Effectiveness of various irrigant activation techniques on the penetration of sodium hypochlorite into lateral canals of mature permanent teeth: A systematic review and meta-analysis

Kumar, Ram Surath; Ankola, Anil V; Sankeshwari, Roopali; Hebbal, Mamata; Hampiholi, Vinuta; S, Lokesh Kumar; Deshpande, Apurva Prashant; Choudhury, Abhra Roy; Khot, Atrey J. Pai

doi:10.1016/j.sdentj.2022.12.004

Cited by 4 publications

(3 citation statements)

References 56 publications

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“…Based on the results obtained, it is assumed that the heating has increased the water's capacity to remove the residual NaOCl deposited on root canal walls, so that the reaction with CHX is not observed. And together with the increase in temperature, the activation of irrigating solutions, through PUI and CUI, improves penetration and increases the flow of the solution, which consequently favors the contact of irrigating solutions with complex anatomical areas [10][11][12].…”

Section: Discussionmentioning

confidence: 99%

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Can Heated Distilled Water Effectively Prevent Precipitate Formation between NaOCl and CHX?

Boppré,

Menezes Savaris,

Catherine Maiola

et al. 2024

International Journal of Dentistry

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Introduction. The present study aimed to investigate the capacity of different irrigation protocols using heated distilled water at 65°C (HDW), in preventing the formation of the brown–orange precipitate observed after the interaction between sodium hypochlorite (NaOCl) and chlorhexidine (CHX). Methods. Forty human canines were selected, prepared, and cleaved in two halves. Images of delimited areas in each root canal thirds were obtained through a stereomicroscope (16x and 40x). After reassembly, the teeth were distributed into four groups (n = 10) according to the final irrigation protocol: G1 (no HDW): EDTA + NaOCl + CHX with conventional irrigation (CI); G2 (HDW + CI): EDTA with passive ultrasonic irrigation (PUI) + NaOCl (PUI) + HDW (CI) + CHX (PUI); G3 (HDW + PUI): EDTA + NaOCl + HDW + CHX with PUI; G4 (HDW + CUI): EDTA (PUI) + NaOCl (PUI) + HDW with continuous ultrasonic irrigation (CUI) + CHX (PUI). After irrigation, the teeth were re-separated and images of the same delimited areas were obtained again. Scores were assigned according to the amount of precipitate observed, comparing the initial and final images. The data were submitted to Kruskal–Wallis, Dunn and Friedman statistical tests (α = 5%). Results. G1(no HDW) showed the highest scores in the analysis between groups (p<0.001), with a greater amount of precipitate in the cervical and medium thirds (p<0.001). The thirds of the other experimental groups did not differ from each other (p>0.05). Conclusion. The intermediate irrigation with heated distilled water at 65°C prevented the formation of brown–orange precipitate, regardless of the use of ultrasonic activation (PUI or CUI).

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Section: Discussionmentioning

confidence: 99%

“…Both improves the dispersion of root canal irrigants via cavitation bubble implosions and/or acoustic streaming [11]. They have advantages over conventional irrigation (CI) with a syringe and needle, improving the penetration of solutions in isthmus and lateral canals [12].…”

Section: Introductionmentioning

confidence: 99%

Can Heated Distilled Water Effectively Prevent Precipitate Formation between NaOCl and CHX?

Boppré,

Menezes Savaris,

Catherine Maiola

et al. 2024

International Journal of Dentistry

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“…Lateral canals, commonly observed in permanent human teeth, establish a connection between the root canal and the periodontal area, serving as a potential pathway for bacterial dissemination from the pulp to the periodontal tissues [ 5 ]. The employment of mechanical techniques for root canal preparation renders instruments incapable of accessing the lateral canals, increasing the challenge of infection control and potentially leading to the failure of root canal treatment [ 6 ]. Consequently, the effective elimination of bacteria from the lateral canals exerts a substantial impact on the treatment outcomes.…”

Section: Introductionmentioning

confidence: 99%

Sonic-assisted antibacterial photodynamic therapy: a strategy for enhancing lateral canal disinfection

Wang,

Lei,

Huang

et al. 2024

BMC Oral Health

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Background Bacterial infections in lateral canals pose challenges for root canal treatment. This in vitro study aims to evaluate the antibacterial efficacy of sonic-assisted methylene blue mediated antimicrobial photodynamic therapy (MB-aPDT) against Enterococcus faecalis (E. faecalis) in infected lateral canals. Methods Sixty-five premolars infected with E. faecalis in lateral canals were randomly divided into five groups (n = 13) and treated with : (1) 5.25% NaOCl (positive control); (2) Saline (negative control); (3) Sonic-assisted MB-aPDT; (4) 3% NaOCl + MB-aPDT; (5) 3% NaOCl + sonic-assisted MB-aPDT, respectively. The antibacterial efficacy was evaluated by the colony- counting method (CCM) and scanning electronic microscope (SEM). Results Both 5.25% NaOCl and the 3% NaOCl + sonic-assisted MB-aPDT exhibited the most effective while comparable antibacterial effects without significant statistical difference (P > 0.05). Furthermore, the antibacterial effect of the 3% NaOCl + MB-aPDT group was significantly higher compared to that of the sonic-assisted MB-aPDT group (P < 0.05). The SEM results demonstrated notable morphological alterations in E. faecalis across all experimental groups, except for the negative control group. Conclusion The concentration of NaOCl can be reduced to a safe level while preserving its antibacterial efficacy through the synergism with the sonic-assisted MB-aPDT in this study.

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Revolucionando La Endodoncia: La Importancia De Irrigantes Múltiples Para Una Desinfección Efectiva Del Sistema De Conductos Radiculares Una Revisión Narrativa

Fernandez Calle,

Macias Limachi,

Vargas Ticona

et al. 2024

RECIMA21

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La investigación titulada "Revolucionando la Endodoncia: La Importancia de Irrigantes Múltiples para una Desinfección Efectiva del Sistema de Conductos" presenta una revisión narrativa sobre la evolución y la relevancia de los irrigantes en el tratamiento endodóntico. Desde el uso de soluciones simples como agua y alcohol, hasta irrigantes avanzados como el hipoclorito de sodio, EDTA y nanopartículas, el estudio enfatiza la necesidad de combinaciones de irrigantes para mejorar la eficacia antimicrobiana y reducir las complicaciones asociadas a infecciones periradiculares. A través de una revisión exhaustiva de la literatura, se identifican vacíos en la investigación sobre la efectividad de las combinaciones de irrigantes en la eliminación de biofilms resistentes. Se discuten también las técnicas de activación como la irrigación ultrasónica, que optimizan la acción de los irrigantes. Entre los hallazgos destacados, se concluye que la aplicación secuencial de irrigantes permite maximizar su efectividad y que el uso de agua ozonizada y tiosulfato de sodio puede ofrecer alternativas prometedoras. El estudio subraya la necesidad de un enfoque integral en la irrigación endodóntica para lograr resultados clínicos óptimos y prevenir la reinfección post-tratamiento.

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Effectiveness of various irrigant activation techniques on the penetration of sodium hypochlorite into lateral canals of mature permanent teeth: A systematic review and meta-analysis

Cited by 4 publications

References 56 publications

Can Heated Distilled Water Effectively Prevent Precipitate Formation between NaOCl and CHX?

Can Heated Distilled Water Effectively Prevent Precipitate Formation between NaOCl and CHX?

Sonic-assisted antibacterial photodynamic therapy: a strategy for enhancing lateral canal disinfection

Revolucionando La Endodoncia: La Importancia De Irrigantes Múltiples Para Una Desinfección Efectiva Del Sistema De Conductos Radiculares Una Revisión Narrativa

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