Endodontic Irrigants and Their Activation Efficacy on Cleansing Post-Space Root Canal Walls

The aim of this study was to evaluate the efficacy of activated irrigants (EDTA e NaOCL) during the cleansing of root walls, of the smear layer, of the debris, and gutta-percha after the preparation of the restorative space. Twenty single and multi-rooted (n = 20) have been collected. All samples were prepared by the same operator, using Nickel-titanium rotating instruments (Mtwo) through the Simultaneous Shaping Technique. The continuous-wave of condensation technique of obturation was used. To all specimens, the restorative space has been made, leaving 5 mm of apical gutta-percha, and postoperative periapical X-rays were performed. The samples were randomly divided into two groups: Group (A): cleansing of the root walls with ultrasonic activation of the irrigants (NEWTRON P5 XS; Satelec Acteon); Group (B): radicular walls wash without ultrasonic activation of endodontic irrigants (NaOCl 5.25% and EDTA 17%). Both dental sample groups were cut longitudinally with a low-speed saw (Isomet); the samples were observed by using a scanning electron microscope (Jeol, Jsm-6060LV) in order to evaluate: (1) the amount of debris/smear layer; (2) the mount of obstruction of dentinal tubules found in the two groups; and (3) evaluation of the presence of gutta-percha. Then, the other five samples each group (with and without ultrasonic activation) were prepared following the same protocol. Then, a universal bonding system (G-Praemio Bond, GC) and a layer of a flowable resin composite (Gaenial Flow, GC) were light-cured and used on top of the prepared root canal walls. The samples were cut in two pieces along the long axis of the root. Then, half sample teeth were kept in an acidic solution (37% HCl) for 48 h in order to completely dissolve dental structures and to have a direct view of resin tags formation under SEM. The other half was prepared to observe the adhesive interface under SEM. The amount of debris was not satisfactory in 9 out of 10 cases in Group B, while in Group A, which has been treated with ultrasounds, the result was either good or great in most of the samples. For the sample group treated with ultrasound, the tubules were evaluated as perfectly clean in 9 out of 10 cases, instead, the results are unsatisfactory for 9 out of 10 cases of group B not treated with ultrasound. Differences between Group A and B were statistically significant. With respect to the presence of debris and tubules obstruction treatment with ultrasonic activation, it offers with no doubt better results. When ultrasonic activation is used in combination with endodontic irrigants, a clean dentin substrate is be obtained for the adhesion of restorative materials, but in order to confirm the findings of this study, further in vivo trials are needed.

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Effect of Smear Layer on the Apical Seal of Endodontically Treated Teeth: An ex vivo Study

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1090 ◽

2012 ◽

Vol 13 (1) ◽

pp. 23-26 ◽

Cited By ~ 1

Author(s):

KG Nischith ◽

GPV Srikumar ◽

Shuaib Razvi ◽

R Vinay Chandra

Keyword(s):

Root Canal ◽

Ex Vivo ◽

Smear Layer ◽

Control Group ◽

Endodontically Treated Teeth ◽

Root Canals ◽

Group A ◽

Group B ◽

Root Canal Irrigant ◽

Ex Vivo Study

ABSTRACT Aim The purpose of this study was to evaluate the effect of smear layer on apical seal of endodontically treated teeth. Materials and methods Sixty freshly extracted human maxillary central incisor teeth were selected and were randomly divided into two experimental groups. Group A of 25 teeth and group B of 25 teeth and a control group of 10 teeth. Cleaning and shaping of the root canals were performed using endodontic K-files up to no. 50 size file in step-back technique. During the process, in root canals of group A, 17% EDTA (ethylenediaminetetraacetic acid) followed by 3% NaOCl (sodium hypochlorite) was used as root canal irrigant. In group B, MTAD (mixture tetracycline citric acid and detergent) was used as a root canal irrigant. In control group, saline was used as root canal irrigant. The root surfaces were then coated with nail polish of both experimental groups and control group. The samples were then immersed in India ink dye for 1 week at 37°C. Results The statistical analysis of the results showed that the apical leakage was significantly more in teeth, where smear layer was not removed. Conclusion The removal of smear layer improves the longterm apical seal and success of endodontically treated teeth. Clinical significance The development and maintenance of apical seal is desirable and considered to be a major prerequisite to improve the outcome of root canal treatment. How to cite this article Nischith KG, Srikumar GPV, Razvi S, Chandra RV. Effect of Smear Layer on the Apical Seal of Endodontically Treated Teeth: An ex vivo Study. J Contemp Dent Pract 2012;13(1):23-26.

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Effects of Ultrasonic Activation on Root Canal Filling Quality of Single-Cone Obturation with Calcium Silicate-Based Sealer

Materials ◽

10.3390/ma14051292 ◽

2021 ◽

Vol 14 (5) ◽

pp. 1292

Author(s):

Sin-Young Kim ◽

Young-Eun Jang ◽

Bom Sahn Kim ◽

Eun-Kyoung Pang ◽

Kiche Shim ◽

...

Keyword(s):

Root Canal ◽

Calcium Silicate ◽

Continuous Wave ◽

Void Volume ◽

Ultrasonic Activation ◽

Sem Images ◽

Root Canal Filling ◽

Gutta Percha ◽

Single Cone

Background: We evaluated the effects of ultrasonic activation on root canal filling quality of the single-cone (SC) obturation technique with calcium silicate sealers and gutta percha cones. Methods: Thirty-six human single-rooted premolars were obturated with gutta percha and sealer. For the continuous wave (CW) group (n = 12), AH Plus with a continuous wave technique was used. The SC group (n = 12) received EndoSequence BC sealer with a single-cone technique. The SCU (SC with the addition of ultrasonic activation) group (n = 12) received the same treatment. Micro-computed tomography was used to scan the teeth, and the void volume within the root canal was evaluated at the apical, middle, and coronal levels. Then cross-sections were observed under a light microscope and scanning electron microscope (SEM). Results: Void volume was significantly lower in the SCU group than in the CW and SC groups. There were no statistically significant differences between the CW and SC groups. The SCU group had fewer voids than the CW and SC groups in the coronal and middle third areas. Specimens showed no apparent gaps or voids in any group. SEM images revealed both gap-free and gap-containing regions at different levels in all groups. Conclusions: Single-cone obturation with calcium silicate-based sealers might obtain enhanced filling quality when used with ultrasonic activation.

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The impact of different irrigants on the quality of root canal walls

Stomatoloski glasnik Srbije ◽

10.2298/sgs0703160s ◽

2007 ◽

Vol 54 (3) ◽

pp. 160-169

Author(s):

Goran Stojilkovic ◽

Jovanka Gasic ◽

Jelena Dakovic

Keyword(s):

Root Canal ◽

Smear Layer ◽

Control Group ◽

Complete Elimination ◽

Canal Irrigation ◽

Root Canals ◽

Root Canal Irrigation ◽

Combined Use ◽

Group A ◽

Group B

Introduction: Root canal irrigation plays an important part in the endodontic therapy. Inadequate irrigation or instrumentation without irrigation increase the accumulation of debris on the cutting surfaces of instruments as well as debris and smear layer on root canal walls. Aim: The aim of this study was to evaluate smear layer removal after irrigation with saline, 5% NaOCl, 15% EDTA and the combination of 15% EDTA and 5% NaOCl. Materials and Methods: The study was conducted at the Clinic for Dentistry and Institute for biomedical research of the School of Medicine in Nis. Twenty five premolars, extracted from orthodontic reasons, were allocated to 5 groups (A-E) of 5 teeth. Root canals of all teeth were instrumented using hand K files. Samples from Group A were instrumented without irrigation (control group). In Group B, the irrigation was done using saline, in Group C 5% NaOCl, in Group D 15% EDTA and in Group E the combination of 15% EDTA and 5% NaOCl. After the treatment, all samples were prepared for scanning electron microscopy (SEM). Central parts of root canals were examined and photomicrographs were taken at different magnification. The amount of debris and smear layer was quantified and the data were statistically analyzed. Results: All four treatment modalities (B, C, D, E) induced changes in the appearance of dentinal walls and the amount of debris and the smear layer compared to the control group (A). The difference between the control group and Group B was statistically significant (p<0.01) and highly significant between the control group and Groups C, D and E (p<0.0001). The combined use of 15% EDTA and 5% NaOCl for irrigation and 1 min final rinse resulted in a complete elimination of the smear layer; the use of saline, 5% NaOCl or 15% EDTA alone failed to remove the debris and smear layer completely. Conclusion: The use of singular solutions for root canal irrigation significantly reduces the amount of debris and the smear layer whereas the combined use of NaOCl and EDTA results in the complete elimination of the smear layer from root canal walls.

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Comparative study of the sealing ability of a polydimethylsiloxane-based root canal sealer

Brazilian Dental Journal ◽

10.1590/s0103-64402005000200011 ◽

2005 ◽

Vol 16 (2) ◽

pp. 145-148 ◽

Cited By ~ 3

Author(s):

Nickolaos Economides ◽

Beltes Panagiotis ◽

Ioannis Kolokouris ◽

Christos Gogos ◽

Ioannis Kokorikos

Keyword(s):

Root Canal ◽

Fluid Transport ◽

Transport Model ◽

Smear Layer ◽

The Other ◽

Human Teeth ◽

Root Canals ◽

Gutta Percha ◽

Sealing Ability ◽

Root Canal Sealers

The purpose of this study was to compare the sealing ability of three root canal sealers, RSA (polydimethylsiloxane sealer), Endion (glass-ionomer sealer) and Topseal (epoxy resin sealer), with and without smear layer removal. Ninety extracted human teeth were selected and assigned to 6 groups (n=15), according to the following protocols: in 3 groups, the smear layer was left intact and the root canals were obturated with gutta-percha points and RSA, Endion and Topseal, respectively; in the other 3 groups, the smear layer was removed and the root canals were obturated in the same way as described above. Microleakage was measured at 7 days, 1 month and 2 months, using the fluid transport model. The results were expressed in µL/24 h. Data were analyzed statistically by Kruskall-Wallis and Mann-Whitney non-parametric tests. The results showed that the Topseal group without smear layer leaked significantly less (p<0.05) than the RSA group without smear layer, at all experimental periods. No statistically significant differences (p>0.05) were found among the other groups, at the established evaluation intervals. The findings of this study showed that the polydimethylsiloxane sealer (RSA) did not yield better sealing ability than the other sealers, either in the presence or in the absence of smear layer. Topseal had the least microleakage from the root canal sealers evaluated.

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Short-term evaluation of an intra-articular technique for cranial cruciate ligament rupture in dogs using nylon or polyester

Semina Ciências Agrárias ◽

10.5433/1679-0359.2018v39n2p593 ◽

2018 ◽

Vol 39 (2) ◽

pp. 593

Author(s):

Tiago Carmagnani Prada ◽

Anderson Coutinho da Silva ◽

Bruno Watanabe Minto

Keyword(s):

Cruciate Ligament ◽

The Other ◽

Polyester Yarn ◽

Short Term ◽

Limb Function ◽

Cranial Cruciate Ligament ◽

Ligament Rupture ◽

Group A ◽

Group B ◽

Cranial Cruciate Ligament Rupture

Cranial cruciate ligament rupture (CCrLR) is a common condition found in the small animal routine, being correlated to traumas, obesity, genetic factors, and primary osteoarthritis (OA) in dogs. Affected animals show articular instability that, if not corrected surgically, may cause secondary OA and loss of limb function. The aim of this study was to compare short-term results of the intra-articular technique for knee stabilization after CCrLR using a surgical button associated with polyester yarn (Group A), the surgical button associated with nylon yarn (Group B), and surgical toggle associated with polyester yarn (Group C). Eighteen dogs presenting CCrLR, weight varying from 5 to 35 kg, and different sex and breed were divided into three groups of six individuals. OA radiographic grade, pre- and post-operative lameness, surgical time, and the macroscopic aspect of cartilage were assessed. The intra-articular technique was performed by passing a suture through two tunnels, drilled in the femoral condyle and tibial crest to stabilize the knee joint. Twelve animals presented a decreased lameness and normal limb function after 15 days. On the other hand, four dogs from Group B presented complications: two dogs had suture rupture after 30 days and other two showed muscular contracture with decreased range of motion, followed by loss of limb function. In Group A, one dog showed suture rupture after 15 days and other had suture infection after 30 days. In Group C, dogs recovered normal limb function without complications. Therefore, surgical toggle associated with polyester yarn was better than the other studied materials.

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"In vitro" evaluation of the apical sealing of root canals obturated with different techniques

Journal of Applied Oral Science ◽

10.1590/s1678-77572003000300005 ◽

2003 ◽

Vol 11 (3) ◽

pp. 181-185 ◽

Cited By ~ 8

Author(s):

Viviane Haiub Brosco ◽

Norberti Bernardineli ◽

Ivaldo Gomes de Moraes

Keyword(s):

Continuous Wave ◽

The Other ◽

Blue Dye ◽

Methylene Blue Dye ◽

Root Canals ◽

Gutta Percha ◽

Sealing Ability ◽

Better Than ◽

Positive Controls

The purpose of this study was to compare the apical sealing of root canals obturated with different techniques. One hundred-six human mandibular incisors were submitted to instrumentation by means of the step-back technique. After instrumentation, one hundred teeth received an impermeable coating on the external surfaces of the crown and root (except for the area nearby the apical foramen). Afterwards, they were divided in five groups containing twenty elements each, according to the obturation technique employed: 1. lateral condensation with Kerr file; 2. continuous wave of condensation technique with System B; 3. thermoplasticized injectable gutta-percha technique with the Ultrafil system; 4. mechanically thermoplasticized gutta-percha with the JS Quick-Fill system and 5. thermoplasticized gutta-percha associated to a master cone with the Microseal system. The six remaining teeth were employed as negative and positive controls. After obturation, the access cavities were sealed and the teeth were immersed in aqueous 2% methylene blue dye for 72 hours at 37ºC. After that, the teeth were longitudinally sectioned and the apical microleakage was evaluated in a stereomicroscope. The Microseal system presented the best apical sealing ability, followed by System B, JS Quick-Fill, Ultrafil and the lateral condensation technique. The statistical analysis of the results demonstrated that: 1. the Microseal system presented an apical sealing similar to System B and better than the other groups; 2. System B presented better apical sealing than the lateral condensation technique, being similar to the other groups; and 3. the lateral condensation, Ultrafil and JS Quick-Fill groups demonstrated similar sealing ability.

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Efficacy of High-Power Laser in Alleviating Pain and Improving Function of Patients With Patellofemoral Pain Syndrome: A Single-Blind Randomized Controlled Trial

Journal of lasers in medical sciences ◽

10.15171/jlms.2019.06 ◽

2018 ◽

Vol 10 (1) ◽

pp. 37-43

Author(s):

Farshad Nouri ◽

Seyed Ahmad Raeissadat ◽

Dariush Eliaspour ◽

Seyed Mansoor Rayegani ◽

Maryam Sadat Rahimi ◽

...

Keyword(s):

Controlled Trial ◽

Pain Syndrome ◽

The Other ◽

Short Term ◽

Randomized Controlled ◽

Group A ◽

Laser Group ◽

Group B ◽

Single Blind ◽

Post Therapy

Introduction: In this study, a single-blind and randomized controlled trial (RCT) for assessing the effectiveness of high-power (up to 12 W) laser therapy (HPLT) on patients with patellofemoral pain syndrome (PFPS) was carried out. Methods: Forty-four patients were randomly assigned to two treatment groups by generating random numbers with MATLAB 2014b software, where odd and even numbers were attributed to sham laser group (group A) and actual laser group (group B), respectively. Group B patients underwent HPLT with total dose of 300 J/session for 5 consecutive sessions separated by a 2-day interval. On the other hand, sham laser was applied to group A patients. Both groups had the same exercise therapy programs during the study period (3 months). The exercise therapy program included isometric knee exercise for 3 sets per day and 10 times in each set, with duration of 10 seconds per time and straight leg raise for 15 seconds 10 times a day. The group codes of patients were not revealed to subjects and data analyzer until completion of the study. Kujala, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS) questionnaires were chosen as outcome measures. These questionnaires were completed at three points during the study; at the beginning of the study to obtain the pre-therapy conditions and one month and three months after the start of the study to evaluate post-therapy conditions. Results: Two main analyses were conducted: within-group and between-group analyses. Withingroup analyses indicated significant improvements in respect to all measurements where pretherapy and post-therapy comparisons were conducted in both groups (P < 0.05). On the other hand, between-group comparisons did not reveal any statistically significant functional difference between group A and group B regarding the evaluative criteria (P > 0.05) except for pain VAS (P < 0.05). Conclusion: This study indicated that short-term HPLT accompanied by appropriate exercise regimen significantly decreased pain in patients with PFPS. But it was not recommended as an efficient modality in functional improvement. Also, it was observed that, in the short-term period of study, HPLT was a safe modality.

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Uniplanar cannulated pedicle screws in the correction of Lenke type 1 adolescent idiopathic scoliosis (AIS)

10.21203/rs.3.rs-34233/v1 ◽

2020 ◽

Author(s):

Yiwei Zhao ◽

Wubo Liu ◽

Suomao Yuan ◽

Yonghao Tian ◽

Xinyu Liu

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Pedicle Screws ◽

Vertebral Rotation ◽

Concave Side ◽

Convex Side ◽

X Rays ◽

Group A ◽

Group B

Abstract Background In the present study, we reported the clinical use of uniplanar cannulated pedicle screws for the correction of Lenke type 1 adolescent Idiopathic scoliosis (AIS), and its safety and clinical outcomes were also evaluated. Methods 68 patients with Lenke type 1 AIS were included, among which 38 patients were treated with uniplanar cannulated screws at the concave side of periapical levels and multiaxial screws at the other levels (group A). Moreover, the remaining 30 patients were treated with all multiaxial screws (group B). The preoperative and postoperative radiographic parameters of the Lenke type 1 AIS, axial vertebral rotation, and the safety of the pedicle screws were evaluated by X-rays and computed tomography (CT). Results Preoperative data was comparable between two groups. The postoperative proximal thoracic (PT) curve, main thoracic (MT) curve, thoracolumbar/lumbar (TL/L) curve, and apical vertebral rotation were significantly improved compared with the preoperative data. The coronal correction rates in group A and B were 83% and 81.9%, respectively (P > 0.05). The derotation rates in group A and B were 60.8% and 43.2%, respectively (P < 0.05). The rotation classification in the group A was also better compared with the group B. The misplacement rate in group A and B was 7.9% and 11.8%, respectively (P < 0.05), and the total misplacement rate on the concave side (11.4%) was higher than that of convex side (8.4%). The lateral perforation was found at the concave side, while the medial perforation was found at the convex side. On the concave side, the misplacement rate in group A and B was 9.7% and 12.3%, respectively (P < 0.05). The grades 2 and 3 perforations were three (3.5%) in the group A and eight (8.2%) in the group B (P < 0.05). On the convex side, the misplacement rate in group A and B was 5.9% and 11.1%, respectively (P < 0.05). The grades 2 and 3 perforations were one (0.9%) in the group A and four (4.4%) in the group B (P < 0.05). Conclusion Collectively, uniplanar cannulated pedicle screws could effectively increase the accuracy of pedicle screws and facilitate the derotation of the apical vertebra compared with the multiaxial pedicle screws. Trial registration retrospectively registered

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Effects of Allogenic Dermal Fibroblasts on Rotator Cuff Healing in a Rabbit Model of Chronic Tear

The American Journal of Sports Medicine ◽

10.1177/0363546518770428 ◽

2018 ◽

Vol 46 (8) ◽

pp. 1901-1908 ◽

Cited By ~ 9

Author(s):

Jieun Kwon ◽

Yun Hee Kim ◽

Sung-Min Rhee ◽

Tae In Kim ◽

Jimin Lee ◽

...

Keyword(s):

Rotator Cuff ◽

Laboratory Study ◽

Bone Healing ◽

Rabbit Model ◽

Dermal Fibroblasts ◽

The Other ◽

Histological Evaluation ◽

Load To Failure ◽

Group A ◽

Group B

Background: The failure of rotator cuffs to heal after repair is an unresolved surgical issue. There have been substantial efforts, including the use of biological supplements, to enhance tendon healing. Dermal fibroblasts are a good candidate for tendon tissue engineering because they are similar to the tenocytes used for collagen synthesis. In addition, they are easily accessible because autologous dermal fibroblasts can be obtained from individual skin without major skin defects and allogenic dermal fibroblasts (ADFs) have already been commercialized in the field of skin engineering. Purpose: To determine the effects of dermal fibroblasts on tendon-to-bone healing in a rabbit model of a chronic rotator cuff tear. Study Design: Controlled laboratory study. Methods: A total of 33 rabbits were randomly allocated into 3 groups (n = 11 each). Supraspinatus tendons were detached and left for 6 weeks to establish a chronic rotator tear model. Torn tendons were repaired in a transosseous manner with the injection of 5 × 106 ADFs with fibrin in group A, fibrin only in group B, and saline only in group C. At 12 weeks after repair, the mechanical test and histological evaluation were performed. Results: Seven rabbits died before the evaluation (1 in group A, 2 in group B, 4 in group C). In the final evaluation, the mean ± SD load to failure was 48.1 ± 13.3 N/kg for group A, 34.5 ± 8.9 N/kg for group B, and 31.1 ± 8.3 N/kg for group C, and group A showed significantly higher load-to-failure values than the other groups ( P = .011). The midsubstance tear rate, which presented stronger tendon-to-bone healing than insertional tear, was 50.0% in group A, 22.2% in group B, 28.6% in group C, but the differences were not statistically significant ( P = .413). In the histological evaluation, group A showed greater collagen fiber continuity and better orientation than the other groups. Conclusion: This controlled laboratory study verified, on the basis of biomechanics and histology, the potential for the use of ADFs in rotator cuff healing. The current results suggest a new biological supplement to increase the rate of rotator cuff healing. Clinical Relevance: The most important finding of this study was the potential for a new biological supplement to enhance rotator cuff healing—a continuing challenge.

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Sequential versus Alternating Regimens in the Treatment of Advanced Breast Cancer

Tumori Journal ◽

10.1177/030089168907500211 ◽

1989 ◽

Vol 75 (2) ◽

pp. 137-140 ◽

Cited By ~ 2

Author(s):

Omar Fernández Giachella ◽

Carlos Gálvez ◽

Carlos Rufino ◽

Adelina Rufino ◽

Federico Morera ◽

...

Keyword(s):

Breast Cancer ◽

Advanced Breast Cancer ◽

Response Rate ◽

Advanced Breast ◽

The Other ◽

Trial Group ◽

Duration Of Response ◽

Group A ◽

Alternate Forms ◽

Group B

With the object of proving whether seqeuntial or alternate forms of chemotherapy would be advantageous one over the other in treating advanced breast cancer and with the purpose of evaluating two different anthracyclines at equimolecular doses in the above-mentioned alternating regimens, 250 patients who had received no prior chemo- or hormonotherapy were entered in a prospective randomized trial. Group A was administered 4-epiadriamycin and cyclophosphamide for 8 courses, followed by 6 cycles of CMF, and medroxyprogesterone acetate (MPA) from the beginning of therapy until progression. In group B, adriamycin + cyclophosphamide were alternated with CMF every two courses until 14 cycles were completed. Group C received 4'-epiadriamycin + cyclophosphamide alternated with CMF for 14 courses. In groups B and C, MPA was administered as in group A. Two hundred and twenty-four patients were evaluated. CR+PR were observed in 55.8 % of group A, 43.4 % of group B, and 46.4 % of group C. Median duration of responses was 16 months (m) in group A, 13 m in group B and 20 m in group C., and median survival (CR + PR) was 16.5 m in group A, 16 m in group B and 24 m in group C. There were no statsitically significant differences among the three groups in terms of response rate, duration of response and survival; furthermore, toxicity was moderate in all groups. At equimolecular doses there were no differences between adriamycin and epirubicin in the alternating schedules.

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