The Effect of the Ultrasonic Irrigant Activation Protocol on the Removal of a Dual-species Biofilm from Artificial Lateral Canals

Retsas, Anastasios; Dijkstra, René J. B.; Sluis, Luc van der; Boutsioukis, C.

doi:10.1016/j.joen.2022.03.005

Cited by 15 publications

(8 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the studies using PUI, activation time for each cycle ranged from 20–30 seconds and for SI ranged from 30–60 seconds, whereas ANP was constant at 30 seconds. Nagendrababu et al ( 57 ) and Retsas et al ( 58 ) stated that activation time has a great implication on the degree of irrigant penetration. In PUI, the high flexibility of the ESI file (EMS, Nyon, Switzerland) when compared to the stainless steel ultrasonic tips, favours the irrigant penetration ( 29 , 32 ).…”

Section: Discussionmentioning

confidence: 99%

Comparative Efficacy of Different Irrigant Activation Techniques for Irrigant Delivery Up to the Working Length of Mature Permanent Teeth: A Systematic Review and Meta-Analysis

Kumar¹

2023

Eur Endod J

View full text Add to dashboard Cite

This systematic review aimed to establish whether various irrigant activation techniques (IATs) result in greater penetration of irrigant up to the working length. The MEDLINE, Scopus and Cochrane Library electronic databases were searched to determine the difference in irrigant penetration depth in the main canal following the use of manual dynamic activation (MDA), sonic irrigation (SI), passive ultrasonic irrigation (PUI), and apical negative pressure irrigation technique (ANP) in comparison with conventional needle irrigation technique (CNI) in mature permanent teeth. Meta-analysis was performed for straight canals as well as curved canals in addition to subgroup analyses for a) Individual IATs in comparison with CNI, b) Comparison of PUI v ANP and SI v ANP in the straight canals, c) comparison of different IATs performed in straight and curved canals. The outcome was presented as effect size: standardized mean difference (SMD) and percentage difference (% diff) of irrigant penetration up to the working length (WL) alongside 95% confidence intervals using chi-square analysis. Of the 840 records screened, 20 studies were included in the systematic review and 17 studies were included in the meta-analysis. It revealed IATs had significant improvement in irrigant delivery up to the WL in straight (% diff: 51.94%, 95% CI: 39.20–64.67%) and curved canals (SMD: 1.08, 95% CI: 0.64–1.52) over CNI. The subgroup analysis revealed ANP was the most effective and significant technique followed by PUI, SI and MDA techniques in straight canals (% diff: 91.70%, 95% CI: 75.63–107.77%) and curved canals (SMD: 1.45, 95% CI: 0.77–2.13). IATs improve irrigant penetration when compared to CNI technique. In both straight and curved canals, ANP is the most effective in delivering the irrigant up to the WL followed by PUI, SI and MDA techniques. Hence adaptation of recent IATs in routine endodontic practice is recommended.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparative Efficacy of Different Irrigant Activation Techniques for Irrigant Delivery Up to the Working Length of Mature Permanent Teeth: A Systematic Review and Meta-Analysis

Kumar¹

2023

Eur Endod J

View full text Add to dashboard Cite

show abstract

“…A change in the needle-insertion depth ( Boutsioukis et al, 2010 ), degree of root canal curvature ( Ahmad et al, 1988 , Boutsioukis et al, 2013 , Castelo-Baz et al, 2021 , Castelo-Baz et al, 2016 ), activation of NaOCl and its continual replenishment ( Pashley et al, 1985 , Stojicic et al, 2010 , Zehnder, 2006 ), and anatomic variations of the lateral canals ( Ricucci et al, 2013 ). Other factors such as power intensity ( Jiang et al, 2011 ), renewal rate, concentration, volume ( Ricucci et al, 2013 ), flow rate ( Pereira et al, 2021 ), and activation time ( Retsas et al, 2022 ) of the irrigant in the lateral canals also have a great implication on the degree of irrigant penetration. The addition of EDTA did not show any significant enhancement of NaOCl penetration into lateral canals ( de Gregorio et al, 2009 ).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of various irrigant activation techniques on the penetration of sodium hypochlorite into lateral canals of mature permanent teeth: A systematic review and meta-analysis

Kumar

Ankola

Sankeshwari

et al. 2023

The Saudi Dental Journal

View full text Add to dashboard Cite

“…Hydrogels are physically or chemically cross‐linked into a 3D network, are insoluble in water (Gun'ko et al., 2017), and thus guarantee maintaining the system integrity in the present setup. Other approaches based on gelatine (Al‐Jadaa et al., 2023) or the use of a dual‐species biofilm (Retsas et al., 2022) also aimed at a setting guaranteeing best possible standardization and control.…”

Section: Discussionmentioning

confidence: 99%

Influence of pulse energy, tip design and insertion depth during Er:YAG‐activated irrigation on cleaning efficacy in simulated severely curved complex root canal systems in vitro

Bürklein,

Abdi,

Schäfer

et al. 2023

Int Endodontic J

View full text Add to dashboard Cite

AimTo investigate the influence of pulse energy, tip geometry and tip position in simulated 3D‐printed root canals with multiple side canals at different levels in all directions on the cleaning performance of laser‐activated irrigation (LAI) compared to sonic activation (EDDY) and conventional needle irrigation (NI).Methodology3D‐printed root canal models (25/.06, length 20 mm, curvature 60°, radius 5 mm) with side canals (diameter 0.2 mm) at 2, 5 and 8 mm from the apex were filled with coloured biofilm‐mimicking hydrogel. LAI (Morita AdvErL Evo, Kyoto, Japan) was performed with six settings (n = 20; pulse‐energy, pulses per second [PPS], tip position): LAI1 (50 mJ, 25 PPS, P400FL, canal entrance [CE]), LAI2 (same as LAI1, but insertion depth 9 mm before the apical endpoint [AE] [corresponding to 1 mm above the first lateral canals]), LAI3 (80 mJ, 25 PPS, P400FL, 9 mm before AE), LAI4 (same as LAI 3, but at CE) for 3 × 20 s each, LAI5 (50 mJ, 25 PPS, P400FL 2 × 20 s, CE & R200T (30 mJ, 25 PPS, 1 × 20 s, 9 mm before AE), LAI6 (30 mJ, 25 PPS, R200T, 9 mm before AE, 3 × 20 s). A continuous irrigation (3 mL/20 s) using distilled water accompanied the irrigation cycles. NI and EDDY (3 × 20 s each; 3 mL/20 s irrigation, insertion AE minus 1 mm, amplitude 4 mm) served as control groups. Biofilm‐mimicking hydrogel removal (ImageJ, NIH) was assessed for the entire system, the central canal and the lateral canals using standardized photographs with a microscope (Expert DN, Müller‐Optronic) and statistically analysed was performed using Kruskal–Wallis and Dunn tests (p = .05). Irrigant extrusion beyond the foramina was also recorded.ResultsLAI2 (99.08%; interquartile range [IQR]: 96.85–100.00) and LAI3 (97.50%; 96.24–100.00) achieved the significantly best and LAI6 (80.08%; 73.41–84.69) the significantly worst removal of hydrogel from the entire root canal system amongst all LAI configurations (p < .05). There were no significant differences between LAI6, EDDY (72.89%; 67.49–76.22) and manual irrigation (54.39%; 51.01–56.94) (p > .05). R200T laser tip caused significantly more often irrigant extrusion than all other techniques (p < .05).ConclusionTip design, energy settings, and the positioning of the laser tip below the canal entrance caused an improvement in cleaning performance of the LAI. However, the small R200T tip created significantly more procedural errors (irrigant extrusion) due to higher concentrated energy.

show abstract

The Effect of the Ultrasonic Irrigant Activation Protocol on the Removal of a Dual-species Biofilm from Artificial Lateral Canals

Cited by 15 publications

References 37 publications

Comparative Efficacy of Different Irrigant Activation Techniques for Irrigant Delivery Up to the Working Length of Mature Permanent Teeth: A Systematic Review and Meta-Analysis

Comparative Efficacy of Different Irrigant Activation Techniques for Irrigant Delivery Up to the Working Length of Mature Permanent Teeth: A Systematic Review and Meta-Analysis

Effectiveness of various irrigant activation techniques on the penetration of sodium hypochlorite into lateral canals of mature permanent teeth: A systematic review and meta-analysis

Influence of pulse energy, tip design and insertion depth during Er:YAG‐activated irrigation on cleaning efficacy in simulated severely curved complex root canal systems in vitro

Contact Info

Product

Resources

About