Efficacy of the photon-initiated photoacoustic streaming combined with different solutions on Enterococcus faecalis in the root canals.

This study aimed to evaluate the efficacy of different irrigation solutions used in photon-initiated photoacoustic streaming (PIPS) or conventional needle irrigation (CNI) for eradication of Enterococcus faecalis from artificial root canals. Altogether, 240 artificial root canal samples were included. The models were split and incubated for 2 days to allow formation of E. faecalis biofilm. The models were randomly divided into two groups (n = 120): CNI and laser-activated irrigation (LAI). Each group was divided into six subgroups according to different irrigation solutions: distilled water, 1% sodium hypochlorite (NaOCl), 2% NaOCl, 5.25% NaOCl, MTAD, and chlorhexidine, respectively. After irrigation, half of the samples (n = 10) were assessed immediately, and the other half of the samples (n = 10) were incubated for 6 hr. Bacterial suspensions were obtained from all samples before and after irrigation, and after incubation, and were quantified adenosine 5'-triphosphate (ATP) assay kit. The biofilms were examined using fluorescent microscopy and analyzed by Image Pro Plus software. Significant reduction of ATP, average fluorescence density after irrigation, and growth after incubation was obtained in LAI group than in CNI group (p < .05). LAI can improve bacteriostasis effect of 2% NaOCl (p < .05). PIPS improved the antibacterial effect of the 2% NaOCl used in root canal therapy.

Attitude of general dental practitioners toward root canal treatment procedures in India.

OBJECTIVE: The percentage of general dental practitioners is very common in India, so the purpose of this study was to assess attitude of general dental practitioners toward root canal treatment (RCT) procedures. MATERIALS AND METHODS: In a cross-sectional study, 178 dentists (96 males and 82 females) were surveyed using a selfadministered, structured questionnaire pretested through a pilot survey. The questionnaire collected information regarding RCT procedures among participants. Data were analyzed using SPSS version 15. Frequency and percentage distributions were calculated. RESULTS: In the present study most of the participants, i.e. 86.4% reported that they perform (RCT) procedures in posterior teeth. Isolation is mainly done with cotton rolls only (74.6%) and very few are using rubber dam in their practice (3.2%). Radiographs were not taken after every step in most of the cases. Rotary instruments were used in less number of cases and K-files were the most popular instruments (66.2%). Also single sitting RCT was not commonly seen. CLINICAL SIGNIFICANCE: This study indicates that most of the general dental practitioners' do not comply with quality standards guidelines such as use of rubber dam as isolation. So dentist should update their knowledge and practices with current techniques and materials through CDE programs.

Intracanal dressing and root canal filling materials in tooth replantation: a literature review.

The prognosis of tooth replantation is usually related to the need of endodontic treatment, which has a direct relationship with the occurrence of root resorptions. Several studies have been undertaken in an attempt to prevent, delay, or treat these complications, which are the main causes of loss of replanted teeth. This literature review examines research evidence on intracanal dressings and root canal filling materials used in cases of tooth replantation. A comprehensive search was performed in the Medline/Pubmed, Bireme and Scielo full-text electronic journal databases to retrieve English-language articles referring to these topics that had been published between 1964 and 2010. Calcium hydroxide (CH) remains the usually recommended choice as an intracanal medicament in replanted teeth; however, there is evidence to support the initial use of a corticosteroid-antibiotic combination such as Ledermix paste to control potential early resorption, prior to the introduction of CH where the beneficial effect in the treatment of progressive root resorption has been well proven. Regarding root filling materials, CH-containing sealers are a good option because of their biological properties. Accurate diagnosis and adequate treatment plan may constitute very complex tasks, particularly in tooth avulsion because several variables are involved. In addition to the technical knowledge and clinical experience directed toward the quality of treatment, patient education may favorably influence the survival of replanted teeth.

Antimicrobial irrigants in endodontic therapy: 1. Root canal disinfection.

UNLABELLED: This paper highlights the importance of root canal disinfection. It discusses the different endodontic irrigants available and comments on how these can be used most effectively. CLINICAL RELEVANCE: Eliminating bacteria from the root canal system is an essential stage in endodontic therapy. Practitioners should be adequately informed and skilled in this vital aspect of endodontics.

Estado actual del hipoclorito de sodio en endodoncia. 2: propiedades fisicoquímicas / Sodium hypochlorite in Endodontics: an update 2: physicochemical properties

El hipoclorito de sodio es un agente antibacteriano efectivo que tiene no sólo la capacidad de desintegrar el tejido pulpar vital o necrótico infectado y la propiedad de desnaturalizar las toxinas, sino también un efecto importante sobre las propiedades estructurales de la dentina, lo cual es consecuencia de la desintegración de su matriz orgánica. Su interacción con otras soluciones irrigantes facilita la remoción del barro dentinario, mejorando de esta manera la adaptación de los materiales de obturación a las paredes dentinarias. El objetivo de este trabajo fue realizar una revisión de las investigaciones pertinentes a las propiedades fisicoquímicas del hipoclorito de sodio utilizado como solución irrigante en endodoncia.

Dye diffusion in instrumented root canals irrigated with different solutions / Difusión de colorante en conductos radiculares instrumentados e irrigados con diferentes soluciones

Success in endodontics depends largely on the activity of the irrigation solutions used during canal cleaning and shaping. Sometimes the irrigation solutions should act deep within the dentin,particularly in cases of chronic infectious lesions, in which it has been found that germs can lodge in the depths of the dentinal tubules. The aim of this study was to compare the penetration of methylene blue in root dentin in instrumented teeth irrigated with different solutions, considering the apical, middle and cervical thirds. Single-rooted teeth were instrumented, irrigated, flooded with 2% methylene blue, washed and cut into thirds. Dye penetration in the dentin was measured by means of two procedures. Linear measurement: maximum dye penetration was recorded towards the four surfaces of each third. Area measurement: the stained surface of each third was measured on digitalizedimages. On analyzing the data with Friedman and Kruskall Wallis tests, it was found that there was greater penetration of methylene blue in the coronary third in all experimental groups, followed by middle and apical thirds. The mean values for the different groups using the linear method were EDTA 17%: 71.69% - 60.10% - 34.55%. NaOCl 2,5%: 54.04% - 41.79% - 27.53%. CHX 0.2%: 44.28%, 37.58%, 17.80%; and using the area method the mean values were: 17% EDTA: 61.52%, 45.44%, 27.08%. 2.5% NaOCl: 38.15%, 30.77%, 14.60%. 0.2% CHX: 40.95%, 35.46%, 12.27%, for the cervical, middle and coronary thirds respectively. Dye penetration wasgreatest with 17% EDTA, followed by 2.5% NaOCl and 0.2% CHX, whereas none was observed when distilled water was used.

El éxito endodóntico depende en gran medida de la acción que ejerzan las soluciones de irrigación durante la limpieza y conformación de los conductos. En algunos casos se hace necesario que las soluciones de irrigación actúen en la profundidadde la dentina, especialmente en casos de lesiones infecciosas crónicas en las que se ha comprobado que los gérmenes pueden alojarse en la profundidad de los túbulos dentinarios. El objetivo del presente trabajo fue comparar la penetración de azul de metileno en la dentina radicular en piezas instrumentadas e irrigadas con diferentes soluciones en los tercios apical, medio y cervical. Dientes unirradiculares fueron instrumentados, irrigados, llenados con azul de metileno 2%, lavados y cortados en tercios. La penetración del colorante en dentina se midió empleando dos procedimientos. Medición lineal: se registró la máxima penetración del colorante en las cuatro caras de cadatercio. Medición de áreas: se midió la superficie coloreada en cada tercio, en imágenes digitalizadas. Al analizar los datos con el test de Friedman y Kruscall Wallis, se observó que el azul de metileno difundió más en el tercio cervical, en todos grupos experimentales, luego medio y apical. La media en los diferentes grupos emplear el método lineal fueron EDTA 17 por ciento:71,69 por ciento - 60,10 por ciento - 34,55 por ciento. NaOCl 2,5 por ciento: 54,04 por ciento - 41,79 por ciento -27,53 por ciento. CHX 0,2 por ciento: 44,28 por ciento, 37,58 por ciento, 17,80 por ciento y por el métodode áreas: EDTA 17 por ciento: 61,52 por ciento, 45,44 por ciento, 27,08 por ciento. NaOCl 2,5 por ciento: 38,15 por ciento, 30,77 por ciento, 14,60 por ciento. CHX 0,2 por ciento: 40,95 por ciento, 35,46 por ciento, 12,27 por ciento, en los tercios cervical, medio y apical respectivamente. Hubo mayor penetración del colorante con EDTA 17 por ciento, luego NaOCl 2,5 por ciento y CHX 0,2 por ciento mientras que no se observó al emplear agua destilada.

Dye diffusion in instrumented root canals irrigated with different solutions / Difusión de colorante en conductos radiculares instrumentados e irrigados con diferentes soluciones

Success in endodontics depends largely on the activity of the irrigation solutions used during canal cleaning and shaping. Sometimes the irrigation solutions should act deep within the dentin,particularly in cases of chronic infectious lesions, in which it has been found that germs can lodge in the depths of the dentinal tubules. The aim of this study was to compare the penetration of methylene blue in root dentin in instrumented teeth irrigated with different solutions, considering the apical, middle and cervical thirds. Single-rooted teeth were instrumented, irrigated, flooded with 2% methylene blue, washed and cut into thirds. Dye penetration in the dentin was measured by means of two procedures. Linear measurement: maximum dye penetration was recorded towards the four surfaces of each third. Area measurement: the stained surface of each third was measured on digitalizedimages. On analyzing the data with Friedman and Kruskall Wallis tests, it was found that there was greater penetration of methylene blue in the coronary third in all experimental groups, followed by middle and apical thirds. The mean values for the different groups using the linear method were EDTA 17%: 71.69% - 60.10% - 34.55%. NaOCl 2,5%: 54.04% - 41.79% - 27.53%. CHX 0.2%: 44.28%, 37.58%, 17.80%; and using the area method the mean values were: 17% EDTA: 61.52%, 45.44%, 27.08%. 2.5% NaOCl: 38.15%, 30.77%, 14.60%. 0.2% CHX: 40.95%, 35.46%, 12.27%, for the cervical, middle and coronary thirds respectively. Dye penetration wasgreatest with 17% EDTA, followed by 2.5% NaOCl and 0.2% CHX, whereas none was observed when distilled water was used.(AU)

El éxito endodóntico depende en gran medida de la acción que ejerzan las soluciones de irrigación durante la limpieza y conformación de los conductos. En algunos casos se hace necesario que las soluciones de irrigación actúen en la profundidadde la dentina, especialmente en casos de lesiones infecciosas crónicas en las que se ha comprobado que los gérmenes pueden alojarse en la profundidad de los túbulos dentinarios. El objetivo del presente trabajo fue comparar la penetración de azul de metileno en la dentina radicular en piezas instrumentadas e irrigadas con diferentes soluciones en los tercios apical, medio y cervical. Dientes unirradiculares fueron instrumentados, irrigados, llenados con azul de metileno 2%, lavados y cortados en tercios. La penetración del colorante en dentina se midió empleando dos procedimientos. Medición lineal: se registró la máxima penetración del colorante en las cuatro caras de cadatercio. Medición de áreas: se midió la superficie coloreada en cada tercio, en imágenes digitalizadas. Al analizar los datos con el test de Friedman y Kruscall Wallis, se observó que el azul de metileno difundió más en el tercio cervical, en todos grupos experimentales, luego medio y apical. La media en los diferentes grupos emplear el método lineal fueron EDTA 17 por ciento:71,69 por ciento - 60,10 por ciento - 34,55 por ciento. NaOCl 2,5 por ciento: 54,04 por ciento - 41,79 por ciento -27,53 por ciento. CHX 0,2 por ciento: 44,28 por ciento, 37,58 por ciento, 17,80 por ciento y por el métodode áreas: EDTA 17 por ciento: 61,52 por ciento, 45,44 por ciento, 27,08 por ciento. NaOCl 2,5 por ciento: 38,15 por ciento, 30,77 por ciento, 14,60 por ciento. CHX 0,2 por ciento: 40,95 por ciento, 35,46 por ciento, 12,27 por ciento, en los tercios cervical, medio y apical respectivamente. Hubo mayor penetración del colorante con EDTA 17 por ciento, luego NaOCl 2,5 por ciento y CHX 0,2 por ciento mientras que no se observó al emplear agua destilada.(AU)

Ultrastructural evaluation of radicular dentin after Nd:YAG laser irradiation combined with different chemical substances.

This aticle sought to evaluate the dentin morphology after irradiation by a Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) laser, using different chemical substances to irrigate radicular canals: distilled water, 17% ethylenediaminetetraacetic acid plus Cetavlon (EDTAC), 1% sodium hypochlorite, and 2% chlorhexidine. Groups were subdivided according to the protocol of laser application (n=9). The specimens were analyzed by scanning electron microscopy (SEM). No differences were found in dentin morphology when different root thirds were examined. Regardless of the chemical substance used, alterations were more evident in groups in which the surfaces were dried before laser irradiation. Fusion areas, craters, carbonization, and partially exposed tubules were verified. When the irradiation was performed in water, the smear layer was incorporated into the laser-modified surface. Among the specimens irrigated with EDTAC and laser-treated, partial obliteration of dentin tubules due to the laser action was verified; in addition, there was no remaining smear layer on the surfaces. Samples irrigated with sodium hypochlorite followed by laser irradiation demonstrated similar morphology to the samples in the chlorhexidine group, with some fusion areas present and no exposed dentin tubules or fissures. The irradiation from an Nd:YAG laser in the presence of EDTAC solution provided a more favorable surface pattern compared to the other experimental conditions, due to the removal of the contaminated layer and the posterior sealing of dentin tubules.

Ability of fourteen chemical agents used in dental practice to induce chromosome aberrations in Syrian hamster embryo cells.

To assess the genotoxicity of 14 chemical agents used in dental practice, the ability of these agents to induce chromosome aberrations was examined using Syrian hamster embryo (SHE) cells. Statistically significant increases in the frequencies of chromosome aberrations were induced in SHE cells treated with 7 of 10 chemical agents used as endodontic medicaments, that is, carbol camphor, m-cresol, eugenol, guaiacol, zinc oxide, hydrogen peroxide, and formaldehyde. The other 3 chemical agents, that is, thymol, glutaraldehyde, and iodoform, did not increase the levels of chromosome aberrations. Of the 4 chemical agents that are used as an antiseptic on the oral mucosa, chromosome aberrations were induced by iodine, but not by the other 3 antiseptics, benzalkonium chloride, benzethonium chloride, and chlorhexidine. Among the 6 chemical agents exhibiting a negative response in the assay, only thymol induced chromosome aberrations in the presence of exogenous metabolic activation. Our results indicate that chemical agents having a positive response in the present study are potentially genotoxic to mammalian cells and need to be studied further in detail.

A survey of sodium hypochlorite use by general dental practitioners and endodontists in Australia.

BACKGROUND: Sodium hypochlorite is used commonly as an endodontic irrigant, but there are no published reports that provide details of its use. This survey sought to determine the percentage of Australian dentists who practiced endodontics, whether they used sodium hypochlorite for irrigation, and the manner of dilution, storage and dispensing sodium hypochlorite used by both dentists and endodontists. METHODS: All Australian endodontists and a stratified random sample of 200 general dentists in Australia were surveyed to address the issues identified above. RESULTS: Almost 98 per cent of dentists surveyed performed endodontic treatment. Among endodontists, nearly 94 per cent used sodium hypochlorite for irrigation compared with just under 75 per cent of general dentists. Sodium hypochlorite use by general dentists was more common in Victoria and South Australia than in other States. An infant sanitizer (Milton or Johnson's Antibacterial Solution) was used by just over 92 per cent of general practitioners and by more than 67 per cent of endodontists. All other respondents used domestic bleach. One hundred and sixty four of the respondents (80 per cent of endodontists and over 90 per cent of general dentists) used a 1 per cent w/v solution. Ten practitioners used a 4 per cent w/v solution, five used a 2 per cent w/v solution and four used a 1.5 per cent w/v solution. Eighty per cent of the practitioners who diluted their sodium hypochlorite before use, used demineralized water for this purpose. The remainder used tap water. Only four practitioners stored sodium hypochlorite in a manner which risked light exposure and loss of available chlorine content. CONCLUSIONS: Sodium hypochlorite is commonly used as an endodontic irrigant and Australian dentists generally stored the material correctly.

Evaluación de la eliminación del barro dentinario / Evaluation of the eliminating of smear layer

La eliminación del barro dentinario adherido a las paredes del conducto es esencial para lograr una eficaz limpieza y desinfección del sistema de conductos radiculares. El propósito de este estudio fue evaluar la eliminación del barro dentinario sobre las paredes del conducto radicular, utilizando distintas soluciones irrigantes durante su preparación biomecánica: hipoclorito de sodio 1 por ciento, Edtac 15 por ciento y ácido cítrico 25 por ciento. Se utilizaron raíces unirradiculares humanas recientemente extraídas, las cuales fueron instrumentadas con limas tipo K e irrigadas con solución fisiológica. Las mismas se separaron en tres grupos de diez muestras cada uno y se utilizaron tres piezas como control. Cada grupo recibió un irrigante adicional distinto: grupo 1, hipoclorito de sodio 1 por ciento, grupo 2, Edtac 15 por ciento y grupo 3, ácido cítrico 25 por ciento. Las piezas dentarias fueron cortadas longitudinalmente y observadas al microscopio óptico metalográfico y electrónico de barrido. Los resultados analizados permitieron concluir que el Edtac fue la solución irrigante que presentó mejores efectos (AU)

Ação do ácido cítrico e o bardac 2250 na remoção de Ca++ e smear layer no canal radicular / Intracanal removal of Ca++ and smear layer by citric acid and bardac 2250

O presente trabalho compara in vitro a desobstrução dos túbulos dentinários e a quelação de Ca++, utilizando trinta dentes instrumentados, aleatoriamente distribuídos em três grupos de dez elementos que receberam a irrigação final com 10ml de Bardac 2250 a 0,5 por cento; 10ml de ácido cítrico a 10 por cento; e 10ml de hipoclorito de sódio a 5 por cento (grupo controle). Dois métodos foram utilizados para verificar a eficácia das soluções: o estudo pelo espectofotômetro de absorção atômica e a leitura ao microscópio eletrônico de varredura. Conclui-se que o ácido cítrico a 10 por cento apresenta-se melhor na captura de Ca++ e na remoção de smear layer (p<0,05), e que eles não apresentam diferenças estatisticamente significativas quanto à remoção de smear layer (p>0,05)

Reação do tecido conjuntivo subcutâneo de rato ao MTA e ao hidróxido de cálcio / Reaction of rat connective tissue to implanted Mineral Trioxide Aggregate (MTA) and to calcium hydroxide

Foram analisadas as reações que ocorrem no tecido conjuntivo de ratos em contato com tubos de polietileno, contendo agregado de trióxido mineral (MTA) e uma pasta de hidróxido de cálcio (Calen). Os animais foram sacrificados nos períodos de 7, 14 e 30 dias. A maioria dos espécimes foram corados com hematoxilina e eosina, os demais com a técnica de Von Kossa para tecidos mineralizados. Próximo às aberturas do tubo foi constatada a presença de insenso infiltrado inflamatório, que no período de 30 dias de apresentou leve. Foi observada tanto junto ao agregado de trióxido mineral como junto à pasta de hidróxido de cálcio (Calen), a formação de uma cápsula fibrosa fina. Nos espécimes tratados pela técnica de Von Kossa somente foram encontradas áreas positivas nos que continham hidróxido de cálcio (Calen)

Soluciones irrigantes en endodoncia / Irrigant solutions in endodontics

Las bacterias cumplen un rol escencial en la iniciación y mantenimiento de la enfermedad pulpoperiodontal. La eliminación de la infección del sistema de conductos radiculares es el objetivo prioritario y la meta final de la terapia endodóntica, lo que se consigue mediante la acción de los instrumentos y de las soluciones irrigantes, complementados por la medicación intermedia. Varias son las soluciones propuestas como irrigantes endodónticos pero ninguna por sí sola posee las propiedades requeridas. El hipoclorito de sodio es ampliamente usado en la terapia endodóntica por su acción antibacteriana y su capacidad de disolver el tejido orgánico. La clorhexidina también fue propuesta como solución irrigante por sus efectos antibacterianos, sustantividad y relativa ausencia de toxicidad. Para incrementar sus efectos, se ha sugerido alternarla con el peróxido de hidrógeno. Pero el efecto bactericida de los irrigantes dependerá de la capacidad que tengan para penetrar en los túbulos dentinarios, un proceso que se ve influído por la presencia o ausencia de barro dentinario. Es por eso que se recomienda el uso de agentes quelantes como el EDTA, para preparar la superficie de la pared del conducto de tal manera que el hipoclorito de sodio pueda ejercer su acción en la profundidad de los conductos accesorios y los túbulos dentinarios, efecto que se puede incrementar con agentes tensioactivos que bajan la tensión superficial y aumentan la permeabilidad dentinaria frente a las soluciones irrigantes. Sin duda, la efectividad de los irrigantes dependerá de la técnica de irrigación que se use en cada situación clínica

Soluciones irrigantes en endodoncia / Irrigant solutions in endodontics

Las bacterias cumplen un rol escencial en la iniciación y mantenimiento de la enfermedad pulpoperiodontal. La eliminación de la infección del sistema de conductos radiculares es el objetivo prioritario y la meta final de la terapia endodóntica, lo que se consigue mediante la acción de los instrumentos y de las soluciones irrigantes, complementados por la medicación intermedia. Varias son las soluciones propuestas como irrigantes endodónticos pero ninguna por sí sola posee las propiedades requeridas. El hipoclorito de sodio es ampliamente usado en la terapia endodóntica por su acción antibacteriana y su capacidad de disolver el tejido orgánico. La clorhexidina también fue propuesta como solución irrigante por sus efectos antibacterianos, sustantividad y relativa ausencia de toxicidad. Para incrementar sus efectos, se ha sugerido alternarla con el peróxido de hidrógeno. Pero el efecto bactericida de los irrigantes dependerá de la capacidad que tengan para penetrar en los túbulos dentinarios, un proceso que se ve influído por la presencia o ausencia de barro dentinario. Es por eso que se recomienda el uso de agentes quelantes como el EDTA, para preparar la superficie de la pared del conducto de tal manera que el hipoclorito de sodio pueda ejercer su acción en la profundidad de los conductos accesorios y los túbulos dentinarios, efecto que se puede incrementar con agentes tensioactivos que bajan la tensión superficial y aumentan la permeabilidad dentinaria frente a las soluciones irrigantes. Sin duda, la efectividad de los irrigantes dependerá de la técnica de irrigación que se use en cada situación clínica (AU)

Endodontic irrigation.

This review of current research and literature investigates trends in endodontic irrigation, focusing on the goals of irrigation and the ability of different irrigants to meet these goals.