Removal of accumulated hard tissue debris from mesial root of mandibular molars evaluated using micro-CT - a systematic review and network meta-analysis

Velmurugan, Natanasabapathy; Arul, Buvaneshwari; Srinivasan, Vignesh; Santosh, Sneha Susan; Vasudevan, Aishwarya; Arockiam, Selva; Ambalavanan, Namasivayam; Kandaswamy, Deivanayagam; Srinivasan, Manali Ramakrishnan

doi:10.1038/s41432-021-0207-x

Cited by 3 publications

(1 citation statement)

References 48 publications

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“…The majority of these studies investigated the removal of hard tissue debris from the isthmus in mesial roots of extracted mandibular molars using micro‐CT. A recent systematic review with network‐meta‐analysis addressing hard tissue debris reduction from the mesial roots of mandibular molars, found that none of the activation methods rendered the canal anatomy completely free of hard tissue debris, but laser‐activated irrigation groups fared better than activation protocols based on intracanal placement of oscillating tips or needles (Natansabapathy et al, 2021 ). Swimberghe et al ( 2019 ), investigating the removal of a biofilm‐mimicking hydrogel containing dentin debris from the isthmus in an acrylic isthmus model, came to similar conclusions.…”

Section: Introductionmentioning

confidence: 99%

Isthmus morphology influences debridement efficacy of activated irrigation: A laboratory study involving biofilm mimicking hydrogel removal and high‐speed imaging

2022

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Aim:Little is known about the influence of isthmus morphology on the debridement efficacy of activated irrigation. The aim of this study was to investigate the influence of isthmus morphology on the debridement efficacy of laser-activated irrigation (LAI), EDDY and needle irrigation (NI), and to explain the methods of isthmus cleaning by LAI and EDDY.Methodology: Four root canal models (apical diameter: 0.30 mm, taper: 0.06, curvature: 23°, length: 20 mm) were produced by CAD-CAM with different isthmus morphologies: long-wide (4 mm; 0.4 mm), long-narrow (4 mm; 0.15 mm), short-wide (2 mm; 0.4 mm) and short-narrow (2 mm; 0.15 mm). The isthmuses were filled with a hydrogel containing dentine debris. The canals were filled with irrigant and models were assigned to the following irrigation protocols (n = 240): needle irrigation (NI) with a 30G needle, Eddy, and LAI (2940 nm Er:YAG-laser, 15 Hz, 40 mJ, SWEEPS, tip at the canal entrance). Standardized images of the isthmuses were taken before and after irrigation, and the amount of removed hydrogel was determined using image analysis software and compared across groups using Kruskal-Wallis test followed by Dunn's multiple comparison. Visualization of the isthmus during activation was achieved using a high-speed camera. The pattern and speed of the flow in the isthmus as well as transient and stable cavitation were analysed using imaging software.Results: Laser-activated irrigation, EDDY and NI removed more hydrogel in shortwide isthmuses than in narrow isthmuses (p < .001). LAI and EDDY removed more hydrogel than NI in every isthmus configuration (p < .001). EDDY showed eddies and stable cavitation, and LAI showed transient cavitation at each pulse, and pulsed horizontal flow with the highest particle speed in closed short isthmuses.Conclusions: Isthmus morphology influences debridement in all irrigation groups. Short-wide isthmuses were the easiest to clean while narrow isthmuses were the most challenging to clean. Width seems to be a more critical anatomical parameter than length. LAI and EDDY resulted in the greatest biofilm removal and performed better than NI. EDDY produced eddies and stable cavitation in the isthmus, and LAI showed transient cavitation and pulsed horizontal flow.

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Section: Introductionmentioning

confidence: 99%

Isthmus morphology influences debridement efficacy of activated irrigation: A laboratory study involving biofilm mimicking hydrogel removal and high‐speed imaging

2022

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Efficacy of different Er:YAG laser–activated photoacoustic streaming modes compared to passive ultrasonic irrigation in the retreatment of curved root canals

et al. 2022

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Effect of activated chlorhexidine and irritrol with photon-induced-photoacoustic-streaming and EDDY^®on the dislocation resistance of biodentine

Bozkurt

Yusufoglu²,

Keskin³

et al. 2022

Niger J Clin Pract

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Removal of accumulated hard tissue debris from mesial root of mandibular molars evaluated using micro-CT - a systematic review and network meta-analysis

Cited by 3 publications

References 48 publications

Isthmus morphology influences debridement efficacy of activated irrigation: A laboratory study involving biofilm mimicking hydrogel removal and high‐speed imaging

Isthmus morphology influences debridement efficacy of activated irrigation: A laboratory study involving biofilm mimicking hydrogel removal and high‐speed imaging

Efficacy of different Er:YAG laser–activated photoacoustic streaming modes compared to passive ultrasonic irrigation in the retreatment of curved root canals

Effect of activated chlorhexidine and irritrol with photon-induced-photoacoustic-streaming and EDDY^®on the dislocation resistance of biodentine

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Removal of accumulated hard tissue debris from mesial root of mandibular molars evaluated using micro-CT - a systematic review and network meta-analysis

Cited by 3 publications

References 48 publications

Isthmus morphology influences debridement efficacy of activated irrigation: A laboratory study involving biofilm mimicking hydrogel removal and high‐speed imaging

Isthmus morphology influences debridement efficacy of activated irrigation: A laboratory study involving biofilm mimicking hydrogel removal and high‐speed imaging

Efficacy of different Er:YAG laser–activated photoacoustic streaming modes compared to passive ultrasonic irrigation in the retreatment of curved root canals

Effect of activated chlorhexidine and irritrol with photon-induced-photoacoustic-streaming and EDDY®on the dislocation resistance of biodentine

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Effect of activated chlorhexidine and irritrol with photon-induced-photoacoustic-streaming and EDDY^®on the dislocation resistance of biodentine