Confocal laser scanning microscopy evaluation of roots subjected to activation protocol in endodontic microsurgery

Iandolo, Alfredo; Abdellatif, Dina; Barbosa, Ana Flávia Almeida; Scelza, Giuseppe; Gasparro, Roberta; Sammartino, Pasquale; Silva, Emmanuel João Nogueira Leal

doi:10.1111/aej.12598

Cited by 5 publications

(3 citation statements)

References 30 publications

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“…Thereupon, the current research is based on these observations to present a new cleansing protocol with activated irrigants in the retro cavities. By combining the latest technologies with the advances in irrigant activation, our proposed technique can rationally improve the success rates of surgical endodontic treatments, which, even today, are around 91% [ 13 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…In particular, the apicoectomy of the new protocol involves the resection of only 1 mm of the apical third compared to the 3 mm recommended in the standard protocol. [ 13 , 15 , 24 , 25 ] This choice is justified by the fact that the retro cavity’s subsequent cleansing phase involves the use of EDTA and NaOCl gel and the ultrasonic activation of both agents. Consequently, with a better diffusion of the irrigants in the lateral anatomies, there is no need to have excessive tissue removal from the apical root.…”

Section: Discussionmentioning

confidence: 99%

“…The obturation was performed using the single cone approach with the sealer Bioseal (Coltene Whaldedent Inc., Cuyahoga Falls, OH, USA) and 25/0.08 gutta-percha cones (Coltene Whaldedent Inc., Cuyahoga Falls, OH, USA). Then, the samples were kept in a saline solution for seven days [ 12 , 13 ].…”

Section: Methodsmentioning

confidence: 99%

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Histological Evaluation of Root Canals by Performing a New Cleaning Protocol “RUA” in Endodontic Surgery

et al. 2023

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Aim: To enhance cleaning during retro-preparation in endodontic microsurgery. Materials and Methods: Forty mandibular premolars were instrumented, filled with a single cone technique, and then retro-preparation was performed and assigned to experiment A. In group A1, the cavity created by the retro preparation was cleansed with 2 mL of normal sterile saline. In group A2, the retro cavity was cleaned with 2 mL of sterile saline after the retro preparation. All the irrigation solutions mentioned above were delivered using an endodontic needle with a lateral vent and a gauge of 30. Subsequently, in group A2, 17% EDTA gel and 5.25% gel were inserted into the cavity and activated using ultrasonic tips. After the irrigation protocols, the specimens were decalcified for histological evaluation. Results: In the experiment, the amount of hard tissue debris was significantly greater in group A1 compared to group A2 (p < 0.05). Conclusions: The samples in group A2, where the new protocol was performed, showed statistically significant results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Histological Evaluation of Root Canals by Performing a New Cleaning Protocol “RUA” in Endodontic Surgery

et al. 2023

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Review of “Outcome of Endodontic Surgery: A Meta- Analysis of the Literature—Part 1: Comparison of Traditional Root-End Surgery and Endodontic Microsurgery” by Setzer and Colleagues in J Endod 36(11):1757-1765, 2010

Nozhenko

2023

J. Endod. Microsurg.

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Traditional root-end surgery (TRES) has played an important role in the management of odontogenic periapical pathology in the practice of oral surgeons already from 1871 [1, 2]. Whereas in conditions of growing application of operating microscope in the life of dentists, the importance of carrying out root canals treatment and surgical management of periapical pathology with the use of a microscope (i.e., endodontic microsurgery [EM]) began to grow in parallel from late 1970s [3, 4]. The growing role of EM created not only the conditions for the publication of EM-oriented articles [5-7], for the development of a narrow-profile peer-review publication—the Journal of Endodontic Microsurgery [8, 9]—but also for the rethinking of classic surgical techniques, namely a resection of the root-end. Nevertheless, TRES is still applied in numerous oral and maxillofacial surgery departments around the world – without the use of a microscope, appropriate microsurgical tools, and materials. That is why we believe that the meta-analysis by Setzer and colleagues (2010) [10] is such that it has not lost its relevance over the past 13 years. It’s highly important due the fact of unique comparison data of positive outcome for TRES versus EM (Table 1). Their research methods included a 43-year literature review, three electronic databases (Medline, Embase, and PubMed) search, and analysis of human studies in five different languages (English, French, German, Italian, and Spanish) [10]. A minimum follow-up period of 6 months for TRES and EM was analyzed [10]. Summarizing the research, it is possible to note that EM is 35% more successful procedure comparing to TRES [10]. Looking at these numbers, all conclusions are obvious. The future lies in the shift of many specialists involved in traditional root-end surgery to self-perform EM or referral to colleagues specializing in this microsurgical direction of dentistry. Having 9 years of experience in dentistry plus 19 years in oral and maxillofacial surgery, I finally want to say to my colleagues that no matter how many years we perform traditional surgical techniques like TRES, we always must rethink what is best for the patient. In sum, it is a pleasure to see how periapical surgery is evolving right in front of our eyes.

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Do Continuous Rotating Endodontic Instruments Extrude Fewer Apical Debris Than Reciprocating Instruments in Non-Surgical Endodontic Retreatments? A Systematic Review

Puleio,

Giordano,

Bellezza

et al. 2024

Applied Sciences

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Background: All endodontic treatment techniques are associated with the extrusion of debris into periradicular tissues through the apex. The extrusion of apical debris can lead to delayed healing or even therapy failure. It is possible to reduce the extrusion into periapical tissues through various approaches. The objective of this systematic review is to evaluate whether, in cases of non-surgical endodontic retreatment, reciprocating instruments cause greater extrusion of debris compared to instruments with continuous rotation. Methods: A search was conducted on PubMed, Ovid MEDLINE, and the Web of Science. The inclusion criterion was in vitro studies comparing apical extrusion in endodontically treated elements using continuously rotating and reciprocating files. Results: The search on scientific databases yielded 164 results, out of which only 16 were eligible for evaluation after screening. Conclusions: The authors of the research included in this review do not agree on the results obtained. Based on the articles analyzed in this systematic review, it remains unclear whether continuous rotation or reciprocating movement of the endodontic instrument can lead to significant differences in apical debris extrusion; it is not possible to provide a clear clinical recommendation regarding the choice of instrument movement for endodontic procedures.

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Confocal laser scanning microscopy evaluation of roots subjected to activation protocol in endodontic microsurgery

Cited by 5 publications

References 30 publications

Histological Evaluation of Root Canals by Performing a New Cleaning Protocol “RUA” in Endodontic Surgery

Histological Evaluation of Root Canals by Performing a New Cleaning Protocol “RUA” in Endodontic Surgery

Review of “Outcome of Endodontic Surgery: A Meta- Analysis of the Literature—Part 1: Comparison of Traditional Root-End Surgery and Endodontic Microsurgery” by Setzer and Colleagues in J Endod 36(11):1757-1765, 2010

Do Continuous Rotating Endodontic Instruments Extrude Fewer Apical Debris Than Reciprocating Instruments in Non-Surgical Endodontic Retreatments? A Systematic Review

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