Introduction: Effective irrigant delivery and agitation are prerequisites for successful endodontic treatment. Ultrasonic irrigation can be performed with or without simultaneous ultrasonic instrumentation. Existing literature reveals that ultrasonic irrigation may have a very positive effect on chemical, biological and physical debridement of the root canal system as investigated in many in vitro studies.
Objective: The purpose of this review article was to summarize and discuss the available information concerning ultrasonic irrigation in endodontics.
Methods: This article presents an overview of ultrasonic irrigation methods and their debridement efficacy. In this paper the relevant literature on passive ultrasonic irrigation is reviewed. Information from original scientific papers or reviews listed in MEDLINE and Cochrane were included in the review.
Results: The use of ultrasound in the irrigation procedure results in improved canal cleanliness, better irrigant transfer to the canal system, soft tissue debridement, and removal of smear layer and bacteria. There are many in vitro studies, but there is a need to standardize protocols, and correlate the clinical efficacy of ultrasonic devices with improved treatment outcomes. Understanding the basis of ultrasonic irrigation is fundamental for clinicians and researchers to improve the design and use of ultrasonic irrigation.
Key words:Ultrasonic irrigation, ultrasound, smear layer, endodontics.
Tomas-Catala CJ, Collado-Gonzalez M, Garcıa-Bernal D, Oñate-Sanchez RE, Forner L, Llena C, Lozano A, Castelo-Baz P, Moraleda JM, Rodrıguez-Lozano FJ. Comparative analysis of the biological effects of the endodontic bioactive cements MTA-Angelus, MTA Repair HP and NeoMTA Plus on human dental pulp stem cells.
PurposeThis study aimed to investigate the clinical anatomy of lower premolar roots in a Spanish population by using cone-beam computed tomography (CBCT), correlating findings with patient gender and tooth type.Materials and MethodsUsing 70 CBCT images, we evaluated 126 healthy, untreated, well-developed lower premolars. The number and morphology of roots and root canals, and the foramina number were assessed. Results for gender and tooth type were compared using the chi-squared and ANOVA tests.ResultsThe average length of teeth and roots was significantly higher in men (p=0.00). All 126 premolars had a single root. One canal was found in 83.3% of the premolars, with no gender or tooth type differences; Vertucci configuration types I and V were the most prevalent. The first premolars showed significantly greater variability than the second premolars (p=0.03). A single apical foramen was found in 89.7% of the premolars, with no differences by tooth type. Women had a significantly higher prevalence of two apical foramina than men (p=0.04). Some degree of curvature was observed in 65% of the premolars, with no differences by gender or tooth type. A root angle of more than 20° was found in 12.98% of the premolars, without any differences by gender or tooth.ConclusionAll premolars were single-rooted. One canal had the most prevalent morphology. More variability in canal anatomy was found in the first premolars. Curvatures greater than 20° were found at less than 5 mm from the apex.
None of the techniques was totally satisfactory in establishing the true working length. There were no differences between the techniques investigated.
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