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1.
BMC Oral Health ; 24(1): 678, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38858636

RESUMO

OBJECTIVE: This systematic review aims to comparatively analyse the amount of dentin removal by free hand and static guided endodontics with dynamic navigation system (DNS) in endodontic access cavity preparation. METHODS: The systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Based on the structured PICO framework of "Comparative evaluation of dynamic navigation system (I) to freehand (C) and static guided endodontics (C) in endodontic access cavity preparation on the preservation of tooth structure (O) when assessed on permanent human teeth (P)", the keywords were formulated and the articles were retrieved from three databases namely PubMed, Scopus and Embase, based on the keywords from the time of inception of DNS till June 2023. The risk of bias assessment was done using a modified Joanne Briggs Institute checklist, which evaluated domains such as randomisation, sample size, image acquisition using CBCT, angulation, accuracy and time taken. As the data was heterogenous, a quantitative meta-analysis was not performed. RESULTS: Initially, 174 articles were retrieved from the three databases, 30 duplicates were removed, after title check 108 articles were excluded and following abstract check only 10 articles qualified for full text analysis. On reviewing the 10 full text articles, 5 articles were excluded and the remaining 5 articles were subjected to the risk of bias analysis which showed that 2 articles displayed low risk of bias and three articles showed high risk of bias. The RoB analysis revealed that only 2 studies evaluated the preservation of dentin in terms of accuracy, angulation and time taken proving the increased precision with minimal loss of tooth structure using DNS. In both the studies, DNS proved to be superior to free hand technique in terms of precision, accuracy and efficiency in locating the canals during access cavity preparation with maximal preservation of tooth structure. CONCLUSION: With the minimal literature evidences, the present systematic review highlights maximal preservation of dentin using DNS. However, further invitro and invivo studies comparing the free hand, static guided endodontics to DNS must be carried out for its translation into clinical practice. CLINICAL SIGNIFICANCE: Dynamic navigation system provides maximal preservation of dentin during access cavity preparation.


Assuntos
Dentina , Humanos , Dentina/diagnóstico por imagem , Preparo de Canal Radicular/métodos , Preparo de Canal Radicular/instrumentação
2.
Sci Rep ; 14(1): 13205, 2024 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-38851745

RESUMO

The evidence base on minimally invasive endodontic (MIE) treatment is limited. This study investigated the influence of MIE shaping on vertical root fracture (VRF) resistance and crack formation of root canal filled teeth. Human maxillary central incisors were randomized into six groups (n = 18, power = 0.9) and embedded in acrylic blocks with artificial periodontal ligaments. The root canals were either instrumented to size #40 and 0.04 taper (+MIE) or enlarged to ISO size #80 (-MIE). The canals were filled with cement-based (C) or adhesive resin-based (A) sealers in single-cone technique. The controls received no treatment or were left unfilled. After chewing simulation (staircase method, 25-150 N, 120,000×), the crack formation on the root surface was analyzed using stereomicroscope/digital imaging and classified (no defect, craze line, vertical crack, horizontal crack). Subsequently, the samples were loaded until fracture. The incidence of defects (56% vertical cracks) was not significantly different between the groups (p ≥ 0.077). VRF resistance was significantly higher in untreated teeth than in +MIE/C (p = 0.020) but did not significantly differ between the other groups (p ≥ 0.068). Minimal canal shaping did not reduce the risk of vertical root fracture and defects of root canal filled teeth.


Assuntos
Fraturas dos Dentes , Raiz Dentária , Humanos , Raiz Dentária/lesões , Tratamento do Canal Radicular/métodos , Incisivo/lesões , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Preparo de Canal Radicular/métodos , Preparo de Canal Radicular/efeitos adversos
3.
BMC Oral Health ; 24(1): 595, 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38778321

RESUMO

INTRODUCTION: Transforming Growth Factor-Beta 1 (TGF-ß1) plays a crucial role in the success of Regenerative Endodontic Procedures (REPs) as they directly impact the proliferation and differentiation of stem cells. TGF-ß1 is released by conditioning of the dentin matrix using 17% EDTA. EDTA was found to have deleterious effects on dentin especially in immature teeth with fragile dentin walls. Decreasing the irrigation time was reported to decrease these effects. Accordingly, enhancement and activation of the EDTA solution to maintain its efficiency in TGF-ß1 release from dentin and thus compensating the reduction in irrigation time was employed. EDTA solution was enhanced by adding Nanobubble (NB) water which contains oxygen filled cavities less than 200 nm in diameter. Additionally, EDTA was activated with XP-endo Finisher rotary file. The aim of this study was to assess the impact of NB enhancement and/or XP-endo Finisher activation of the EDTA solution on the TGF-ß1 release from dentin. METHODS: Fifty standardized root segments with open apex were allocated to two main groups according to whether EDTA was enhanced with NB water or not, and within each group whether XP-endo Finisher activation was used or not in addition to a Negative Control group. The concentration of the released TGF-ß1 in the root canal was measured using enzyme-linked immunosorbent assay (ELISA). The statistical analysis was done using the Shapiro- Wilk, Kolmogorov Smirnov, ANOVA and Post-hoc Tukey tests. RESULTS: All groups released a considerable amount of TGF-ß1 with the highest values in the EDTA/NB/XP group, followed by EDTA/NB, EDTA/DW/XP, EDTA/DW and Negative Control groups respectively. CONCLUSIONS: The results of this study suggest that NBs can promote the success of REPs since it revealed a significant increase in the TGF-ß1 release following its use in the enhancement of the EDTA solution. A comparable effect was obtained by XP-endo finisher activation of the EDTA solution. The combined use of NBs and XP-endo Finisher can be a promising addition in REPs. Accordingly, Enhancement and activation of the EDTA solution may compensate decreasing the EDTA irrigation time attempted to avoid the deleterious effect of EDTA on dentin.


Assuntos
Dentina , Ácido Edético , Endodontia Regenerativa , Fator de Crescimento Transformador beta1 , Ácido Edético/farmacologia , Fator de Crescimento Transformador beta1/metabolismo , Humanos , Dentina/efeitos dos fármacos , Endodontia Regenerativa/métodos , Irrigantes do Canal Radicular/farmacologia , Água , Preparo de Canal Radicular/métodos , Ensaio de Imunoadsorção Enzimática
4.
Clin Oral Investig ; 28(6): 340, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38801642

RESUMO

BACKGROUND: Pediatric rotary file systems were developed to solve manual file limitations. With many systems available, it may be tricky to select the most appropriate one. AIM: to assess & compare Kedo-S Square, Fanta-AF™-Baby rotary files with manual K-file concerning removed dentin amount, canal transportation, centric ability & root canal taper using CBCT in primary anterior teeth. DESIGN: Extracted Seventy-five upper primary anterior teeth with intact 2/3 root length were collected and divided into three groups based on root canal instrumentation, group-I: prepared using K-file, group-II: prepared using Kedo-S Square, and group-III: prepared using Fanta AF™ Baby file. The teeth were imaged with CBCT before & following canal instrumentation. Then, the removed dentin amount was calculated at each root-canal level. The Kruskal-Wallis test was utilized to statistically analyze study data. RESULT: The difference among the three groups was highly statistically significant at cervical & apical thirds concerning dentin thickness changes on both mesial & distal sides following canal preparation with the least removed dentin in the Kedo-S Square group(P < 0.0001). Regarding transportation & centering ability, a non-significant difference between the three groups was found. 80% of the Fanta AF™ Baby group had good-tapered preparation compared to the Kedo-S Square (72%) and K-file (40%) groups(P < 0.05). CONCLUSION: Kedo-S Square was preferable to Fanta-AFTM-Baby & manual K-files in primary root canal preparation.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Desenho de Equipamento , Preparo de Canal Radicular , Dente Decíduo , Humanos , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Técnicas In Vitro , Dente Decíduo/diagnóstico por imagem , Incisivo/diagnóstico por imagem , Instrumentos Odontológicos , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/cirurgia
5.
BMC Oral Health ; 24(1): 612, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38802852

RESUMO

BACKGROUND: Growth factors embedded in the extracellular matrix of the dentin play an important role in the migration, proliferation, and differentiation of dental pulp stem cells in regenerative endodontics. In regenerative endodontic treatments, the type of irrigation solution used is crucial for the release of growth factors (GFs) from the dentin matrix. This study evaluated the effectiveness of different irrigant activation techniques (IAT) using two different chelating agents, 17% ethylenediaminetetraacetic acid (EDTA) and 9% etidronic acid (HEDP), in terms of their GF release. METHODS: Seventy-two mandibular premolar teeth were prepared to simulate an open apex. The root fragments were irrigated with 20 ml of 1.5% sodium hypochlorite and 20 ml of saline solution. Eight root fragments were randomly separated for the control group, and the remaining 64 fragments were randomly separated into eight groups based on two different chelating agents (17% EDTA and 9% HEDP) and four different IAT ((conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI), sonic activation with EDDY, and XP-endo Finisher (XPF)). TGF-ß1, VEGF-A, BMP-7 and IGF-1 release levels were determined using an ELISA, and statistical analysis was performed using the Kolmogorov-Smirnov test, ANOVA, and the Tukey test (p < .05). RESULTS: Compared to the control group, the experimental groups showed significantly higher GF release when using EDTA or HEDP. Among the activation groups, the EDDY group triggered the highest GF release, and the CNI group triggered the lowest. CONCLUSIONS: IAT with EDTA and HEDP can increase GF release, with EDDY being the most effective IAT method. Using chelating agents with IAT may be beneficial in regenerative endodontic treatments.


Assuntos
Quelantes , Dentina , Ácido Edético , Ácido Etidrônico , Irrigantes do Canal Radicular , Humanos , Irrigantes do Canal Radicular/farmacologia , Dentina/efeitos dos fármacos , Ácido Etidrônico/farmacologia , Quelantes/farmacologia , Técnicas In Vitro , Peptídeos e Proteínas de Sinalização Intercelular , Endodontia Regenerativa/métodos , Dente Pré-Molar , Preparo de Canal Radicular/métodos
6.
J Contemp Dent Pract ; 25(3): 250-259, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38690699

RESUMO

AIM AND BACKGROUND: To compare the root canal volume in primary teeth using hand and rotary instruments and to evaluate root canal filling techniques and flow of root canal obturation materials in the postinstrumented root canal volume using spiral computed tomography (SCT). MATERIALS AND METHODS: Freshly extracted 16 primary molars were randomly divided into two groups and subjected to SCT analysis before and after instrumentation. For the manual technique (group I) with eight teeth were prepared using K files, and rotary (group II) eight teeth preparation was performed with ProTaper files. The filled volume in each canal was measured using SCT, and the percentage of obturated volume was calculated. The data were statistically analyzed using the Mann-Whitney U test. RESULTS: There was a statistically significant difference in both groups' volume of root canals enlarged. Even though both K files and the ProTaper system brought about enlarged canals after instrumentation, there was a statistically significant increase in volume after using K files in two canals. In three canals, there was a statistically significant increase in volume after using ProTaper. Irrespective of the obturation technique and materials used, there is no statistically significant difference in the volume after obturation. CONCLUSION: From the results of this study, the ProTaper file system shows suitable volumetric enlargement up to an optimum level, which is needed in primary root canal walls, and is better in canal shaping, as evidenced by good postobturation volume. CLINICAL SIGNIFICANCE: The traditional method of cleaning and shaping the root canals in permanent teeth using manual stainless-steel files can lead to undesirable curvatures in root canal morphology, making correctly filling the root canals difficult. It is also time-consuming and sometimes leads to iatrogenic errors. Rotary nickel-titanium (Ni-Ti) instrumentation techniques have been developed to overcome these problems. How to cite this article: Yadav DBUC, Varma RB, Kumar JS, et al. Volumetric Analysis of Hand and Rotary Instrumentation, Root Canal Filling Techniques, and Obturation Materials in Primary Teeth Using Spiral CT. J Contemp Dent Pract 2024;25(3):250-259.


Assuntos
Cavidade Pulpar , Dente Molar , Materiais Restauradores do Canal Radicular , Obturação do Canal Radicular , Preparo de Canal Radicular , Tomografia Computadorizada Espiral , Dente Decíduo , Humanos , Obturação do Canal Radicular/métodos , Dente Decíduo/diagnóstico por imagem , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/anatomia & histologia , Tomografia Computadorizada Espiral/métodos , Dente Molar/diagnóstico por imagem , Instrumentos Odontológicos , Técnicas In Vitro
7.
Braz Dent J ; 35: e245883, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38775594

RESUMO

This study assessed the intratubular antibacterial ability of different activated irrigations after chemical mechanical preparation. Seventy-two palatal root canals of upper molars were infected with Enterococcus faecalis for 4 weeks, and then initial bacterial collection from the main root canal was performed. The root canals were prepared by using a WaveOne Gold large (45/.05) and distributed into 6 groups according to the activation of the final irrigation: ultrasonic activation (UA), XP-Endo Finisher (25/.00), XP Clean (25/.02), EasyClean (25/.04) in reciprocating motion and continuous rotary motion (ECRot), and conventional irrigation. After final irrigation, another bacterial collection from the main root canal was performed, and the root was sectioned transversely in three-thirds and stained for analysis by confocal laser microscopy. Intratubular bacteria were collected through dentin powder and plated for bacterial viability analysis. Intergroup and intragroup comparisons were performed by using analysis of variance and repeated measures analysis of variance, respectively, both at 5% significance. ECRot had higher antibacterial ability than UA (p<0.05), and both were superior to the other groups (p<0.05) in both methodologies. It can be concluded that activation of final irrigation enhances the disinfection of the root canal system, and activators have different efficacies.


Assuntos
Antibacterianos , Enterococcus faecalis , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Humanos , Irrigantes do Canal Radicular/farmacologia , Preparo de Canal Radicular/métodos , Antibacterianos/farmacologia , Cavidade Pulpar/microbiologia , Microscopia Confocal , Irrigação Terapêutica/métodos , Dente Molar
8.
Clin Exp Dent Res ; 10(3): e893, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38770579

RESUMO

OBJECTIVES: The present study reviews the current literature regarding the utilization of the extended finite element method (XFEM) in clinical and experimental endodontic studies and the suitability of XFEM in the assessment of cyclic fatigue in rotary endodontic nickel-titanium (NiTi) instruments. MATERIAL AND METHODS: An electronic literature search was conducted using the appropriate search terms, and the titles and abstracts were screened for relevance. The search yielded 13 hits after duplicates were removed, and four studies met the inclusion criteria for review. RESULTS: No studies to date have utilized XFEM to study cyclic fatigue or crack propagation in rotary endodontic NiTi instruments. Challenges such as modelling material inputs and fatigue criteria could explain the lack of utilization of XFEM in the analysis of mechanical behavior in NiTi instruments. CONCLUSIONS: The review showed that XFEM was seldom employed in endodontic literature. Recent work suggests potential promise in using XFEM for modelling NiTi structures.


Assuntos
Endodontia , Análise de Elementos Finitos , Níquel , Titânio , Humanos , Ligas Dentárias/química , Instrumentos Odontológicos , Endodontia/instrumentação , Endodontia/métodos , Teste de Materiais , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Estresse Mecânico
9.
J Clin Pediatr Dent ; 48(3): 156-165, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38755994

RESUMO

There is currently a lack of research on the application of newly developed irrigation techniques in root canal treatment of primary teeth. This study aimed to evaluate the effects of various irrigation activation techniques on two key parameters: apical debris extrusion (ADE) and dentinal tubule penetration depth (DTPD) of the root canal filling material. A total of 96 primary mandibular second molars were randomly divided into 4 groups: Group 1-Conventional Needle Irrigation (CNI), Group 2-XP-Endo Finisher (XPF), Group 3-EndoActivator (EA), and Group 4-Passive Ultrasonic Irrigation (PUI). In all groups, the One Reci single-file system was used for root canal preparation. For ADE measurement, each group was rinsed with distilled water. For DTPD assessment, sodium hypochlorite (NaOCl) was applied. ADE quantification was performed by collecting debris in pre-weighed Eppendorf tubes. A combination of fluorescent dye and root canal filling material (DiaPex Plus) was used for root canal filling. In order to examine DTPD, horizontal cross-sections of the coronal and apical regions of the teeth were taken with a thickness of 1 mm. The maximum and mean DTPD was examined by confocal laser scanning microscopy. Data were analyzed using the Kruskal-Wallis, One-way ANOVA, and Mann-Whitney U tests (p = 0.05). As a result, PUI had the highest mean ADE and CNI had the lowest mean ADE, while CNI had the highest mean DTPD in both the coronal and apical regions, whereas PUI had the lowest mean DTPD in the coronal region, and EA had the lowest mean DTPD in the apical region. There were no statistically significant differences in DTPD and ADE among the four groups. Comparing intragroup maximum DTPD across all groups, it was significantly higher in the coronal region than in the apical region (p < 0.05). ADE and DTPD of root canal filling materials in primary teeth did not differ significantly among CNI, XPF, EA and PUI irrigation activation techniques.


Assuntos
Dente Molar , Irrigantes do Canal Radicular , Preparo de Canal Radicular , Irrigação Terapêutica , Dente Decíduo , Humanos , Irrigação Terapêutica/métodos , Irrigantes do Canal Radicular/uso terapêutico , Preparo de Canal Radicular/métodos , Hipoclorito de Sódio/uso terapêutico , Microscopia Confocal , Materiais Restauradores do Canal Radicular/uso terapêutico , Cavidade Pulpar/efeitos dos fármacos , Agulhas
10.
Dent Mater J ; 43(3): 420-429, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38644213

RESUMO

This study investigated the wettability and consistency of various endodontic sealers, both inorganic and organic, and evaluated their sealing ability of root canals using the single-cone obturation technique, with and without ethylenediaminetetraacetic acid (EDTA) treatment. Bovine root canals were endodontically prepared and filled in preparation for the dye penetration test with toluidine blue solution. All sealers exhibited contact angles similar to or lower than dentin and displayed superior consistency. Among the sealers, organic sealers used without EDTA treatment showed reduced dye penetration compared to inorganic sealers. However, some inorganic and organic sealers showed dye penetration in the sealer and dentin of root canals subjected to EDTA treatment. In conclusion, the single-cone obturation technique, combined with these endodontic sealers, achieved close contact with root canal dentin due to their wettability and consistency. However, the sealing ability of certain sealers was influenced by EDTA treatment.


Assuntos
Ácido Edético , Teste de Materiais , Materiais Restauradores do Canal Radicular , Obturação do Canal Radicular , Molhabilidade , Materiais Restauradores do Canal Radicular/química , Animais , Bovinos , Obturação do Canal Radicular/métodos , Combinação de Medicamentos , Infiltração Dentária , Cavidade Pulpar , Silicatos/química , Propriedades de Superfície , Compostos de Cálcio/química , Resinas Epóxi/química , Colagem Dentária/métodos , Compostos de Alumínio/química , Técnicas In Vitro , Óxidos/química , Hidróxido de Cálcio/química , Preparo de Canal Radicular/métodos , Guta-Percha/química , Dentina/efeitos dos fármacos , Corantes
11.
Shanghai Kou Qiang Yi Xue ; 33(1): 54-58, 2024 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-38583025

RESUMO

PURPOSE: To compare the forming ability of four kinds of nickel-titanium instrument preparation resin for simulated curved root canal. METHODS: A total of 40 single bend resin simulated root canals were randomly divided into 4 groups with 10 in each group. Four kinds of nickel-titanium instruments (ProTaper, HyFlex EDM, WaveOne Gold and Reciproc Blue) were used for root canal preparation, and divided into group A, group B, group C and group D. The preparation time of the four groups was compared, the root canal images before and after preparation were analyzed by computer image analysis software, and the changes of the preparation time, curvature and curvature radius of the four groups were recorded. With the root tip as the center of the circle, the radius of 1-10 mm was selected as concentric circle arcs. The detection points were overlapping root canal intersection points. The resin removal amount and center positioning force of the inner and outer walls of the root canal at different detection points were recorded. Statistical analysis was performed with SPSS 20.0 software package. RESULTS: The root canal preparation time in group A was significant longer than that in group B, C and D(P<0.05), but there was no significant difference in the curvature and curvature radius of the root canal among the four groups (P>0.05). The removal amount of resin from the root canal wall in group C was significant lower than that in group A, B and D (P<0.05) when the distance from the detection point to the apical foramina was 5, 6, 8, 9 and 10 mm, respectively. The removal amount of resin from the outer wall of the root canal in group C was significant lower than that in group A, B and D (P<0.05) when the distance from the detection point to the apical foramina was 5, 6, 7, 9 and 10 mm, respectively. The root tip offset of group A from the detection point to the apical hole of 1, 2, 3, 4, 6, 7, 8, 9 and 10 mm was significant greater than that of group B, C and D(P<0.05). CONCLUSIONS: Among the four instruments, ProTaper has the largest apical deviation, HyFlex EDM, WaveOne Gold and Reciproc Blue have better ability of root canal forming.


Assuntos
Cavidade Pulpar , Titânio , Níquel , Instrumentos Odontológicos , Preparo de Canal Radicular/métodos , Desenho de Equipamento
13.
PLoS One ; 19(4): e0299896, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38568900

RESUMO

The objective was to evaluate the effect of glide path and coronal flaring on the dentin volume removal and percentage of touched walls in curved canals using two heat-treated rotary files. The mesiobuccal canal of forty-eight, randomly selected, extracted mandibular molars was divided into two groups of 24 each, according to the type of instrument used (RACE EVO and EdgeSequel rotary files). Each group was further divided into three subgroups; Group (A): Control using one file shaped to 04/30, Group (B) with a glide path (EdgeGlidePath (EGP)), and Group (C): with a glide path and coronal flaring (EGP and EdgeTaper Platinum (ETP) SX file respectively). The root canals were then instrumented using the assigned instruments. The assessment was carried out using micro-CT. The comparison of the mean values of the tested groups about dentin volume removal and percentage of untouched walls did not reach statistical significance (p<0.05). Glide path and coronal flaring had an insignificant effect on the dentin volume removal and percentage of untouched walls in curved canals.


Assuntos
Temperatura Alta , Níquel , Preparo de Canal Radicular , Microtomografia por Raio-X/métodos , Preparo de Canal Radicular/métodos , Ligas , Titânio , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/cirurgia , Desenho de Equipamento
14.
Lasers Med Sci ; 39(1): 112, 2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38656634

RESUMO

PURPOSE: To measure the dynamic characteristics of the flow field in a complex root canal model activated by two laser-activated irrigation (LAI) modalities at different activation energy outputs: photon-induced photoacoustic streaming (PIPS) and microshort pulse (MSP). METHODS: A phase-locked micro-scale Particle Image Velocimetry (µPIV) system was employed to characterise the temporal variations of LAI-induced velocity fields in the root canal following a single laser pulse. The wall shear stress (WSS) in the lateral root canal was subsequently estimated from the phase-averaged velocity fields. RESULTS: Both PIPS and MSP were able to generate the 'breath mode' of the irrigant current under all tested conditions. The transient irrigation flush in the root canal peaked at speeds close to 6 m/s. However, this intense flushing effect persisted for only about 2000 µs (or 3% of a single laser-pulse activation cycle). For MSP, the maximum WSS magnitude was approximately 3.08 Pa at an activation energy of E = 20 mJ/pulse, rising to 9.01 Pa at E = 50 mJ/pulse. In comparison, PIPS elevated the WSS to 10.63 Pa at E = 20 mJ/pulse. CONCLUSION: Elevating the activation energy can boost the peak flushing velocity and the maximum WSS, thereby enhancing irrigation efficiency. Given the same activation energy, PIPS outperforms MSP. Additionally, increasing the activation frequency may be an effective strategy to improve irrigation performance further.


Assuntos
Reologia , Humanos , Cavidade Pulpar/efeitos da radiação , Irrigação Terapêutica/métodos , Irrigação Terapêutica/instrumentação , Lasers , Irrigantes do Canal Radicular , Técnicas Fotoacústicas/métodos , Preparo de Canal Radicular/métodos , Preparo de Canal Radicular/instrumentação
15.
BMC Oral Health ; 24(1): 476, 2024 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-38643094

RESUMO

OBJECTIVES: This study aimed to design a modified passive-deflation sealer injection needle and investigate its ability to improve obturation quality of single-cone technique through assessing the distribution of voids in root canals using micro-computed tomography (micro-CT). MATERIALS AND METHODS: Forty-eight mandibular incisors were divided into eight groups (n = 6), according to the taper of root canal preparation (0.06 or 0.04), the needle used for sealer injection (modified or commercial iRoot SP injection needle), and the obturation method (iRoot SP sealer-only or single-cone obturation). After obturation, each specimen was scanned by micro-CT. The volumetric percentage and distribution of all voids were first analyzed and compared among groups, then the open and closed voids were separately analyzed and compared among single-cone obturation groups. RESULTS: Compared to commercial needle groups, modified needle groups showed much less voids, especially in the apical root canal part (P < 0.05). Besides, the modified needle groups produced much less open voids than commercial needle groups despite the root canal taper (P < 0.05). CONCLUSIONS: The modified passive deflation sealer injection needle could effectively improve the quality of single-cone obturation through reducing intra-canal voids, especially open voids throughout the root canal, thus might possibly be developed as an effective intra-canal sealer delivering instrument.


Assuntos
Cavidade Pulpar , Materiais Restauradores do Canal Radicular , Silicatos , Humanos , Microtomografia por Raio-X , Cavidade Pulpar/diagnóstico por imagem , Obturação do Canal Radicular/métodos , Preparo de Canal Radicular/métodos , Guta-Percha
16.
J Endod ; 50(5): 659-666, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38431198

RESUMO

INTRODUCTION: To evaluate the push-out bond strength (POBS) of AH Plus sealer to root dentin and the adhesive interface quality after calcium hydroxide (Ca(OH)2) intracanal dressing removal with different final irrigation protocols. METHOD: After root canal instrumentation and irrigation, 40 root canals were filled with Ca(OH)2 and sealed. After 14 days, the specimens were randomly distributed according to the irrigation protocols for Ca(OH)2 removal (n = 10): GH2O (control) - distilled water; GNaOCl - 1% NaOCl; GEDTA - 17% EDTA; GEDTA + NaOCl - 17% EDTA + 1% NaOCl. The root canals were filled with AH Plus sealer and gutta-percha. After 7 days, the roots were sectioned into dentin slices and submitted to POBS test and analysis of the adhesive interface under scanning electron microscope. The POBS data were statistically evaluated (analysis of variance and Tukey test). The Kruskal-Wallis and Mann-Whitney tests were used to analyze the adhesive interface (α = 0.05). RESULTS: GH2O, GNaOCl, and GEDTA + NaOCl had similar POBS values, with higher values on the apical third, in comparison with other thirds (P < .05). A homogeneous and free-of-gaps adhesive interface was observed for GH2O, GNaOCl, and GEDTA + NaOCl, with difference between GH2O and GEDTA (P < .05). GH2O and GEDTA + NaOCl presented higher sealer tags formation (P < .05). CONCLUSION: The final rinse with EDTA for Ca(OH)2 dressing removal had a negative effect on the POBS of the filling material to root dentin. The use of EDTA followed by NaOCl had results similar to the distilled water, providing uniform and free-of-gaps adhesive interface, and a higher number of sealer tags.


Assuntos
Hidróxido de Cálcio , Colagem Dentária , Dentina , Resinas Epóxi , Materiais Restauradores do Canal Radicular , Irrigantes do Canal Radicular , Irrigação Terapêutica , Hidróxido de Cálcio/química , Humanos , Dentina/efeitos dos fármacos , Materiais Restauradores do Canal Radicular/química , Resinas Epóxi/química , Colagem Dentária/métodos , Irrigação Terapêutica/métodos , Cavidade Pulpar/efeitos dos fármacos , Microscopia Eletrônica de Varredura , Hipoclorito de Sódio/química , Ácido Edético , Preparo de Canal Radicular/métodos , Análise do Estresse Dentário , Teste de Materiais
17.
Eur J Prosthodont Restor Dent ; 32(2): 212-218, 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38536738

RESUMO

OBJECTIVE: To evaluate the effect of different agitation methods on apical extrusion of 1.5% sodium hypochlorite (NaOCl) in an ex vivo model of immature teeth. METHODS: Sixty extracted human inferior incisors were prepared to simulate immature teeth and embedded in an artificial root socket made of silicone impression material. The teeth were then divided into four groups: Conventional needle irrigation (CNI) alone, CNI supplemented with Ultrasonic Irrigant Activation (UIA), EasyClean (EC), or XP-endo Finisher (XPF). Extruded NaOCl was collected, reacted with m-cresol purple, and its absorbance values were measured. The data were statistically analyzed using One-way analysis of variance with a significance level of 5%. RESULTS: All groups showed apically extruded irrigating solution, and the mean volumes of extruded NaOCl did not differ significantly between any of the test groups (p⟩0.05). CONCLUSION: The activation of 1.5% NaOCL by UIA, EC, or XPF as supplementary to CNI does not promote greater apical extrusion when compared to CNI alone in simulated immature teeth.


Assuntos
Irrigantes do Canal Radicular , Hipoclorito de Sódio , Espectrofotometria , Irrigação Terapêutica , Hipoclorito de Sódio/administração & dosagem , Humanos , Irrigantes do Canal Radicular/administração & dosagem , Irrigação Terapêutica/métodos , Preparo de Canal Radicular/métodos , Ápice Dentário , Técnicas In Vitro , Incisivo
18.
J Dent ; 144: 104928, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38484867

RESUMO

OBJECTIVES: Synthesise evidence on post-endodontic pain (PEP) in adult teeth undergoing primary root canal treatment with the adjunctive use of laser-activated irrigation (LAI) as compared with conventional needle irrigation (CNI) during the first post-operative week. DATA: An electronic search was performed; no language constraints or restriction on the year of publication were applied. SOURCES: Medline, Scopus, Cochrane and PubMed on 04 June 2023 STUDY SELECTION: Randomised clinical trials (RaCTs) that evaluated PEP after LAI of endodontic irrgants were included. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used. PEP was analysed at various time intervals until 1 week after treatment, related to the type of LAI used and the need for analgesia. REULTS: Of the 793 articles identified through the electronic database search, 6 RaCTs were included. Qualitative review was favoured over meta-analysis due to substantial methodological heterogeneity between studies. Five studies were at high risk for bias determined by the Cochrane Risk-of-Bias 2 tool. Diode LAI demonstrated superior efficacy to needle irrigation in reducing pain 6-48 h post-treatment. The impact of LAI by photon-induced photoacoustic streaming (PIPS) was unclear and no difference was observed between PIPS and needle irrigation. However, PIPS mitigated PEP better than manual dynamic activation, sonic and ultrasonic activation. There was no difference in analgesia intake between LAI and needle irrigation groups. CONCLUSIONS: LAI may help reduce PEP in the first 48 h. Methodological standardisation of future RaCTs on LAI would be beneficial in allowing a more accurate review with the possibility of quantitative synthesis. CLINICAL SIGNIFICANCE: This unique synthesis used stringent criteria to reduce confounding factors and provided valuable evidence regarding PEP with different types of LAI. It helps clinicians choose an appropriate LAI technique as compared with CNI and predicts a time frame for reducing PEP.


Assuntos
Dor Pós-Operatória , Tratamento do Canal Radicular , Irrigação Terapêutica , Humanos , Dor Pós-Operatória/prevenção & controle , Dor Pós-Operatória/etiologia , Irrigação Terapêutica/métodos , Tratamento do Canal Radicular/métodos , Irrigantes do Canal Radicular/uso terapêutico , Preparo de Canal Radicular/métodos , Preparo de Canal Radicular/instrumentação , Ensaios Clínicos Controlados Aleatórios como Assunto , Lasers , Adulto , Medição da Dor
19.
J Endod ; 50(7): 976-981, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38522577

RESUMO

INTRODUCTION: The aim of this study was to investigate the feasibility of a real-time three-dimensional dynamic navigation system (3D-DNS) for post space preparation (PSP) in root canal-treated teeth and to compare the accuracy and efficiency of 3D-DNS to freehand (FH) for PSP. METHODS: Fifty-four maxillary molars were divided into two groups: 3D-DNS (n = 27) and FH group (n = 27). Cone beam computed tomography (CBCT) scans were taken preoperatively and postoperatively. The drilling path for the PSP was virtually planned in the preoperative CBCT scan in the X-guide software (X-Nav Technologies, Lansdale, PA). For the 3D-DNS group, the PSP drilling was conducted under dynamic navigation. The 3D deviations and angular deflections were calculated. The residual dentin thickness (RDT) was determined after PSP. The operation time and the total number of mishaps were recorded. Shapiro-Wilk, t-test or Mann-Whitney rank sum, weighted Cohen's kappa, and Fisher exact tests were used (P < .05). RESULTS: The PSP was completed in all samples (54/54). The 3D-DNS was more accurate than the FH, with significantly fewer 3D deviations and angular deflections (all, P < .05). The 3D-DNS required less operating time than the FH (P < .05). For the 3D-DNS, no teeth had RDT < 1 mm, whereas 6/27 in the FH showed RDT < 1 mm after the PSP. There was no difference in the total number of mishaps (P > .05). CONCLUSION: Within the limitations of this in vitro study, the 3D-DNS is feasible for PSP. The 3D-DNS improved the accuracy and efficiency of PSP. The dynamic navigation system can potentially become a safe and reliable technology for PSP.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Imageamento Tridimensional , Humanos , Imageamento Tridimensional/métodos , Técnicas In Vitro , Dente Molar/diagnóstico por imagem , Técnica para Retentor Intrarradicular , Preparo de Canal Radicular/métodos , Preparo de Canal Radicular/instrumentação , Estudos de Viabilidade , Tratamento do Canal Radicular/métodos
20.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 42(1): 75-81, 2024 Feb 01.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-38475954

RESUMO

OBJECTIVES: This study aimed to compare the differences among four kinds of mechanical Ni-Ti files including T-Flex, Reciproc Blue (RB), ProTaper Gold (PTG), and ProTaper Universal (PTU) in dentinal microcrack generation after root canal preparation in vitro by using micro-computed tomography (micro-CT) analysis. METHODS: A total of 32 freshly extracted double-root-canal premolars with an angle not exceeding 10° were selected and established as root canal preparation models in vitro. Then, the specimens were randomly assigned to four experimental groups (n=8) according to the different Ni-Ti systems used for root canal preparation: group T-Flex, group RB, group PTG, and group PTU. The voxel size of the micro-CT was set at 17.18 µm. Pre- and post-operative cross-sectional images of roots (n=56 940) were scanned and analyzed to identify the presence of dentinal microcracks. The results of each group were expressed by the quantity and percentage of sectional images with microcracks. McNemar test was used to determine whether a significant difference existed in the existence of dentinal microcracks before and after instrumentation. The level of significance was set at P<0.05. RESULTS: Overall, 11.04% of the images presented dentinal defects (n=6 288). Dentinal microcracks were observed in 9.82%, 10.79%, 12.27%, and 11.25% of the post-instrumentation images from groups T-Flex, RB, PTG, and PTU, respectively. However, all these dentinal microcracks were already present in the corresponding pre-operative images. No new microcrack of premolars were generated after the root canal preparation utilizing the aforementioned systems. CONCLUSIONS: Denti-nal microcracks already existed in advance in extracted teeth before root canal preparation. Root canal preparation using the T-Flex, RB, PTG, and PTU systems did not induce the formation of new dentinal microcracks on the straight root canals of premolars.


Assuntos
Ligas , Níquel , Preparo de Canal Radicular , Preparo de Canal Radicular/métodos , Titânio , Microtomografia por Raio-X , Dentina , Cavidade Pulpar
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