigate prevalence and survival of Escherichia coli (surrogate for Salmonella) on dry bulb onions after application of contaminated irrigation water at the end of the growing period. Irrigation water was inoculated at 3 log most probable number (MPN)/100 mL (2022 and 2023) or 5 log MPN/100 mL (2023, drip only) with a cocktail of rifampin-resistant E. coli and applied with the final irrigation (0.4 acre-inch/0.4 hectare-cm) to onions. Onion bulbs (40 or 80) were sampled immediately after irrigation and throughout field curing (4 weeks) and E. coli was enumerated using a MPN method. For drip irrigation, at 3 log MPN/100 mL E. coli was detected on 13% of onions at 24 h but not detected at 0 h; at 5 log MPN/100 mL for drip irrigation applied to saturated soil, E. coli was detected in 63% of onions at 0 h. Prevalence significantly (P<0.05), decreased after 7 d of curing with cell densities of 1-1,400 MPN/onion. At the end of field curing in 2023, 1/80 onions had detectable E. coli (2.04 MPN/onion). E. coli was detected in a significantly smaller percentage of onions (2022: 13%; 2023: 68%) after a contaminated drip irrigation event compared to overhead irrigation (98-100%; P<0.05). After overhead irrigation E. coli was detected in onions (1-1,000 MPN/onion) on day 0. Prevalence decreased significantly (P <0.05) after 7 d of field curing in both years (2022: 15%; 2023: 7%). E. coli was not detected on Calibra onions (80/year) at the end of field curing in either year but was detected at <12 MPN/onion in 2.5-3.75% of onions (n=80) for other cultivars. These data confirm limited contamination risk associated with drip irrigation water quality and begin to quantify contamination risks associated with overhead irrigation of dry bulb onions.

Deficit irrigation of reclaimed water relieves oat drought stress while controlling the risk of PAEs pollution in microplastics-polluted soil.

Reclaimed water irrigation has emerged as a critical alternative in agricultural regions facing water scarcity. However, soil pollution with microplastics (MPs) greatly increases the exposure risk and toxic effects of reclaimed water contaminations, such as phthalate esters (PAEs). A field experiment consisting of soil column pots evaluated the feasibility of using PAEs-contaminated water to irrigate oats (Avena sativa L.) in drought seasons. Three irrigation regimens based on soil matric potential thresholds (-10 kPa, -30 kPa, -50 kPa) explored the impact of PAE-contaminated water on oat physiology and environmental pollution in soil with and without MPs contamination. The results showed that treating oats at the SMP of -30 kPa boosted shoot biomass by 3.1%-14.0% compared to the drought condition at -50 kPa, and the root biomass of oats was significantly increased. The physiological metrics of oats indicated that irrigation at -50 kPa induced drought stress and oxidative damage in oats, particularly during the milk stage. Different irrigation treatments influenced the accumulation of PAEs in plants, soil, and leachate. The ratios of leachate to irrigation water in -10 kPa treatment with and without MPs addition were 1.18% and 4.48%, respectively, which aggravated the accumulation of pollutants in deep soil layers and may cause groundwater pollution. MPs pollution in soil increased the content of PAEs in the harvested oats and reduced the transport and accumulation of PAEs in deep soil layers (20-50 cm) and leachate. The coupling of PAEs in irrigation water with soil MPs pollution may exacerbate plant damage. However, the damage can be minimized under the scheduled irrigation at -30 kPa which could balance crop yield and potential risks.

Detour canal, a civil engineering heritage created through historical struggle for water resources, now provides the habitats for a rare freshwater fish.

The Ariake catfish, Tachysurusaurantiacus, is a freshwater fish endemic to Kyushu Island, Japan. However, these catfish are now endangered owing to environmental changes. Despite their status, there is scant quantitative research on the Ariake catfish regarding their potential conservation. The Yabe River is a typical catfish habitat situated in the northern part of Kyushu Island (Ariake Area) and has a unique civil engineering heritage, as represented by the so-called 'detour canal'. The canals were created owing to competition by two Domains to divert additional water resources into their own territory for rice cultivation during the Edo Period (1603-1867). To fill the research gap on the Ariake catfish and assess the ecological value of detour canals, in this study, we conducted a survey of local catfish populations and nine environmental parameters that can affect them. We found that the population volume of the Ariake catfish was significantly higher in canals than in ordinary branch rivers. Although the detour canals were not originally constructed for biodiversity conservation, they nonetheless unintentionally provide catfish habitat at present. As these canals represent a remarkable example of a contribution by a civil engineering heritage structure to biodiversity conservation, our study should be used as a potential justification for preserving the canals, as well as conserving the aquatic species that utilise them as vital habitat.

Estimation of irrigated crop artificial irrigation evapotranspiration in China.

Agriculture water use accounts for 70% of the total water withdrawal worldwide. The evapotranspiration during crop growth is one of the important hydrological processes in the agricultural water cycle. This study proposed the concept of artificial irrigation evapotranspiration of irrigated crops to describe that the evapotranspiration caused by irrigation water use. Irrigated crops rely on two kinds of water sources: precipitation and irrigation water. With the construction of irrigation schemes, the artificial irrigation evapotranspiration plays an increasingly important role in the dualistic water cycle system of irrigated cropland. To reveal the amount of artificial irrigation evapotranspiration of 17 categories of irrigated crops in China, this study proposed a new quantitative model system which was established based on traditional evapotranspiration models and soil water balance models. Based on the new model system, we calculated the annual artificial irrigation evapotranspiration of irrigated crops for the period 2013 to 2017 in China. The results showed that the proportion of artificial irrigation evapotranspiration to the total evapotranspiration of irrigated crops was 41.3%, whose value was 228.1 km3 a-1. The artificial irrigation evapotranspiration in different agricultural water management regions were 90.0 km3 a-1 in the northeast region, 86.0 km3 a-1 in the southeast region, and relatively low 52.2 km3a-1 in the west region. The results of this study can provide methods for water management and policy-making in agricultural irrigated areas, and it can also provide a preliminary understanding of the influence of human activities on the dualistic water cycle in cropland.

In Vitro Cone Beam CT Analysis of the Efficacy of Three Supplementary Steps In the Removal of Obturation Material in Endodontic Retreatment.

OBJECTIVES: To evaluate and compare the efficacy of XP-endo Finisher R (FKG Dentaire, Le Locle, Neuchatel, Switzerland), EDDY (VDW Dental, Munich, Germany), and passive ultrasonic irrigation (PUI) as supplementary steps following the D-RaCe retreatment file system (FKG Dentaire) in the removal of root canal obturation material using cone beam CT. MATERIALS AND METHODS: A total of 45 two-rooted permanent maxillary first premolars were selected. Following access preparation, cleaning, and shaping with Hero Shaper (Micro Mega, Besançon, BFC, France) rotary file up to 25/04%, thermoplasticized obturation was performed with TotalFill BC sealer (FKG Dentaire) and gutta-percha. The specimens were subjected to routine retreatment using the D-RaCe retreatment file system. Cone beam computed tomography (CBCT) and volumetric analysis were performed before and after this procedure. The samples were divided into group A (XP-endo Finisher R: n=15), group B (EDDY: n=15), and group C (PUI: n=15). Finally, a third CBCT was taken and a volumetric analysis was done. Statistical analysis was done using SPSS Statistics version 26.0 (IBM Corp., Armonk, NY, USA). RESULTS: The lowest mean residual volume of obturation material was seen with XP-endo Finisher R (1.6 mm3), followed by PUI (1.7 mm3). The EDDY showed the least efficiency in complete debridement of the root canals (3.6 mm3). This difference in values was statistically significant. CONCLUSION: The XP-endo Finisher R and PUI showed superior performance than EDDY in the removal of remaining obturation material from the root canal system after retreatment with the D-RaCe retreatment file system. However, none of the systems were able to completely remove the root canal obturation materials.

The impact of siphoning effect on renal pelvis pressure during ureteroscopy using an in vitro kidney and ureter model.

PURPOSE: To experimentally measure renal pelvis pressure (PRP) in an ureteroscopic model when applying a simple hydrodynamic principle, the siphoning effect. METHODS: A 9.5Fr disposable ureteroscope was inserted into a silicone kidney-ureter model with its tip positioned at the renal pelvis. Irrigation was delivered through the ureteroscope at 100 cm above the renal pelvis. A Y-shaped adapter was fitted onto the model's renal pelvis port, accommodating a pressure sensor and a 4 Fr ureteral access catheter (UAC) through each limb. The drainage flowrate through the UAC tip was measured for 60 s each run. The distal tip of the UAC was placed at various heights below or above the center of the renal pelvis to create a siphoning effect. All trials were performed in triplicate for two lengths of 4Fr UACs: 100 cm and 70 cm (modified from 100 cm). RESULTS: PRP was linearly dependent on the height difference from the center of the renal pelvis to the UAC tip for both tested UAC lengths. In our experimental setting, PRP can be reduced by 10 cmH20 simply by lowering the distal tip of a 4 Fr 70 cm UAC positioned alongside the ureteroscope by 19.7 cm. When using a 4 Fr 100 cm UAC, PRP can drop 10 cmH20 by lowering the distal tip of the UAC 23.3 cm below the level of the renal pelvis. CONCLUSION: Implementing the siphoning effect for managing PRP during ureteroscopy could potentially enhance safety and effectiveness.

Is SWEEPS better than PUI in reducing intracanal bacteria and inflammation in cases of apical periodontitis?

To evaluate the efficacy of SWEEPS mode of the Er: YAG laser(SL) and passive ultrasonic irrigation(PUI) in the eradication of microorganisms and in the inflammation detection by IL-1ß. Thirty patients with chronic apical periodontitis(AP) were allocated into two groups: Group SL-SWEEPS laser activated irrigation(n = 15) and Group PUI-passive ultrasonic irrigation(n = 15). Bacteriological samples were taken before(S1) and after chemomechanical preparation(S2), and then after final irrigation activation(S3). The levels of total bacteria and Streptococci were measured by means of PCR. Blood samples were collected before and 3rd day after treatment. Enzyme-linked immunosorbent assay was used to measure the levels of IL-1ß. The bacterial reduction showed no differences between groups after chemo-mechanical treatment and after irrigant activation(p = 0.590). Post-treatment IL-1ß levels were lower than pretreatment levels in both groups(p < 0.001). SL or PUI application in addition to chemomechanical preparation has similar effects on total bacterial level and inflammation detected by IL-1ß in patients with AP.

Tracking and managing the water-food-environment-ecosystem (WFEE) nexus in groundwater irrigation districts using system dynamics modelling.

Groundwater irrigation districts, which play a crucial role in the Earth's critical zone, are confronted with numerous challenges, including water scarcity, pollution, and ecological degradation. These issues come from multiple systems and are linked to a groundwater-dominated water-food-environment-ecosystem nexus problem related to agricultural activities (WFEE). There is a pressing need for the scientific characterization and evaluation of the WFEE nexus in groundwater irrigation districts to assure high-quality, sustainable development. Furthermore, it is critical to provide practical and efficient regulations at the farmer level to uphold the health of this nexus. This paper presents a mapping network that focuses on groundwater irrigation districts. The network aims to convert the restriction indicators utilized to maintain the health of the WFEE nexus (at the irrigation district scale) into the targets employed to manage farmers' living and agricultural activities (at the farmer scale). Additionally, a system dynamics model is created to track and manage the interacting relationships between the WFEE nexus and farmers' living and agricultural activities. This proposed model employs a structured parameter system comprising targets, state parameters, regulatory parameters, and evaluation parameters. This system can get insight into the status of the WFEE nexus at the farmer level using state parameters, induce tailored management and regulation measures using regulatory parameters, assess the effectiveness of various measures using the evaluation parameters, and finally provide decision support to enhance the health of the WFEE nexus. The findings from the research conducted in the Yong'an groundwater irrigation district demonstrated that the model accurately described the relationship between the WFEE nexus and farmers' activities in groundwater irrigation districts. Furthermore, the model responded strongly to a variety of improvement strategies, including adjustments in planting area, optimization of planting pattern, improvement of irrigation method, and implementation of agronomic measures. As a result, it provided farmers with decision support for applying agricultural management methods and addressing the WFEE nexus problem in groundwater irrigation areas.

Transfer of heavy metals from soil to vegetables: A comparative assessment of different irrigation water sources.

This study aimed to assess the transfer factor (TF) of heavy metals (HMs) from soil to commonly consumed vegetables irrigated with different water sources. The field study covered 36 m2 of agricultural land in Kermanshah province, Iran, divided into nine equal-sized plots. Coriander, basil, and radish were the three types of vegetables cultivated and subjected to irrigation over two months, utilizing three different water sources: treated wastewater effluent (TWE), river water (RW), and well water + nitrogen fertilizer (WWF). After the irrigation and harvesting stages, soil samples from the cultivation area and harvested vegetables were collected. These samples underwent analysis using the ICP-OES method to assess HM levels and subsequent calculation of the TF of HMs from soil to plants. The results revealed that the TF levels indicated plants' relatively weak response (TF < 1) to the absorption of HMs. For non-toxic elements (Mn, Fe, Zn, Cu, Ni), TF values were generally higher than those for toxic elements (Cd, As, Pb) across all three vegetable types and irrigation treatments. The study's findings suggest that the TF of HMs in the studied vegetables varied based on the irrigation source and vegetable type. Various factors, including the type of irrigation source and vegetable, influenced the TF of HMs, each having different impacts on the transfer rate of each HM. The study highlights the importance of monitoring irrigation water and soil quality to prevent the accumulation of HMs in cultivated vegetables, thereby mitigating potential risks to human health.

A promising approach utilising photothermal energy to disinfect the root canal system: An in vitro investigation.

This study aimed to assess root canal disinfection through various irrigation protocols, including a novel photothermal system called 'LEAP'. Mandibular premolars were infected with Enterococcus faecalis and divided into five groups for different treatments: Group 1: standard needle irrigation; Group 2: passive ultrasonic irrigation; Group 3: GentleWave; Group 4: LEAP; and Group 5: Group 1 + Group 4. Microbial counts were measured before (S1) and after disinfection (S2) using colony-forming units (CFU) and confocal laser scanning microscopy (CLSM). Results revealed a significant reduction in bacterial counts for all groups (p < 0.05). While the percentage of dead bacteria near the canal wall (0-50 µm) did not differ significantly, at 50-150 µm, LEAP and SNI + LEAP exhibited significantly higher bacterial reduction than other groups (p < 0.05). The findings indicate that LEAP is comparable to existing irrigation devices in the main root canal and notably superior in tubular disinfection.

Effects of antiseptic irrigation solutions on osseointegration in a cementless tibial implantation mouse model.

Despite the success of standard antiseptic irrigation solutions in reducing periprosthetic joint infection (PJI) rates, there is still a need for more effective solutions. Synergistic use of povidone-iodine (PI) and hydrogen peroxide (H2O2) has shown promising results; however, the optimal solution concentration balancing bactericidal activity and osseointegration remains unknown. This study aims to evaluate the impact of these antiseptic irrigation solutions on osseointegration and the bone-implant interface strength in vivo. Forty C57BL/6 mice underwent bilateral tibial implantation surgery and were randomly allocated into three groups receiving 0.3% PI, 10% PI mixed with 3% H2O2, or saline as irrigation solutions intraoperatively. Assessments were performed on postoperative Days 1 and 28, including plain radiographs, microcomputed tomography (microCT) evaluation, histological analysis, immunohistochemistry, and biomechanical pull-out testing. No wound complications were observed. MicroCT scans revealed no differences in peri-implant trabecular bone parameters. Biomechanical pull-out testing showed no differences in the bone-implant interface strength across groups. Histological analysis indicated no differences in bone and bone marrow percentage areas among treatment groups. Immunohistochemical analysis demonstrated no differences among groups in peri-implant osteocalcin, osterix, or endomucin-positive cells. In conclusion, using either antiseptic irrigation solution showed no differences in osseointegration parameters compared to the control group, demonstrating safety and the absence of toxicity. CLINICAL RELEVANCE: Dilute 0.3% povidone-iodine and a 1:1 combination of 10% povidone-iodine mixed with 3% hydrogen peroxide can be safely used during primary and revision total joint arthroplasty without compromising osseointegration or causing wound complications.

Contribution of wastewater irrigated vegetables to the prevalence of soil-transmitted helminth infection among female farmers in Addis Ababa, Ethiopia.

BACKGROUND: Untreated or inadequately treated wastewater carrying human feces can host helminth eggs and larvae, contaminating the soil and plants that are irrigated with it. In Addis Ababa, farmers use untreated wastewater to grow vegetables; however, there are little data currently available published on vegetables' contribution to the prevalence of helminth among female farmers along the Akaki River, in Addis Ababa, Ethiopia. METHODS: A cross-sectional study was conducted in Addis Ababa City in February 2022. A stratified random sampling method was used to sample farming households. The sample size for each district was determined by a proportional allocation to the total number of households in the area. Two hundred and fifty-two composite vegetable samples and 101 farmers' stool samples were collected and analyzed for helminth prevalence. Data on socio-demographics were collected by trained data collators using a structured questionnaire. Kato-Katz concentration was used to detect STH from a stool sample. Stata version 14.0 was used to process the data. Poisson regression was used to identify the association between STH prevalence in the vegetable and the farm's stool. RESULTS: Helminths were found in 67.5% of vegetables sampled and 20.8% of female farmers' stools. Ascaris lumbricoides eggs (vegetable 48.4% and stool 9.9%) were identified in all analyzed samples. Hookworm eggs (vegetable 13.1% and stool 8.9%) and Trichuris trichiura eggs (vegetable 5.9% and stool 2%) were also isolated. The total number of helminth eggs present in wastewater-irrigated vegetables and female farmers' stool had a positive association (p < 0.05) with a regression coefficient of 1.92 (95% CI = 1.56-2.28). CONCLUSIONS: The study found a significant prevalence of helminth infections, particularly Ascaris lumbricoides, in stool and vegetable samples irrigated with wastewater. A clear association was found between vegetable production and a higher prevalence of helminth infections among female farmers. Therefore, it is important to ensure that farmers are educated in the importance of food washing and sanitation/hygiene practices when using wastewater irrigation for vegetable crops.

Perioperative Dyselectrolytemia in Patients Undergoing Transurethral Resection of the Prostate Using 0.9% Normal Saline Irrigation.

BACKGROUND: The choice of irrigation fluid used in transurethral resection of the prostate (TURP) has a significant impact on serum electrolyte levels. Among the many available options, 0.9% normal saline (NS) is considered to be more physiological. MATERIAL AND METHODS: This observational study was conducted on 60 adult males aged 50-70 years, classified as American Society of Anesthesiologists grade 1 and 2, undergoing TURP with 0.9% NS irrigation under spinal anesthesia achieved with a mixture of 0.5% heavy bupivacaine. The patients' hematocrit and serum electrolyte levels were obtained after six hours and compared with preoperative values. RESULTS: Hematocrit reduced from 40.32 ± 6.27 to 31.07 ± 5.40 (p < 0.001). Both serum sodium and potassium decreased from 136.77 ± 3.27 to 128.31 ± 5.91 and from 4.02 ± 0.26 to 3.81 ± 0.36, respectively (p < 0.001). However, serum chloride showed only a minimal increase from 101.58 ± 2.88 to 102.25 ± 1.66 (p < 0.12). CONCLUSION: Although the changes in serum sodium and potassium were statistically significant, they did not have any physiological consequences in our study. However, this emphasizes the importance of vigilant electrolyte monitoring to identify and mitigate the risk of electrolyte disturbances during TURP surgeries.

Effects of endodontic root canal irrigants on tooth dentin revealed by infrared spectroscopy: a systematic literature review.

BACKGROUND: Root canal irrigation endodontic solutions have effects on the chemistry of dentin. Infrared spectroscopy is a non-destructive chemical characterization method where the strength of absorption often correlates with mineral or organic composition. OBJECTIVES: To survey effects of commonly used irrigation solutions on the composition of root dentin as detected by widely-available Fourier transform infrared spectroscopy (FTIR) methods. METHODS: Electronic databases were searched for articles published between 1983 to 2023. After risk of bias assessments (OHAT), studies were grouped according to effects per irrigation solution. Inclusion criteria comprised in vitro studies that used extracted human or bovine teeth, treated by irrigation solutions characterized using FTIR spectroscopy and presenting spectral data. Publications that did not share FTIR spectra were excluded. RESULTS: A wide range of concentrations, durations, and methodologies have been tested but only 30 out of 3452 studies met our inclusion criteria. Different FTIR methods were used with the Attenuated Total Reflection (ATR) variant being the most common (21 studies). Investigated solutions included sodium hypochlorite (NaOCl), ethylenediaminetetraacetic-acid (EDTA), 1-hydroxyethylidene-1-1-diphosphonic-acid (HEDP), peracetic-acid (PAA), glycolic-acid (GA), and citric-acid (CA) though most focused on NaOCl and EDTA. All solutions had detectable effects on the FTIR signature of dentin. NaOCl mainly affects the organic signatures, revealing reduced amide/phosphate ratios with increasing concentrations. EDTA mainly effects the inorganic component, increasing with time and concentration, yet glycolic acid has stronger effects than EDTA on dentin. Beyond the type of irrigant and dentin exposure durations, concentration and protocol of application had strong effects. There is a lack of studies comparing similar irrigants under conditions that mimic clinical scenarios analyzing bulk sample because FTIR of powder dentin differs from bulk measurements. SIGNIFICANCE: The ideal root-canal irrigant should combine local disinfection properties with minimal compositional effects on healthy dentin. FTIR methods appear reliable to identify important changes in root dentin chemical composition. Such information can help understand when endodontic irrigation might lead to root degradation or possibly contribute to long term failures such as vertical fractures. Awareness of chemical damage from irrigation procedures may help clinicians select procedures that reduce deleterious effects on the root canal structures.