Evaluation of smear layer and debris removal by stepwise intraoperative activation (SIA) of sodium hypochlorite

Plotino, Gianluca; Colangeli, Mauro; Özyürek, Taha; De‐Deus, Gustavo; Panzetta, Claudia; Castagnola, Raffaella; Grande, Nicola M.; Marigo, Luca

doi:10.1007/s00784-020-03358-6

Cited by 27 publications

(17 citation statements)

References 41 publications

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“…Some limitations of SEM analysis should be also highlighted as one of the factors influencing the results of the present study. Even though SEM is a widely accepted method to assess the ability of endodontic irrigants to remove debris and smear layers [ 34 ], this method requires sample sectioning and allows the evaluation only of small selected areas, hence resulting in the potential loss of some valuable information [ 35 ]. In order to minimize these limitations, each third of gently halved roots was fully screened under SEM and only areas with the greatest amount of debris and smear layers were selected for further analysis.…”

Section: Discussionmentioning

confidence: 99%

Cytotoxicity and Efficacy in Debris and Smear Layer Removal of HOCl-Based Irrigating Solution: An In Vitro Study

Bilvinaite

Zongolaviciute

Drukteinis

et al. 2022

JFB

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In the present study we evaluated the cytotoxicity of super-oxidized water on human gingival fibroblasts and its efficacy in debris and smear layer removal from root canal walls. Cultured gingival fibroblasts were exposed to super-oxidized water (Sterilox), which was diluted in Iscove’s modified Dulbecco’s medium (IMDM) at 30%, 40%, 50%, 60% and 70% concentrations. The control group was maintained in IMDM. The cell viability was evaluated by means of an MTT assay after incubation periods of 1 h, 2 h, 24 h and 48 h. Pathological cellular changes were also observed under fluorescence and phase contrast microscopes. The efficacy in debris and smear layer removal was evaluated in comparison to the conventional application of sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA). Forty maxillary premolars were randomly divided into two equal groups (n = 20) and shaped with ProTaper NEXT rotary instruments using Sterilox or NaOCl/EDTA for irrigation. Afterwards, roots were split longitudinally and examined under a scanning electron microscope. The results revealed that super-oxidized water and sterile distilled water have acceptable biological properties for endodontic applications at concentrations up to 50% (p > 0.05). Moreover, super-oxidized water is equally effective in debris and smear layer removal as compared to NaOCl/EDTA (p > 0.05).

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Section: Discussionmentioning

confidence: 99%

Cytotoxicity and Efficacy in Debris and Smear Layer Removal of HOCl-Based Irrigating Solution: An In Vitro Study

Bilvinaite

Zongolaviciute

Drukteinis

et al. 2022

JFB

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“…However, mechanical preparation usually leads to hiding bacteria in some places that cannot be cleaned [22]. In addition, the smear layer produced by mechanical preparation and cutting covers the root canal wall, dentinal tubules, lateral root canals, isthmus, and other structures, thus becoming a thriving place for bacteria and interfering with the root canal disinfection and lling [23]. The narrow apical space, the complexity of root canals, limitations of mechanical preparation, and chemical irrigation make it di cult to remove the smear layer [24].…”

Section: Discussionmentioning

confidence: 99%

comparison of the root canal cleaning efficacy of three irrigation methods, XP-endo Finisher, EDDY, and PUI at different apical sizes: an in vitro study

Zheng¹,

X²,

Hu³

et al. 2022

Preprint

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Objectives To compare the effects of three irrigation methods (Passive Ultrasonic Irrigation (PUI), EDDY, and XP-endo Finisher (XPF)) in removing the smear layer of the curving root canals under different apical sizes.Material and methods Seventy-two mesial roots of mandibular molars were divided into nine groups according to different apical sizes and the irrigation protocols: group A1 (size 25, EDDY), group A2 (size 25, XPF), and group A3 (size 25, PUI); group B1 (size 30, EDDY),group B2 (size 30, XPF), and group B3 (size 30, PUI); group C1(size 35, EDDY),group C2 (size 35, XPF), and group C3 (size 35,PUI).The irrigation effect was evaluated by scanning electron microscopy at ×3000 magnification using a 5-point scoring system and statistically analyzed by Kruskal-Wallis and Mann-Whitney tests. Results The application of PUI in mandibular molars should be prepared with the apical size of at least size 35(P＜0.05), and that of EDDY and XPF should only be prepared to size 25(P＜0.05).Conclusion Irrespective of the irrigation activation methods,none could completely remove the smear layer,while EDDY and XPF have a better cleaning effect than PUI under smaller apical size.Clinical relevance EDDY and XPF can be used as safer and more efficient irrigation activation devices.

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“…Cleaning and shaping procedures are the key factors in controlling inflammation in the root canal and periapical areas [ 25 ]. Many new endodontic instruments have been introduced and used extensively in endodontics to deliver irrigants into the area after instrumental preparation, which has been shown to be an effective way to reduce apical inflammation [ 11 , 26 ]. The aim of this study was to evaluate the efficacy of root canal treatment with different endodontic irrigation techniques in vivo using the rat model.…”

Section: Discussionmentioning

confidence: 99%

Comparison of EASYDO ACTIVATOR, passive ultrasonic, and needle irrigation techniques on the treatment of apical periodontitis: a study in rats

Feng

Zhao

et al. 2022

Clin Oral Invest

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Objectives To evaluate the long-term therapeutic effect of EASYDO ACTIVATOR, passive ultrasonic irrigation, and needle irrigation in experimental apical periodontitis in rats. Materials and methods Sprague-Dawley male rats were used to produce periapical lesions. The pulp chambers of the bilaterally first mandibular molars were exposed and left open for 21 days. The rats were divided into four groups according to different irrigation protocols. Seven days after irrigation, the mandibles were removed for micro-CT, histological, and immunohistochemical analysis. Serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were assessed by enzyme-linked immunosorbent assays (ELISA). Statistical data were analyzed by one-way analysis of variance (ANOVA) with LSD tests. Results The passive ultrasonic irrigation and EASYDO ACTIVATOR groups had the smallest apical lesions compared to the other groups (P < 0.05), while the needle irrigation group had smaller lesions than the control group (P < 0.05). The EASYDO ACTIVATOR group had less inflammation infiltration compared to the control and needle irrigation groups (P < 0.05). The control and needle irrigation groups had more TNF-α expression compared to the passive ultrasonic irrigation and EASYDO ACTIVATOR groups (P < 0.05). The lowest IL-6 expression was observed in the EASYDO ACTIVATOR group. The EASYDO ACTIVATOR group had the lowest serum level of TNF-α than other groups (P < 0.05). IL-6 expression was significantly lower in the EASYDO ACTIVATOR group in comparison with the control and needle irrigation groups (P < 0.05). Conclusions EASYDO ACTIVATOR can significantly reduce the apical lesions and decrease the inflammatory response around the periapical area. Clinical relevance EASYDO ACTIVATOR is recommended for clinical application.

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Evaluation of smear layer and debris removal by stepwise intraoperative activation (SIA) of sodium hypochlorite

Cited by 27 publications

References 41 publications

Cytotoxicity and Efficacy in Debris and Smear Layer Removal of HOCl-Based Irrigating Solution: An In Vitro Study

Cytotoxicity and Efficacy in Debris and Smear Layer Removal of HOCl-Based Irrigating Solution: An In Vitro Study

comparison of the root canal cleaning efficacy of three irrigation methods, XP-endo Finisher, EDDY, and PUI at different apical sizes: an in vitro study

Comparison of EASYDO ACTIVATOR, passive ultrasonic, and needle irrigation techniques on the treatment of apical periodontitis: a study in rats

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