Root Canal Disinfection Articles with the Highest Relative Citation Ratios. A Bibliometric Analysis from 1990 to 2019

The relative citation rate (RCR) is a normalized article-level metric useful to assess the impact of research articles. The objective of this bibliometric study is to identify and analyze, in root canal disinfection, the 100 articles having the highest RCRs in the period 1990–2019, then compare them with the top 100 articles most cited. A cross-sectional study was performed, and the search strategy ((Disinfection AND root canal) AND ((“1990/01/01”[Date-Publication]: “2019/12/31”[Date-Publication]))) relied on PubMed (n = 4294 documents), and article data were downloaded from the iCite database. The 100 articles with the highest RCRs and the top 100 cited were selected and evaluated in bibliometric terms. Among the 100 articles with the highest RCRs, there were no differences in the three decades for RCRs values, but there were in citations, being 2000–2009 the most cited. The USA was the predominant country (n = 30), followed by Brazil (n = 14). The most frequent study designs were reviews (n = 27) and in vitro (n = 25) and ex vivo (n = 24) studies. All subfields were well represented, although they varied over time. In 2010–2019, regenerative procedures and irrigation/disinfection techniques were predominant. Considering the RCR’s top 100 articles, 76 were common with the 100 most cited articles. Using the RCR metric allowed us to identify influential articles in root canal disinfection, a research field with topics of significance that fluctuate over time. Compared to citations, RCR reduces the time from publication to detection of its importance for the readership and could be a valid alternative to citation counts.

Analysis of two irrigation methods in root canal disinfection against E. Faecalis biofilm under the influence of the concentration, volumen, and time in contact of the irrigant

The purpose of this ex vivo study was to evaluate the effectiveness of two irrigation techniques against E. Faecalis biofilm: conventional irrigation (CI) and passive ultrasonic irrigation (PUI). Furthermore, to investigate a possible cumulative effect of disinfection in the final irrigation, leaving the hypochlorite in the root canal for 2 or 5 minutes without agitation. A total of 63 premolars were divided into 9 groups (n = 7): Groups CI - 2.5 and CI - 5.25: Conventional irrigation with 2.5% and 5.25% NaOCl, respectively, a total of 6 mL for 1 min. Groups CI/PUI - 2.5 and CI/PUI - 5.25: CI + PUI with 2.5% and 5.25% NaOCl respectively, a total of 12 mL for 2 min. Groups CI/PUI - 2.5-2 (total of 14 mL for 4 min) and CI/PUI - 2.5-5 (total of 14 mL for 7 min): CI + PUI, plus final irrigation leaving the NaOCl 2,5% in the root canal for 2 or 5 minutes without agitation, respectively. Groups CI/PUI - 5,25-2 (total of 14 mL for 4 min) and CI/PUI - 5,25-5 (total of 14 mL for 7 minutes): CI + PUI, plus final irrigation leaving the NaOCl 5,25% in the root canal for 2 or 5 minutes without agitation, respectively. Control Group: CI + PUI, final irrigation leaving sterile saline solution for 5 min. The CI/PUI - 5,25 group showed a significantly greater reduction of E. faecalis than in the CI/PUI - 2.5 group. All other groups did not differ significantly from each other. The control group showed a less efficient reduction of E. faecalis. The CI associated with PUI was sufficiently able to reduce the bacterial load of E. faecalis. The final irrigation, leaving the hypochlorite in the root canal for 2 or 5 minutes without agitation did not demonstrate relevance in this study. Successive changes of the irrigating liquid, resulting in greater volume, demonstrated better results in disinfecting the root canal system.

INVESTIGATION OF ANTIBACTERIAL ACTIVITY OF ND: YAG - LASER AND STANDARD ENDODONTIC TREATMENT

Introduction: The microbial infection is one of the main causes of the dental pulp and periodontal diseases. Previously used methods for its elimination are not fully effective, and often some microorganisms in root canals (RC) remain unaffected after treatment. Another modern method for disinfection of root canal system is laser disinfection. Different types of lasers are used - Nd: YAG, Er: YAG, Diode laser. Purpose: The purpose of our study is to compare the antibacterial activity of ND: YAG laser and conventional endodontic therapy in the treatment of infected root canals. Materials and methods The study involved 36 teeth of patients diagnosed with pulp gangrene or chronic periapical periodontitis, requiring endodontic treatment. They were divided into two groups of 18 teeth each one. The teeth in both groups are prepared by Protaper Universal rotary instruments (Maillefer Instruments SA, Ballaigues, Switzerland). In group 1the root canals disinfection is performed with a Nd: YAG laser (source of Nd: YAG laser (1064 nm) is the AT Fidelis - Fotona d.d., Ljubljana laser system). In group 2 was used the following protocol of root canal disinfection: 2.5% sodium hypochlorite solution and 17% EDTA divided by irrigation with distilled water. Then a sterile paper point is placed in the root canals, and a microbiological sample is taken again. Results: In all compared pairs, there was no significantly different effect regarding the number of microorganisms. Conclusions: The disinfection rinsing method with NaOCl has the strongest antimicrobial effect in clinical studies (90% against all microbial isolates). The use of Nd: YAG laser independently is not always sufficient for root canal disinfection - the effect is about 66%.

Influence of Different Conditioning Treatments on The Bond Integrity of Root Dentin to rGO Infiltrated Dentin Adhesive. SEM, EDX, FTIR and MicroRaman Study

The present study aimed to synthesize and equate the mechanical properties and dentin interaction of two adhesives; experimental adhesive (EA) and 5 wt.% reduced graphene oxide rGO) containing adhesive. Scanning electron microscopy (SEM)-Energy-dispersive X-ray spectroscopy (EDX), Micro-Raman spectroscopy, push-out bond strength test, and Fourier Transform Infrared (FTIR) spectroscopy were employed to study nano-bond strength, degree of conversion (DC), and adhesive-dentin interaction. The EA was prepared, and rGO particles were added to produce two adhesive groups, EA-rGO-0% (control) and rGO-5%. The canals of sixty roots were shaped and prepared, and fiber posts were cemented. The specimens were further alienated into groups based on the root canal disinfection technique, including 2.5% sodium hypochlorite (NaOCl), Photodynamic therapy (PDT), and ER-CR-YSGG laser (ECYL). The rGO nanoparticles were flake-shaped, and EDX confirmed the presence of carbon (C). Micro-Raman spectroscopy revealed distinct peaks for graphene. Push-out bond strength test demonstrated highest values for the EA-rGO-0% group after NaOCl and PDT conditioning whereas, rGO-5% showed higher values after ECYL conditioning. EA-rGO-0% presented greater DC than rGO-5% adhesive. The rGO-5% adhesive demonstrated comparable push-out bond strength and rheological properties to the controls. The rGO-5% demonstrated acceptable DC (although lower than control group), appropriate dentin interaction, and resin tag establishment.

Use of electromagnetic stimulation on an Enterococcus faecalis biofilm on root canal treated teeth in vitro

Root canal disinfection is of utmost importance in the success of the treatment, thus, a novel method for achieving root canal disinfection by electromagnetic waves, creating a synergistic reaction via electric and thermal energy, was created. To study electromagnetic stimulation (EMS) for the disinfection of root canal in vitro, single rooted teeth were instrumented with a 45.05 Wave One Gold reciprocating file. Specimens were sterilized and inoculated with Enterococcus faecalis ATCC 29,212, which grew for 15 days to form an established biofilm. Samples were treated with 6% sodium hypochlorite (NaOCl), 1.5% NaOCl 1.5% NaOCl with EMS, 0.9% saline with EMS or 0.9% saline. After treatments, the colony forming units (CFU) was determined. Data was analyzed by Wilcoxon Rank Sums Test (α = 0.05). One sample per group was scored and split for confocal laser scanning microscopy imaging. There was a significant effect with the use of NaOCl with or without EMS versus 0.9% saline with or without EMS (p = 0.012 and 0.003, respectively). CFUs were lower when using 0.9% saline with EMS versus 0.9% saline alone (p = 0.002). Confocal imaging confirmed CFU findings. EMS with saline has an antibiofilm effect against E. faecalis and can potentially be applied for endodontic disinfection.