Paper points revisited: risk of cellulose fibre shedding during canal length confirmation

Brown, Don W.

doi:10.1111/iej.12663

Cited by 10 publications

(5 citation statements)

References 15 publications

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“…Classic (Unodent) was identified to be the most absorbent paper point brand. This could be attributed to larger pore sizes within its cellulose membrane (Zehnder et al, 2014), which may also explain their less ridged and fibre‐shedding properties (Brown, 2017). Surprisingly, no meaningful volume could be further attained after 60 s sampling duration, a curvilinear relationship also observed by Shimauchi et al (1996), and a 1 mm insertion depth.…”

Section: Discussionmentioning

confidence: 99%

Periradicular tissue fluid‐derived biomarkers for apical periodontitis: An in vitro methodological and in vivo cross‐sectional study

et al. 2023

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BackgroundPeriradicular tissue fluid (PTF) offers a source of diagnostic, prognostic and predictive biomarkers for endodontic disease.Aims(1) To optimize basic parameters for PTF paper point sampling in vitro for subsequent in vivo application. (2) To compare proteomes of PTF from teeth with normal apical tissues (NAT) and asymptomatic apical periodontitis (AAP) using high‐throughput panels.Methodology(1) To assess volume absorbance, paper points (n = 20) of multiple brands, sizes and sampling durations were inserted into PBS/1%BSA at several depths. Wetted lengths (mm) were measured against standard curves to determine volume absorbance (μL). To assess analyte recovery, paper points (n = 6) loaded with 2 μL recombinant IL‐1β (15.6 ng/mL) were eluted into 250 μL: (i) PBS; (ii) PBS/1% BSA; (iii) PBS/0.1% Tween20; (iv) PBS/0.25 M NaCl. These then underwent: (i) vortexing; (ii) vortexing/centrifugation; (iii) centrifugation; (iv) incubation/vortexing/centrifugation. Sandwich‐ELISAs determined analyte recovery (%) against positive controls.(2) Using optimized protocols, PTF was retrieved from permanent teeth with NAT or AAP after accessing root canals. Samples, normalized to total fluid volume (TFV), were analysed to determine proteomic profiles (pg/TFV) of NAT and AAP via O‐link Target‐48 panel. Correlations between AAP and diagnostic accuracy were explored using principal‐component analysis (PCA) and area under receive‐operating‐characteristic curves (AUC [95% CI]), respectively. Statistical comparisons were made using Mann–Whitney U, anova and post hoc Bonferonni tests (α < .01).Results(1) UnoDent's ‘Classic’ points facilitated maximum volume absorbance (p < .05), with no significant differences after 60 s (1.6 μL [1.30–1.73]), 1 mm depth and up to 40/0.02 (2.2 μL [1.98–2.20]). For elution, vortexing (89.3%) and PBS/1% BSA (86.9%) yielded the largest IL‐1β recovery (p < .05).(2) 41 (NAT: 13; AAP: 31) PTF samples proceeded to analysis. The panel detected 18 analytes (CCL‐2, ‐3, ‐4; CSF‐1; CXCL‐8, ‐9; HGF; IL‐1β, ‐6, ‐17A, ‐18; MMP‐1, ‐12; OLR‐1; OSM; TNFSF‐10, ‐12; VEGF‐A) in ≥75% of AAP samples at statistically higher concentrations (p < .01). CXCL‐8, IL‐1β, OLR‐1, OSM and TNFSF‐12 were strongly correlated to AAP. ‘Excellent’ diagnostic performance was observed for TNFSF‐12 (AUC: 0.94 [95% CI: 0.86–1.00]) and the PCA‐derived cluster (AUC: 0.96 [95% CI: 0.89–1.00]).ConclusionsOptimized PTF sampling parameters were identified in this study. When applied clinically, high‐throughput proteomic analyses revealed complex interconnected networks of potential biomarkers. TNFSF‐12 discriminated periradicular disease from health the greatest; however, clustering analytes further improved diagnostic accuracy. Additional independent investigations are required to validate these findings.

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Section: Discussionmentioning

confidence: 99%

Periradicular tissue fluid‐derived biomarkers for apical periodontitis: An in vitro methodological and in vivo cross‐sectional study

et al. 2023

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“…Es inherente que una opción intraoperatoria de primera mano constituye el empleo de las puntas de papel, las cuales poseen celulosa vegetal en su composición, misma que es un polímero altamente hidrofílico y por ende les confiere las propiedades de absorción que aquellas poseen (Siqueira, 2001;Brown, 2017). No obstante, hay que tener precaución con el empleo de las puntas de papel para no tocar los tejidos periapicales con ellas, ya que la celulosa no puede ser degradada por las células del sistema inmune (Siqueira, 2001) y podría entonces provocar reacciones a cuerpo extraño y ser posible causa de persistencia de lesiones perirradiculares (Siqueira, 2001;Brown, 2017;Koppang, et al, 1988).…”

Section: Puntas De Papelunclassified

“…En razón de lo antes indicado, se ha referido que deberían realizarse más investigaciones para fabricar puntas de papel que sean biocompatibles (Brown, 2017). En este sentido, una investigación ha evidenciado el potencial uso de puntas de papel fabricadas con celulosa bacteriana durante el tratamiento endodóntico, ya que éstas puntas demostraron una biocompatibilidad más alta, una tasa de absorción 10 veces mayor que las puntas de papel convencionales a base de celulosa vegetal, así como mantuvieron una alta fuerza tensil, incluso cuando estaban ya húmedas (Yoshino et al, 2013).…”

Section: Puntas De Papelunclassified

Conducto con exudado persistente: Causas y manejo clínico

Álvarez-Vásquez

Fernández

Ortiz

2021

RSD

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Objetivo: El objetivo de esta revisión integrativa de la literatura fue abordar las causas y manejo clínico del conducto con exudado persistente o “conducto llorón”, que es una entidad clínica caracterizada por la presencia intraconducto de exudado inflamatorio persistente, pese al tratamiento de conducto en ejecución, incluso después de varias citas. Metodología: Se realizó un levantamiento bibliográfico en las bases de datos Pubmed, Scopus y EBSCO, en idioma inglés y sin restricción de fecha de publicación. Los términos de búsqueda empleados en combinación fueron: conducto húmedo, conducto llorón, exudado persistente, exudación intraconducto persistente y, tratamiento de conducto radicular. Resultados y conclusión: Se concluye que la causa principalmente descrita es la microbiana, en forma de biofilm bacteriano o infección recalcitrante. Respecto a su manejo clínico, existen disponibles una serie de abordajes, como las puntas de papel, la medicación intraconducto y sistemas de aspiración como el EndoVac, en tanto que el empleo de la terapia con láser Nd:YAG requiere de más estudios que respalden su uso clínico.

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“…Bununla birlikte, kağıt koni ile yapılan çalışma boyu kontrolünün direk veya olarak selüloz liflerin periapikal bölgeye itilmesine yol açabileceği bildirilmiştir. 15,16 Selüloz liflerin inatçı kronik apikal lezyonlara sebep olarak tedavi başarısızlığı-na sebep olabileceği bilinmektedir. 17 Yöntem kullanılırken avantaj ve dezavantajları göz önünde bulundurulmalıdır.…”

Section: Kağıt Koni İncelemeleriunclassified

Working length determination methods in endodontics

Şen¹,

Erdemir²

2018

Yeditepe J Dent

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ÖZETÇalışma boyunun doğru belirlenmesi, başarılı endodontik tedavinin en önemli basamaklarından biridir. Çalışma boyu, koronalde belirlenen bir referans noktasından apikalde kanal tedavisi işlemlerinin sonlandırılacağı sınıra kadar devam eden mesafe olarak tanımlanır. Genel olarak, minör apikal foramen, bu tedavi işlemlerinin bitirileceği son nokta olarak kabul gör-mektedir. Kök kanal uzunluğunun belirlenmesinde; parmak hassasiyeti, radyografik incelemeler, dijital görüntüleme yöntemleri, kağıt koni yöntemi, elektronik yöntem ve bu yön-temlerin farklı kombinasyonları kullanılabilmektedir. Bu derlemenin amacı, çalışma boyu belirleme yöntemlerinin çalışma prensipleri, avantajları, dezavantajları ve teknik gelişimlerinin gözden geçirilmesidir.Anahtar kelimeler: Endodonti, diş apeksi, odontometri, radyografi, taktil hissi SUMMARY Accurate determination of the working length is one of the crucial steps for a successful endodontic treatment. Working length is defined as the distance from a determined coronal reference point to the level at which root canal treatment procedures should terminate. Minor apical foramen is generally accepted as the termination point of these treatment procedures. Tactile sense, radiographic examinations, digital imaging systems, paper point technique, electronic method and different combinations of these methods are used for the determination of root canal length. The aim of this review is to present an overview on working principles, advantages, disadvantages and technical developments of the working length determination methods.Keywords: Endodontics, tooth apex, odontometry, radiography, tactile sense GİRİŞ Etkili bir kemomekanik preparasyon ve sızdırmaz bir kök kanal dolgusunun yapılabilmesi için çalışma boyunun doğru belirlenmesi şarttır. Kök kanal çalışma boyu, koronal olarak belirlenen bir referans noktasından kanalın şekillendirilip doldurulacağı noktaya kadar uzanan mesafedir.1 Kök kanal preparasyonu ve dolgusunun genel olarak 'minör apikal foramen' de bitirilmesi kabul görmektedir.2 'Minör apikal foramen' , kök pulpasının ve periodontal alanla birleştiği sınır olarak tarif edilir. 'Apikal daralım' veya 'fizyolojik foramen' olarak da adlandırılır. Anatomik apeksten 0-2mm içeride yer alabileceği gösterilmiştir.3 Bununla birlikte, apikal foramen her zaman dişin anatomik apeksi ile aynı doğrultuda yer almaz. Foramen açılımı apeksin lateralinde ve 3mm'yi bulan uzaklıklarda olabilmektedir.4 Dolayısıyla, hekimin gözle göremediği fakat tedavi başarısında büyük önem taşıyan bu noktanın belirlenmesi titizlikle yapılmalıdır.5 DERLEME

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Paper points revisited: risk of cellulose fibre shedding during canal length confirmation

Abstract: All brands of paper point may shed cellulose fibres both directly and indirectly with a significant influence of brand on the degree of fibre shedding. Further work should be undertaken to develop biocompatible absorbent dental points.

Cited by 10 publications

References 15 publications

Periradicular tissue fluid‐derived biomarkers for apical periodontitis: An in vitro methodological and in vivo cross‐sectional study

Periradicular tissue fluid‐derived biomarkers for apical periodontitis: An in vitro methodological and in vivo cross‐sectional study

Conducto con exudado persistente: Causas y manejo clínico

Working length determination methods in endodontics

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