Survey on Recent Advances in Root Canal Disinfection

The Journal of the American Dental Association, 2015

Background. The purpose of this study was to determine whether differences exist in disinfection protocols between endodontists and general dentists. Methods. The authors sent an invitation to participate in a Webbased survey to 950 dentists affiliated with the Spanish Board of Dentistry. Participants responded to 9 questions about irrigation protocols and other factors related to disinfection during root canal therapy. Results. A total of 238 (25.05%) study participants successfully completed and returned the surveys. Among these participants, 50% were general dentists and 50% were endodontists. The authors found no statistically significant differences in respondents' first choice of an irrigant solution (that is, sodium hypochlorite), but they noted statistically significant differences in the protocols used by general dentists and by endodontists in relation to the concentration of sodium hypochlorite (P ¼ .0003), the use and type of irrigant used to remove the smear layer (P ¼ 5.39 Â 10 À10), the use of adjuncts to irrigation (P ¼ 5.98 Â 10 À8), the enlargement of the apical preparation when shaping a necrotic tooth (P ¼ .001), and the maintenance of apical patency throughout the debridement and shaping procedure (P ¼ .04). Conclusions. General dentists and endodontists embrace different disinfection protocols. The results of the survey demonstrated that endodontists keep up to date with protocols published in the literature, whereas general dentists use protocols learned during their dental training. Both groups of clinicians should be aware of the importance of disinfection techniques and their relationship to treatment outcomes. Practical Implications. Controlling microorganisms during a root canal treatment, especially in cases with necrotic pulp, is essential to improve treatment outcomes. Clinicians should update their protocols and also consider referring patients to a specialist when their protocols are based on traditional techniques, especially in those cases with necrotic pulp.

Egyptian Dental Journal

Article is licensed under a Creative Commons Attribution 4.0 International License

International Journal of Innovative Research in Medical Science, 2021

Introduction: Bacteria play a crucial role in the pathogenesis of pulpal and periradicular pathoses. For example: Apical periodontitis is an inflammation of dental periapical tissues developed as a response to colonization of microorganisms in root canal system. The elimination of microbial species from the infected root canal system necessitates a strict aseptic condition for Instrumentation, disinfection and inter appointment medication. Enterococcus faecalis and Candida albicans had been commonly associated organisms in treatment-resistant infections. Methods: This was an observational cross-sectional study based on web-survey questionnaires developed by the authors with high confidence. The sample size was 304 estimated using the Qualtrics calculator with a confidence level of 95% and a margin of error of 5%. The questionnaire is divided into sections, regarding endodontic practice include endodontic education , years of experience , used of rubber dam or no and how to used irri...

International journal of health sciences

Root canal decontamination is a crucial step in achieving endodontic success. For this, absolute eradication of microbes from root canal is of paramount importance. This in vivo study aimed at comparing the Conventional, EndoActivator and EndoVac irrigation system in reducing intracanal bacterial load. 70 necrotic, single rooted teeth having chronic periapical lesions were selected for endodontic therapy and randomly assigned into three groups. Group 1 – 20 teeth treated using Conventional needle irrigation. Group 2 – 20 teeth treated using EndoActivator system. Group 3– 20 teeth treated using EndoVac system. After the surface disinfection, access opening was done. Groupwise irrigation with NaOCl (VISHAL DENTOCARE PVT.LTD.) and EDTA (AMMDENT CANALARGE) was done with each canal in between instrumentation. Data were obtained by culturing bacterial samples of root canal before and after chemomechanical preparation under both aerobic and anaerobic conditions and CFU was counted. Statist...

Deleted Journal, 2024

The study's objective was to compare passive ultrasonic activation (PUI) and photon-induced photoacoustic streaming (PIPS) laser-activated irrigation methods for disinfecting the root canal. Materials and methods: E. faecalis and Candida albicans were injected into Forty-five single-rooted upper anterior human teeth to create a biofilm, then randomly divided into four groups that differ in the activation method (PIPS group, PUI group, and a control group that employs syringe irrigation without activation). A confocal scanning electron microscope (CLSM) was then used to evaluate and compare groups in terms of bacterial reduction. Results: The various test groups differed statistically significantly from one another (p<0.001). The mean value of PIPS was (57.34±3.70), while the lowest value was found in the PUI group (41.40±6.38). Comparisons between pairs showed that the PIPS group had a value that was significantly higher when compared to other groups (p<0.001). Conclusions: The biofilm elimination capacity of sodium hypochlorite irrigant was improved by activating it with an Er:YAG laser using the PIPS approach, showing the best biofilm eradication in the apical third. However, None of the root canal disinfection techniques achieved full eradication.

Clinical Oral Investigations

Objectives The impact of conservative instrumentation on the disinfection of root canals with different curvatures has not yet been determined. This ex vivo study aimed to evaluate and compare the effect of conservative instrumentation with TruNatomy (TN) and Rotate and a conventional rotary system, ProTaper Gold (PTG), on root canal disinfection during chemomechanical preparation of straight and curved canals. Materials and methods Ninety mandibular molars with straight (n = 45) and curved (n = 45) mesiobuccal root canals were contaminated with polymicrobial clinical samples. Teeth were divided into three subgroups (n = 14) according to the file systems and the curvature. Canals were instrumented with TN, Rotate, and PTG, respectively. Sodium hypochlorite and EDTA were used as irrigants. Intracanal samples were taken before (S1) and after (S2) instrumentation. Six uninfected teeth were used as negative controls. The bacterial reduction between S1 and S2 was measured by ATP assay, f...

International Journal of Applied Dental Sciences, 2020

Contemporary endodontics has seen an unprecedented advance in technology and materials. This review is aimed to bring some light over the advances in root canal disinfection. Jointly, these advances are aimed at improving the state of the art and science of root canal treatment.

Egyptian Dental Journal /Egyptian Dental Journal, 2024

Background: The space for irrigant cleansing action that ultimate root canal dimensions is influenced by root canal size and taper. Aim of the study: to investigate the effect of minimal invasive endodontic preparation technique with different irrigation protocols on the cleanliness of extracted mandibular permanent molars. Materials and methods: A total of eighty extracted mandibular permanent molars were selected in this study. All teeth were divided into 4 groups depending on the taper and size of the file that was used for each group: group I: up to size 25 taper 0.04, group II: up to size 25 taper 0.06, group III: up to size 30 taper 0.04 and group IV: up to size 30 taper 0.06. Each group was randomly divided into two subgroups: In Subgroup A: traditional irrigation technique without activation of the irrigant while in Subgroup B: traditional irrigation technique with ultrasonic activation of the irrigant. Results: By using Chi square and Paired-t tests, when comparing the subgroup A to subgroup B of each group, it revealed significant difference between them regarding group I, group II and group III, but no significant difference between them regarding group IV in case of debris removal. But, it revealed no significant difference between them regarding smear layer removal except in group I. Conclusion: A root canal preparation to a size 25 taper 0.04 with irrigant activation resulted in significantly less residual debris in the root. In addition to, there is no significant difference in smear layer removal between all the groups.

Journal of Endodontics, 2010

The aim of the present study was to determine the disinfection of preparations carried out by using the Protaper or MTwo system in canals infected with Enterococcus faecalis. Methods: Twentyeight distobuccal canals of upper molars were used, in which the canals were sterilized after being enlarged to #20 file and then contaminated with an inoculation of a culture of E. faecalis. After the incubation period, bacterial samples were collected and were seeded on plates for analysis of colony-forming units (CFU)/mL. The teeth were divided into 2 groups according to the rotary system used for instrumentation; 2 noninstrumented teeth served as the control group. Then bacterial samples were collected and were seeded on plates for analysis of CFU/mL again. The data obtained were evaluated by the Wilcoxon and Mann-Whitney U tests. Results: Bacterial reduction was 81.94% and 84.29%, respectively, in ProTaper and Mtwo systems, and there was no statistically significant difference (P > .05). Conclusions: Both systems, ProTaper and Mtwo, reduced the amount of bacteria in the mechanical disinfection of the root canal system, demonstrating that they are suitable for this purpose. (J Endod 2010;36:1238-1240

2014

Root canal irrigants play an indispensable role for the complete disinfection of the root canal system, in particular those areas of the root canal that are not accessible for instrumentation. Modern, biologic root canal therapy should be performed with suitable irrigating solutions and intracanal medicaments. The goal of endodontic treatment is to free the treated tooth from infection and prevent re infection as thoroughly as possible by means which do not put the organism at risk. Sodium hypochlorite, ethylene diamine tetra acetic acid, hydrogen peroxide and chlorhexidine are the most commonly used root canal irrigants in endodontic practice, but they do not satisfy all the properties of an ideal root canal irrigant. Newer irrigants such as MTAD, tetraclean, ozonated water, photon activated disinfection have arrived in the market & are commercially available. In this review article, the specifics of the pulpal microenvironment and the resulting requirements for irrigating solution...