This study evaluated surface wear and resistance to fracture of reciprocating and novel rotary instruments after use in curved canals. Twenty new instruments (n = 5/each group): Reciproc Blue, ...WaveOne Gold, XP‐endo Shaper (XPS) and TruNatomy were used twice for the instrumentation of simulated curved canals in plastic blocks. The instrumentation was performed according to the manufacturer's instructions at body temperature. Surface roughness was evaluated, using a profilometer, before instrumentation and twice after the instrumentation. Instruments were, then, subjected to a cyclic fatigue test to evaluate the time to failure. Differences were assessed using ANOVA and post hoc tests (α = 0.05). The XPS instruments showed significantly higher values of roughness compared with TruNatomy at every stage, especially after the second use (p < 0.008). Reciprocating instruments showed superior cyclic fatigue resistance compared with novel rotary instruments (p < 0.05). TruNatomy showed minimal surface roughness, and XPS exhibited significantly higher surface roughness.
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CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
The aim of this study was to evaluate the transportation and centering ability of 5 different rotary and reciprocating file systems with different metallurgical properties and surface treatments in ...curved root canals.
Fifty mesiobuccal round canals of upper molars with a curvature of 25°–40° were assigned to 5 experimental groups (n = 12) according to the instrumentation system used: ProTaper Next (Dentsply Sirona, York, PA), Reciproc Blue (RCB VDW, Munich, Germany), Reciproc (VDW), TruNatomy (TRN Dentsply Sirona), and XP-endo Shaper (FKG, La Chaux-de-Fonds, Switzerland). During instrumentation, 5 mL 2.5% sodium hypochlorite was used in each root canal. The final irrigation protocol included 15% EDTA followed by sodium hypochlorite irrigation. The micro–computed tomographic scanning of the samples was performed before and after instrumentation to analyze the transportation and centering ability at 3 canal levels. The results were analyzed with the 1-way analysis of variance test with the corresponding post hoc test.
Overall, RCB caused significantly more canal transportation compared with the other techniques (P < .05). There were no significant differences between the other techniques (P > .05). ProTaper Next had a significantly better ability to stay within the central axis of the root canal compared with the Reciproc and RCB techniques (P = .046 and P = .017, respectively). In the apical third, all techniques caused similar apical transportation and centering ability (P > .05). In the middle and cervical parts of the canal, the RCB caused significantly greater canal transportation than the other techniques (P < .05).
Under the limitations of this study, all tested techniques had similar transportation and centering abilities in the apical part of the canal. However, the overall results and those in the middle and coronal parts of the canal indicated that reciprocating instruments resulted in more canal transportation and less centered preparations.
Abstract The purpose of this study was to evaluate polymicrobial coronal leakage of mineral trioxide aggregate (MTA) and amalgam. There were 108 single-rooted teeth randomly divided into 3 groups of ...32 teeth each and positive and negative control groups of 6 teeth and obturated with gutta percha and either Diaket (3M/ESPE, Seefeld, Germany), AH Plus (Dentsply, De Trey, Konstanz, Germany), or Ketac Endo (3M/ESPE). These groups were further divided into 2 subgroups of 16 teeth in which root ends were resected and obturated with either MTA or zinc-free amalgam. The samples have been incorporated in a dual-chamber leakage model with a polymicrobial marker of five facultative anaerobes on the coronal part. Leakage was observing during a period of 90 days. The least leakage was found in a combination of Diaket and MTA (76.9 ±14.8 days) followed by AH Plus and MTA (66.1 ± 18.7), Diaket and amalgam (60.0 ± 23.1), AH Plus and amalgam (56.9 ± 22.1), and Ketac Endo and MTA (42.1 ± 17.8), whereas the greatest leakage was observed in the Ketac Endo and amalgam group (40.0 ± 17.24). Samples filled with MTA showed significantly better sealing than samples filled with amalgam (p < 0.05).
•SWEEPS used after single-file reciprocating instrumentation removed all pulp tissue from round canals and was more successful than the UAI and SNI•Single application of SWEEPS without previous ...mechanical instrumentation is not sufficient enough for the removal of pulp tissue from round root canal
: This study evaluated the efficacy of a new laser-assisted irrigation system, the shock wave enhanced emission photo-acoustic streaming (SWEEPS) technique in removing pulp tissue from single-rooted premolars.
: Freshly extracted mandibular premolars with round root canals (n = 40), scanned using cone beam computed tomography, were randomly divided into control and four experimental (according to the irrigation technique used) groups (n = 8/group). Groups 1, 2, and 3 were instrumented using Reciproc Blue (RB25/0.06) followed by final irrigation protocol (FIP), activated by SWEEPS, ultrasonically activated irrigation (UAI), and conventional irrigation (CI), respectively. In these groups, 7 mL 3% NaOCl in total was used during instrumentation; for FIP, 3% NaOCl (60 s), ethylenediaminotetraacetic acid (60 s), and 3% NaOCl (30 s). In group 4, SWEEPS activation of 3% NaOCl for 6 × 30 s alone was performed. The untreated control group specimens were processed for histological evaluation of remaining pulp tissue (RPT) in each canal third. The results were analyzed using the Mann-Whitney U test (α = 0.05).
: Significant differences were observed between the control group and the experimental groups (p<0.05). In the middle third, the UIA and SWEEPS showed similar efficacy (p = 0.171), superior to CI and SWEEPS without instrumentation (p<0.05). In the apical third, SWEEPS was the most efficient (p = 0.002), and UIA and CI showed no difference (p = 0.643).
: SWEEPS was superior to UIA and CI in removing RPT in the apical region of round canals after single instrument root canal preparation; SWEEPS without instrumentation was inefficient in removing pulp tissue.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Objectives
To evaluate the efficacy of passive ultrasonic irrigation (PUI) and super short pulse (SSP) and shock wave–enhanced emission photoacoustic streaming (SWEEPS) modes of Er:YAG ...laser–activated irrigation (LAI) with two different laser tips, in removing filling remnants after conventional retreatment in severely curved root canals.
Materials and methods
The study sample consisted of 40 extracted molars with curved mesiobuccal root canals. The canals were instrumented with ProTaper Next and filled with an epoxy resin–based sealer and gutta-percha using continuous wave vertical compaction and warm injection back-filling. After retreatment with ProTaper Universal Retreatment system and sodium hypochlorite (NaOCl), all samples were randomly divided into four groups (
n
= 10) according to the final irrigation technique: PUI, LAI/SSP, SWEEPS/flat-tip, and SWEEPS/radial-tip, using 6 mL of 3% NaOCl for an activation time of 3 × 30 s. The samples were subjected to micro-CT scans after root canal filling, retreatment, and final irrigation. The filling material volume and percentage reduction were calculated.
Results
All tested irrigation techniques were successful in the elimination of the filling remnants after the retreatment (
p
< 0.001). The LAI/SSP group showed a higher reduction rate than the SWEEPS/flat-tip group (
p
= 0.032). No significant differences were found between the other groups (
p
> 0.05).
Conclusion
All tested techniques improved the removal of filling material during retreatment in curved canals. LAI/SSP showed slightly better results than other techniques.
Clinical relevance
The study highlights the need for additional activated irrigation after the retreatment of curved root canals. The choice between PUI and LAI is not decisive for success.
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CMK, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Purpose High-energy lasers have been proposed as an alternative to the conventional surgical drill in oral and maxillofacial surgery. The aims of this study were to compare thermal changes of the ...bone surface, procedure time, and volume of the removed bone after drilling with an erbium (Er):yttrium-aluminum-garnet (YAG) laser versus a low-speed surgical drill. The bone sections were observed under light microscopy and examined histologically. Material and Methods Thirty bone blocks were prepared from porcine ribs. On each block 2 holes (tunnel preparations) were performed using a low-speed, 1.0-mm-wide, surgical pilot drill and an Er:YAG laser (pulse energy, 1,000 mJ; pulse duration, 300 μs; frequency, 20 Hz). The temperature induced by the preparation techniques was measured using an infrared camera. The removed bone volume was calculated by a modified mathematical algorithm. The time required for the preparation was measured with a digital stopwatch and a time-measurement instrument integrated within the computer program. The cortical and spongiose surfaces of the specimens were examined microscopically and histologically under a light microscope with a high-resolution camera. Results The Er:YAG laser removed significantly more bone tissue than the drill ( P < .01) in a significantly shorter time ( P < .01). The temperature was statistically lower during the laser preparation ( P < .01). Cavities prepared with the laser were regular with clear sharp edges and knifelike cuts. In the drill group, the preparations exhibited irregular edges full of bone fragments and fiberlike debris. Histologic examination of the laser sides showed a 30-μm-thick altered sublayer. The tissue in the drill group was covered with a smear layer without any alterations. Conclusions The Er:YAG laser produced preparations with regular and sharp edges, without bone fragments and debris, in a shorter time, and with less generated heat. Thermal alterations in the treated surface were minimal.
This study aimed to evaluate the efficacy of Shock Wave Enhanced Emission Photoacoustic Streaming (SWEEPS) in the removal of remaining pulp tissue from the root canal isthmus area in lower molars and ...compare it with ultrasonically activated irrigation (UAI) and conventional needle irrigation (NI). Forty-one lower molars with isthmuses between mesial canals were included in the study. The teeth were randomly distributed into experimental groups (
n
= 12/each) based on the final irrigation protocol (SWEEPS, UAI, or NI) and a control group (C) (
n
= 5). The traditional access cavity of the mesial part of each tooth was made in all samples. The mesial root canals in the experimental groups were instrumented with a Wave One Gold Primary (25/.07) file using 3% sodium hypochlorite (NaOCl) while the distal canal served as a control for the presence of pulp tissue. No treatment was performed in the C group. Sections from the isthmus region were processed for histopathology to measure the remaining pulp tissue (RPT). The results were analyzed using analysis of variance and the Kruskal-Wallis test (α = 0.05). There were no significant differences in the relative surface area of root canals and isthmus among the groups (
p
> 0.05). Samples in the SWEEPS group had significantly less RPT than UAI, NI, and C (
p
= 0.003, 0.014, 0.003, respectively). There were no significant differences between the UAI and NI (
p
= 0.583). SWEEPS was the most efficient in debridement of the root canal isthmus area. UAI and NI showed similar but lower efficiency.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
•445 nm diode laser wavelength shows decent antimicrobial effect in endodontic procedures.•445 nm photoactivated disinfection gives better results than 445 nm photothermal disinfection.•Diode laser ...root canal disinfection cannot replace standard sodium hypochlorite rinse.
Aims: 1) Evaluation of the photo-thermal (PT) and photo-activated (PAD) antibacterial effect of the 445/970 nm diode laser on E. faecalis, S. aureus and C. albicans mixed biofilms grown together inside root canals of human teeth. 2) Defining a potentially efficient clinical protocol for safe and predictable usage in endodontic procedures.
Methodology: The root canals of 100 extracted human teeth with single straight canals were prepared with ProTaper NEXT files, sterilized, contaminated with a combination of three cultures (E. faecalis, S. aureus, C. albicans) and incubated for 15 days. The samples were randomly distributed into three groups (n = 20) and treated as follows: Group 1 (G1) – the 445 nm photo-thermal (PT) effect, Group 2 (G2) – a combination of the 445 nm and 970 nm PT effect, Group 3 (G3) – the 445 nm photo-activated (PAD) effect with 0.1% riboflavin, Group 4 (G4) – a combination of 3% sodium hypochlorite (NaOCl) and the 445 nm PAD effect. Four samples were used as positive control (non-treated) and four as a negative control. 12 aditional samples were used as a control for the G4 (3% NaOCl rinse without the laser). The number of viable microbes in each canal was determined by the colony forming unit (CFU) count.
Results: A statistically significant reduction in the microbial population after all treatments was observed (P < 0.001). Groups 2 and 3 showed similar results, both better than Group 1. Group 4 produced the best results.
Conclusions: The 445 nm PAD protocol has a stronger antimicrobial effect than the 445 nm PT protocol. Prolonged exposure time to laser light and a combination of wavelengths (445/970 PT protocol) helps in the reduction of microbes. C. albicans appears to be more sensitive to laser irradiation than the other bacteria tested in this study. Following current results, tested laser protocols could be recommended for clinical usage but only as an adjunct to “classic” NaOCl rinse since alone they are not able to completely eradicate all microorganisms.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Highlights • The addition of the aPDT to the conventional chemomechanical root canal preparation led to the significant further reduction of the number of CFUs or even to complete elimination of ...bacteria in some cases. • The addition of the aPDT to the conventional chemomechanical root canal preparation led to the significant of bacteria species from the root canal. • The combination of chemomechanical preparation and the aPDT was more successful elimination of both gram positive and gram negative bacteria species compared to the chemomechanical preparation alone.
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•Using micro-CT to evaluate the efficacy of a novel laser activated irrigation in the removal of intracanal filling remnants.•The SWEEPS® was more effective than PUI, when used in combination with ...NaOCl, in the removal of filling remnants during root canal retreatment.•Additional activated irrigation of root canal with a solvent after the retreatment improved the removal of filling remnants from curved root canal.
This study aimed to evaluate the effect of Er:YAG laser-initiated shockwave-enhanced emission of photoacoustic streaming (SWEEPS®) and passive ultrasonic irrigation (PUI) combining thymol-based solvent or sodium hypochlorite (NaOCl) in the removal of filling remnants from curved canals.
Forty-eight curved root canals were instrumented and filled with an epoxy-resin-based sealer and gutta-percha. The canals were retreated with a Wave One Gold primary file (tip size 25; variable taper) and sodium hypochlorite (NaOCl). After the retreatment, the samples were randomly divided into four groups according to the additional irrigation protocol: PUI/NaOCl, PUI/solvent, SWEEPS®/NaOCl or SWEEPS®/solvent. The volume of filling material in root canal was measured after root canal filling, after mechanical retreatment, after final irrigation protocol and after additional irrigation protocol, using micro-CT. The results were analyzed using Kruskal-Wallis test with the post-hoc Mann-Whitney U test and Wilcoxon test (α=0.05).
In the PUI group, irrigation with the solvent or NaOCl resulted in similar filling reduction (p = 0.224). In the SWEEPS® group, irrigation with NaOCl resulted in a significantly greater filling reduction compared to the solvent (p = 0.021). The SWEEPS®/NaOCl group was more effective than the PUI/NaOCl group (p = 0.008). No significant differences were found between PUI/solvent and SWEEPS® groups (p>0.05) and PUI/NaOCl and SWEEPS®/solvent group (p>0.05).
Although all tested protocols improved the removal of filling remnants from curved root canal, the SWEEPS® was more successful than PUI when NaOCl was used. Both tested techniques showed similar efficacy when in combination with the solvent.
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