scholarly journals Effect of sodium hypochlorite solution and gel with/without passive ultrasonic irrigation on Enterococcus faecalis, Escherichia coli and their endotoxins

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 642
Author(s):  
Amjad Abu Hasna ◽  
Laiana Pereira Da Silva ◽  
Fernanda Carvalho Pelegrini ◽  
Cláudia Luísa Ribeiro Ferreira ◽  
Luciane Dias de Oliveira ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Enterococcus Faecalis ◽  
Sodium Hypochlorite ◽  
Ethylenediaminetetraacetic Acid ◽  
Lipoteichoic Acid ◽  
Sodium Hypochlorite Solution ◽  
Passive Ultrasonic Irrigation ◽  
E Coli ◽  
Significant Difference ◽  
Ultrasonic Irrigation

Background: Sodium hypochlorite (NaOCl) is the most commonly used irrigant in endodontics. The purpose of this study was to evaluate the effect of NaOCl solution (2.5%) and gel (3%) with/without passive ultrasonic irrigation (PUI) on Enterococcus faecalis, Escherichia coli, and their endotoxins, lipopolysaccharide (LPS) and lipoteichoic acid (LTA). Methods: 40 human lower premolars were contaminated with E. coli (ATCC 25922) for 28 days and E. faecalis (ATCC 29212) for 21 days. Specimens were randomly divided into four groups: (1) 2.5% NaOCl irrigating the canals without PUI activation; (2) 2.5% NaOCl with PUI; (3) 3% NaOCl gel irrigating the canals without PUI; and (4) 3% NaOCl gel with PUI. 40 mL of irrigant was used for each group. PUI activation was carried out using E1-Irrisonic stainless-steel tip at 10% frequency. After treatment, all specimens were filled with 3mL of 17% ethylenediaminetetraacetic acid (EDTA) for 3min and then washed with nonpyrogenic saline solution. Three samples were collected from the canals: S1, at baseline to confirm biofilm formation; S2 after treatment; and S3 after EDTA. Samples were assessed for E. coli and E. faecalis colony forming units, and LPS and LTA were assessed using chromogenic kinetic LAL assay and ELISA, respectively. Data were analyzed by Kruskal-Wallis, Friedmann and Dunn tests with α≤0.05. Results: All groups were effective in reducing the microbial load of E. coli and E. faecalis after treatment without a significant difference among the groups. NaOCl and NaOCl gel groups had no significant difference in reducing LPS and LTA. Statistically increased reduction was seen for NaOCL + PUI and NaOCl gel + PUI compared for groups without PUI. Conclusions: NaOCl gel has the same antimicrobial action of NaOCl solution and can partially detoxify endotoxins. PUI improves NaOCl (gel or solution) action over E. faecalis and E. coli and their endotoxins.

scholarly journals Effectiveness of XP-Endo Finisher and passive ultrasonic irrigation on intracanal medicament removal from root canals: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiani Zhou ◽  
Tingjun Liu ◽  
Lihong Guo
Keyword(s):  
Systematic Review ◽  
Ethylenediaminetetraacetic Acid ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
Passive Ultrasonic Irrigation ◽  
Significant Difference ◽  
Ultrasonic Irrigation

Abstract Background XP-Endo Finisher (XPF) and passive ultrasonic irrigation (PUI) are commonly used in intracanal medicament removal. The effectiveness of these two techniques needs to be compared, and evidence-based research should be conducted. Methods A comprehensive literature search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar up to December 20th, 2020. The outcomes of the included trials were pooled into the Cochrane Collaboration’s Review Manager 5.3 software. Cochrane’s risk-of-bias tool 2.0 was applied to assess the risk of bias. Results Nine articles were included in this systematic review and processed for data extraction, and eight studies were identified for meta-analysis. In general, the use of PUI showed better medicament removal effectiveness than XPF (odds ratio [OR]: 3.09; 95% confidence interval [CI], 1.96–4.86; P < 0.001). PUI was also significantly more efficient than XPF in the apical third (OR: 3.42; 95% CI, 1.32–8.84; P = 0.01). For trials using sodium hypochlorite (NaOCl) alone, PUI was also significantly more effective than XPF on intracanal medicaments removal (OR: 5.23; 95% CI, 2.79–9.82; P < 0.001). However, there was no significant difference between PUI and XPF when NaOCl and ethylenediaminetetraacetic acid (EDTA) were used in combination (OR: 1.51; 95% CI, 0.74–3.09; P = 0.26). In addition, for studies whose intracanal medicament periods were two weeks, the effectiveness of PUI was statistically better than the XPF (OR: 7.73; 95% CI, 3.71–16.07; P < 0.001). Nevertheless, for trials whose intracanal medicament time was one week or over two weeks, no differences between the XPF and PUI were found (OR: 1.54; 95% CI, 0.74–3.22; P = 0.25) (OR: 1.42; 95% CI, 0.44–4.61; P = 0.56). Conclusions The meta-analysis is the first study to quantitatively compare the effectiveness of XPF and PUI techniques on intracanal medicaments removal. With rigorous eligibility criteria, the study only included high-quality randomised controlled trials. The study indicated that PUI might be superior over XPF techniques for removing intracanal medicaments from artificial standardized grooves and cavities in the root canal system. The anatomical areas, irrigation protocol, and intracanal medicaments time may influence the cleaning efficacy.

scholarly journals Effectiveness of XP-Endo Finisher and Passive Ultrasonic Irrigation on Intracanal Medicament Removal From Root Canals: a Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Jiani Zhou ◽  
Tingjun Liu ◽  
Lihong Guo
Keyword(s):  
Systematic Review ◽  
Large Scale ◽  
Ethylenediaminetetraacetic Acid ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Passive Ultrasonic Irrigation ◽  
Significant Difference ◽  
Ultrasonic Irrigation

Abstract Background: XP-Endo finisher (XPF) and passive ultrasonic irrigation (PUI) are commonly used in intracanal medicament removal. The effectiveness of these two techniques needs to be compared, and evidence-based research should be conducted. Methods: A comprehensive literature search was conducted in PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar up to December 20th, 2020. The outcomes of the included trials were pooled into the Cochrane Collaboration’s Review Manager 5.3 software. Cochrane’s risk-of-bias tool 2.0 was applied to assess the risk of bias.Results: Nine articles were included in this systematic review and processed for data extraction, and eight studies were identified for meta-analysis. In general, the use of PUI showed better medicament removal effectiveness than XPF (odds ratio [OR]: 3.09; 95% confidence interval [CI], 1.96-4.86; P < 0.001). In subgroup analysis, when anatomical areas were focused on the apical third region of the canal, PUI was also significantly more effective than XPF (OR: 3.42; 95% CI, 1.32-8.84; P = 0.01). For trials using sodium hypochlorite (NaOCl) alone, PUI was also significantly more effective than XPF on intracanal medicaments removal (OR: 5.23; 95% CI, 2.79-9.82; P < 0.001). However, there was no significant difference between PUI and XPF when NaOCl and ethylenediaminetetraacetic acid (EDTA) were used in combination (OR: 1.51; 95% CI, 0.74-3.09; P = 0.26). In addition, for studies whose intracanal medicament periods were two weeks, the effectiveness of PUI was statistically better than the XPF (OR: 7.73; 95% CI, 3.71-16.07; P < 0.001). Nevertheless, for trials whose intracanal medicament time was one week or over two weeks, no differences between the XPF and PUI were found (OR: 1.54; 95% CI, 0.74-3.22; P = 0.25) (OR: 1.42; 95% CI, 0.44-4.61; P = 0.56). Conclusions: PUI might be superior over XPF techniques for removing intracanal medicaments from artificial standardized grooves and cavities in the root canal system. The anatomical areas, irrigation protocol, and intracanal medicaments time may influence the cleaning efficacy. More large-scale and high-quality trials are warranted to validate the conclusions.

scholarly journals Bond strength at the cement/dentin interface according to protocols for final irrigation of post space

2019 ◽  
Vol 18 ◽  
pp. e191376
Author(s):  
Carla Frehner Andrade ◽  
Paulo Fernando Otoni da Fonseca Filho ◽  
Marilisa Carneiro Leão Gabardo ◽  
Leonardo Fernandes da Cunha ◽  
Flares Baratto-Filho ◽  
...  
Keyword(s):  
Bond Strength ◽  
Ethylenediaminetetraacetic Acid ◽  
Paired Comparison ◽  
Resin Cement ◽  
Paired Comparisons ◽  
Passive Ultrasonic Irrigation ◽  
Pull Out ◽  
Significant Difference ◽  
Ultrasonic Irrigation ◽  
Post Space

Aim: The aim was to evaluate the bond strength at the cement/dentin interface in the post space, after specimens were treated with different final irrigation protocols, followed by cementation with a dual resin cement. Methods: Forty-eight extracted uniradicular human premolars were divided into four groups according to the irrigation (n = 12): control with distilled water; 2.5% sodium hypochlorite (NaOCl) + ethylenediaminetetraacetic acid (EDTA); 2.5% NaOCl + passive ultrasonic irrigation (PUI); and 2% chlorhexidine (CHX). The pull-out test was performed. The results were evaluated using ANOVA with Tukey’s paired comparisons, with a significance of 5%. Results: When all groups were compared, significant difference occurred (p = 0.006), and in the paired comparison, NaOCl + PUI and CHX differed (p = 0.005). The CHX showed significantly higher adhesive defects between cement and dentin than other groups. Conclusions: The final irrigation protocol for cleaning after preparation for post space directly influences the bond strength at the cement/dentin interface.

scholarly journals Effect of Passive Ultrasonic Irrigation on Enterococcus faecalis from Root Canals: An Ex Vivo Study

2015 ◽  
Vol 26 (4) ◽  
pp. 342-346 ◽  
Author(s):  
Juliane Maria Guerreiro-Tanomaru ◽  
Gisselle Moraima Chávez-Andrade ◽  
Norberto Batista de Faria-Júnior ◽  
Evandro Watanabe ◽  
Mário Tanomaru-Filho
Keyword(s):  
Enterococcus Faecalis ◽  
Root Canal ◽  
Saline Solution ◽  
Ex Vivo ◽  
Canal System ◽  
Passive Ultrasonic Irrigation ◽  
Root Canals ◽  
Significant Difference ◽  
Ultrasonic Irrigation ◽  
Root Canal System

<p>Endodontic irrigation aims to clean and disinfect the root canal system. Passive ultrasonic irrigation (PUI) is based on the use of an ultrasound-activated instrument into the root canal filled with irrigant. The aim of this study was to evaluate, ex vivo, the effectiveness of PUI in eliminating <italic>Enterococcus faecalis</italic> from root canals. Seventy-five extracted human single-root teeth were used. After root canal preparation, specimens were inoculated with <italic>E. faecalis</italic> and incubated at 37 °C for 21 days. Specimens were distributed into five groups (n=15), according to the irrigation method: PUI + saline solution (PUI/SS); PUI + 1% NaOCl (PUI/NaOCl); conventional needle irrigation (CNI) + saline solution (CNI/SS); CNI + 1% NaOCl (CNI/NaOCl); No irrigation (control). Microbiological samples were collected at three time points: initial (21 days after inoculation), post-irrigation (immediately after irrigation), and final (7 days after irrigation). Data were obtained in CFU mL<sup>-1</sup> and subjected to analysis by ANOVA and Tukey's tests at 5% significance level. The post-irrigation samples did not demonstrate statistical difference between PUI/SS and CNI/SS nor between PUI/NaOCl and CNI/NaOCl (p>0.05), but PUI/NaOCl and CNI/NaOCl had lower CFU mL<sup>-1</sup> number than the other groups (p>0.05). Statistically significant difference was observed between the initial and post-irrigation samples and between the post-irrigation and final samples (p<0.05) in all groups, except in the control. The final samples of all groups presented bacterial counts similar to the initial samples. PUI or CNI with 1% NaOCl contribute to disinfection, but are unable to eradicate <italic>E. faecalis</italic> from the root canal system.</p>

scholarly journals Effectiveness of Vapor Lock Effect Removal in Endo Training Blocks: Manual Dynamic Agitation versus Passive Ultrasonic Irrigation

2019 ◽  
Vol 9 (24) ◽  
pp. 5411
Author(s):  
Mario Dioguardi ◽  
Vito Crincoli ◽  
Diego Sovereto ◽  
Giorgia Apollonia Caloro ◽  
Riccardo Aiuto ◽  
...  
Keyword(s):  
Sodium Hypochlorite ◽  
Root Canal ◽  
Ethylenediaminetetraacetic Acid ◽  
P Value ◽  
Passive Ultrasonic Irrigation ◽  
Disposable Syringe ◽  
Ultrasonic Irrigation ◽  
Edta Ethylenediaminetetraacetic Acid

Root canal cleaning plays an important role in endodontics. In most cases, root canal cleaning is performed using irrigants, such as sodium hypochlorite or EDTA (ethylenediaminetetraacetic acid). The efficacy of these irrigants may be compromised by different phenomena, such as vapor lock. Different methods can be used to overcome this problem; in this paper, we compare the efficacy of two such methods: manual dynamic agitation (MDA) and passive ultrasonic irrigation (PUI). We shaped 50 endo training blocks, which were divided into two groups of 25 samples each, into MDA or PUI groups. In both groups, the vapor lock was produced by delivering a watery solution using a disposable syringe with a tip-opened needle. Using the MDA technique, vapor lock was removed in 15/25 cases. The PUI technique produced the same results in 17/25 cases, where vapor lock was only reduced, not removed. The MDA method produced an average reduction in vapor lock of 80%, whereas the PUI method yielded a 55% reduction. The differences among groups were assessed through a Mann–Whitney U test, and the results had a p-value of 0.0013, which was considered to be statistically significant. The MDA method was able to effectively remove vapor lock. PUI, however, was only able to reduce but not remove vapor lock.

scholarly journals Efficacy of continuous apical negative ultrasonic irrigation (CANUI) in penetration of simulated lateral canals in extracted teeth

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pablo Castelo-Baz ◽  
Francisco J. Rodríguez Lozano ◽  
María J. Ginzo-Villamayor ◽  
Ramón Miguéns Vila ◽  
Juan Seoane-Romero ◽  
...  
Keyword(s):  
Sodium Hypochlorite ◽  
Positive Pressure ◽  
Sodium Hypochlorite Solution ◽  
Passive Ultrasonic Irrigation ◽  
Hypochlorite Solution ◽  
Root Canals ◽  
Working Length ◽  
Ultrasonic Irrigation ◽  
Curved Root Canals

AbstractThe aim of this study was to evaluate the efficacy of continuous apical negative ultrasonic irrigation into simulated lateral canals and the apical third in straight and curved root canals. Two simulated lateral canals were created 2, 4 and 6 mm from the working length in 120 single-rooted teeth (6 canals/tooth, n = 360 straight, n = 360 curved). The teeth were randomly divided into 3 experimental groups: positive pressure irrigation (PPI) (n = 20); passive ultrasonic irrigation (PUI) (n = 20); continuous apical negative ultrasonic irrigation (CANUI) (n = 20). 20% Chinese ink was added to a 5% sodium hypochlorite solution and delivered into the root canals. The results showed a significantly higher (P < 0.05) penetration of irrigant into the lateral canals and up to working length in the CANUI group for straight and curved roots. CANUI improves penetration into the lateral canals and up to the working length of the cleared teeth in straight and curved roots.

scholarly journals Advantages and application of ultrasonic irrigation in endodontics

2021 ◽  
Author(s):  
Maha A. Abdulwahab ◽  
Lama A. Alghamdi ◽  
Nawaf A. Alshamrani ◽  
Khalid M. Alharbi ◽  
Salem M. Alghamdi ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Sodium Hypochlorite ◽  
Root Canal ◽  
Initial Phase ◽  
Current Practice ◽  
Ethylenediaminetetraacetic Acid ◽  
Passive Ultrasonic Irrigation ◽  
Combined Use ◽  
Ultrasonic Irrigation ◽  
Traditional Approaches

In the current practice, evidence shows that the currently used irrigant solutions (including sodium hypochlorite combined with and without chlorhexidine or ethylenediaminetetraacetic acid) cannot achieve full cleaning outcomes of the root canal. Accordingly, recent approaches were directed to innovate more efficacious modalities that can overcome the limitations of manual instrumentation and irrigation solutions. In this context, ultrasonic irrigation has been described in the literature as a favorable approach with significantly enhanced outcomes. We have provided evidence regarding the use of ultrasonic irrigation in endodontics. Our findings indicate that passive ultrasonic irrigation is more effective than manual instrumentation in eradicating debris and achieving favorable disinfection. Besides, it has been evidenced that the modality significantly reduces the time to achieve favorable treatment outcomes compared with the traditional approaches. It has been furtherly shown that more favorable outcomes were associated with the combined use of passive ultrasonic irrigation with manual instrumentation. Therefore, it has been suggested that manual instrumentation should be used at the initial phase to achieve adequate preparation, and passive ultrasonic irrigation should be used later on to achieve root canal cleaning.

scholarly journals Effectiveness of calcium and sodium hypochlorite associated with passive ultrasonic irrigation on pulp tissue dissolution – An in vitro study

2016 ◽  
Vol 31 (3) ◽  
pp. 109
Author(s):  
Matheus Albino Souza ◽  
Ana Paula Almeida ◽  
Vitória Menin ◽  
Daniel Lima Dalla Lana ◽  
Ana Paula Farina ◽  
...  
Keyword(s):  
Sodium Hypochlorite ◽  
In Vitro Study ◽  
Pulp Tissue ◽  
Calcium Hypochlorite ◽  
Passive Ultrasonic Irrigation ◽  
Significant Difference ◽  
Before And After ◽  
Ultrasonic Irrigation ◽  
Group 5

Objectives: To compare, in vitro, the effectiveness of calcium hypochlorite and sodium hypochlorite associated with passive ultrasonic irrigation (PUI) on pulpal tissue dissolution.Methods: The pulp tissue of forty-five bovine incisors was removed and each complete pulp was divided into two pieces of similar volume, resulting in 90 pieces distributed into nine groups (n=10), according to dissolution procedure: G1: distilled water; G2: 2.5% NaOCl; G3: 5.25% NaOCl; G4: 2.5% Ca(OCl)2; G5: 5.25% Ca(OCl)2; G6: 2.5% NaOCl+PUI; G7: 5.25% NaOCl+PUI; G8: 2.5%Ca(OCl)2+PUI and G9: 5.25% Ca(OCl)2+PUI. Each sample was weighed on a high precision balance before and after the dissolution procedure. The differences in weights were calculated and the mean percentage loss was determined. The data were statistically analyzed using two-way ANOVA and Games-Howel tests at 5% significance level.Results: Group 5 (5.25% Ca(OCl)2), 6 (2.5% NaOCl+PUI), 7 (5.25% NaOCl+PUI), 8 (2.5% Ca(OCl)2+PUI) and 9 (5.25% Ca(OCl)2+PUI) showed the highest mean percentages of weight reduction when compared to other groups (p<0.001). However, there was no statistically significant difference between them (p<0.001).Conclusions: Ca(OCl)2 and PUI contributes significantly to dissolution of pulp tissue.

scholarly journals Outcomes of Endodontic Therapy Comparing Conventional Sodium Hypochlorite Irrigation with Passive Ultrasonic Irrigation Using Sodium Hypochlorite and Ethylenediaminetetraacetate. A Retrospective Analysis

2016 ◽  
Vol 10 (1) ◽  
pp. 375-381 ◽  
Author(s):  
Moritz Hertel ◽  
Katja Sommer ◽  
Eckehard Kostka ◽  
Sandra Maria Imiolczyk ◽  
Husam Ballout ◽  
...  
Keyword(s):  
Sodium Hypochlorite ◽  
Clinical Symptoms ◽  
Treatment Success ◽  
Success Rates ◽  
Chi Square ◽  
Passive Ultrasonic Irrigation ◽  
Ultrasonic Irrigation ◽  
Endodontic Irrigation ◽  
Group 2

The aim of the present study was to investigate the clinical outcomes of two different standardized endodontic irrigation protocols. It was assumed that the additional use of ethylenediaminetetraacetate (EDTA) and passive ultrasonic irrigation (PUI) would result in an increased rate of absence of symptoms and remission based on the periapical index (PAI) compared to passive irrigation using only sodium hypochlorite (NaOCl). Data and radiographs from 199 teeth retrieved from the institutional endodontic database were analyzed retrospectively. In 106 teeth irrigation was performed using only NaOCl (protocol 1). Ninety-three teeth were irrigated using NaOCl and EDTA (protocol 2). Chlorhexidine (CHX) was additionally used in revision treatments in both groups. All irrigants in group 2 were activated by PUI. Mean follow-up periods were: protocol 1 = 9.2 ± 4.4 and protocol 2 = 6.6 ± 2.5 months (p < 0.0001 (chi-square test). The frequencies of the PAImasterpoint and PAIfollow-up scores did not differ significantly between teeth, which received either protocol 1 or 2 (p = 0.555 and 0.138). Statistical analysis revealed no significant association between treatment success (absence of clinical symptoms and PAIfollow-up = I or PAImasterpoint > PAIfollow-up > I) and the applied protocol (success rates: protocol 1 = 72.6% vs. protocol 2 = 82.8%; p = 0.203). Furthermore, the frequency of extractions did not differ significantly between the two protocols (p = 0.102). No association was found between follow-up time and treatment success (p = 0.888). The hypothesis was not confirmed. Even though the obtained success rate was higher after supplementing the irrigation protocol with EDTA and PUI, no significance was recorded. Hence, protocol 2 was not superior to protocol 1 regarding therapy success, at least within the limited follow-up period. It may be cautiously concluded that sufficient mechanical debridement combined with passive NaOCl irrigation results in comparably high success rates compared to EDTA and PUI.

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